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Idea Description
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Innovation 'Elevator Pitch':

Using simple technology, we enable care homes to coordinate the monitoring of vital signs, weight and hydration acting as an early warning system with direct integration into GP systems.

Overview of Innovation:

Inhealthcare have developed a Digital Care Home service, which coordinates the monitoring of vital signs, weight and hydration. It acts as an early warning system, highlighting changes in health which may otherwise go undetected. Their service includes a digital patient record which integrates directly with GP systems, meaning that it can be accessed by local NHS teams.

Our digital health services are in place in over 80 care homes in the UK, helping care home managers and nurses carry out frequent checks on residents.

Find out how it works on our website http://www.inhealthcare.co.uk/digital-health-solutions/care-homes/.

You can also read a blog from Georgia Nelson about a pilot of our Digital Care Home in 14 care homes in Northern Irealand http://www.inhealthcare.co.uk/telehealth-undernutrition-service-care-homes-northern-ireland/.

Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
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Innovation 'Elevator Pitch':
Sensium Wireless Vitals Monitoring is proven to lead to treatment of sepsis 6 hours quicker than NEWS, reduce LOS by 10% and readmission by 45%. The only wearable vital sign monitor with peer reviewed RCT data showing significant clinical benefits. 
Overview of Innovation:
In general care areas of a hospital vital signs are typically taken during routine observation rounds once every 4-8 hours. If a patient deteriorates between these observation rounds the warning signs can go undetected for hours, potentially leading to serious & costly consequences. 
 
Sensium is a discreet, wearable, wireless system for monitoring vital signs of patients outside of high acuity areas. A light comfortable sensor worn on the patient’s chest accurately and reliably monitors and reports vital signs, providing data every 2 minutes. By notifying clinicians of changes in patients’ vital signs Sensium brings the nurse to the deteriorating patient, allowing intervention before the condition worsens, thereby improving patient outcomes, shortening hospital stays and lowering treatment costs. It enables nurses to prioritise patient care where it is needed most.   Sensium is focussed exclusively on general care clinicians whose patients currently do not have the safety and security of continuous vital sign monitoring.
 
The Sensium Patch provides accurate and continuous monitoring of the 3 key leading indicators of patient deterioration: heart rate (HR), respiration rate (RR) & axillary temperature (T). Sensium wirelessly communicates this physiological data via safe and secure low power wireless communication to the Sensium bridges placed through the ward area.  Sensium allows patients to ambulate freely, untethered to static and expensive equipment whilst still having the reassurance of continuous monitoring.
 
The bridges are connected into the hospital IT system, and software installed on the hospital network allows patient data to be seamlessly conveyed. Crucially, notifications can be configured to work with hospital pager systems/mobile notification devices, giving the clinical team data when they need it, where they need it. To save time and ensure accuracy Sensium can be easily integrated with the hospital admission, discharge, transfer systems and electronic medical records.
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Digital health / Innovation and adoption / Patient and medicines safety
Benefit to NHS:
Currently approximately 10% of patients are harmed during their hospital stay and this represents a cost to the NHS of over £2.5bn just to cover the additional length of stay for these patients. Improved monitoring regimes and early detection of deterioration is key to reducing this significant burden.
 
Patients undergoing major abdominal surgery have an 30-40% risk of complications with a leading complication being sepsis. Hospital acquired (HA) sepsis (e.g. sepsis that develops after a surgical procedure) has twice the mortality rate and twice the treatment cost of community-acquired sepsis and rates of HA sepsis are rising. A recently-published study aimed to assess differences in outcomes between patients being monitored using the Sensium system in addition to intermittent (routine) observations and patients being monitored by routine observations alone [1].  The study was designed as a pilot cluster-randomised, prospective, parallel-group, controlled single-centre pilot study and consenting participants were allocated to one of two monitoring arms for the length of their admission. The primary outcome measure was time to antibiotics after the first evidence of sepsis, defined according to a revised consensus conference definition in 2001 [2]. Secondary outcome measures included length of hospital stay, 30-day readmission rate, mortality and patient acceptability. 226 patients were randomised between January and June 2017. 140 patients were randomised to continuous remote monitoring; 86 patients were randomised to receive intermittent monitoring alone. There were a similar number of complications and sepsis events across both arms of the study, indicating that both groups had similar baseline risk factors.

On average, patients receiving Sensium continuous monitoring were administered antibiotics 6.4 hours sooner after evidence of sepsis, had a 10% shorter average length of hospital stay and were 45% less likely to require readmission within 30 days of discharge than those patients in the intermittent monitoring group. Patients found the monitoring device to be acceptable in terms of comfort and perceived an enhanced sense of safety. Given that every hour’s delay in treatment of sepsis has been shown to be associated with a 7% increase in risk of mortality [3], a 6-hour reduction in time to administer antibiotics is a significant result and further studies are ongoing to demonstrate similar benefits in other clinical settings.
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
Sensium’s solution offers several key benefits to the West Midlands and its population. The key benefits of Sensium compared to competitor products are as follows:

Product Performance: Sensium uses clinically accepted ‘gold standard’ methods of vital sign measurement, deriving heart rate from single-lead ECG, respiration rate from thoracic impedance, and temperature from an axilla sensor.  In contrast, our competitors derive respiratory rate from pulse or ECG measurements which has known limitations in certain clinical conditions and provide only skin temperature measurement which has limited clinical value.

Customer Focus: Sensium is recognised by our customers for exceptional customer support.  Once we deploy our product at a clinical site, we provide on-site technical support for installation and troubleshooting and clinical support for training for as long as it takes for the system to be truly embedded in the clinical workflow and providing tangible benefits. Sensium has clinical and technical staff based in the West Midlands region on hand for support.

Clinical Evidence: Sensium understand that medicine is an evidence-based science and we are engaged in a series of clinical research studies designed to show clinical efficacy, improved clinical outcomes, and health economic benefits.  To date, Sensium are the only company providing wearable wireless technology for early detection of patient deterioration that have independent and peer-reviewed publications showing benefits of our technology demonstrated through randomised controlled trials
 
 
Current and planned activity: 
Our initial engagement with the NHS has been to introduce Sensium to general surgery wards and areas with high risk and infection prone patients e.g. colorectal, trauma and haematology wards. Discussions with many NHS hospitals have also shown significant interest and benefit for the use of Sensium for ‘Step down’ areas for patients who aren’t sick enough for ITU but still show cause for concern and for high risk conditions such as Hospital Acquired Sepsis opioid depression and AF. 

We have engaged with the Emergency Laparotomy Collaborative with a view to patch these types of patients. When approaching the NHS, we have been primarily engaging with Anaesthetists as they witness many patient deteriorations, as well as consultants and sepsis/patient deterioration leads, matrons and clinical IT leads. We plan to interact more directly with medical directors and members of the directorate earlier on in the process if possible. Future plans include home monitoring to follow patients’ home.
What is the intellectual property status of your innovation?:
CE mark and FDA 510(k) cleared.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
N/A
Ease of scalability: 
2
Co-Authors:
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Innovation 'Elevator Pitch':
The vPad allows clinicians to remotely monitor and manage the long-term health of residents in care homes by establishing long term health baselines.
Overview of Innovation:
The vPad is tablet sized device that features a number of attachment modules that allows the transfer of proxy biophysical data into a GP IT clinical system.
 
The system supports the establishment of long term health baselines for care home residents - enabling earlier detection of deteriorations in health and improving decision making from care home staff regarding when to seek emergency health care - potentially avoiding unnecessary hospital admissions and emergency GP visits by integrating the NEWS2 scoring system.
 
We believe the solution ties in well with NHS England's Enhanced Health in Care Homes framework. Our system bridges the communication and medical data transfer gap between primary care practices and care homes. We are integrated with EMIS and have TPP interoperability in the development pipe works too.
 
The system has two components:
  1. Equipment. vPad, an All-in-One vital sign smart monitor. The device measures Blood Pressure, SpO2, Pulse rate and Temperature. It also has a built-in 12-lead ECG for atrial fibrillation detection.
  2. Software. 121 Sync Agent connects the GP clinical system with vPad through Wi-Fi/3G and synchronises vital sign measurements to the Electronic Patient Record. It displays an on-screen historical vital signs baseline.
Currently Knowsley CCG are piloting the system with care homes and we're in talks with a number of others.

We're eager to run trials with other CCGs too. If you're interested in exploring this further please let us know and we'll arranged a demo at your organisation to showcase the benefits it can provide.

If you would like more information about the vPad or if you’d like discuss this product and its potential further please call us on 0330 678 0588. Likewise email us at info@121sync.com for any enquiries.
 
 
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Innovation and adoption
Benefit to NHS:
1. Patient outcomes
  • Earlier detection of deteriorating health
  • Through establishing health baselines it becomes easier to manage a patient with long term conditions
  • Intervene when appropriate to potentially avoid a non-elective hospital admission or a relatively extended stays in hospital.
  • Track a patients recovery/treatment
 
2. Efficiency improvements
  • Integration with GP IT clinical system means that the transfer of patient data is significantly quicker.
  • Synchronisation of data means that no human error is involved in uploading data to patient record
  • GPs or community matrons become more informed as they can access patients’ summary care record at the point of contact
  • If left within a care home, care home staff can take readings thereby freeing up the GPs time and reducing the need to travel
  • NEWS2 scoring system appropriately indicates the seriousness of abnormal biophysical data and the required action. Thereby potentially reducing the number of unnecessary GP/Community matron/ambulance call outs.
  • NEWS2 scoring systems allows staff across different types of care to communicate in a common language.
 
3. Cost Effectiveness
  • Keeping patients within their residential setting is cheaper than admittance and a prolonged stay in hospital
  • Seamless data transfer removes unnecessary duplication of records, the need for paper documents and staff (previously required to enter printed/written data into IT clinical systems)
  • Potential reduction in ambulance/GP call outs – saves fuel and time if the call outs are unnecessary.
  • If left in a care home it can empower staff and add value to care.
Initial Review Rating
4.40 (2 ratings)
Benefit to WM population:
Benefit to WM population
With technology, medicine, healthcare and lifestyles ever improving, people are living longer and longer than they used to.

A projection made by the office for national statistics (ONS) states that ‘By 2041, the 1960s baby boomers will have progressed into their 70s and 80s, and by 2066 there could be an additional 8.6 million people aged 65 years and over in the UK’. At this stage the UK’s 65+ age group would account for 26.5% of the population.

The NHS estimates that roughly 1 in 7 OAPs (65+) currently reside in a care home. Based on the aforementioned projection this number will likely rise in the near future.
The issue will be more pronounced in the West Midlands area with the ONS currently estimating that OAPs make up 18.3% of the total population (2016 population estimate).

At age 65 years, both men and women can expect to spend around half of their remaining life expectancy in good health. However, the likelihood of being disabled and/or experiencing multiple chronic and complex health conditions among those aged 65 years and over increases with age. As life expectancy increases, so does the amount of time spent in poor health.

Healthcare requirements increase with age, with healthcare costs increasing steeply from around age 65 years. Hospital admissions have increased since roughly the beginning of 2007, but with a steeper increase in admissions for the 65+ age group. This has contributed to rising healthcare costs.

A study carried out by Stoke and the North Staffordshire CCGs featured in the Care Home Strategy (2015/17) found that on average 230 (Northern Staffordshire) care home residents were admitted to hospital each month. In 2013/14 there were a total of 2804 admissions which costed the NHS £6.73 million with an average length of stay of 6.94 days.
With relevance to reducing unplanned admissions and A&E attendances local data analysis demonstrated that approximately 30% of unplanned admissions from care homes could’ve be avoided with improved care planning and proactive management or timely access to specialist services.

By implementing our solution we have the potential to better manage a growing ageing population who by default will have increasing dependency on an ever strained healthcare service. Through the prevention of illness, where possible, therein lies the potential of saving vast amounts of both time and money.
Current and planned activity: 
Current and Planned Activity
We are currently focusing on approaching CCGs, as care home services are often commissioned through CCGs it also makes sense to approach these organisations so that they can see first see the cost effectiveness of our solution.

We have also networked through various conferences, which has allowed us to reach out to a number of clinicians who have shown interest in the vPad.

We are currently trialling with Knowsley CCG and are due to start with another practice imminently. 

We’re looking to trial with other organisation and clinicians so that they may also see the benefits of both our solution and investing in technology to enhance the provision of healthcare.
Return on Investment (£ Value): 
N/A
Return on Investment (Timescale): 
N/A
Ease of scalability: 
2
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