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Idea Description
Supplementary Information
Detailed Submission Data
Innovation 'Elevator Pitch':
BVI technology is an innovative and easy to use, mHealth service to determine the percentage and distribution of visceral fat using a mobile device (tablet) or a smart phone.
Overview of Innovation:
The Body Volume Indicator (BVI) is a new measurement for healthcare and obesity. After eight years of successful and innovative validation from scientific collaborators around the world, BVI is now undergoing final testing prior to a full launch later in 2017.

Using 3D technology, BVI calculates risk factors associated with a person's body shape, by measuring weight and body fat distribution, with particular focus on the abdomen; the area associated with the greatest risk.

BVI is designed to be a long-term addition to the Body Mass Index (BMI); the current recognised standard for measurement of obesity. The intention is for the Body Volume Indicator to become a Body Volume Index by 2020, by which time sufficient data will have been collected globally. Using smartphone technology, BVI data can now be collected anywhere with web or internet access.

Body Volume, as an indicator of health, offers a potential long-term solution as a measure of individual health risk.

BVI was developed in the West Midlands and collaborators have included Heartlands Hospital, Aston University, Mayo Clinic and the Medical Research Council. The application was patented in the US in 2012 and throughout Europe in 2015.



Current Status
In 2012 Select Research obtained exclusive use of the largest and most comprehensive collection of Body Composition Data (BCD) of visceral fat data from MRI scans in the world. This has been used to develop an App which will be used to scan/photograph lightly clothed patients and then comparing their BCD database to predict their body fat and visceral fat.

Further research and development is being undertaken with our current BVI (Body Volume Index) tool, to provide additional evidence and to validate the efficacy, and appropriateness of this BVI application in real-life environments. Through a ‘real-life’ project work with WMAHSN will provide clinical validation for the underpinning methodology, thus making potential users (Clinicians, patients & public) aware of the benefits (social and economic) of utilising the service.

Thus our current BVI application is to be incorporated into the existing patient pathways currently used by Health Exchange Health Trainers in the West Midlands.

NB: The application has been patented in the US in 2012 and throughout Europe in 2015 and covers all measurements of part body volume for healthcare from a 3D scan. Body fat is a part volume of the human body.

Please assist us with our 5 min Survey http://BVISurvey.SSIsurveys.com
Stage of Development:
Evaluation stage - Representative model or prototype system developed and can be effectively evaluated
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Initial Review Rating
3.93 (3 ratings)
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Innovation 'Elevator Pitch':
BVI measures body proportions and fat distribution avoiding the need for costly techniques such as MRI and CT scanning for visceral fat measurements. Funding is being sought to undertake a region wide trial prior to NHS national deployment.
Overview of Innovation:
For over 20 years, Select Research have been pioneers in 3D measurement of the human body and over the last 10 years have developed a novel method of measuring human body volume in 3D, derived from 2D images. Released initially as a Body Volume 'Indicator' or BVI, the aim, once enough data has been assembled worldwide, is for the 'indicator' to become a Body Volume 'Index' by the year 2020. The BVI technology is patented in Europe and the US and is currently being used in professional healthcare, fitness, academic research on an iOS platform with an android version scheduled to be completed by April 2018; well in advance of the requested April 2018 date for potential national deployment under the ITP award, where BVI has been shortlisted by NHS England.
The Body Volume Indicator (BVI), unlike BMI, creates a 3D image of a patient’s body, enabling body proportions and fat distribution to be accurately measured for each patient, avoiding the need for costly, intrusive and time-consuming techniques such as MRI and CT scanning for visceral fat measurements. Furthermore, this provides professionals with a more accurate measurement of patient health, which in turns leads to improved diagnosis and therefore better clinical outcomes. This produces a patient specific BVI number, developed over 10 years by Mayo Clinic, which ranges from 0-20 and is based upon the ratio of abdominal volume to total volume, relative to that person’s age, gender and ethnicity. BVI will enable NHS professionals to identify where there is increased risk to patient health, wherever BMI is currently used throughout primary and secondary care with patients.
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: 
Wellness and prevention of illness / Digital health
Benefit to NHS:
Obesity worldwide is measured today using the Body Mass Index (BMI) tool as the global health indicator for risk. Invented in 1824, the BMI tool uses just height and weight, and therefore doesn't differentiate between people with the same BMI reading who have different body shapes and weight distribution, such as people with athletic build or those with more abdominal volume. BMI was originally intended by the Belgium statistician, Adolphe Quetelet for general population measurement, so is not suitable for use anymore in the modern age where personalised medicine is the framework for healthcare delivery, and does not consider factors such as age, lifestyle or ethnicity. In addition, a recent study by J. Gómez-Ambrosi, et al found that BMI is miss-classifying up to 29% subjects with increased cardio metabolic risks, suggesting that the patient groups with the highest needs are being failed, treatment is being delayed and a significant unnecessary cost is burdening the NHS which could be avoided if body volume distribution was accurately measured. The NHS currently spend £12.4 nationally on data collection. BMI is used today in healthcare not out of choice, but by default, as no viable alternative has been available; BVI now provides the NHS with a unique opportunity to innovate and change.
The Body Volume Indicator (BVI), unlike BMI, creates a 3D image of a patient’s body, enabling body proportions and fat distribution to be accurately measured for each patient, avoiding the need for costly, intrusive and time-consuming techniques such as MRI and CT scanning for visceral fat measurements. Furthermore, this provides professionals with a more accurate measurement of patient health, which in turns leads to improved diagnosis and therefore better clinical outcomes. This produces a patient specific BVI number, developed over 10 years by Mayo Clinic, which ranges from 0-20 and is based upon the ratio of abdominal volume to total volume, relative to that person’s age, gender and ethnicity. BVI will enable NHS professionals to identify where there is increased risk to patient health, wherever BMI is currently used throughout primary and secondary care with patients.
BVI Pro has successfully passed the review stages of the NHS ITP programme and is now with Simon Stevens, CEO of NHS England for review. Confirmation is expected in February 2018.
 
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
In the West Midlands almost seven out of every 10 people are overweight or obese, whilst 81 per cent are unaware about the link with cancer. Health chiefs have warned Birmingham could be forced to spend more than £2 billion EVERY YEAR to tackle a growing obesity crisis unless urgent action is taken.
Dr Andrew Coward, chairman of Birmingham’s Childhood Obesity Steering Group, said the link between obesity and cancer is now as serious as the cancer and smoking links of the past. The GP made the striking comparison as it emerged obesity will cost the city £2.6 billion a year by 2050 if something isn’t done to tackle the problem. In the West Midlands almost seven out of every 10 people are overweight or obese, whilst 81 per cent are unaware about the link with cancer.
The easy use of the BVI Pro app means patients can conveniently measure themselves at home or in as part of a health check at a GP surgery, negating the need for invasive manual measurements to be taken.. With NHS choices currently receiving 1.5 million visitors a day, BVI Pro could be incorporated, leading to more patients able to measure their BVI, reducing time spent with healthcare professionals; enabling patients to take a more active role in managing their healthcare.

BVI Pro could provide part of an online NHS system, through which patients could access other healthcare apps, health records, and book appointments, providing patients with convenient access to their BVI data, using the unique Patient NHS Number. This would produce a more comprehensive NHS service on obesity data for policy and prevention programmes. 
The app creates a 3D patient avatar, enabling parametric measurements. Patients have been shown to be more motivated to treatment plans when presented with their own ‘avatar’ (Boelcart et al. 2008.) Leading to an improvement in lifestyle management, resulting in a reduction in cost to the NHS. Once two patient images are captured, BVI and fat distribution can be measured in less than 30 seconds. These results can be integrated with medical records, via the BT enabled N3 ‘spine’ network, providing doctors with a holistic and unparalleled databank for patient health.


 
Current and planned activity: 
BVI has been through 4 stages of the NHS England Innovation Technology Payment programme and is in review with Simon Stevens with a view to being phased in, starting with one area of the country before rolling out.
We are looking at fast track access to the NHS through The Academic Health Science Network and have applied for a H2020 grant to roll out BVI across Europe. AHSN have recommended BVI for deployment. We are awaiting confirmation. See attachments.
Most of the validations have been undertaken by The Mayo Clinic and the University of Westminster. We are requiring more data on a wider range of ethnic origins and the West Midlands is a perfect place to start as it has such a diverse population.

 
What is the intellectual property status of your innovation?:
The BVI technology is patented in Europe (EP1993443 B1) and the US (US8374671 B2) and is currently being used in professional healthcare, fitness, academic research on an iOS platform with an android version scheduled to be completed by January 2018.
 
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
Simple
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Innovation 'Elevator Pitch':
Recap Health enables NHS clinicians and social care professionals to efficiently deliver personalised, relevant, timely and up-to-date digital health and social care content (videos, leaflets, website pages etc) direct to selected patients/clients. 
Overview of Innovation:
                                  

Recap Health is a cloud hosted patient education and clinical information delivery application. It enables clinicians to quickly find and send relevant digital health content to their patients, helping patients to become better informed and better able to manage their own health effectively.

Clinicians
Clinicians select relevant digital content (videos, leaflets, web pages, third party apps, events etc ) from a library of pre-approved digital content. Content can be searched by health condition, age, language and media type etc. Content can also be packaged into pre-defined 'bundles' to facilitate speed of use. At the click of a button clinicians can send content to individual patients.

Clinicians can favourite content for future use. They also can see what content their peers use and they can see clinician and patient reviews and rating of content. 

Patients:
Patients with Recap Health accounts receive an email notification, alerting them to the arrival of new content. They login and see their personalised content (videos, leaflets, apps, website pages etc), in an attractive personalised webpage. As well as consuming the content, patients also can hide content, rate and provide feedback on their content and share it electronically with family and friends.

Organisations:
Recap Health records whether and when a patient has accessed their content which enables organisations to classify patients in relation to how 'activated'/engaged they are.

In future, organisations will be able to set a series of time or behaviour based rules associated with how patients relate to their content. Rules can trigger in-app messages, emails and or offers of live chats.  In this way Recap can become a platform for engaging with 'at risk' or newly motivated patients in a more proactive way.

In addition, short online surveys can be presented to individual patients to measure knowledge and motivation to self care, both pre and post accessing content. 

Recap Health has been developed in partnership with a Mental Health and Community Trust but we believe it can also be used also by Acute Trusts, Community Trusts, GP Federations and Local Authorities. It also can be a vehicle for health and social care economies that wish to foster clincial collaboration across professional and organisational boundaries, to achieve shared self-care and patient engagement objectives expressed in STPs, NMCs and/or digital roadmaps. 

 
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: 
Mental Health: recovery, crisis and prevention / Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Education, training and future workforce / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
In general terms, by using Recap Health, NHS organisations can raise patients' health literacy levels and their ability to practice effective self-care. Clinicians also can extend their relationship with their patients beyond the boundaries of face-to-face encounters.  

More specifically, NHS organisations can realise some or all of the following benefits:

Cost Savings:
- Less demand as more knowledgeable patients become more motivated and better able to practice effective self care
- From the digital storage and electronic distribution of large volumes of patient information

Quality:
- Better version control of patient information and a tighter focus on the nature of the information itself
- Better relevance and timeliness of patient information sent to patients
- Access to ongoing patient feedback about the quality and relevance of information sent to them 
- Access to data reporting on which content is most popular, most used, most revisited etc.

Intelligence:
- Access to data identifying the extent that individual patients consume content, which allows patients to be stratified into activation cohorts 
- Audit trail ​of information interventions

Cultural:
- Makes collaboration across a health and social care economy more likely as clinicians from multiple organisations use Recap to communicate with 'shared' patients
- Empowers frontline or generalist staff as they gain the ability to find and distribute content traditionally distributed only by specialists (often after an appointment)
- Accelerates the 'media shift' trend away from traditional information leaflets towards short videos
- Supports the drive towards a paperless NHS 
Online Discussion Rating
5.00 (2 ratings)
Initial Review Rating
4.20 (1 ratings)
Benefit to WM population:
By accepting electronic invitations to join Recap Health, patients in the West Midlands will:
  • have easy access to personalised, timely and accurate healthcare information 24/7 
  • have a much better opportunity to become more knowledgeable about their condition / healthcare situation and what appropriate self care strategies are
  • feel more connected to the clinicians and NHS organisations that serve them
Current and planned activity: 
Recap Health is being trialled at scale by a Community and Mental Health Trust in another region. 

We plan to start marketing Recap Health across the UK in mid March 2017. Our preference though is to work with WMAHSN to find one or more suitable early customers and to work closely together to:

1) better understand the value proposition and associated technical and legal risks; 
2) further develop the product to optimise value
3) determine appropriate price points and licencing terms
4) explore the potential for sourcing validated 3rd party content at scale to supplement locally generated content 
5) develop appropriate implementation support services informed by the experience of early adopters.

On the product side we have a highly detailed and fully costed technical roadmap for developing out new features and improving existing usability, features and design. We are pursuing this on an ongoing basis, with pace dictated by when cash becomes available to us.


 
What is the intellectual property status of your innovation?:
Recap Health has been created by Health2Works Ltd. As such we own and control use of all software code. 
Return on Investment (£ Value): 
medium
Return on Investment (Timescale): 
2 years
Ease of scalability: 
2
Regional Scalability:
Recap Health can scale very easily, both in terms of numbers of users and distinct implementations. For example a version for a new customer can technically be cloned and deployed with a few hours.
 
There will however be technical work for H2W to do to serve a multi-organisation customer. Either we will need to deploy separate instances of Recap Health and retrospectively connect them together or we will need to do this work prior to commencing deployments. The work involves determining identities and permissions for organisations, job roles and shared patients and associating these with bespoke views of the content library.
 
Implementation for customers is more time consuming than technical deployment. Customers will need to develop and resource an implementation plan, focused on 1) content curation and review, 2) service roll-out, 3) product awareness sessions, 4) clinician account generation processes etc. We plan to offer an implementation support service at cost to new customers.

 
Measures:
We believe Recap Health has the potential to help NHS organisations realise at least 12 tangible benefits associated with Cost Savings, Quality Improvement, Data Acquisition and Culture Change. These benefits are already listed in the Benefits to NHS section of this submission.
 
The measures associated with these potential benefits will need to be identified and agreed with customers and ideally a local University research unit. We have a good relationship with Keele University (our local University) and we are in discussion with them about the possibility of Keele offering independent research support to new Recap Health customers in the West Midlands.
Adoption target:
Our aim is to have 4 NHS organisations as customers in the next 12 months, with one being multi-organisation in nature.

We prefer to focus entirely on the WM region, however we plan to start UK wide marketing activity in mid March, unless a strong focus on West Midlands looks like it will meet our needs.
Rejection Reason:
​The panel felt that while Recap Health was a strong and versatile proposal, it didn’t sufficiently focus on diabetes prevention. There were also concerns that the need for professionals to prescribe specific bundles would make the implementation phase dependent on significant clinicians engagement activity before any benefits could be realised. On that basis, the panel decided not to recommend the product for this specific challenge.
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