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Idea Description
Supplementary Information
Innovation 'Elevator Pitch':
MIRA is a software application designed to make physiotherapy fun and convenient for patients in need of rehabilitation. It turns physical exercises into video-games and uses Microsoft Kinect to track and assess patient treatment compliance.
Overview of Innovation:
Physiotherapy and rehabilitation can be a long, difficult and sometimes painful process. Treatment plans can be cumbersome and a slow recovery can be disempowering for patients. 70% of patients do not adhere to home exercises, which increases the total time needed for recovery, leading to higher costs for the healthcare sector.

MIRA displays these exercises as video-games and asks patients to complete the recommended movements to progress through each game level. As a result, patients are playing, while at the same time actually recovering. The patient’s performance data is also tracked, storing all the repetitions, improvements or issues for the therapists to adapt the treatment accordingly. As each patient and their treatment require careful planning, MIRA is designed as a tool for the therapists, to enable specialists to customise the treatment for each individual. Our innovative software can be tailored to the patient’s condition, needs and goals (stroke, falls prevention, MSK disorders etc.), using off-the shelf hardware (laptop/PC and motion sensor).

The software application is registered as a Class I Medical Device in Europe (CE Mark) and can be installed in any clinical environments where patients go for their regular treatment sessions, as well as at home where patients can be remotely monitored by their therapists. This allows the patient to exercises at home under the remote supervision of a healthcare provider. Furthermore, MIRA reduces costs by supplementing staff and reducing waiting times, as well as by decreasing the necessary number of clinic visits and the travel costs associated to them.

The system runs on Windows PCs, using Microsoft Kinect, a mainstream motion capture camera, to engage and track patients throughout their treatment.

MIRA Rehab has 14 UK institutions and another 44 worldwide, helping 600 patients monthly. The youngest patient to have ever used the system was 3 years old, while the oldest is 102. MIRA was recently featured on BBC, as well as on TED.com in 2015.












www.mirarehab.com

Video links:
MIRA – Play your way to recovery
MIRA – Helping older people regain their mobility
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)
Similar Content3
Innovation 'Elevator Pitch':
Intensive,home self treatment of many chronic medical conditions involving muscles, circulation and joints using a unique muscle stimulator  is  safe, well tolerated,  effective,  inexpensive and supported by  high quality clinical evidence.
 
 
Overview of Innovation:
Neuromuscular Electronic Stimulation (NMES) therapy represents a unique treatment  modality  for  intensive “self care” of chronic conditions where  therapist  assisted   hospital or clinic  based  conventional treatment might be disruptive, prohibitively expensive and often ineffective. With 6 FDA indications this therapy is widely adopted in the USA.
 
Conditions suitable for  treatment  include Arthritis, rehabilitation after SCI, TKA, THA, Stroke and  others. Treatment of wounds, and avoidance of DVT using electrotherapy are both currently under review by the Cochrane Collaboration.Recent research has shown that Sarcopenia can be reversed with improvements  in ambulation and  balance which may enable and  prolong  self–sufficiency.
 
For optimum effectiveness home self- treatment  should  be well  supervised  and in order to enable supervision we can provide a web based “Virtual Clinic “. This establishes a  reassuring “circle of care” around the patient and allows  ongoing contact between clinicians and patients.
 
The Neurocare™NC2000  (FDA and CE certified)  intended  for this project is a safe, non-invasive Neuromuscular Electronic stimulator (NMES). Its unique electronic design allows high powered (for full muscle involvement) stimulation at very low current (for comfort and safety).
 
It differs significantly from conventional NMES systems in that it recruits both “active” and “inactive” or injured muscle fibres, strengthening and re-educating the muscle by simulating exercise using a higher maximum output (300volts+) whilst only producing less than 10 milliamps of current. Devices can be purchased or rented.
 
With minimum familiarisation patients can self-treat with the Neurocare™ NC2000  reducing the need for lengthy and costly stays in hospital or clinic. A therapy simple  to operate and well tolerated means that treatment episodes with the Neurocare™  2000 in the self-care setting can be more frequent and intensive thereby promoting faster relief from symptoms and  full recovery . 
A recent article on  treating diabetic ulceration and other complications of diabetic foot and a  list  of clinical evidence for NMES treatment for the above and many other  chronic conditions  is available on request from Neurocare Europe Limited.
 
Effective, low cost therapy, patient self-administered, allows intensive treatment at a time convenient to the patient and delivers major treatment cost reduction for HCAs and greatly improves HRQoL  for the patient.
 

 
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 / Education, training and future workforce / Wealth creation / Clinical trials and evidence / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
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Benefit to WM population:
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Current and planned activity: 
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What is the intellectual property status of your innovation?:
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Return on Investment (£ Value): 
N/A
Return on Investment (Timescale): 
N/A
Ease of scalability: 
N/A
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Innovation 'Elevator Pitch':
We develop connected, accessible devices that use interactive games, musical expression and machine learning to support therapy and training of physical, cognitive and communication skills.
Overview of Innovation:
Our interactive platform is designed to make rehabilitation fun, exciting and engaging. Our first product, Monoma uses gamified exercises and music making to address the training needs of our clients. It has been user-tested by people with cognitive, learning and motor disabilities. Furthermore it has already been tested in therapy, special education and assisted living settings.
Monoma consists of:
  • A set of modular hardware controllers with RGB led lights and uses touch sensors in a novel format to provide unparalleled sensitivity. It is dynamic, offers bi-directional communication and opens up new interaction possibilities.
 
  • The controllers connect via Bluetooth to our software platform. The platform consists of rehabilitation exercises that combine sounds, music, colours and lights. Therapists and educators can choose from memory, turn taking, musical improvisation, orchestration, reaction to stimuli and exer-gaming routines among others. Our application allows for full customisation of the hardware (i.e number of units, colour, sensitivity, dynamic range) and the exercise settings (difficulty level, songs, notes, timing) in order to serve different needs and abilities.
 
  • Monoma uses data mining and machine learning to collect valuable data and report on reaction times, evolution of memory, force and speed abilities of the users. This allows for real time adaptation of the exercises based on users’ abilities, long term progress tracking and evaluation of therapists’ practice.

Validation
Monoma has been evaluated by 100+ therapists therapists who have found that it helps improve the independence and wellbeing of our clients, specifically the improvements are:
  • training of sensorimotor functioning (orientation, coordination, fine and gross motor skills, strength and endurance of movement)
  • training of cognitive functioning (attention, reaction to stimuli, memory)
  • training of communication and social skills (turn taking, eye contact and initiation)
  • accessible creative expression

Monoma is easy to set up, is customisable and can be used in several settings. The device provides feedback to the users’ actions, therefore educators will not need to constantly reinforce them. The data collection and analysis is also deemed very important for the evaluation of users’ progress.

Video of the product here: https://vimeo.com/156258164
Stage of Development:
Close to market - Prototype near completion and final form may require additional validation/evaluation and all CE marking and regulatory requirements are in place
WMAHSN priorities and themes addressed: 
Wellness and prevention of illness / Education, training and future workforce / Digital health / Innovation and adoption / Person centred care
Return on Investment (£ Value): 
N/A
Return on Investment (Timescale): 
N/A
Ease of scalability: 
N/A
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Innovation 'Elevator Pitch':
Enabling patients to self-rehabilitate with clinically evidenced treatment plans to improve the speed of recovery and enhance patient outcomes. Reducing unnecessary prescription of medicines, scans and surgery; along with GP and Physio workloads.
 
Overview of Innovation:
Rehab Me offers GP’s a tool to help advise and support their patients without necessarily referring them to a physio for a scan or prescribing pain medication. It provides easy to access evidenced based advice sheets, treatment plans and interactive prompts to support compliance and outcome tracking, as well as signposting patients to further support and prevention pathways.
 
How it works: A simple digital solution, accesses on-line or via a downloadable all which operates on a stand-alone basis or be integrated into existing GP systems.
 
Step 1 - patient injury or MSK condition identified by GP who then prints off the relevant advice sheet from the Rehab Me website. This provides evidence-based exercises and advice regulated by standard physiotherapy practice and directs patient to the Rehab Me website for the patient to register.

Step 2 - patient registers on the Rehab Me website and selects the treatment plan advised by the GP. This will then provide scheduled exercises including frequency and number of repetitions across the treatment plan period. This is automatically linked to the patient’s calendar to enable reminders and prompts over the treatment period which can be anywhere between 6-10 weeks.
 
Step 3 - the patient can access the plan via the website or a downloadable app. The patient will be prompted each day and guided by their virtual physio with the use of easy to follow HD videos and/ or detailed descriptions.  Patients track their own adherence and progress through the website or via the app. They can also record and track pain each day to help assess progress and provide PROM data for their GP.
 
Step 4 – at any time the GP can view progress and results for a patient on a treatment plan; and if appropriate advice on a new exercise plan virtually so the patient can progress without the need for another appointment.
 
Step 5 – during or after a course of treatment, Rehab Me can signpost access to other relevant resources to encourage people to adopt exercise into their everyday lives to prevent relapse. This includes a social prescribing section encouraging patients to join gyms, walking clubs etc.
 
Part of the service provided by Rehab Me includes educational training on MSK issues as part of the process to this new pathway for GP’s to adopt in their practice.

The Rehab Me data platform adheres to appropriate NHS data IG and GDPR requirements, with all data securely stored on a cloud based server.
 
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 / Innovation and adoption
Benefit to NHS:
The Rehab Me solution has been proven to:
  • Reduce unnecessary prescription of medicine
  • Reduce the need for costly scans and potential surgery
  • Reduce demand on physio appointments
  • Improve a GP’s ability to provide relevant MSK advice
  • Improve patient activation and compliance
  • Improve waiting times for specialist physio appointments
  • Support First Contact Practitioners in GP surgeries.
 
There is further opportunity for Rehab Me to reduce demand through earlier preventative treatment, on-going self-management support and improvement in post-surgery recovery and potential length of stay in hospital.
 
The results: a structured 18-month proof of concept across five GP practices servicing c70,000 people resulted in 2300 patients being supported, achieving the following key results.
 
  • 89% of GPs said they are now ‘confident’/ ‘extremely confident’ in managing MSK issues, versus 33% at the start
  • 70.3% of GPs recommended over 50% of patients to Rehab Me rather than referring to a physio.
  • 30.8% of GPs reduced prescribing medication by 50%
  • 25.9% of GPs reduced referral for imaging (XR, USS, MRI)
  • 19.2% reduced prescribing medication by 70% for MSK conditions
  • 50% improvement in patient pain scores, average score of 3/10 to 6/10
  • 66.7% of GPs rated the pilot 10/10 (with 10 = fantastic)
  • Reduced physio waiting times, from over 7 weeks to just 2 weeks for patients
Initial Review Rating
4.80 (2 ratings)
Benefit to WM population:
For Patients
  • Immediate and faster recovery time
  • Improve health, well-being and pain management
  • Increased confidence and empowerment to re-habilitate.
  • Reduced inconvenience and travel time for appointments
  • Avoid risks and side effects of anti-inflammatories, analgesics or other medications    
  • Potential surgery avoidance or painful injections
  • Easy and convenient solution access.
For GP’s
  • Increase knowledge and confidence to support patients with MSK conditions
  • Reduction in prescribed medicines
  • Reduction in physio referrals
  • Reduction in imaging and consultant referrals
  • Reduction in GP appointments
  • Ability to track patient activation and PROMS
  • Increased practice efficiency.
For NHS Physiotherapy clinics and other referral departments
  • Reduced number of referrals
  • Reduced wait times to enhance intervention effectiveness
  • Improved prioritisation of serious patient referrals
  • Enhanced quality of service and care
For Commissioners
  • Better resource utilisation
  • Increased capacity at lower cost
  • Alignment to the GIRFT programme
  • Strong ROI based in increased capacity and reduced medication / scan costs
For the Economy
  • Local employment - potential to build software development team locally
  • Local office - commercial office space
Current and planned activity: 
The Rehab Me solution has been supported By NHS England through its Clinical Entrepreneur programme and identified by Dr. Tony Young, (National Clinical Lead for Innovation) as a lead example of a new and exciting digital solution for scaling across the NHS.
 
The Rehab Me platform has been developed to Beta release level and is now ready for further development to ensure a robust and scalable software solution which can be easily integrated into other NHS systems.
 
The next stage requires effective engagement with appropriate PCN or GP Federations or CCG to secure financial commitment to embed the solution, support its development and assist in further case study creation and cost benefit analysis. This will then enable a comprehensive sales and marketing drive across England.
What is the intellectual property status of your innovation?:
Copyright of all content owned by Surrey Physio along with software design
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
Simple
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