Creation
Draft
Initial
Detailed
Accepted
Adoption
Idea Description
Supplementary Information
Innovation 'Elevator Pitch':
Currently, a GP refers Obstructive Sleep Apnoea patients to an NHS Specialised Sleep Centre. Averaging 24 wks & 3-5 hospital visits before the Patient starts treatment.
Now, a GP with SOMNOtouch can receive results in 48-72Hours (3days vs. 6Mths)
Overview of Innovation:
Currently
The vast majority of patients with Obstructive Sleep Apnoea (OSA) are referred by their GP to a Specialised Sleep Centre at an NHS Hospital with a Average waiting time 12 Weeks


Patients are initially seen by a Consultant or a Sleep Physiologist who would prescribe a Diagnostic Study to be performed either in hospital or at the patient’s home. Average waiting time 12 Weeks
The patient returns to have the sleep study done or to collect the monitor and then returns the device the next day. After a further waiting time of upto 6 Weeks the patient visits the hospital again to obtain the results of the sleep study and if Positive, to discuss treatment.
A letter is sent to the GP informing them of the results and if agreed, a prescription is issued by the GP for the recommended therapy this may also take an average of 6 Weeks to arrive.
This is prior to any treatment being administered such as a CPAP where if used they attend annually to check on compliance and progress.

This 6 month process is dramatically reduced by the S-Med Service to just a few days before an intervention can be delivered.


Now
The GP fits SOMNOtouch, a Combined OSA/Hypertension Monitoring Device to the patient, after 24 hours they return to the GP practice where the device is removed and the GP uploads the data from the device to a secure NHS Digital Cloud Server.
SOMNOtouch NIBP - Five devices in One
Video link: http://www.s-med.co.uk/Products#nav-product-86

S-Med Ltd’s Qualified and Registered Physiologists interprets the study and provides a recommendation for further treatment or investigation within 24 to 48 hours to the GP surgery. (All analysis and interpretations are supervised by a senior Consultant).

The report is sent to the GP who would then provide a prescription for the relevant therapy to be provided.

Thus within 48 to 72 hours a patient can be treated or directed for additional investigations or treatment before their condition deteriorates.

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':
Sensium accurately & reliably monitors & transmits patients’ vital signs every 2 minutes & notifies of deterioration between Observation rounds. Easy to use, SensiumVitals provides tangible benefits for patients, clinicians & for the hospital.

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 & reliably monitors & 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. This includes patients on general wards, post-operative med/surg. wards & patients waiting before & after treatment in A&E departments.
 
Sensium Patch provides accurate & 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 & secure low power wireless communication to the Sensium bridges placed through the ward area.
 
The bridges are connected into the hospital IT system, & 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 & ensure accuracy Sensium can be easily integrated with the hospital admission, discharge, transfer systems & electronic medical records.
 
Sensium allows patients to ambulate freely, untethered to static & expensive equipment whilst still having the reassurance of continuous monitoring.
 
The 3 most serious, costly & avoidable care incidents in unmonitored patients are: Sepsis, Cardiac arrest, Respiratory depression. 
  • In Britain more than 100k people suffer from severe sepsis each year. 37k of them will die from the disease. Each case of severe sepsis costs the NHS £20k meaning treatment costs £2bn a year.
  • There are approx 25,428 in-hospital cardiac arrests in the UK per year. More than 80% of hospitalised patients who suffer a cardiac arrest do not recover.
  • 1 in 100 patients treated with opioids for moderate to severe post-operative pain will experience events related to respiratory depression. 17 In the UK there are approx 7m operations performed each year resulting in a potential 70k cases of respiratory depression.
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
Benefit to NHS:
75% of all adverse events & preventable deaths occur outside the ICU in unmonitored beds.

All hospitalised patients are at risk of deterioration but most catastrophic incidents are preceded by periods of change & abnormality in patient’s vital signs. If these changes in vital signs are detected & reacted to in a timely fashion then a significant proportion of costly patient deterioration can be avoided.
 
Currently approx. 10% of patients are harmed during their hospital stay & this represents a cost to the NHS of over £2.5b just to cover the additional length of stay for these patients. Improved monitoring regimes & early detection of deterioration is key to reducing this significant burden.
 
Sensium notifies the clinical team of patient deterioration allowing intervention before the condition worsens, thereby improving patient outcomes, shortening hospital stays & 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 & security of continuous vital sign monitoring.
 
The system is configurable to display up to 24 hours of vital signs trend data. Highly flexible, Sensium allows clinicians to configure alert levels for each vital sign as appropriate to their clinical environment.
 
For the Clinician:
  • Real-time, early detection & notification of patient deterioration
  • Ability to access information at the nurse station or via other web-enabled devices
  • Integrates with existing workflow without customisation
For the Hospital:
  • Improves patient recovery & reduced length of stay
  • Avoids high cost treatments through early detection
  • Quick & easy to integrate into existing systems
For the Patient:
  • Non-intrusive, lightweight & comfortable to wear
  • Provides reassurance of continuous monitoring
  • Non-restrictive, allowing freedom of movement
Patient deterioration is a significant & growing problem but there is a mounting body of published evidence that supports early identification of the changes in physiology as the most critical factor in avoiding these dangerous & costly episodes. Studies suggest that the greatest area for improvement is not treating the deteriorated patient but more importantly early identification of the deteriorating patient. Delayed recognition of the signs of patient decline is the strongest predictor of patient mortality. To view the evidence, along with our case studies, click here.


Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
With ageing populations driving healthcare demand & heightened expectations of quality of life during & post medical treatment the NHS is under increasing pressure to achieve more with less.
 
Cost effective patient monitoring regimes will become increasingly important to:
  • Improve patient outcomes
  • Reduce care costs associated with expensive & largely avoidable patient deterioration episodes
  • Drive clinical effectiveness through data & evidence-based decision making
The increasing incidence of sepsis is likely to be due to people living longer & more medical/surgical interventions being performed. People with co-morbidities are more likely to survive their illness & for longer than before, which leads to much of the hospital-acquired sepsis that now occurs.
 
Data for finished discharge episodes with a primary or secondary diagnosis of sepsis for patients in England 2010-15 is below.



On average each UK Acute Trust will spend £13m on sepsis treatment & management annually.

The chart below is from Key statistics from the National Cardiac Arrest Audit 2015/16 report, based on data for in-hospital cardiac arrests in NHS acute hospitals.
 

Cardiac arrests are usually preceded by measurable changes in vital signs, by monitoring & reacting to these changes a significant proportion of in-hospital cardiac arrest deaths can be predicted & ultimately prevented.
 
Postoperative opioid-induced respiratory depression is a significant cause of death & brain damage. The Anaesthesia Closed Claims Project database of 9,799 claims was reviewed by 3 authors reviewing 357 claims that occurred 1990/2009 for the likelihood of RD using literature-based criteria. 97% were judged as preventable with better monitoring & response.



Deterioration can happen between observation rounds. If a patient deteriorates between these rounds the warning signs can go undetected for hours potentially leading to serious & costly consequences.
 
Working as your early warning system, Sensium provides affordable, real-time monitoring for patients:
  • Notifies of deterioration: delivered direct to relevant caregiver
  • Tracks HR, RR & axillary temperature: the 3 vital signs widely used in clinical practice as leading indicators of patient decline
  • Eliminates cross infection risk: through single use Sensium Patches
  • Allows free movement: for patients throughout the connected area
  • Offers seamless integration: server software easily integrates with ADT, AD, EMR etc
  • Comfortable for patients: light-weight, unobtrusive patch
Current and planned activity: 
We would like to engage with WMAHSN’s Patient Safety Collaborative Network through the Meridian online health innovation exchange to share our innovative solution to help deliver on improving patient safety across the West Midlands region. Specifically, Sensium would like to give hospitals in the West Midlands region the opportunity to realise the clinical and economic benefits associated with closer monitoring of patients’ vital signs.
 
Patients die because signs of deterioration are missed. There is a huge unfulfilled need for better monitoring of vital signs to identify high-risk patients who are on general hospital wards. Patient deterioration is often overlooked or not detected at all. One of the reasons is the intensity in nursing and frequency of vital signs monitoring which decreases from the Intensive Care via ward towards home. Early detection of physiological instability is crucial to prevent death and disability.



Further details: nightingale business case proposition.
 
What is the intellectual property status of your innovation?:
Aspects of the core technology are patented (14 separate patent families) to ensure freedom to operate.
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
Read more
Hide details
Innovation 'Elevator Pitch':
Cera is a multi-award winning, technology-enabled homecare provider. Our technology allows us to respond and deliver tailored care within hours of an enquiry, while empowering our care-workers to deliver the highest standards of care.
 
Overview of Innovation:
Cera is a digital disruptor of the home care space, with in-house and proprietary technology. We have created a platform able to i) create digital care reports whereby during a carer visit, carers log information on their smartphone using our platform, with health and behaviour data on the user, which allows for metrics to be monitored and better care to be delivered – this data is also accessible to family members and healthcare professionals permitting much better connected services; ii) use of artificial intelligence based on the data collected by carers, to predict if users are going to experience health deteriorations such as their blood pressure worsening or the onset of a urine infection, based on subtle signals that carers may have logged – this allows us to escalate a service user’s care should they be at high risk of deterioration, or contact their doctor more proactively, potentially preventing adverse health events or the need to go to hospital; iii) use of an artificial intelligence chatbot – Martha – that provides decision support to carers based on questions they ask. The chatbot aims to transfer some of the knowledge and experience which established carers possess to carers with less experience; by doing this, we aim to make care more consistent.

Cera has provided hundreds of thousands of care hours with a 95% satisfaction rating, and is growing at an average of 25% a month. It has received over £13 million of funding from investors such as Kairos Ventures, Kima Ventures, David Buttress (former CEO of JustEat), Paul Wilmott (leads digital globally for McKinsey), Charles Songhurst (former Global Head of M&A at Microsoft) and Peter Sands (former Chairman of Davos). It has been recognised by the Government's Cabinet Office as a role model for innovative businesses partnering with the public sector, and Sir Nick Clegg recently joined the company. Cera has received a number of awards including the Most Outstanding Digital Health Innovation of the Year, the LaingBuisson Dementia Care Award, the Best London Home Care Company at the Social Care Awards 2018.
 
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 / Education, training and future workforce / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
We are the pioneer of innovative care delivery and have been widely recognised as the UK’s leader in transforming the sector. So far we have delivered hundreds of thousands of care sessions with a 95% satisfaction rating. Crucially, we are often able to start care within 24 hours when requested; this is markedly faster than other companies who take 3-4 weeks, and means that healthy people do not need to stay in hospital waiting for their care to be arranged.
We are developing a Artificial Intelligence platform that utilises data collected by carers to predict if users are going to experience health deteriorations, such as their blood pressure worsening or the onset of a urine infection. This allows us to escalate a user’s care should they be at high risk of deterioration, or contact their doctor more proactively, potentially preventing adverse health events. We are also developing an artificial intelligence chatbot that provides decision support to carers based on questions they ask. The chatbot aims to transfer some of the knowledge and experience which established carers possess to carers with less experience.

At present, clinical doctors are not involved in the active review of our clients’ data. However, there are several members of our clinical care team that review reports from each care visit through our digital care platform. Furthermore, using our digital care platform - where data is stored and viewable - it is possible for us to allow GPs and hospital doctors to access the information relating to their own clients. This would be after authenticating themselves on our platform and be possible through our portal website. We are exploring partnerships with Clinical Commissioning Groups which would allow these data sharing partnerships to be made possible.  ​
 
Initial Review Rating
4.20 (1 ratings)
Benefit to WM population:
We are offering a better experience for our carers, who are offered flexible working and are empowered using technology, translating to an annual carer retention rate of over 90%. We achieve that by paying them up to 50% more than industry average, and supporting their learning via a combination of in-class and online teaching. Our e-learning platform, Learning Pool, has been very successful in engaging our carers to further their knowledge, improving the overall standards of care we provide.  

The care workers are periodically in touch with family members and are certainly aware of important care-related matters through the family members before they begin care. Care workers and family members always have the option to contact each other immediately through Cera Care at any time. Family members can access the visit reports completed by care workers through our portal as soon as they are completed - we believe this gives them a level of transparency that is simply not possible without a digitised solution. We have a comprehensive and clear consent process which all clients must sign before we deliver any care. The scope of this consent covers data capture by care workers, data storage on our platform and processing such as this for the purpose of improving patient care.
 
Our machine learning algorithm is also a work in progress - currently in prototype form. It uses data from the client’s care plan (past medical history, medication, important disabilities, care schedule) and visit reports captured by visiting care workers (mood, nutrition, hydration, activity level, sleep, bowel movements) to attempt to predict when clients are at high risk of experiencing a deterioration in their health. Currently it has an AUC ROC of 0.72. As we collect more data, we will continue to improve its performance. Since we have not operationalised this prototype, we do not require ethics approval and it is not considered a medical device because it does not offer medical diagnostic capability nor does it actively conduct treatment. If we decided to use it to inform our care workers’ practices - we can register it as a Class I device.
Current and planned activity: 
In 2018 we have delivered NHS CCG funded care with the following CCGs: Lambeth, Tower Hamlets, Haringey, Enfield, and previously had partnered with CCGs including Brent, Harrow and Hillingdon, and East London Foundation Trust, in addition to marketing in NHS hospitals including: Central Middlesex, West Middlesex, Northwick Park, Royal Marsden, Whittington and Barnet & Chase Farm and a Marketing Agreement with BMI hospitals across London. NHS 111 is exploring a collaboration with Cera. One potential outcome of this would be to permit the integration of data records from Cera into the 111 service
What is the intellectual property status of your innovation?:
We own IP for our Digital Care Platform and algorithm
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
3 years +
Ease of scalability: 
3
Read more
Hide details
Innovation 'Elevator Pitch':
More people die of SUDEP (Sudden Unexpected Death in Epilepsy) than in house fires every year.
 
Every home has smoke detector, so why shouldn’t all epileptics have a device that alerts people close by so that they can provide assistance when needed?
Overview of Innovation:
Embrace is the world’s 1st system for seizure detection based on analysing multiple physiological data sensed at the wrist.



Should someone with Epilepsy experience an ‘unusual event’, such as a convulsive seizure, an alert will be sent via their smartphone to parents, friends or caregivers, summoning immediate help. Additionally, a caregiver can also wear a 'companion' Embrace. When the two Embraces are within range (e.g. in nearby rooms), the 'companion' Embrace worn by the caregivers will vibrate to alert them.

The Embrace watch has received awards for its design & innovative technology. The watch monitors Electrodermal Activity (EDA), also known as Galvanic Skin Response (GSR), which is autonomic data that is activated by regions deep in the brain involved in emotions such as fear, anxiety & excitement.
 
Embrace watch also functions as a sleep monitoring & activity tracking device.
 
What else do Embrace sensors monitor?
Embrace comes with an app called Mate. Mate combines events that are entered manually with events that are sensed by Embrace. Mate helps see how patterns of sleep, autonomic stress, skin temperature and physical activity may interact with seizure events. (NB: initial release of Mate app features rest and activity information, while features like autonomic stress monitoring, are still in development and will be added later). For example, if there are an increased number of absence seizures when stress levels have been high and sleep has been irregular, then these can be tracked to see if changing these patterns reduces the number of seizures.
 
Embrace and Alert app system for seizure detection is for investigational use only. The system is currently not clinically proven to detect seizures. Evidence of seizure characterization using the technology in Embrace has been gathered in a number of clinical trials since the initial discovery of skin conductance changes during a seizure was published in 2012. Empatica is currently conducting clinical trials to evaluate seizure detection of generalised tonic clonic seizures (GTCS) using the Embrace watch & Empatica Alert app.
 
The automatic physiological data logging provided by the Embrace system is valuable when someone experiences a seizure as they may not remember what has happened themselves. A diagnosis is often based on finding out what happened to the individual before, during and after a seizure.
 
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 / Wealth creation / Clinical trials and evidence / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
The number of people in the UK diagnosed with epilepsy has risen sharply in recent years. There are around 65 million people living with epilepsy in the world, with an estimated 600,000 people in the UK.
 
Every day in the UK, 87 people are diagnosed with epilepsy. Only 52% people with epilepsy in the UK are seizure-free.
 
During 2013, 1,187 people in the UK with epilepsy died earlier than expected (premature death). Some of these deaths could have been prevented. A clinical audit of epilepsy deaths in 2002 found that 64 per cent of adult deaths and over half of child deaths were possibly or probably avoidable.
 
Epilepsy is misdiagnosed in 20-30% of cases: most commonly, non-epileptic conditions are incorrectly diagnosed as epilepsy. Up to 40% of children referred to a tertiary clinic do not have epilepsy.  In 2004, the National Institute for Clinical Excellence (NICE) estimated the direct costs of epilepsy misdiagnosis (including inappropriate treatment, but not including individuals’ lost productivity from misdiagnosis) to be between £130m and £190m per year (NICE (2004) Epilepsy, second consultation, Appendix G).
 
Limiting the rate of misdiagnosis will help to reduce the risk of teratogenicity in wrongly diagnosed patients and will prevent patients wrongly diagnosed with epilepsy from facing, for example, unnecessary restrictions in employment and in other areas of life. Better diagnostic services are also likely to reduce any treatment gaps or inequalities, and, through encouraging independent living, improve the rate of employability for people with epilepsy. Finally, patients will have a greater choice of treatment options and a greater sense of empowerment
 
Epilepsy is an ambulatory-sensitive condition, meaning that better management in the community or primary care setting can effectively avoid unnecessary visits to the emergency department and non-elective hospital admissions.
 
Prevention of 15 admissions to hospital would Save the salary of a single epilepsy nurse
Estimate from National Audit of Seizure Management in Hospitals 2 (NASH2)
 
In 2009, there were 13 million prescription items of anti-epileptic drugs dispensed in the community in England, at a net ingredient cost of £300 million (NHS Information Centre Prescription Cost Analysis 2009. The net ingredient cost is the cost of the drug before discounts, not including any dispensing costs of fees).
Initial Review Rating
4.60 (1 ratings)
Benefit to WM population:
Epilepsy affects 54,000 people in the West Midlands (Source Birmingham City Council May 2016). The economic and social costs of managing this cohort is very significant.
 
Gaining control of one’s epilepsy not only saves direct health related costs in terms of fewer emergency or longer term hospital admissions, but also enables individuals with epilepsy to continue working and maintain their independence.
Current and planned activity: 
Current activity:
The Embrace device was only recently launched in the UK in November 2016. Currently clinical trials are taking place in the USA.
https://support.empatica.com/hc/en-us/sections/200817625-Seizure-Characterization-Clinical-Trial-monitoring-with-Embrace
 
We have taken orders from a number of Local Authority Assistive technology departments and are keen to engage further with the NHS.

Planned/future activity:
The published trial results cited above were from predicate devices. We need to collect more data using the Embrace and Alert app to complete the medical and FDA certification processes before we are able to make any claims regarding seizure detection performance of this system.
 
We are very keen to work more closely with any West Midlands network that provides support to people with Epilepsy or Autism.
 
What is the intellectual property status of your innovation?:
Patents Held by Empatica – further info available upon request.

The device is currently being fast tracked through FDA approval.

It also holds - Certifications:  CE Mark, FCC CFR 47 Part 15,  RoHS.
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
Read more
Hide details
0
0
Votes
-99999

Created by

Share and Follow