Sensium: Early Detection of Patient Deterioration (#2673)

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Draft
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Detailed
Accepted
Adoption
Idea Description
Supplementary Information
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)
Similar Content4
Innovation 'Elevator Pitch':
RespiraSense demonstrated a potential for 6-12 hours earlier detection of patient deterioration when compared to the standard of care. Putting that into context, for every 30-minute delay in treating Sepsis, increases the risk of mortality by 7%.
Overview of Innovation:
RespiraSense is the world's only continuous respiratory rate monitor. Respiratory rate is the earliest and single most sensitive indicator of patient deterioration, more so than heart rate if systolic blood pressure. In fact, 26 breaths per minute are considered the earliest point of divergence between Spo2 and respiratory rate. Giving rise to 12+hours of false security is accurate RR is not measured. 

The standard of care remains the manual counting of breaths per minute, which has been shown to be biased and prone to error. With evidence showing no change in the quality of measurements for over 170 years (1846SirHutchenson) (2017Badawy). 

RespiraSense gives medical teams the advantage of being able to intervene early, thus reducing time to intervention and improving outcomes. Outcomes such as Average Lenght of Stay, Average Unit Cost of Care, and Patient Safety targets can be achieved. 

RespiraSense is a simple, wireless, and discrete wearable monitor, placed on at admission and worn/measuring continuously for upto 7 days. Each patient recieves a new sensor and a reusable electronic device or Lobe. See how the system works @ 
https://www.youtube.com/watch?v=u6KB1hBPQbM​ 
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 / Education, training and future workforce / Wealth creation / Clinical trials and evidence / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
Each year, there are approximately 500,000 admissions of Sepsis and Pneumonia with an average unit cost of £4,600 per admission. These two conditions are increasing in incidence and oftentimes lead to an escalation of care due to the risk of undetected deterioration. It is shown that a 5% reduction in the escalation of care of these two pathways alone, through the use of continuous Respiratory Rate monitoring triggering decreased time to interventions (Fluids, Oxygen, Antibiotics, Steroids), can reduce the average unit cost by £300 and the average length of stay by 0.5 days. This translates into a total Net cash saving of £115m and 250K bed days. Popular opinion suggests that as high as 20% reduction is achievable - Evidence pending. 

Each event prevented, having an average cost of £25,000, will pay for a whole year's supply of sensors for one year. 
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
West Midlands Trusts are driving the awareness of Sepsis through their ambulance services, patient awareness campaigns, and in-hospital initiatives. With 44,000 lives lost each year attributed to Sepsis, it is important to Prevent, Diagnosis Early, and Effectively Treat the condition. RespiraSense focused on the area of Diagnosis Early. Research suggests that NEWS2 is a more sensitive indicator of deterioration due to Sepsis than QSOFA. Both of which have Respiratory Rate as a key parameter to measure. There is clearly value in monitoring this essential vital sign accurately, and clear additional benefit to having it monitored continuously. RespiraSense achieves both with low impact of False alarm due to its innovative design, boasting advanced motion-tolerance. 
Current and planned activity: 
PMD Solutions is working with Nursing Times to launch an educational campaign on the clinical science and importance of respiratory rate monitoring in acute care clinical practice. 

In addition, PMD Solutions is looking for Respiratory and Emergency teams to partner with and create a culture of Peer Leadership in the development of best practice for respiratory rate monitoring. 
What is the intellectual property status of your innovation?:
RespiraSense is positioned to be the new industry standard in respiratory rate monitoring. It is patented in Europe, United States, China, Hong Kong, and Japan. 
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
2
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Innovation 'Elevator Pitch':
RespiraSense demonstrated a potential for 6-12 hours earlier detection of patient deterioration when compared to the standard of care. Putting that into context, for every 30-minute delay in treating Sepsis, increases the risk of mortality by 7%
Overview of Innovation:
RespiraSense is the world's only continuous respiratory rate monitor. Respiratory rate is the earliest and single most sensitive indicator of patient deterioration, more so than heart rate if systolic blood pressure. In fact, 26 breaths per minute are considered the earliest point of divergence between Spo2 and respiratory rate. Giving rise to 12+hours of false security is accurate RR is not measured. 

The standard of care remains the manual counting of breaths per minute, which has been shown to be biased and prone to error. With evidence showing no change in the quality of measurements for over 170 years (1846SirHutchenson) (2017Badawy). 

RespiraSense gives medical teams the advantage of being able to intervene early, thus reducing time to intervention and improving outcomes. Outcomes such as Average Length of Stay, Average Unit Cost of Care, and Patient Safety targets can be achieved. 

RespiraSense is a simple, wireless, and discrete wearable monitor, placed on at admission and worn/measuring continuously for up to 7 days. Each patient receives a new sensor and a reusable electronic device or Lobe. See how the system works @ https://www.youtube.com/watch?v=u6KB1hBPQbM  
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 / Wealth creation / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
Each year, there are approximately 500,000 admissions of Sepsis and Pneumonia with an average unit cost of £4,600 per admission. These two conditions are increasing in incidence and often lead to an escalation of care due to the risk of undetected deterioration. It's shown that a 5% reduction in the escalation of care of these two pathways alone, through the use of continuous Respiratory Rate monitoring triggering decreased time to interventions (Fluids, Oxygen, Antibiotics, Steroids), can reduce the average unit cost by £300 and the average length of stay by 0.5 days. This translates into a total Net cash saving of £115m and 250K bed days. Popular opinion suggests that as high as 20% reduction is achievable - Evidence pending. 

Each event prevented, having an average cost of £25,000, will pay for a whole year's supply of sensors for one year.
Initial Review Rating
5.00 (2 ratings)
Benefit to WM population:
West Midlands Trusts are driving the awareness of Sepsis through their ambulance services, patient awareness campaigns, and in-hospital initiatives. With 44,000 lives lost each year attributed to Sepsis, it is important to Prevent, Diagnosis Early, and Effectively Treat the condition. RespiraSense focused on the area of Diagnosis Early. Research suggests that NEWS2 is a more sensitive indicator of deterioration due to Sepsis than QSOFA. Both of which have Respiratory Rate as a critical parameter to measure. There is clinical and economical value in monitoring this essential vital sign accurately and clear additional benefit to having it monitored continuously. RespiraSense achieves both with low impact of False alarm due to its innovative design, boasting advanced motion-tolerance. 
Current and planned activity: 
PMD Solutions is working with Nursing Times to launch an educational campaign on the clinical science and importance of respiratory rate monitoring in acute care clinical practice. 

In addition, PMD Solutions is looking for Respiratory and Emergency teams to partner with and create a culture of Peer Leadership in the development of best practice for respiratory rate monitoring. 
What is the intellectual property status of your innovation?:
RespiraSense is positioned to be the new industry standard in respiratory rate monitoring. It is patented in Europe, United States, China, Hong Kong, and Japan. 
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
Regulatory Approvals:
Please describe any current regulatory approvals you have achieved and how they were met/ in progress/planned.
Commercial information:
Please describe how the product/service is being developed commercially, whether in development, trials, pilot or full commercial delivery. Include the results you have from any market/demand surveys and forecasts . Please include any research you have on the broader commercial opportunity for the innovation both within the health sector nationally and internationally.
Investment activity:
Please describe what stage of investment you have reached and whether you are seeking additional rounds of investment. Please include cash investment as well as investment of soft assets such as access to specialist equipment, knowledge, trial base etc. and indicate the types/sources of your investment such as grants etc.
Regional Scalability:
Please describe how the innovation could be scaled across the WM region. Have you implemented at scale in any other regions?
Measures:
What outcomes are you hoping to achieve and what are the measures that you will use to gauge the success of the innovation and how will these assessments be made? Please ensure that you have quality, safety, cost and people measures.
Adoption target:
What are the targets for adoption across the WM and what are the minimum viability levels?
Investment sought:
What investment are you looking for in order to support wider adoption of this innovation and what have you managed to secure to date? Please provide a breakdown of these costs if possible.
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Innovation 'Elevator Pitch':
GroundVision provides the next generation of patient observations, and a range of dashboards, including our specialised Rapid Detection and Response (RADAR) view, to enable an efficient, proactive response to the deteriorating patient.
Overview of Innovation:
Over 6,000 people die every year in hospital as a result of “failing to rescue” a deteriorating patient. GroundVision provides a simple and cost effective system to record and calculate EWS (Early Warning Score) and a variety of other observations and assessments, from Bristol Stool to Fluid Balance, at the patient bedside to ensure that deteriorating patients are quickly and accurately identified.

As well as the ability to record patient observations at the bedside, GroundVision provides a variety of specialised views for different departments of a hospital:

Ward View
Displays information and observations about all patients on a ward.
 
Critical Care View
Displays information and observations about all patients in the Trust, with filtering capabilities, enabling searches for groups of patients (e.g. those that are deteriorating).
 
Infection Control View
Displays information about Bristol Stool Samples and infectious patients, enabling better control of infection outbreaks.
 
Ops Team View
Displays all side rooms in the hospital, with information about their occupancy, including a reason and priority for the isolation of a patient.
 
Dashboard View
Allows users to create customisable reports/graphs about a wide range of patient and observation related information.
 
RADAR (Rapid Detection And Response) View
Provides a view that shows all deterioration patients within their “score banding” who have not been responded to. The solution also graphically shows their health trajectory enabling healthcare staff to intervene before the patient triggers. This real-time view can be displayed via tablet, desktop or electronic whiteboard onsite or remotely.

Our solution has been developed alongside nurses, so it is easy to use as well as being low cost. It can be used on any device and accessed remotely as well as on site.
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 / Patient and medicines safety / Person centred care
Benefit to NHS:
GroundVision can provide a variety of benefits to the NHS:
  • Reduction in patient mortality
  • Reduction in hospital length-of-stay
  • Reduction in time taken to record/calculate Obs/EWS
  • Improvement in the accuracy of EWS calculations
  • Increased levels of clinical attendance
  • Increase compliance with hospital protocols
  • Reduction in the number of unexpected cardiac arrests
  • Fewer admissions to ICU
  • Reduction in the number of ICU days
  • Reduction in the number of infection outbreaks
As well as this, it brings the NHS one step closer to being paperless.
Initial Review Rating
3.80 (1 ratings)
Benefit to WM population:
It can help NHS organisations within the West Midlands area by improving patients safety and patient outcomes.
Current and planned activity: 
We have been engaged with Surrey and Sussex Healthcare NHS Trust, co-developing our solution alongside them and providing pilot projects, rolling out our solution to several wards.

We are also currently engaged with other NHS organisations within that area, such as Kent Community Healthcare NHS Foundation Trust.

We will continue to engage with as many NHS organisations as we can as well as continuing to develop our solution, to increase the wealth of observations and assessments that we have available to contribute towards improving patient safety.
What is the intellectual property status of your innovation?:
Simply Clever Ltd (trading as GroundVision) own the intellectual property 100%
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
3 years +
Ease of scalability: 
2
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Innovation 'Elevator Pitch':
The RAPID project is a pioneering research study using real-time diagnostic information inspired by the world of Formula 1.
Vital signs continuously monitored wirelessly and advanced algorithms provide early warinng of deterioration.
Overview of Innovation:
The RAPID (Real-Time Adaptive and Predictive Indicator of Deterioration) project – is the first of its type in the world. It constantly collects data from children on our cardiac wards including their:
  • heart rate
  • breathing rate
  • oxygen levels
This is a new and exciting way for children to be monitored and gives important early warning signs of deterioration that can be acted on quickly. 
The study was based on McLaren’s expertise in using hundreds of sensors to collect and analyse real-time data during a race to optimise its strategy on the track and Aston University's expertise in applied mathematics.
This technology has been adapted to be used in healthcare for the first time. Hi-tech wireless sensors, designed by Isansys Lifecare are attached to the chest and hands/ankle of children to measure vital signs. The information collected is processed in real-time using machine learning techniques developed by mathematicians from Aston University which are embedded into McLaren’s data analytics platform, LIFEINSIGHT™.
This new technology means that signs normally recorded every one to four hours on paper charts could potentially become a thing of the past. Children will have access to continuous individual monitoring that gives more accurate information helping them to receive faster treatment and shorter stays in hospital.
The wireless technology and wearable sensors remove the need for cables and leads, which can restrict effective monitoring. This means parents can hold and interact normally with their child while knowing they are being safely and continuously monitored.
The three-year study was jointly funded by a £1.8 million grant from the Welcome Trust and Department of Health, through the Health Innovation Challenge Fund, started in November 2014, and aims to recruit around 1,200 patients when it reaches its completion in late 2017.
 
Stage of Development:
Trial stage - Trial stage to prove that the idea actually works as intended
WMAHSN priorities and themes addressed: 
Advanced diagnostics, genomics and precision medicine / Wealth creation / Clinical trials and evidence / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
Wireless monitoring is complex but worth solving for the future as it is definitely easier to have patients not wired up to expensive monitors. More patients can be monitored more frequenly at a reduced cost.
Advanced early warning will allow earlier detection and treatment of deterioration and therefore hopefully prevent the healthcare and human costs of preventable deterioration.
Initial Review Rating
4.60 (1 ratings)
Online Discussion Rating
5.50 (2 ratings)
Benefit to WM population:
There will be large numbers of recruits to this Portfolio adopted study. Scaling up planned in WM hospitals.
Current and planned activity: 
In feasibility trial phase to complete in November 2017 and report May 2018. Follow-on trial to be designed in 2016 looking at scaling up in BCH and other centres.
What is the intellectual property status of your innovation?:
Copyright of visualisations, trademark of logo and patent of algorithms in process.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
3 years +
Ease of scalability: 
3
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