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Idea Description
Supplementary Information
Innovation 'Elevator Pitch':
Kemuri portable K-Sockets have a 500% return on investment in one year. Use them to accelerate hospital discharge of elderly or frail people into reablement by social services.
Overview of Innovation:



Kemuri K-Sockets are power sockets with multiple sensors that continuously measure:
  • Movement of people in the kitchen;
  • Electrical power for kettles, microwaves or toasters;
  • Room temperature;
  • Power supply.
They send data via the Internet via GSM mobile phone communications. Kemuri software learns patterns of normal activity and analyses Activities of Daily Living (ADLs) every hour. As soon as the system identifies too many changes from normal, it automatically alerts people who need to respond to possible risks. Responders can be families, carers or 24/7 alarm response centres.

The WebApp gives evidence of reablement of the service users. It gives confidence to responders who have been given informed consent to view the data. For example:
  • Wandering or unattended falls: Kemuri alerts non-return to kitchen;
  • Nutrition & Hydration: Kemuri alerts risk of dehydration or malnutrition;
  • Engaged the Community: Kemuri apps are free to authorised family, carers or voluntary sector;
  • Active in the home: If people can eat, drink and move around in warm surroundings – then they are performing key ADLs.
Portable K-Sockets are allocated to discharge teams as part of the normal hospital discharge process. Families or other carers have to respond to alerts and determine the action to be taken. The devices are re-allocated to patients every 6 weeks. Thereafter fixed K-Sockets can be installed in kitchens as wellbeing monitors.



The cost is less than £500 per year, and the notional saving on bed days is approximately £400 per day. By using a unit eight times per year, more than £3200 budget is released for more patients. This represents more than 500% return on investment in one year. This must be worth a trial in the region. Additional benefit can come from reduced re-admissions.

Surrey County Council have awarded a grant of £50,000 for measuring the reablement process and subsequent wellbeing monitoring.
Stage of Development:
Evaluation stage - Representative model or prototype system developed and can be effectively evaluated
Similar Content5
Innovation 'Elevator Pitch':
Kemuri portable K-Sockets have a 500% return on investment in one year.  Use them to accelerate hospital discharge of elderly or frail people into reablement by social services.
Overview of Innovation:

Kemuri K-Sockets are power sockets with multiple sensors that continuously measure:
  • Movement of people in the kitchen;
  • Electrical power for kettles, microwaves or toasters;
  • Room temperature;
  • Power supply.
They send data via the Internet via GSM mobile phone communications.  Kemuri software learns patterns of normal activity and analyses Activities of Daily Living (ADLs) every hour.  As soon as the system identifies too many changes from normal, it automatically alerts people who need to respond to possible risks.  Responders can be families, carers or 24/7 alarm response centres.

The WebApp gives evidence of reablement of the service users.  It gives confidence to responders who have been given informed consent to view the data.  For example:
  • Wandering or unattended falls: Kemuri alerts non-return to kitchen;
  • Nutrition & Hydration: Kemuri alerts risk of dehydration or malnutrition;
  • Engaged the Community: Kemuri apps are free to authorised family, carers or voluntary sector;
  • Active in the home: If people can eat, drink and move around in warm surroundings – then they are performing key ADLs.
Portable K-Sockets are allocated to discharge teams as part of the normal hospital discharge process. Families or other carers have to respond to alerts and determine the action to be taken.  The devices are re-allocated to patients every 6 weeks. Thereafter fixed K-Sockets can be installed in kitchens as wellbeing monitors. 

The cost is less than £500 per year, and the notional saving on bed days is approximately £400 per day.  By using a unit eight times per year, more than £3200 budget is released for more patients.  This represents more than 500% return on investment in one year.  This must be worth a trial in the region.  Additional benefit can come from reduced re-admissions.

Surrey County Council have awarded a grant of £50,000 for measuring the reablement process and subsequent wellbeing monitoring.





 
Stage of Development:
Evaluation stage - Representative model or prototype system developed and can be effectively evaluated
WMAHSN priorities and themes addressed: 
Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
Two areas of immediate benefit are the saving of excess bed days for non-medical reasons and the avoidance of re-admission. 
  • Many elderly and frail people cannot be safely discharged from hospital without a period of reablement by family members or professional domiciliary carers.  The NHS typically funds this for a maximum of six weeks – at lower cost than the occupation of a hospital bed.  After assessment and transfer of care to social services, continuous monitoring by K-Sockets permits safe discharges a day or more earlier.  This eases the problems of Bed Managers seeking to release beds for new patients.
  • During reablement, automatic alerts warn of unusual changes of activity.  They could indicate the risk of unattended falls, dehydration, malnutrition of hypothermia; all costly to the NHS.  Appropriate action could avoid the need for re-admission.  
Kemuri is designed for both family carers and 24/7 response services.  Portable K-Sockets require zero installation time and do not require broadband.  Monitoring and machine learning starts within minutes and any people with consent for data sharing can immediately view the data or receive alerts.
 
Longer-term benefits come from wellbeing monitoring after reablement.  Portable K-Sockets can be replaced by fixed K-Sockets.  The data analysis could reveal medical problems, such as UTIs, and preventive action could avoid more costly treatments.    
 
Benefit to WM population:
Most older people want to return to their own homes as soon as possible after treatment.  Unfortunately, for some independent people, they cannot be discharged because there is no care provision at home.  Perhaps they have no local family or friends.  Consenting to reablement monitoring by K-Sockets could accelerate their discharge and improve health outcomes. 

Families also obtain peace of mind, whether they live locally or at great distances.  At any time of day, people can be alerted to possible problems and respond appropriately.  Most frequently it may only require a reassuring phone call.  On other occasions it could be an unattended fall or medical event that needs clinical action.  Earlier treatment leads to better health outcomes.

It may be possible to reduce the costs of domiciliary care with more-timely and less frequent visits. 
This is an example screen:



A green day shows normal activity.  An amber day shows more changes from normal activity – but may not be cause for alarm.  Red days are alerted during the day and are a call for action.  Viewers can drill down to more detail, and the screen below could indicate the risk of hypothermia.



K-Sockets are invaluable as passive monitors to supplement active telecare devices, such as pendant alarms.  The latter are not worn continuously by 90% of the people who have them and they need reasonable cognition to use them when necessary.  K-Sockets are not stigmatising and do not require any change of lifestyle.

For more information and downloads see http://www.kemurisense.com
Current and planned activity: 
Cornwall Council is trialling 20 portable K-Sockets for reablement.  In one case, an alert was sent to a family member before they knew about an unattended fall.
 
Surrey County Council have awarded a grant for TECS Innovation.  The plan is to supply 40 portable K-Sockets for reablement and then supply 100 fixed K-Socket to vulnerable people for six months.  Social Care will perform assessments as part of their normal case management.  An anonymised log of each service user should provide evidence of the bed days saved.  Statistics of readmission or transfer to full-time residential care can be compared to current averages.
 
Many K-Sockets are operational in small trials and some are still operational after years of use in private houses and housing association properties.  They could collect data for several years in long-term trials for clinical trials, such as for drugs for relieving the symptoms of dementia.
What is the intellectual property status of your innovation?:
Kemuri has patents pending; GB1417259.7, effective date of 30 September 2014 and PCT/GB2015/000275, International Filing Date of 30 September 2015. 
 
Kemuri, KemuriSense, K-Sockets and K-Fobs are registered trademarks. 
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
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Innovation 'Elevator Pitch':
Protect people with dementia from unattended falls, dehydration, malnutrition and hypothermia by hourly checking patterns of normal activities in their kitchens. 
Overview of Innovation:
Many older people want to live independently for as long as possible, causing anxiety for family and friends.  They are often in denial of their declining capacity, proud and won’t wear pendants.  With impaired cognition, many suffer from unattended falls, dehydration, malnutrition or hypothermia.  They are admitted to hospital needing longer treatment for poorer health outcomes and greater risk of transfer into a care home. 

To make sure that service users are moving around as normal, drinking, eating and warm, Kemuri checks every hour.  It alerts families and carers of important changes and provides valuable details for guiding action.  Peace of mind results in better outcomes and reduced costs for everybody.

Kemuri does not stigmatise because it looks a familiar Power Socket to the service user.  There’s nothing to remember and people continue with normal activities such as boiling kettles and heating food in microwaves or other electrical equipment.


KemuriSense® mains Smart Power Sockets continuously monitor motion, power usage, temperature and humidity and send data via GSM mobile phone signals to the Internet.  Mains power loss is automatically reported whilst it continues to report other sensor readings.  

The Wellbeing Monitor App informs families and carers of older vulnerable people who:
  • Want to live independently
  • Reject or forget pendant alarms
  • Deny declining capacity
  • Show symptoms of dementia
  • Remove things they don’t understand
  • Need daily monitoring 


Predictive analytics check every hour for changes to patterns of motion and power usage.  If there are many changes, then alerts may be sent to families, carers or 24/7 response centres.

As stated by a Commissioning Manager at a County Council, “ ... this is a unique product ….  I think there’s potential here for both self funder and LA funding as a potential option that fills a gap that conventional telecare does not.”
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 / Digital health
Benefit to NHS:
Dementia is increasing in the population. Kemuri is a tool for stabilising the wellbeing of older people living alone who are declining in their ability to undertake Activities of Daily Living. Better wellbeing means healthier people, better health outcomes & more efficient use of NHS resources. Institute of Ageing research shows a range of pathways that people take before they are unable to live independently.


Early intervention is proven to reduce costs significantly. Kemuri should be deployed as soon as people are showing early symptoms of dementia. With loss in mobility, falls are inevitable: half those 80+ fall at least once p.a. Falls cost the NHS £2bn p.a. People with dementia tend to forget their pendant alarms/wearable telecare devices. If unable to call for help they may suffer for days before discovery & admission to A&E with medical complications. Kemuri’s hourly analysis of patterns of motion power usage automatically alerts to the risk of unattended falls.

In comparison pendant alarms are ineffective with early stage dementia. Out of 1.6m issued 32% are never worn & only 8% are worn all the time as prescribed. 500,000 unworn pendant alarms waste as much as £80m p.a. Kemuri continuously monitors motion, learns patterns of activity without any cognitive input from the service user.


A value to the NHS of early A&E admission into hospital is better health outcomes & more people discharged back to independent living on average after 12.3 days (discharge to residential care on average 31.7 days, 2.5 times longer).



£5000 could be re-allocated for each episode avoiding discharge to a care home. Unattended falls longer than 24 hours result in stabilisation time, longer treatment & delayed transfers of care. Kemuri preventive telecare with a wellbeing monitor & daily attention will also help to minimise the number of patients suffering the effects of hypothermia, dehydration & malnutrition.
  • Cold homes cost the NHS in England more than £1.36bn p.a.
  • Dehydration complications include low blood pressure, weakness, dizziness, increased risk of falls, & pressure sores
  • Malnutrition costs the NHS £7bn p.a. Risk (in 2010) was 28% in patients < 60 years, 32% 60-79 years & 44% if > 80 years
Kemuri could be funded by the NHS for a few weeks after discharge on the grounds that people admitted in a healthier state are less complex to treat, have improved health outcomes & are less likely to be readmitted, with the ongoing service funded by Social Services or self-funders.
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
West Midlands has a population of 5.6 million people covering an area of more than 5,000 square miles.  It is a region full of contrasts and diversity.  It includes the second largest urban area in the country (Birmingham, Solihull and the Black Country) yet over 80% of the area is rural.  It is the second most ethnically diverse region in the country after London.  There are probably 40,000 older people who might be suitable for passive wellbeing monitoring.  Many of these are admitted to hospital and may not be able to return to their own homes. 

Older people are at the focus of Kemuri wellbeing monitoring.  Hourly and daily pattern analysis reduces risk and extends the period that they can continue to live independently at home.  Everybody has access to information that reduces the risk of unattended falls, dehydration, malnutrition and hypothermia.  Alerts are automatic without older people having to change their life style.  A familiar power socket is not stigmatising or intrusive.  There are no wearable devices to remember or unfamiliar sensors to be discarded.  Discharge from hospital could be accelerated with a KemuriSense Power Socket pre-installed.

Families and carers use the Wellbeing App for peace of mind.  At any time of day, from anywhere in the World, people can view the changes to patterns of behaviour.  There’s an option to receive alerts after more changes than usual.  They can enquire about wellbeing with full knowledge of the predictive analysis and decide on appropriate action. Some of the tragic outcomes of unattended falls are avoidable with hourly monitoring.  Additionally, it’s possible to confirm that domiciliary carers have provided drinks and meals at the time they were ordered.

Service organisations benefit from accurate data.  Sheltered housing wardens, domiciliary care providers and alarm response centres have full access to the Wellbeing Monitor and can prioritise their care calls.  Kemuri is efficient to deploy.  The portable model is operational in ten seconds with no skill required.  The fixed model can be installed and tested within 15 minutes.  There are no rules to enter because the system learns patterns of activity.  Alerts are automatically sent to response centres or users of the app.  
Current and planned activity: 
Manufacturing batches of 100 units for trials/sales to housing associations/telecare service providers. First trials are in sheltered accommodation in County Durham in conjunction with Durham University (part of EU funded Erasmus+ project)

Controlled clinical trials required to collect evidence to support the benefits claimed (reducing impact of falls). Sample sizes to account for significant number of subjects continuing to live normally without any falls requiring intervention. Access to medical records/cost of treatment/health outcomes/discharge data/subsequent care pathways required

Kemuri collects accurate lifestyle data that can be used in clinical trials of drugs dispensed to people living independently including people with cognitive impairment/physical disability not able to record times of events/ambient conditions. KemuriSense power sockets can collect data for several years, in dementia trials it may be possible to identify rates of decline & use it to modify the care regime
What is the intellectual property status of your innovation?:
Kemuri has patents pending; GB1417259.7, effective date of 30 September 2014 and PCT/GB2015/000275, International Filing Date of 30 September 2015. 

Note that the patent applies to more devices than a power socket.  It covers the internal electronics and components, which could be incorporated into any equipment consuming significant amounts of power. 

Kemuri and KemuriSense are registered trademarks.  
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
2 years
Ease of scalability: 
3
Regulatory Approvals:
The KemuriSense Smart Power Socket has been tested for EMC (Electro Magnetic Compliance) and CE certification. 

The product only measures ambient conditions and does not require certification as a medical device.
Commercial information:
We are building batches of 100 for field trials with availability in January 2017. 

The projected sales shown in the table below.



The growth accelerates as more telecare resellers become customers.

Current and potential telecare users: The Strategic Society Centre undertook a major quantitative research project entitled Who uses telecare? published in 2012 to explore usage of telecare among older people in England and identify potential users of telecare. It provided a conservative estimate based on 2008 data that among the over-50s in England, there were well over 1 million telecare users. However, by mapping individuals with similar conditions, the report was able to identify around 2.5 million more individuals living alone who may be able to benefit from telecare, and potentially as many as 4.1 million with conditions that could merit the use of telecare.

Further, the report stated that around 30% to 50 % of current telecare users paid for their telecare themselves or with the help of a family member. Among private and non-privately funded telecare users, it appears there is little difference in incomes. This suggests that relatively low income is not a barrier to individuals and their families funding telecare themselves or that most users can contribute to the cost of telecare support.
The report made recommendations to policymakers to aim to boost the usage of telecare to at least double current prevalence focusing on individuals living alone. It also recommended that policymakers and the industry should focus on targeting informal carers, including both cohabiting and non-cohabiting family carers as potential beneficiaries of greater usage of telecare.

Global telecare market: The global telecare market is valued at c. £1 billion per annum and is forecast by the Deloitte Centre for Health Solutions to grow at a rate of 5% per annum from now to 2018. The factors contributing to growth and market attractiveness are related to government initiatives and funding and the public willingness and receptivity towards technological advancement. The UK is the leading market for telecare products and services, with the UK telecare market share of up to 25% of the global market. Other prominent markets for telecare in terms of ageing populations that demand such services include France, Italy and Benelux (comprising Belgium, Luxemburg and the Netherlands).

Ireland, Malta, Singapore, Hong-Kong, Malaysia and Saudi Arabia as potential overseas markets for KemuriSense®, as those territories use British standard socket outlets.
Investment activity:
Kemuri was founded by Dr Leonard Anderson, Russell Anderson and Michael Anderson in January 2014.  Together, they worked on the concept for an older person’s carer assistance solution after failing to find a suitable product and service on the market.  The Company’s activity to date has been focused on product and web-services development and has been funded from private and public sources.  Kemuri’s proof-of-concept project was successfully completed in October 2015, assisted by grants from Innovate UK; £66,734 for a Smart Grant and £5,000 for a Smart Voucher. A £2,000 prize from Kent County Council paid for the first smart power socket prototype. 

Dr Anderson has provided an unsecured director's loan facility of £100,000.

Innovate UK sponsored £5000 research with the Institute of Ageing at Newcastle University for the Ethics of Passive Monitoring.

The company raised £545,000 in a private offer via West Hill Capital.  The funds are being deployed to refine the core product infrastructure, to develop the mobile app, to recruit staff across operations and to build an online sales platform. 

Kemuri has been awarded with €100,000 as a partner in an Erasmus + project for people-centred centred design.  Our UK partner is Durham University together with others in Netherlands, Czech Republic and Slovenia

The Company is a growth business and will not be cash generative in the short term as it invests heavily in developing the business in order to generate long-term profitable business relationships.

A key requirement is to find funding for an academic study to collect evidence for the value of predictive analytics for a period of at least one year.  Grants are being sought from multiple sources.
Regional Scalability:
Smart power socket production is scalable (batches of 100-1000 p.m) in the Woking production facility (larger volumes achieved by second sourcing manufacture). The Web technology is cloud-based & can be rapidly scaled by commissioning more servers/storage at short notice. WM scale-up can be generated by raising awareness with the following:
  • Social Services Commissioners/OTs
  • GP Surgeries, Mental Health & Hospital Trusts
  • Housing Associations & Voluntary Sector eg AgeUK
  • Telecare Service Companies
  • Local media/online sales websites 
Welbeing, our telecare service partner’s clients include WM local authorities & housing associations, providing installation & call monitoring services to any new customers in the region.

As a start-up our effort is directed to delivering reliable hardware & software with small sample numbers. Our design objective is for KemuriSense power sockets to operate continuously for at least 5 years. First trials have started in County Durham housing associations.
Measures:
In co-operation with an academic research partner, we hope to achieve the following in a trial:

Quality
  • Continuous reliable operation
  • Avoidance of false alerts
  • Recognising unattended falls, strokes or other episodes that result in a carer taking action that saved time and cost for medical intervention.
  • Peace of mind achieved for families and carers
  • Identifying trends that indicate the risk of hypothermia, dehydration and malnutrition.
  • Identifying activity at unusual times of day that lead to helpful family or medical intervention 
Safety
  • Electrical safety of products after installation in kitchens.
  • Security of personal data and avoidance of data loss. 
Cost
The trial budget is £500,000.  This would include the costs of selection, installation, monitoring, service support and surveying families throughout the trial.  Note that his includes detailed data analysis, medical services, the final report and communications.
 
People
The target group for research is a cohort that has these attributes:
  • Reject pendant alarms
  • Deny declining capacity
  • Want to live independently
  • Show symptoms of dementia
  • Need daily monitoring
A percentage will be used as a control group who are not included in the Trial.  The total numbers are to agreed by the academic research partner from one of the West Midlands universities.
 
Ethics
Finding volunteer older people and their next of kin will require access to the medical records and adult social care records of older people living alone.  This will also be needed during the trial to measure the times and costs of medical treatment.  Approval by the Ethics Committee will be required.  
Adoption target:
Assuming that there are 500,000 unused pendants in the UK, there are approximately 40,000 candidates for Kemuri wellbeing monitoring in a West Midlands population of 5 million.   

500 is a reasonable target for 2017/2018 – with an possibility of growing to 10,000 in 5 years.  
Investment sought:
A total investment of £500,000 over two years would provide a trial that provides evidence for wider adoption in the Region.  For budgeting purposes, this breaks down as follows:
  • £40,000 - Project Management
  • £100,000 – Installation and Web services for 120 older people and their families
  • £50,000 – Health service costs
  • £250,000 – Academic research costs
  • £60,000 – Kemuri cost to support the trial. 
The findings should be applicable throughout the UK. 

The objective is to obtain SBRI funding for the project.  
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Innovation 'Elevator Pitch':
Technology to assist older people living independently with declining cognition, who are at risk of hypothermia, dehydration, malnutrition and unattended falls.
Overview of Innovation:
Many older people want to live independently for as long as possible, causing anxiety for family and friends.  They are often in denial of their declining capacity, proud and won’t wear pendants. Especially with impaired cognition, many suffer from hypothermia, dehydration, malnutrition or unattended falls.  They are admitted to hospital needing longer treatment for poorer health outcomes and greater risk of transfer into a care home. 
 
To make sure that service users are warm, drinking, eating and moving around as normal, Kemuri checks every hour and provides actionable information and alerts for the families and carers.  It increases peace of mind in addition to better outcomes and reduced costs for services users, families and the public sector.
 
Kemuri looks like a Familiar Power Socket to the service user; no changes to life style, plug in kettle and microwave, not stigmatising, not intrusive and tamperproof.
 


Technically it is mains-powered, continuously monitoring five sensors and sending data via a mobile phone connection to the Internet.  It has internal battery back-up to report power loss. 
 
The Wellbeing Monitor App is designed for the families and carers of older vulnerable people who:
  • Want to live independently
  • Reject or forget pendant alarms
  • Deny declining capacity
  • Show symptoms of dementia
  • Remove things they don’t understand
  • Need daily monitoring
  
 
Predictive analytics check every hour for changes to patterns of motion and power usage.  If there are many changes, then alerts may be sent to families, carers or 24/7 response centres.
 
As stated by a Commissioning Manager at a County Council, “ ... this is a unique product ….  I think there’s potential here for both self funder and LA funding as a potential option that fills a gap that conventional telecare does not.”
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: 
Mental Health: recovery, crisis and prevention / Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Clinical trials and evidence / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
The Kemuri Wellbeing Monitor is used the context of the care of older people living alone who are losing their ability to undertake Activities of Daily Living (ADL).  Research by the Institute of Ageing shows the range of pathways that people take before they are unable to live independently

Kemuri is effective when people are less mobile, possibly showing early symptoms of dementia.  They do not need, or welcome, daily contact and cannot, or will not, use pendant alarm systems.  They can be encouraged to continue living as actively as possible and maintain a reasonable quality of life for more years.  If people stay in the right hand side of the curve, average saving is £1900 per year.  People on the left hand side cost an extra £15,500 per year.

Kemuri’s hourly analysis of multiple sensor data enables people to gain insight into the risk of hypothermia, dehydration, malnutrition, unattended falls and power loss.  It is preventive telecare; unlike alarms that are reactive telecare.

The most common telecare service is the provision of pendant alarms.  Out of 1.6 million issued, 32% are never worn, only 8% are worn all the time, as prescribed.  These 500,000 unworn pendant alarms are ineffective for identifying falls, strokes or coma.  This wastes as much as £80 million per year.  Kemuri is passive telecare that continuously monitors ambient conditions and use of electrical devices e.g. kettles and microwaves.  

 
After an emergency admission into hospital, discharge to a residential care home is 2.5 times longer than discharge to independent living at home.
 

 
Including cost of stabilisation, treatment and excess bed days, this costs an average of £5000 more per non-elective hospital stay.  Preventive telecare with a wellbeing monitor and family intervention will help to minimise the number of patients suffering from hypothermia, dehydration, malnutrition and unattended falls.  People admitted in a healthier state are less complex to treat, have improved health outcomes and less likely to be readmitted.  
 
Kemuri is specifically designed for a cohort of older people who are often in denial of their declining ability.  Typically they won’t use their pendant alarms, reject wearable devices, have memory lapses and resist any changes to their normal routine.  Some may show other symptoms of the onset of dementia.  Many will be over 85 years old and not receiving regular visits from family or friends.
 
Initial Review Rating
2.80 (2 ratings)
Benefit to WM population:
West Midlands has a population of 5.6 million people covering an area of more than 5,000 square miles.  It is a region full of contrasts and diversity.  It includes the second largest urban area in the country (Birmingham, Solihull and the Black Country) yet over 80% of the area is rural.  It is the second most ethnically diverse region in the country after London.  There are probably 40,000 older people who might be suitable for passive wellbeing monitoring.  Many of these are admitted to hospital and may not be able to return to their own homes. 
 
Kemuri wellbeing monitoring can extend the period that older people can continue to live independently at home.  It avoids the stigma of wearables and unfamiliar sensors that can be damaged or removed.  A power socket is a very familiar device and installation does not require changes in patterns of normal behaviour.  They are easily installed into kitchens of sheltered accommodation.  Wardens or housing scheme managers can easily check wellbeing daily and avoid some of the tragic outcomes of unattended falls. 
 
Peace of mind is the greatest value for many families.  They can check daily, or even hourly, that people are living normally, fitting in with their own daily routines, from anywhere in the world.  They can be alerted if there are lots of changes that may give them concern.  Alerts can also be directed to 24/7 response centres.  They can confirm that domiciliary carers have provided drinks and meals at the time they were ordered.
 
Families spread over the world can be part of an older person’s care plan.  Social contact with the older person can be more directed and appear less intrusive.  You can ask if somebody had a nice day in the garden or slept well, in the full knowledge of activity in the kitchen at that time of day. 
 
Caring for older people is very time consuming and costly if professionals are used.  However, there are probably four times as many unpaid carers providing care on a voluntary basis.  There are also examples of people who have to give up their jobs in order to care for their vulnerable parents, this represents a loss to the local economy and taxable income.  Regular checks with the Kemuri well-being monitor could allow people to have more time for paid employment.  
Current and planned activity: 
After the completion of the Proof of Concept, Kemuri is now scaling up manufacture for B2B sales through accredited telecare service companies.  The first is Welbeing (Wealden and Eastbourne Lifeline), which has the telecare service contract for Staffordshire.  They have the capacity to install Kemuri anywhere in the Region.  Welbeing provides telecare for statutory bodies and self-funders.  The latter are increasing in number as many local authorities are reducing budgets for adult social care.
 
We are building batches of 100 units.  Many of the first batches can be made available for trials by health and social care clients.  Trials are necessary to collect evidence that preventive wellbeing monitoring does actually improve health outcomes and reduce time until discharge.   
What is the intellectual property status of your innovation?:
Kemuri has patents pending; GB1417259.7, effective date of 30 September 2014 and PCT/GB2015/000275, International Filing Date of 30 September 2015. 
 
Note that the patent applies to more devices than a power socket.  It covers the internal electronics and components, which could be incorporated into any equipment consuming significant amounts of power. 
 
Kemuri and KemuriSense are registered trademarks.  
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
2 years
Ease of scalability: 
2
Regulatory Approvals:
The product has been prototyped and progressing through the Certification process. EMC compliance has been achieved and final Safety report for CE certification is expected in Feb 2016. 
 
It is not a medical device since it only measures ambient conditions.
Regional Scalability:
The production of smart power sockets is scalable from batches of 100 to 1000 per month in the production facilities in Woking.  Larger volumes could be obtained by second sourcing the manufacturer in the UK or overseas.
 
The Web technology is cloud-based and can be very rapidly scaled by commissioning more servers and storage at very short notice. 
 
The installation can be performed by our telecare service partner, Welbeing.  They are a growing company with over 60,000 service users in NHS Trusts, Social Services, sheltered housing and care agencies throughout the UK, including the West Midlands.   They offer a nationwide telecare service with 24/7/365 monitoring facilities in a TSA accredited contact centre.  
 
Kemuri is building up the operations support as it is recruiting more engineering and IT staff.
Measures:
In co-operation with an academic research partner, we expect to plan the following measures:
 
Quality
  • Continuous reliable operation
  • Avoidance of false alerts
  • Recognising unattended falls, strokes or other episodes that result in a carer taking action that saved time and cost for medical intervention.
  • Peace of mind achieved for families and carers
  • Identifying trends that indicate the risk of hypothermia, dehydration and malnutrition.
  • Identifying activity at unusual times of day that lead to helpful family or medical intervention
 
Safety
  • Electrical safety of products after installation in kitchens.
  • Security of personal data and avoidance of data loss.
 
Cost
  • The cost target is £2500 for each older person involved in the trial.  This would include the costs of selection, installation, monitoring, service support and questioning families throughout the trial.  Note that this includes detailed data analysis, medical services, the final report and communications.
  • The final operational cost target is £2 per day, to include installation, Web services, smartphone apps, technical support and reseller profit margin.   
 
People
The target group for research is a cohort that has these attributes:
  • Reject pendant alarms
  • Deny declining capacity
  • Want to live independently
  • Show symptoms of dementia
  • Need daily monitoring
A percentage will be used as a control group who are not included in the Trial. Finding these people may require the inspection of medical and social care records, which will need approval by an Ethics Committee.  
Adoption target:
Assuming that there are 500,000 unused pendants in the UK, there are approximately 30,000 candidates for Kemuri wellbeing monitoring in a West Midlands population of 5 million.   
 
The reasonable viable number is 300 (1% of WM total) – with an expectation to grow to 12,000 service users within 5 years (20% of WM total).  
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Innovation 'Elevator Pitch':
The Assure helps people to keep their independent lifestyle in the knowledge that if they need help/assistance the people they choose to respond, be they family or friends will be alerted quickly.  It can also support hospital discharge & reablement.
Overview of Innovation:
The Assure personal monitoring & alert system gives people confidence that if anything happens to them, help is at hand.
 
Designed for reliability of service, simplicity of use & elegance of design, The Assure personal alarm system is easy to set up & users can access the Acticheck online dashboard via their computer, tablet or smartphone to easily manage their settings.  They can also give their family & friends peace of mind by giving them permission to see their information & activity online should they choose to.
 
The ‘fit & forget’ monitoring wristband, designed to be worn 24/7, is made from medical-grade silicone for a comfortable fit & can be adjusted to any wrist-size.  With a contemporary lightweight design that is comfortable to wear, water-resistant & has a long battery life, wearers do not feel stigmatised.
 
The Assure system links the wristband to the base unit that is connected via the internet to the Cloud-based Acticheck server.  It passes messages between the user’s wristband & the Cloud, & to their personal responder network when needed.
 
With four ways of triggering an alert & two chances to cancel the alert, The Assure covers a wide range of eventualities giving complete home & garden coverage. 
  • SOS alert button: call for help with a simple squeeze of the wristband
  • Continuous fall monitoring: The Assure wristband listens for an unusual impact followed by a lack of movement that could be a severe fall
  • Wellness checks at a time to suit:  set The Assure to buzz once or more a day to check that the user is well, press a single button to say they are OK
  • Daily emails: for those who want confirmation users are up & active
  • End-to-end checks: the system updates its status several times an hour giving confidence that the system is working & also checks the wristband is being worn so that the user is protected
  • An online dashboard: so the chosen responders can see the user’s activity in real time if permission is given to them 
When an alert is initiated The Assure system gives two chances for it to be cancelled by the user, if both are not responded to The Assure will start to call the people in their personal responder network one-by-one with an automated message until one accepts the alert.  They will then be told, emailed &/or texted the user’s location & confidential access instructions, along with any first responder instructions such as vital medication requirements.

For more information visit https://www.acticheck.com
https://youtu.be/ZUWpme1wKkk​
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 / Digital health
Benefit to NHS:
National data shows that the number of hospital admissions amongst older people is increasing. Over the last 10 years hospital discharges (and therefore admissions) for those over 75 have been rising at a much faster rate than ageing trends in the population; almost four times faster (38% compared to 10%).
 
The growth in hospital readmissions has been higher still, up by 86% for those over 75. This national picture is supported by the results of research by Royal Voluntary Service: of 401 people over 75 who had been in hospital within the last 5 years, 13% had been readmitted within three months. (source: http://www.royalvoluntaryservice.org.uk/Uploads/Documents/Reports%20and%20Reviews/Going_home_alone.pdf)
 
The Assure helps people with long-term health and care needs to stay out of hospital or residential care for longer, thereby reducing costs to the NHS and social care by avoiding the need for more costly interventions whilst maximising outcomes for patients and service users.
 
The demographic and budgetary pressures mean that the health service has to find new and better ways to ensure that high quality services continue to be provided. Remote telemonitoring is a prime example of this innovation.
 
The Assure supports people to continue to live independently in their own homes with the peace of mind that an intervention can be made should they require help or assistance.  With earlier interventions helping prevent deterioration it can help to reduce unnecessary hospital admissions, giving confidence and reassurance to users, carers and families.
  • 1/3 of all UK households are older households*
  • 3.5 million 65+ live alone. This is 36% of all people aged 65+ in GB*
  • 2 million people over 75 live alone*
  • There are now 11.6 million people aged 65 or over in the UK*
  • Falls are the largest cause of emergency hospital admissions for older people, and significantly impact on long term outcomes, e.g. being a major precipitant of people moving from their own home to long-term nursing or residential care*
  • Falls account for up to 40% of ambulance call-outs to homes for people aged 65+,153 costing £115 per callout*
  • 38% of delayed transfers of care within participating organisations were on care of older people wards* 
* - taken from Age UK, Later Life in the United Kingdom, June 2016

http://www.ageuk.org.uk/Documents/EN-GB/Factsheets/Later_Life_UK_factsheet.pdf?dtrk=true
 
Benefit to WM population:
Within the last ten years’ hospital admissions for those over 75 have been rising at an even faster rate than ageing trends in the population: almost four times faster. Worryingly the growth in hospital readmissions has been higher still, up by 86 per cent for those over 75.

By supporting people effectively in the community, The Assure helps those with long-term health and care needs to stay out of hospital or residential care, thereby reducing costs to the NHS and social care by avoiding the need for more costly interventions whilst maximising outcomes for patients and service users.

Although technology alone is not the complete answer, it can make an enormous contribution to independent living and quality of life for people who choose to remain living in their own home The Assure helps to manage risk and support continued independence.
Current and planned activity: 
Future developments: Go Anywhere
We are already well on the path to developing a mobile app.  This links the wristband to the wearer’s smartphone which provides mobile data and location.  The current smartband has been designed to be upgraded to link to a smartphone.
 
Procurement / Adoption: -  We would like to see greater regional awareness and adoption of The Assure, working in partnership with providers to focus on individual patient outcomes and to effectively embed technology enabled care to deliver services that are truly person centred. 
What is the intellectual property status of your innovation?:
Patent granted. 
Fully CE Certified.
EN 300 220-2 v2.41
EN 301 489-1
EN 60950-1:2006 + A2: 2013
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
3
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Innovation 'Elevator Pitch':
We believe that without massive intrusion, or changing the way our loved ones want to live life, the 3rings platform can harness the power of the Internet of Things to provide protection and safety to our ageing loved ones.
Overview of Innovation:
A ‘Thing’ is a small device or sensor that sends information over the internet. 3rings works with a range of Things (sensors) that passively monitor a person’s daily routine, from a simple plug through to the Amazon Echo which can be used to create a unique safety net of care. Start off with a simple plug that lets you know the person you care for is up and about and add new Things as needed.
 
 
With 3rings it’s simple to include family, friends and other carers in your circle of trust. 3rings gives daily reassurance by sending emails and messages to the 3rings App as well as timely alerts by text or calls when changes in behaviour could be cause for concern.
 
The 3rings Portal allows you to stay informed and up-to-date regarding the person you care for. The connected Things or 3rings Plug enabled appliance lets the 3rings Platform know each time activity is sensed and current information is displayed so you know that things are OK. If no signal has been received you will be alerted.

 The 3rings Plug turns an existing appliance such as a kettle, microwave or TV into a simple sensor. You can set flexible rules that suit the person you care for, for example “I expect mom to make a cup of tea between 9 and 11 each morning”.  Your 3rings Plug will alert you if that cup of tea isn’t made, directly to your smartphone, tablet or computer. The 3rings Plug lets your 3rings Portal know each time a connected appliance is turned on/off via its in-built ‘mobile phone’. The 3rings Portal listens for the message, which it expects between the times that you have set to let you know the person you care for is active and OK, or if no signal has been received you will be alerted.
 
A range of Things is available that can let you know, for example, if the person you care for is living in an environment which is too cold or equally too hot, motion sensors can be placed around the home to give a clear picture of activity, supporting healthcare professionals to plan the right level of care that may be required. Activity sensors allow for the monitoring of fridge and microwave doors, if no activity is seen on the fridge, microwave or the food cupboard it may suggest that the person you care for is not eating properly enabling early intervention and sensors can also be attached to doors to detect activity.
 
The 3rings Cloud Portal lets you decide when to check the 3rings Things and Plug for activity and who should be notified for alerts.
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 / Person centred care
Benefit to NHS:
Despite considerable efforts to plan hospital discharges well, emergency readmissions within 28 days of leaving hospital run at around 15% for people aged over 65 in England and overall numbers are rising.   Improving support for older people at home, either to prevent hospital admission (or readmission) or to facilitate discharge when they are ready to leave hospital – is key to patient flow. (Source: http://bit.ly/2tN2KIA)
 
There can be limited understanding of what happens over the entirety of the period of time between the original spell in hospital the 28 or less days in the community. Monitoring patients effectively after hospital discharge can aid healthcare teams to recognise early warning signs and intervene before an emergency readmission becomes necessary.
 
Using 3rings technology, patients who have been discharged can be monitored more closely and interventions put in place at an earlier stage to help to prevent readmission. 3rings sensors are battery-powered, and can be mounted anywhere you'd like to know what's going on.
 
The information delivered by the sensors provides valuable information for care professionals to assess a person’s care needs. With tools available such as our PAL (Pattern of Active Life) you can easily understand what is happening when, helping you to plan the best way to care.
 
Sensors connect wirelessly to a 3rings Hub (a small box with one or two aerials) installed in the home, that work with or without an existing internet connection. The 3rings sensors are powered by small ‘coin’ batteries with a normal life of around 12 months. Up to 50 3rings sensors can be connected to a single hub, so they can work equally well in a community housing scheme or an individual's home.
 
All 3rings sensors can work individually or in groups of the same or different types to allow you to build the safety net of care that is needed to support a person in their own home.
 
As the number of people aged 60 and over is projected to increase from 14.9m in 2014 to 21.9m by 2039, and as part of this growth, the number of over-85s is estimated to more than double from 1.5 million in 2014 to 3.6 million by 2039 (source: http://bit.ly/1kXa3DA) the provision of more support for older patients returning home safely after a hospital stay will reduce the risk of readmission to hospital.
 
 
3rings technology can also be used to support hospital discharge for a number of conditions, for example stroke and hip/knee replacement.
Benefit to WM population:
Hospitals with higher than expected readmission rates are subject to a financial penalty.  Factors outside the hospital’s control include patients’ age, gender, race, number of previous admissions, clinical conditions, discharge destination, access to primary care, and length of stay (Billings et al., 2006; Howell et al., 2009; Lyratzopoulos et al., 2005; Weinberger et al., 1996; Holland et al., 2005; Camberg et al., 1997). (Source: http://bit.ly/2tmsEQ4)
 
3rings technology can help the region’s NHS in avoiding, or reducing to a minimum, readmission following discharge from hospital for certain types of patient co-horts.
 
If a person does not recover well, it is more likely that they will require hospital treatment again within the 30 days following their previous admission, thus, readmissions are widely used as an indicator of the success of healthcare in helping people to recover.
 
In the West Midlands (2010/11) there were 497,022 observed hospital discharges with 61,129 observed readmissions (source: https://indicators.hscic.gov.uk/webview/)
 
There can be limited understanding of what happens over the entirety of the period of time between the original spell in hospital the 28 or less days in the community. Monitoring patients effectively after hospital discharge can aid healthcare teams to recognise early warning signs and intervene before an emergency readmission becomes necessary.
 
Using 3rings technology, patients who have been discharged can be monitored more closely and interventions put in place at an earlier stage to help to prevent readmission. 3rings sensors are battery-powered, and can be mounted anywhere you'd like to know what's going on.
Current and planned activity: 
We would like to see greater regional awareness of technology to support hospital discharge and would like to work with regional health providers to focus on supporting patients in their home to reduce readmission rates and to use technology enabled care to deliver services that are truly person centred. 
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
2
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