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Idea Description
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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)
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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 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':
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
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Innovation 'Elevator Pitch':
​​​This innovation empowers chemotherapy patients to undertake leucocyte monitoring in their own home. A small-scale trial has been completed showing positive feedback from patients, clinicians and carers potentially saving time, lives and money.
Overview of Innovation:
Dignio helps Health Providers (Hospitals, Clinics, Home Nursing etc) to achieve better outcomes for their patients and reduce the need for traditional face to face consultations and admissions via an integrated Telehealth, Remote Patient Monitoring, eCBT and ePROMs platform.
The side effects of chemotherapy seriously impact cancer patients’ daily lives. Managing them effectively is a long-time concern for doctors and clinicians.
Dignio Prevent is a secure, off-the-shelf, cloud based, device agnostic, Remote Patient Monitoring and Telehealth Solution. Dignio can be deployed very quickly with no input from, or impact on, current IT structures, software or licensing services. For chemotherapy patients Dignio can provide a complete remote patient vital signs monitoring solution which included an innovative, Bluetooth enabled, home based, white blood cell monitoring device.
By combining daily Remote Patient Monitoring of vital signs with CBT and frequent home based white blood cell measurement, healthcare providers can follow the patient in real-time and quickly catch any deterioration in the patient’s health and decrease the number of outpatient visits and reduce chance of hospital re-admission. 
Patients and their carers prefer to be at home, they feel more secure, more in control and less stressed. They begin to learn about and understand how they are responding to chemotherapy and begin to modify their behaviour and manage themselves.
This solution can be delivered on a "per patient per month" subscription basis.
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Mental Health: recovery, crisis and prevention / Long term conditions: a whole system, person-centred approach / Advanced diagnostics, genomics and precision medicine / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
Instances of Cancer are increasing and it is estimated that there will be 300,000 new diagnoses a year by 2020. Following publication of the Cancer Taskforce report in July 2015 there is pressure to drive down waiting times, increase diagnostic capacity and reduce outpatient visits.

Dignio Prevent can help healthcare providers to quickly catch any deterioration in a patient’s health helping to reduce treatment cost, decrease hospital readmission and improve patient experience and outcomes saving time, saving lives anbd saving money.
Online Discussion Rating
5.00 (1 ratings)
Initial Review Rating
4.60 (1 ratings)
Benefit to WM population:
Every year, around 31,300 people are diagnosed with cancer in the West Midlands.
The Children’s Cancer Trials Team at the University of Birmingham-based Cancer Research UK Clinical Trials Unit is the only one of its kind in the UK.
Birmingham is at the forefront of childhood cancer research with the team engaged in ground-breaking cancer research, testing and clinical trials across the UK and internationally.
By combining daily remote monitoring of both somatic vital signs and mental health combined with frequent white blood cell measurement at home we can follow the patient almost in real-time and quickly catch any deterioration in the patients’ physical and mental health and decrease the chance of hospital re-admission.
Current and planned activity: 
We are currently engaged with the NHS Test Bed program across a number of use cases in multiple NHS regions.
What is the intellectual property status of your innovation?:
Source code is protected, UI design protected, branding protected
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
Simple
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?
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