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Innovation 'Elevator Pitch':
OsCare Sono allows early assessment of Osteoporosis risk in an out of hospital environment. It is a low cost device, can be used by any healthcare professional, emits no radiation, proven technology & vastly improved patient outcomes and cost savings
Overview of Innovation:
The OsCare Sono™ measures ultrasound wave propagation longitudinally in the radial bone. In comparison to other ultrasound bone sonometers, the OsCare Sono™ has a lower ultrasound frequency, of about 200 kHz. The low frequency ultrasound travels deeper in to the bone tissue providing better correlation with cortical thickness and its patented transducers and algorithms help to eliminate the effect of soft tissue. Oscare Sono also uses the radial bone which is easier to access and more sensitive to osteoporotic changes.

The device compares the measurement result to the available reference population group data and calculates the Z- and T-Score values, indicating if the patient has an increased risk of osteoporosis and future fractures.
OsCare Sono™ measurement results help to recognize those individuals who are at higher risk for osteoporosis and potentially further investigations such as a DEXA.
Osteoporosis is an increasingly prevalent skeletal disease characterized by diminished bone strength and increased risk of fracture which costs the NHS £2.9bn annually.

‘The International Society of Clinical Densitometry (ISCD), the International Osteoporosis Foundation (IOF) and the European Society for Clinical and Economical Aspects of Osteoporosis and Osteoarthritis (ESCEO) describe in their position statements that although DXA (dual X-ray absorptiometry) and the femoral neck are the reference technology and site for diagnosing osteoporosis, other techniques such as quantitative ultrasound (QUS) can be used in clinical practice to identify patients at high or low risk of having osteoporosis. The Foundation and Societies stated that QUS is proven to predict osteoporotic fractures similarly to central DXA.’

Oscare Sono is highly portable and can be set up within minutes in an environment suitable for assessing patients.
No ionising radiation is emitted and therefore there is no restriction on location or IMIR regulations.

Early assessment of patients at risk of Osteoporosis in the NICE pathway will identify patients at risk of osteoporosis and allow early intervention.
Oscare will enable large scale assessment of patients at risk of Osteoporosis, facilitate early intervention and improve patient outcomes.
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 Content1
Innovation 'Elevator Pitch':
The National Osteoporosis Society has pioneered a package of support for the commissioning and improvement of secondary fracture prevention services.  This can save the average CCG 1.7m over 5 years.
 
Overview of Innovation:
The Fracture Liaison Service (FLS) care model enables secondary fracture prevention through identification of low trauma or fragility fractures by means of dedicated case finding, with assessment and treatment of osteoporosis where appropriate.  This model has been replicated across the UK since April 2015 with the support and expertise of the National Osteoporosis Society.  A team of specialist development managers with clinical and commissioning experience is currently working with 167 sites (to date) to support new service development (50), or quality improvement of existing services (78).  Preliminary results from an analysis of the effectiveness of these services in preventing secondary fractures indicate a significant positive difference between sites with an FLS, and those without.

Operating in a tough economic climate with health budgets tightly constrained, investment in new services must demonstrate both a solid evidence-base and a strong business case.  There is strong evidence that investment in FLS results in improved quality of care and financial savings in health and social care.  The NOS has produced a suite of online resources to support FLS development and improvement.  A comprehensive FLS Implementation Toolkit supports providers and payers in the commissioning process and is provided free of charge. [1] Users can create a compelling, evidence based business case without the need for advanced skills in costing, modelling or other health economic techniques.  The SDT is also available at any stage throughout the implementation process to support clinical pathway or business case development.  Advice is available regarding outcome measures and performance indicators, as well as effective data collection for service evaluation.  This service is provided free of charge. 

To date, 9 new FLS have been commissioned (8 new services and 1 augmented service).  These new services represent FLS provision to an additional cumulative population of nearly three million people, which could prevent more than 1000 hip fractures over 5 years.  This in turn represents gross savings across health, social care, and community services of £17.3m (service costs typically run at less than 40% of the gross benefit).
 
[1] The Implementation Toolkit https://www.nos.org.uk/health-professionals
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Wealth creation / Innovation and adoption / Person centred care
Benefit to NHS:
The aim of the National Osteoporosis Society (NOS) is a future without fragility fractures.   Fragility fractures are common: 1 in 2 women and 1 in 5 men break a bone after the age of 50.[i]  People who have had one fracture are at greater risk of sustaining another (i.e. a secondary fracture).  There is strong evidence that investment in Fracture Liaison Services (FLS) results in improved quality of care and financial savings for the whole associated health economy.  
As highlighted earlier, to date, nine new FLS have been commissioned nationally (eight new services and one augmented service), with the support of NOS project management.  These new services represent FLS provision to an additional cumulative population of nearly three million people, which could prevent more than 1000 hip fractures over five years.  This in turn represents gross savings across health, social care, and community services of £17.3m (service costs typically run at less than 40% of the gross benefit).
 
[i] Van Staa TP, Dennison EM, Leufkens HG, Cooper C. Epidemiology of fractures in England and Wales, Bone 2001; 29 (6):517-522.
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
As part of the FLS Implementation Toolkit[i], the NOS has developed a financial model (the FLS Benefits Calculator) which demonstrates potential future fracture reduction and cost savings for any given population.  Taking an exemplar from the West Midlands: If Coventry and Rugby CCG were to commission a FLS, the Benefits Calculator indicates that 345 fractures would be prevented over 5 years of operation of the service.  Of these, 145 are hip fractures, which at a conservative estimate, cost the health economy around £17,000 each.  
The calculation shows a total gross saving[ii] of £2,909,841 - £1,470,702 in acute care, £1,362,565 in social care and £76,574 in community and primary care.
 
[ii] We estimate the cost of the service to be approximately 37% of the gross benefit
Current and planned activity: 
The NOS is currently providing bespoke project management support to 168 sites across the UK, including 15 sites in the West Midlands area, looking to set up or improve an FLS:  
  1. Facilitation of engagement with stakeholders to generate commitment to FLS.
  2. Assistance to stakeholders from inception to launch of FLS, including development of the economic and business case; service specification; and resource and capacity planning.
  3. Assistance with recruitment and training of the fracture liaison nurse (FLN). [i]
  4. Input to enable the development of an FLS to meet the UK FLS Clinical Standards. [ii]
  5. Help to establish relevant protocols/care pathways for the service.
  6. Work with commissioners to ensure services are sustained.
  7. Assistance re. data collection and methods of analysis, reporting and evaluation.
 
[i] FLS Fracture Prevention Practitioner Training https://www.nos.org.uk/health-professionals/elearning
What is the intellectual property status of your innovation?:
The Implementation Toolkit is the property of the National Osteoporosis Society, but is available free of charge.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
3 years +
Ease of scalability: 
Simple
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