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Innovation 'Elevator Pitch':
BVI technology is an innovative and easy to use, mHealth service to determine the percentage and distribution of visceral fat using a mobile device (tablet) or a smart phone. 
Overview of Innovation:
The Body Volume Indicator (BVI) is a new measurement for healthcare and obesity. After eight years of successful and innovative validation from scientific collaborators around the world, BVI is now undergoing final testing prior to a full launch later in 2017.

Using 3D technology, BVI calculates risk factors associated with a person's body shape, by measuring weight and body fat distribution, with particular focus on the abdomen; the area associated with the greatest risk.

BVI is designed to be a long-term addition to the Body Mass Index (BMI); the current recognised standard for measurement of obesity. The intention is for the Body Volume Indicator to become a Body Volume Index by 2020, by which time sufficient data will have been collected globally. Using smartphone technology, BVI data can now be collected anywhere with web or internet access.

Body Volume, as an indicator of health, offers a potential long-term solution as a measure of individual health risk. 

BVI was developed in the West Midlands and collaborators have included Heartlands Hospital, Aston University, Mayo Clinic and the Medical Research Council. The application was patented in the US in 2012 and throughout Europe in 2015.


 
Current Status
In 2012 Select Research obtained exclusive use of the largest and most comprehensive collection of Body Composition Data (BCD) of visceral fat data from MRI scans in the world. This has been used to develop an App which will be used to scan/photograph lightly clothed patients and then comparing their BCD database to predict their body fat and visceral fat.
 
Further research and development is being undertaken with our current BVI (Body Volume Index) tool, to provide additional evidence and to validate the efficacy, and appropriateness of this BVI application in real-life environments. Through a ‘real-life’ project work with WMAHSN will provide clinical validation for the underpinning methodology, thus making potential users (Clinicians, patients & public) aware of the benefits (social and economic) of utilising the service.
 
Thus our current BVI application is to be incorporated into the existing patient pathways currently used by Health Exchange Health Trainers in the West Midlands.
 
NB: The application has been patented in the US in 2012 and throughout Europe in 2015 and covers all measurements of part body volume for healthcare from a 3D scan. Body fat is a part volume of the human body.

Please assist us with our 5 min Survey http://BVISurvey.SSIsurveys.com​ 
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 / Advanced diagnostics, genomics and precision medicine / Wellness and prevention of illness / Wealth creation / Clinical trials and evidence / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
Visceral fat is body fat stored within the abdominal cavity around a number of important internal organs such as the liver, pancreas, and intestines often referred to as 'active fat'. This type of fat plays a potentially dangerous role in affecting how our hormones function.

Higher amounts of visceral fat are associated with increased risks of a number of health problems.  NHS healthcare costs attributed to obesity are £5.1b p.a. and set to rise by £7.1b by 2030; The cost to the UK economy is £27b p.a. Benefits through effective intervention based on accurate visceral body fat determinations are complex but undoubtedly would lead to a reduction in the burden of obesity (diabetes, heart disease, stroke, and certain cancers), by a reduction in years lost to premature mortality and disability (DALY). NICE suggests reducing obesity of 1% would save the “NHS and local authorities around £97 million per year.” Diabetes costs the NHS over £1.5m an hour or 10% of the NHS budget for England and Wales. 

The lifetime benefits of weight loss - direct £297 and indirect £2068 estimates based on 50% compliance and 25% success.  A saving to the NHS of between £1.2m and £6.9m, and the economy of between £135m and £1620m.

Select’s BVI tool App predicts the early identification body and visceral fat & estimates via a quick, simple and non-invasive scan which provides an insight and benchmark for clinicians and their patients; just by taking two photographs of a patient. 

Therefore BVI significantly contributes to the monitoring, intervention and control processes for clinicians and other health professional to apply, so that they can tackle and halt the potential for escalation into Diabetes and CHD etc.


Particular value for patients will be that they can monitor their own progress and to improvement at home. Through recognition of the scale of their own obesity and particularly any high levels of visceral fat. The early identification of visceral fat, through this simple, quick and accurate method of measuring obesity will thus take a large step towards achieving considerable saving to the NHS and the UK economy.

The proposal for delivery of BVI is under discussion with BVI data (including BMI, Waist Circumference, and Waist to Hip Ratio automatically) stored for tracking purposes on patient records via the N3 spine. Automatic data collection through BVI of current methods saves time, money and provides new informative data on body composition for future research.
Online Discussion Rating
5.50 (2 ratings)
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
Clinical Outcomes & Economic
In the West Midlands 65.7 per cent of people are carrying excess weight, along with 65.6 per cent of people in the East Midlands. Obesity costs the UK economy exceed £3 billion per year. In Birmingham, over 25% of the population are obese - the third highest rate in the UK. The high prevalence of obesity in adults within England show that national averages of over 40% of males overweight and more than 20% obese in the 16-75 year age range, while in women the averages are lower for the overweight classification but higher for obesity.
 
Nationally GPs make 97,000 annual referrals to weight watching programmes (WWP) and costs will reach £15.6m p.a. in 2017. A saving of £48.5 per patient might be made using the BVI App. With as low as 10% uptake, £0.5m could be saved, rising to £2.8m with a 60% uptake. Better management of weight issues with patients will have significant cost savings within the West Midlands.
 
This tool will support early detection of visceral fat and therefore allow a much more preventative and timely approach to supporting West Midlands Patients to make positive lifestyle change.
 
Environmental
The BVI App offers considerable environmental benefits in reducing the number of visits (road trips) to a surgery and specialist clinics. It will also allow people within remote and rural locations to engage in such activities.
 
Research
Additional R&D is being undertaken with the WMAHSN, to further ‘validate’ the efficacy, appropriateness and validity of the BVI application in real-life environments using the BVI App, which is being incorporated into the existing patient pathways.
 
Commercially
The adoption of this technology within the West Midlands and UK will also allow our company to grow and develop, not only with increasing its functions and capabilities but also in marketing this to a worldwide healthcare organisations and individuals as obesity is a major developed countries epidemic. 
 
There is also interest from other commercial organisations involved in weight management and associated healthcare which will further extent this products role and integration with people taking charge of their well being.

Trials
The BVI tool will be tested in 3 locations in the West Midlands with patients and GP Practices in Birmingham, Dudley and Solihull. Analysis of weight loss achieved over a period will be monitored.

Please assist us with our 5 min Survey http://BVISurvey.SSIsurveys.com​ 
Current and planned activity: 
Current BVI application is undergoing R&D and incorporation into existing patient pathways within the West Midlands via;
  • Patient Engagement - Face to face consultation, scanning of approximately 1000+ patients
  • Clinical Benefits - Analysis and monitoring of weight loss achieved over a defined period. Developing delivery protocols
  • Dissemination - Facilitation of BVI tool awareness raising sessions with Key Public Health and NHS Management, Clinical Teams and frontline staff
  • Training - BVI tool training to specialist clinical teams (Primary & Acute), ensuring correct use of the tool and providing feedback for use with patients
  • Data analysis – Verification/validation of App algorithms
  • Data gathering - Provision of clinically requested data – Core data profiling to gauge health outcomes and patient benefits. Establishing minimum data requirements
Required
  • Evaluation & Trials - Seeking trial interests
  • Adoption – Looking for discussions with CCG’s, Healthcare and Council Health Prevention teams   
What is the intellectual property status of your innovation?:
BVI has both BVI Patents and Trademarks approved.
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
Simple
Regional Scalability:
We have not as yet implemented at scale within the WM region or elsewhere. The BVI product will be launched in the US market in March 2017 and Select Research Ltd are currently in discussions with Health Exchange and NHS Heartlands Hospital (who are collaborators on BVI development) for a possible follow on wider trial across the region for 2017.
Measures:
When the BVI app has been fully completed in terms of it’s scalability for widespread use, the trial results have been published and the launch takes place in April 2017, the success criteria will be determined by the number of users and the take up when the product is available and being used by customers.
 
Development is currently ongoing with scaling of the technical infrastructure for release on all accepted and recognised technical platforms (e.g. Google Play. App Store) in late April 2017. The success criteria will then become easily measurable by virtue of the volume of downloads achieved after launch.
Adoption target:
These will be dependent upon the outcome of the discussions with NHS Heartlands Hospital and Health Exchange as to a future extended trial.
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Innovation 'Elevator Pitch':
BVI measures body proportions and fat distribution avoiding the need for costly techniques such as MRI and CT scanning for visceral fat measurements. Funding is being sought to undertake a region wide trial prior to NHS national deployment.
Overview of Innovation:
For over 20 years, Select Research have been pioneers in 3D measurement of the human body and over the last 10 years have developed a novel method of measuring human body volume in 3D, derived from 2D images. Released initially as a Body Volume 'Indicator' or BVI, the aim, once enough data has been assembled worldwide, is for the 'indicator' to become a Body Volume 'Index' by the year 2020. The BVI technology is patented in Europe and the US and is currently being used in professional healthcare, fitness, academic research on an iOS platform with an android version scheduled to be completed by April 2018; well in advance of the requested April 2018 date for potential national deployment under the ITP award, where BVI has been shortlisted by NHS England.
The Body Volume Indicator (BVI), unlike BMI, creates a 3D image of a patient’s body, enabling body proportions and fat distribution to be accurately measured for each patient, avoiding the need for costly, intrusive and time-consuming techniques such as MRI and CT scanning for visceral fat measurements. Furthermore, this provides professionals with a more accurate measurement of patient health, which in turns leads to improved diagnosis and therefore better clinical outcomes. This produces a patient specific BVI number, developed over 10 years by Mayo Clinic, which ranges from 0-20 and is based upon the ratio of abdominal volume to total volume, relative to that person’s age, gender and ethnicity. BVI will enable NHS professionals to identify where there is increased risk to patient health, wherever BMI is currently used throughout primary and secondary care with patients.
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 / Digital health
Benefit to NHS:
Obesity worldwide is measured today using the Body Mass Index (BMI) tool as the global health indicator for risk. Invented in 1824, the BMI tool uses just height and weight, and therefore doesn't differentiate between people with the same BMI reading who have different body shapes and weight distribution, such as people with athletic build or those with more abdominal volume. BMI was originally intended by the Belgium statistician, Adolphe Quetelet for general population measurement, so is not suitable for use anymore in the modern age where personalised medicine is the framework for healthcare delivery, and does not consider factors such as age, lifestyle or ethnicity. In addition, a recent study by J. Gómez-Ambrosi, et al found that BMI is miss-classifying up to 29% subjects with increased cardio metabolic risks, suggesting that the patient groups with the highest needs are being failed, treatment is being delayed and a significant unnecessary cost is burdening the NHS which could be avoided if body volume distribution was accurately measured. The NHS currently spend £12.4 nationally on data collection. BMI is used today in healthcare not out of choice, but by default, as no viable alternative has been available; BVI now provides the NHS with a unique opportunity to innovate and change.
The Body Volume Indicator (BVI), unlike BMI, creates a 3D image of a patient’s body, enabling body proportions and fat distribution to be accurately measured for each patient, avoiding the need for costly, intrusive and time-consuming techniques such as MRI and CT scanning for visceral fat measurements. Furthermore, this provides professionals with a more accurate measurement of patient health, which in turns leads to improved diagnosis and therefore better clinical outcomes. This produces a patient specific BVI number, developed over 10 years by Mayo Clinic, which ranges from 0-20 and is based upon the ratio of abdominal volume to total volume, relative to that person’s age, gender and ethnicity. BVI will enable NHS professionals to identify where there is increased risk to patient health, wherever BMI is currently used throughout primary and secondary care with patients.
BVI Pro has successfully passed the review stages of the NHS ITP programme and is now with Simon Stevens, CEO of NHS England for review. Confirmation is expected in February 2018.
 
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
In the West Midlands almost seven out of every 10 people are overweight or obese, whilst 81 per cent are unaware about the link with cancer. Health chiefs have warned Birmingham could be forced to spend more than £2 billion EVERY YEAR to tackle a growing obesity crisis unless urgent action is taken.
Dr Andrew Coward, chairman of Birmingham’s Childhood Obesity Steering Group, said the link between obesity and cancer is now as serious as the cancer and smoking links of the past. The GP made the striking comparison as it emerged obesity will cost the city £2.6 billion a year by 2050 if something isn’t done to tackle the problem. In the West Midlands almost seven out of every 10 people are overweight or obese, whilst 81 per cent are unaware about the link with cancer.
The easy use of the BVI Pro app means patients can conveniently measure themselves at home or in as part of a health check at a GP surgery, negating the need for invasive manual measurements to be taken.. With NHS choices currently receiving 1.5 million visitors a day, BVI Pro could be incorporated, leading to more patients able to measure their BVI, reducing time spent with healthcare professionals; enabling patients to take a more active role in managing their healthcare.

BVI Pro could provide part of an online NHS system, through which patients could access other healthcare apps, health records, and book appointments, providing patients with convenient access to their BVI data, using the unique Patient NHS Number. This would produce a more comprehensive NHS service on obesity data for policy and prevention programmes. 
The app creates a 3D patient avatar, enabling parametric measurements. Patients have been shown to be more motivated to treatment plans when presented with their own ‘avatar’ (Boelcart et al. 2008.) Leading to an improvement in lifestyle management, resulting in a reduction in cost to the NHS. Once two patient images are captured, BVI and fat distribution can be measured in less than 30 seconds. These results can be integrated with medical records, via the BT enabled N3 ‘spine’ network, providing doctors with a holistic and unparalleled databank for patient health.


 
Current and planned activity: 
BVI has been through 4 stages of the NHS England Innovation Technology Payment programme and is in review with Simon Stevens with a view to being phased in, starting with one area of the country before rolling out.
We are looking at fast track access to the NHS through The Academic Health Science Network and have applied for a H2020 grant to roll out BVI across Europe. AHSN have recommended BVI for deployment. We are awaiting confirmation. See attachments.
Most of the validations have been undertaken by The Mayo Clinic and the University of Westminster. We are requiring more data on a wider range of ethnic origins and the West Midlands is a perfect place to start as it has such a diverse population.

 
What is the intellectual property status of your innovation?:
The BVI technology is patented in Europe (EP1993443 B1) and the US (US8374671 B2) and is currently being used in professional healthcare, fitness, academic research on an iOS platform with an android version scheduled to be completed by January 2018.
 
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
Simple
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Innovation 'Elevator Pitch':
A platform combining the best of WhatsApp, LinkedIn and Slack with an innovative, compliant architecture to provide a universal data and messaging layer for health care.
Overview of Innovation:
Need

Out-dated and overly bureaucratic health communications are a source of enormous inefficiency and frustration for doctors, nurses and patients. 600,000 clinicians in the UK alone have turned to consumer messaging solutions like WhatsApp to solve the problem. But these solutions have been ruled inappropriate for use in health use under GDPR and sparked 1000 NHS disciplinary actions to date.

Innovation

1. Unique “serverless” network architecture scales users exponentially with linearly scaling costs.
2. Free and ethical: Core functions are free for everyone, with no need to monetise sensitive data to pay for servers
3. Compliant by design: GDPR & health privacy standards built in to the architecture itself. All data stored in phone.
4. Super-simple user interface is easy to adopt and easy to use, enabling a bottom-up approach to market.

Market

Hospify is a market-dominance play, designed to capture the majority of healthcare professionals in the UK (2.9m), EU (23m) & South America. Most users will join at least two Hubs (employer Hub, union Hub, specialism Hub, pharmaco Hub, insurance Hub).

Approach
  • Simplicity and trust of core messaging drives bottom-up adoption by nurses and care workers, led through employer and union hubs.
  • Broadcast messaging function enables replacement of both hospital pagers and costly SMS systems, driving adoption employers & CCGs.
  • Platform is built out using APIs to provide a messaging layer for other, more specialised workflow and data-driven services, allowing them to function within an ecosystem.
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: 
Wellness and prevention of illness / Clinical trials and evidence / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
A net budget impact of Hospify for the whole of the NHS community staff population, with a projected 51.2% uptake, has been calculated to be £166m p.a. by 2023/4. Please see the attached Budget Impact Model, constructed in collaboration with Kent Surrey Sussex AHSN, for methodology and more detailed analysis.
Initial Review Rating
4.20 (1 ratings)
Benefit to WM population:
An analysis of the impact on the WM population specifically has not yet been carried out, but the attached Budget Impact Model includes an analysis of the similarly sized Kent Surrey Sussex region, with 12,565 community healthcare staff. The impact on this regions was calculated as £10.48m p.a. by 2023/4. Again, please see the attached Budget Impact Model for more detail.
Current and planned activity: 
The free version of Hospify, available via the Apple and Android app stores, was released in February 2018 and now has around 5000 clinical users in more than 100 hospitals and clinics throughout the UK. 

The paid version of the platform, the Hospify Hub (https://hub.hospify.com) has been available as a live beta from April 2019 and is currently being trialled by around 20 heathcare organisations, including:
  • Birmingham Community NHS Trust
  • University Hospitals North Midland
  • Cambridge & Peterborough NHS Trust
  • Lincolnshire Community NHS Trust
  • Corby NHS Health Centre (Lakeside+)
  • The GP Service telehealth company 
  • Royal Blackburn
In addition, following two paid trials, we have an agreement in place with UNISON Health, the largest public sector health union in the country with around around 500,000 members, to begin selling Hospify to its 200+ branches once the release version of the platform goes live in September 2019.

We are also on the Kent Surrey Sussex AHSN digital health accelerator programme.
What is the intellectual property status of your innovation?:
Hospify Limited owns all IP in the Hospify platform. We have UK trademarks for name and logo in place, and EU, US and Colombian trademarks in process.
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
3 years +
Ease of scalability: 
Simple
Regional Scalability:
The primary region for the initial rollout of the Hospify Hub from September 2019 will be the West and North Midlands. Hospify works very closely with UNISON Regional Branch team based out of the UNISON office in Birmingham, which co-ordinates the union branches throughout this region.
 
From September Hospify will, with the active support of UNISON’s regional team, be selling the Hospify Hub to UNISON branches in the region and promoting the platform’s adoption among nurses and support staff who are also union members.
 
This will allow us to generate revenues while also building an active userbase in multiple hospitals in the region. Once we have identifiable user clusters, we will begin approaching the relevant hospital authorities, and encouraging them to approve Hospify for use at work by their clinical teams.
 
This approach has already proven to work at the Royal Stoke and Wye Valley, where the UNISON activity has led directly to constructive discussions with the hospital management.
Measures:
Healthcare staff currently use either bleeps or phones when it comes to communication, neither of which are efficient nor particularly effective in a complex, modern healthcare environment, or indirect instant messaging solutions such as SMS or WhatsApp, which are not legally compliant with patient safety and data protection rules.

Hospify is a platform designed to allow healthcare professionals and patients to collaborate and connect using instant and trusted communication across dispersed teams and extended clinical networks and in the process:
  • Produce both time and cost savings for staff
  • Cut through a layer of administration, improving efficiency
  • Reduce reliance on SMS
  • Provide security controls without fear of transgressing EU GDPR requirements
  • Offer an easy interface for staff and patient surveys
  • Capture and store data to help improve patient outcomes by cutting unnecessary appointments and reducing adverse events.
A Budget Impact Analysis was commissioned from Kent Surrey Sussex AHSN by Hospify in order to assess, from the perspective of the healthcare system, the impact of such a communication platform both broadly in terms of costs and benefits and in a second instance, specifies to select pilot sites in a community healthcare setting. As there is no quantified evidence of Hospify working in practice within a community environment, results from external research on instant messaging systems was collected and used to show the potential outcomes.

The NICE budget impact template was used as a starting point to create a model for instant messaging systems and modified accordingly to fit the Hospify analysis. The full study and health economic framework for future studies can be found in the attached Budget Impact Analysis document. Post-funding, Hospify intends to conduct its own quantified study using this framework. The planned pilot site is currently Frimley Park NHS Trust in Surrey, but it would be possible to relocate this to the West Midlands.
Adoption target:
Hospify aims to have 30% of the 131,072 NHS staff in the West Midlands to be using the free version of the app by the end of 2023, with a higher proportion of adoption (51%) among the region’s 18,879 community healthcare staff.
 
Around 10% of these would be anticipated to be using the Hospify desktop app, paid for via the Hospify Hub.
 
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