Brain in Hand: a personalised digital support system for organisation, anxiety, memory, and problem-solving (#3183)

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Idea Description
Supplementary Information
Innovation 'Elevator Pitch':
Brain in Hand helps individuals to achieve their goals, build confidence, and overcome problems more independently. Secure cloud-based software allows users to develop personal support plans accessible via mobile and stay connected to supporters.
Overview of Innovation:
Brain in Hand’s professional support system gives people easy access to personalised digital self-management tools and human support. Always available via mobile, it helps with remembering things, making decisions when anxious or confused, and coping with unexpected events. Suitable for people with a range of neurological and mental health difficulties, Brain in Hand improves confidence, enables people to cope with anxiety, and increases independence. It also reduces demand on carers and support services.
Whenever we provide support to an individual, we tailor it to their unique needs – and, just as importantly, their unique strengths and goals. Users receive personal planning sessions guiding them to consider what they want to achieve and how best to use the software to do it: using a person-centred approach, a Brain in Hand specialist helps the individual – and their supporters – to begin populating a secure website with their schedule, prompts and reminders for important tasks, and a bespoke stock of strategies in the user’s own words. This information is accessible via mobile software, providing the user with anytime-anywhere access to their most effective co-produced solutions and enabling them to solve problems independently while building healthy habits.
A typical selection of goals to which BiH users might relate strategies, broken down into simple steps, might include:
  • Emotions and feelings: managing anxiety
  • Travel: using public transport
  • Communication: expressing needs
  • Social: new people and new situations
  • Study or work skills: breaking down assignments
  • Organisation: knowing where to be and when
  • Independent living: managing housework, remembering to eat
  • Relationships: responding to others’ behaviour
The software also allows users to monitor their wellbeing and review successes, plus connect to existing supporters or on-demand remote support.
We can deliver all elements of the system to users or work with organisations to introduce BiH into services in the most appropriate way for them.
Completely configurable to each person’s needs, Brain in Hand is a complete support system linking the individual, their supporters or carers, and support teams together using a digital framework. It is digital self-management and human care. Our philosophy is not to try to cure conditions but to enable our users to manage difficulties and be the person they want to be; this leads to a reduction in required support over time, as seen in case studies.
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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Overview of Innovation:
Brain in Hand gives easy access to personalised support from your phone. Used by people with autism or mental health problems, the software is packed with features to help you remember activities, reduce anxiety and feel supported. It’s accompanied by a telephone mentor service to help you at times when you need extra support.  Together this helps you achieve your goals – whether that’s travelling independently, staying in school, going to college or university, starting work for the first time or just learning how to deal better with life’s up and downs.
Amongst people using the system 94% report that it’s having a positive impact on their life, 88% cope better with problems and feel more confident and 100% say it provides them with help when they need it.
Lots of organisations use Brain in Hand as part of their support service delivery and are already seeing both improved outcomes and significant cost savings. 

Arming people with autism, mental health conditions or learning disabilities with access to their own coping strategies and giving them the option of requesting additional support when they need it, helps them to make good progress towards independence. Those using Brain in Hand report significant mental health benefits vital for increased independence including reduced anxieties, fewer panic attacks and incidents of self-harm.
This enables goals to be achieved including travelling independently, starting work and living independently.  Each of these represent significant transformations in quality of life.
Organisations report universal reductions in anxiety and restraints, increase in goals achieved and state they are better informed for review or commissioning meetings.
 
The progression towards independence also provides cost savings, an average of £4,500 per user each year.  Savings cover from a wide range of sources including:
  • Reduced support worker 1:1 day time or educational support
  • Move from residential to independent living
  • Reduced need for support when travelling
  • Reduced need for night time support
  • Avoid carer breakdown
  • Reduced carer’s service
  • Reduction in Mental Health crisis intervention
  • Reduction in emergency GP visits
  • Reduction in A&E visits
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Innovation 'Elevator Pitch':
Prompt is a back up memory app and web dashboard to help people with daily difficulty recalling essential information about people, places and events.
Overview of Innovation:
Prompt emulates the way memory works by collating personal context about people, places and events. It aims to manitain confidence and independence for people living with impaired memories, due to conditions such as early dementia, mild cognitive impairment or recovering from stroke, brain injury or chemotherapy. An app provides help in the hand by embedding images and contextual information in reminders as well as making it available through natural language search. A web dashboard is available for family, friends and carers to help manage content, send reminders and messages. Analytics track user behaviour and send alerts if change is detected. The system will also use personal data to surface useful information, such as reminders of regular events, even if they're not in the diary as well as offering support with current location and why a user might be at that place. Future panned developments include complete voice interaction and integration with sensors.

Prompt has been developed in consultation with clinicians, people living with dementia, recovering from stroke and brain injury and their families. Research has been supported by Alzheimer's Society, Headway and the Child Brain Injury Trust. Development has been supported by Nominet Trust, UnLtd and Innovate UK. The company has also recently completed the Health Social Innovators accelerator programme and recently won a european pitch competition run by disruptive transpsort company Uber,
Stage of Development:
Trial stage - Trial stage to prove that the idea actually works as intended
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 / Wealth creation / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
More than 800,00 people in the UK are living with dementia, of whom 5-8% are under 65. Up to 10% of people over 60 will have mild cognitive impairment and 4 out of 5 will develop dementia. Timely intervention is a key strategic priority, the Prime Minister's Challenge on Dementia 2020 suggests people over 40 should be asked about memory function during routine check ups. Of the £26bn annual cost of care, £4.5bn is funded by the NHS; the remainder is mad up of social care and the opportunity cost of unpaid, informal care.
There are also almost 200,000 stroke and brain injury survivors in the UK. The cost of care is £5.3bn each year and almost half is the cost of informal care.
Previous research shows that regularly accessing memories and related information will embed them for longer and neuroscience research shows that memory works holistically, related information or images can prompt recall in addition to direct reminders.
For dementia, Prompt aims to help users maintain their confidence and independence as long as possible, potentially delaying the need for additional support and reducing the case load in memory clinics. If adopted at an early enough stage, as a memory enhancing strategy, the system will identify cognitive change through behaviours tracked by  the analytics system and could provide an early warning system for timely intervention.
For stroke and brain injury, the system will support recovery; research shows 90% of stroke survivors lack confidence during the recovery phase and need support to regain and then maintain their independence. Prompt has the potential to accelerate and maintain recovery and independence, reducing the time needed for support.
Initial Review Rating
3.80 (1 ratings)
Benefit to WM population:
Informal care costs or lost opportunities for people caring for those with dementia or recovering stroke/brain injury in the UK are estimated to be £14bn each year and that doesn't take into account  worry and stress.

Families supporting loved ones often feel they don't want to interfere oe intrusive, but at the same time they worriy about how theyre coping. Prompt is designed to support someone who is still able to manage the system, to maintain their independence and quality of life - but (if the user gives permission) families can see their daily activities through the web dashboard, so alleviating their concerns. The dashboard shows, at a glance, what events are coming up and what's being stored in the system. It can also display any appointments missed and a mood indicator using sentiment analysis.

People in the West Midlands living with or supporting someone with impaired memory function will benefit from improved quality of life and better mental health.

More generally, the West Midlands will benefit by being seen as a thought leader in innovation cognitive impairment, jobs created and the revenues generated by Memrica.
Current and planned activity: 
Memrica is currently working with Liverpool CCG and Mental Health Trust to test the system with a user group to build a business case for adoption. The company is also working with St Andrews Healthcare in Northampton to test with patients in the facility and in the community. St Andrews is a Centre of Excellence for brain injury and also supports people with dementia.
Memrica has research partnerships with Alzheimer's Society and Headway. 2 pilots are planned for this summer with ExtraCare Charitable Trust and Trafford Housing Association, one of which will be independently evaluated by Worcester University's Association of Dementia Studies.
Memrica has a relationship with Appello, an emergency call centre provider, which is diversifying into digital innovation and an agreement to jointly tender for opportunities in innovation in supporting people with cognitive impairment.

An initial version of Prompt is now available for public testing, support to accelerate take up would be great.
What is the intellectual property status of your innovation?:
Copyright in design and layouts
Trademark application to be made
 
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
Simple
Regional Scalability:
Memrica Prompt is a digital innovation and the key to scaling is market adoption. For the current public Beta 50 people signed up in 48 hours, revealing a consumer appetite. Memrica is developing partnerships with housing providers to drive adoption among their residents - ExtraCare Trust and Lenches Trust - and is seeking other partnerships.
Measures:
Memrica is partnering with Worcester University's Association of Dementia Studies to develop metrics to measure improvement of quaity of life during a short trial. Memrica is also in discussion with NESTA to join their Dementia Citizens initiative, which gathers reserach infirmation from participants on the platform. The format for the Worcester ADS study is a pre and post questionnaire to gather qualitative self assessment about levels on confidence and independence indicated by things people feel they can no longer do or feel anxious about compard to their experiences after the test period. The same  pre and post questionnaire will also be sent to a family member or supporter, who can give their perspective on any changes noted, to give a 360 degree view. The questionnaire will also include questions about impressios of the quality of the app and supporting dashboard as well as training and support given.

Following launch Memrica will also assess.Prompt against KPIs: number of downloads, % conversions to payment, market presence measured by social media mentions and contacts via the website and recruitment success, when compared to similar businesses.
Adoption target:
Prompt is not only targetted at the West Midlands for adoption. To break even on current modelling 30,000 monthly users are required.
Rejection Reason:
The investment committee decided not to invest in this innovation.
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Innovation 'Elevator Pitch':
Yecco is a fully digital telehealth & telecare self-management platform for monitoring all aspects of a person’s past & real-time health status. Our products also allow environmental monitoring & home automation to enable full remote care & support.
Overview of Innovation:
Yecco brings new & exciting ways of data sharing as the trend moves towards patients managing their health & taking control of their health data.

Our solutions facilitate self-management of chronic conditions & can help to reduce emergency readmissions to hospital. In 2012-13 more than 1 million emergency readmissions within 30 days of discharge cost an estimated £2.4 billion.* Yecco can be used to support hospital discharge as it monitors the safety & health of a person living when back in their own home. 



View our video & see how Yecco can support a patient with Diabetes & COPD – https://www.youtube.com/watch?v=vMBFoaKy--g

Yecco’s own private, social network allows its patients, health & care professionals to share medical & device information with any connection they wish, enabling consumers, health & care professionals to share real-time medical & device data. It can be used at home, work, care settings, medical & care facilities.

Features include:
  • Share medical data with chosen family, friends & clinicians
  • Ability for another person to manage your profile
  • Create & send group messages & on your timeline
  • Keep a check on your health in real time using the Yecco medical devices or add readings manually
  • Add thresholds to alert chosen connections 
  • Store personal, medical & medication information
  • Built in calendar & reminder support
  • Video to stay in contact/facilitate remote consultations
  • Message facility
  • Task planner
  • Group connection
  • Educational content
  • Response questionnaires    
Yecco medical devices can measure vital signs with accuracy & precision using Bluetooth to automatically connect to an iOS or Android device(s) using the Yecco App for a simple & effortless measurement in real time.

The Yecco multi-function sensor offers power & flexibility that’s not been available before in a home sensor. Paired with the Yecco App & through the use of the Yecco Docking Station it can automatically detect abnormalities in physiological data, alerting chosen connections on the Yecco network.
 
The multi-function sensor can connect directly to the WIFI network. Features include the ability to activate the camera on the mobile device to investigate alerts.

  • Motion detection
  • Door & window open or closed status
  • Smoke detection
  • Carbon monoxide detection
  • Temperature & humidity
  • Add separately & plug in:
    • Bed occupancy sensing pad
    • Enuresis pad (to detect for moisture in a bed or chair)
    • Rechargeable battery
There is the option to keep a check on your health using the Yecco Wearable Watch.
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:
Rising demand for services, combined with restricted or reduced funding, is putting pressure on the capacity of local health and social care systems.
 
The NHS spends around £820 million a year treating older patients who no longer need to be there.
 
(Source: https://www.nao.org.uk/wp-content/uploads/2015/12/Discharging-older-patients-from-hospital-Summary.pdf)
 
Yecco Pro App
 
Yecco Pro is a licensed cloud-based interface that enables organisations to remotely monitor multiple patients.
 
Yecco Pro gives medical professionals multi patient monitoring with real time data for early intervention. Powerful threshold and notification options assist all professionals to give improved patient outcomes and increased safety.


Features include:
  • Receives real time data for early intervention
  • Interface for clinician to patient communication
  • Set thresholds to assist in disease management and early intervention for improved patient outcomes and safety
  • Set alerts / notifications
  • Group patients
  • Filter and create reports (CSV)
  • Video conference calling
This modular platform enables Yecco to add other 3rd party modules or interface to Electronic Patient Record system or data contextualisation platforms that enable intelligent triage and diagnosis across a range of data sources


Yecco's product are currently being used by Surrey and Boarder Partnership testbed that is monitoring the health and wellbeing of patients that have mild o moderate levels of dementia. The aim of the project is to assist clients in monitoring and reduce the burden on front line NHS services. (GP’s appointments, health work home visit and hospital re-admissions). The health and wellbeing reading take form the Yecco devices is being monitor in partnership with the KSSAHSN/University of Surrey. http://www.sabp.nhs.uk/tihm/partnership. Currently awaiting health economics stats and data from project.
Online Discussion Rating
4.00 (2 ratings)
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
The past few decades have seen significant improvements in life expectancy, however, rising longevity brings increasingly complex & chronic health conditions, placing substantial demands on health & social care services.
 
At the same time services are experiencing significant financial pressure & need to find ways of lowering costs while maintaining or improving the quality of care provided.
 
This requires new ways of working in order to meet increasing demand & deliver care that is safe & cost‑effective while reducing reliance on hospital & institutional based care.
 
Technology can help to support these new ways of working.
 
When hospital discharge goes wrong it comes at significant cost both to individuals & to the health and social care system. In 2012-13 there were more than 1 million emergency readmissions within 30 days of discharge costing an estimated £2.4 billion. Source: http://bit.ly/2sKBn1p


The number of older people in England is increasing rapidly, by 20% between 2004 & 2014 & with a projected increase of 20% over the decade to 2024. Hospitals have also experienced increases in the number of emergency admissions of older patients, by 18% between 2010-11 & 2014-15. Older patients now account for 62% of total bed days spent in hospital.
 
The relative growth in numbers of older people is important. The number of older people with an emergency admission to hospital increased by 18% between 2010-2011 & 2014-15 (compared with a 12% increase overall).
 
While NHS spending has grown by 5% in real terms between 2010--11 & 2014-15, local authority spending on adult social care has reduced by 10% in real terms since 2009-10.  Source: http://bit.ly/2tuy9we
 
Yecco is an innovative solution that monitors the safety & health of a person living in their own home or in a care setting.  This combined telehealth & telecare solution can enable health & care providers to meet the health & social care needs of individuals in their charge.
 
By using Yecco technology to monitor if a person is physically safe, for example that they have not left the cooker on or had a fall, as well as critical indicators such as blood pressure or blood oxygen levels to indicate that they are not medically at risk can improve user’s quality of life & reduce long-term health care costs.

Yecco can help to keep people safe in their own home & reduce the number of unnecessary hospital visits, increase confidence in users to manage their own health & alleviate the pressures & concerns of caregivers.
 
Current and planned activity: 
We wish to work with regional health & care providers & WMAHSN's Patient Safety Collaborative & Care Home Network. We also wish to explore if our technology can be used to support Mental Health Services, possibly to monitor & support patients coming off medication.
 
Our products are being used by Surrey & Boarder Partnership testbed to monitor the health & wellbeing of patients with mild to moderate levels of dementia. The project's aim is to assist clients in monitoring & reduce the burden on front line NHS services (GP appts, health work home visit & hospital re-admission). The health & wellbeing readings taken from Yecco devices is being monitored in partnership with KSSAHSN/University of Surrey.
 
We previously demonstrated our products & services to EMAHSN & are currently involved in the Falls Prevention tender (EMAHSN led). Yecco products & services have been purchased by Neath & Port Talbot Borough Council to monitor & support regional LD clients (awaiting deployment date).       
What is the intellectual property status of your innovation?:
Yecco has developed its software and applications and retains the IP to this. It also owns IP in some of the hardware products developed in-house (sensors and IoT gateways). Some 3rd party integrated products (such as generic medical devices for vital sign monitoring are not Yecco IP). These products are in the process of being further protected. 

Yecco is currently in use in the NHS England IoT testbed with Surrey and also within other local authorities. Our products comply with the required data model, structure, coding and security requirements that have been dictated. We are also working with established telecare and telehealth organisations where compliance is required / requested to various standards and integration with 3rd party alarm management systems.
 
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
2
Measures:
Yecco are currently involved in Surrey and boarder partnership NHS foundation trust testbed programme for monitoring patients with mild to moderate dementia. The project is currently ongoing. yecco have requested information relating to the impatch of the project and health economic details. As soon as this information has been published yecco willl add this information into the meridian system 

    
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