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Idea Description
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Innovation 'Elevator Pitch':
The RAPID project is a pioneering research study using real-time diagnostic information inspired by the world of Formula 1.
Vital signs continuously monitored wirelessly and advanced algorithms provide early warinng of deterioration.
Overview of Innovation:
The RAPID (Real-Time Adaptive and Predictive Indicator of Deterioration) project – is the first of its type in the world. It constantly collects data from children on our cardiac wards including their:
  • heart rate
  • breathing rate
  • oxygen levels
This is a new and exciting way for children to be monitored and gives important early warning signs of deterioration that can be acted on quickly. 
The study was based on McLaren’s expertise in using hundreds of sensors to collect and analyse real-time data during a race to optimise its strategy on the track and Aston University's expertise in applied mathematics.
This technology has been adapted to be used in healthcare for the first time. Hi-tech wireless sensors, designed by Isansys Lifecare are attached to the chest and hands/ankle of children to measure vital signs. The information collected is processed in real-time using machine learning techniques developed by mathematicians from Aston University which are embedded into McLaren’s data analytics platform, LIFEINSIGHT™.
This new technology means that signs normally recorded every one to four hours on paper charts could potentially become a thing of the past. Children will have access to continuous individual monitoring that gives more accurate information helping them to receive faster treatment and shorter stays in hospital.
The wireless technology and wearable sensors remove the need for cables and leads, which can restrict effective monitoring. This means parents can hold and interact normally with their child while knowing they are being safely and continuously monitored.
The three-year study was jointly funded by a £1.8 million grant from the Welcome Trust and Department of Health, through the Health Innovation Challenge Fund, started in November 2014, and aims to recruit around 1,200 patients when it reaches its completion in late 2017.
 
Stage of Development:
Trial stage - Trial stage to prove that the idea actually works as intended
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Innovation 'Elevator Pitch':
Sensium Wireless Vitals Monitoring is proven to lead to treatment of sepsis 6 hours quicker than NEWS, reduce LOS by 10% and readmission by 45%. The only wearable vital sign monitor with peer reviewed RCT data showing significant clinical benefits. 
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 and reliably monitors and 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, allowing intervention before the condition worsens, thereby improving patient outcomes, shortening hospital stays and 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 and security of continuous vital sign monitoring.
 
The Sensium Patch provides accurate and 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 and secure low power wireless communication to the Sensium bridges placed through the ward area.  Sensium allows patients to ambulate freely, untethered to static and expensive equipment whilst still having the reassurance of continuous monitoring.
 
The bridges are connected into the hospital IT system, and 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 and ensure accuracy Sensium can be easily integrated with the hospital admission, discharge, transfer systems and electronic medical records.
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 / Patient and medicines safety
Benefit to NHS:
Currently approximately 10% of patients are harmed during their hospital stay and this represents a cost to the NHS of over £2.5bn just to cover the additional length of stay for these patients. Improved monitoring regimes and early detection of deterioration is key to reducing this significant burden.
 
Patients undergoing major abdominal surgery have an 30-40% risk of complications with a leading complication being sepsis. Hospital acquired (HA) sepsis (e.g. sepsis that develops after a surgical procedure) has twice the mortality rate and twice the treatment cost of community-acquired sepsis and rates of HA sepsis are rising. A recently-published study aimed to assess differences in outcomes between patients being monitored using the Sensium system in addition to intermittent (routine) observations and patients being monitored by routine observations alone [1].  The study was designed as a pilot cluster-randomised, prospective, parallel-group, controlled single-centre pilot study and consenting participants were allocated to one of two monitoring arms for the length of their admission. The primary outcome measure was time to antibiotics after the first evidence of sepsis, defined according to a revised consensus conference definition in 2001 [2]. Secondary outcome measures included length of hospital stay, 30-day readmission rate, mortality and patient acceptability. 226 patients were randomised between January and June 2017. 140 patients were randomised to continuous remote monitoring; 86 patients were randomised to receive intermittent monitoring alone. There were a similar number of complications and sepsis events across both arms of the study, indicating that both groups had similar baseline risk factors.

On average, patients receiving Sensium continuous monitoring were administered antibiotics 6.4 hours sooner after evidence of sepsis, had a 10% shorter average length of hospital stay and were 45% less likely to require readmission within 30 days of discharge than those patients in the intermittent monitoring group. Patients found the monitoring device to be acceptable in terms of comfort and perceived an enhanced sense of safety. Given that every hour’s delay in treatment of sepsis has been shown to be associated with a 7% increase in risk of mortality [3], a 6-hour reduction in time to administer antibiotics is a significant result and further studies are ongoing to demonstrate similar benefits in other clinical settings.
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
Sensium’s solution offers several key benefits to the West Midlands and its population. The key benefits of Sensium compared to competitor products are as follows:

Product Performance: Sensium uses clinically accepted ‘gold standard’ methods of vital sign measurement, deriving heart rate from single-lead ECG, respiration rate from thoracic impedance, and temperature from an axilla sensor.  In contrast, our competitors derive respiratory rate from pulse or ECG measurements which has known limitations in certain clinical conditions and provide only skin temperature measurement which has limited clinical value.

Customer Focus: Sensium is recognised by our customers for exceptional customer support.  Once we deploy our product at a clinical site, we provide on-site technical support for installation and troubleshooting and clinical support for training for as long as it takes for the system to be truly embedded in the clinical workflow and providing tangible benefits. Sensium has clinical and technical staff based in the West Midlands region on hand for support.

Clinical Evidence: Sensium understand that medicine is an evidence-based science and we are engaged in a series of clinical research studies designed to show clinical efficacy, improved clinical outcomes, and health economic benefits.  To date, Sensium are the only company providing wearable wireless technology for early detection of patient deterioration that have independent and peer-reviewed publications showing benefits of our technology demonstrated through randomised controlled trials
 
 
Current and planned activity: 
Our initial engagement with the NHS has been to introduce Sensium to general surgery wards and areas with high risk and infection prone patients e.g. colorectal, trauma and haematology wards. Discussions with many NHS hospitals have also shown significant interest and benefit for the use of Sensium for ‘Step down’ areas for patients who aren’t sick enough for ITU but still show cause for concern and for high risk conditions such as Hospital Acquired Sepsis opioid depression and AF. 

We have engaged with the Emergency Laparotomy Collaborative with a view to patch these types of patients. When approaching the NHS, we have been primarily engaging with Anaesthetists as they witness many patient deteriorations, as well as consultants and sepsis/patient deterioration leads, matrons and clinical IT leads. We plan to interact more directly with medical directors and members of the directorate earlier on in the process if possible. Future plans include home monitoring to follow patients’ home.
What is the intellectual property status of your innovation?:
CE mark and FDA 510(k) cleared.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
N/A
Ease of scalability: 
2
Co-Authors:
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Innovation 'Elevator Pitch':
Clinical decision making improved via proactive digital remote monitoring. Together driving cost efficiencies, improving patient outcomes & avoiding hospital admissions. (CE Class 1a: data server sits within HSNC:  proven ¯ 67% admissions: scalable)
Overview of Innovation:
CliniTouch Vie is a digital health solution that reduces unnecessary hospital admissions.
 
CliniTouch Vie is a locked-down tablet with integrated 3G for intensive monitoring, education & empowerment with integrated direct messaging & video support.  Dynamic care plans & evidence-based algorithms enable automatic triage for healthcare teams.  Fast & simple to implement for the most at-risk patients. 
 
Launched in 2016, system is CE marked & MHRA approved. An evidence based digital health platform that clinically supports patients to better manage their condition. It has the flexibility to be adapted for data analytics & clinical decision-making support in chronic disease management (eg COPD, heart failure & diabetes), frailty & assisted discharge programmes for ambulant & non-ambulant patients
 
Clinical & economic evidence has been generated from trials with 300 respiratory patients [Ghosh et al, 2016, https://doi.org/10.12968/bjhc.2016.22.3.123]. Our evidence based digital solution increases patient access to care & promotes greater clinician-patient collaboration for the 15million people with LTCs. It drives timely, proactive intervention, minimising need for more acute costly care enabling sustainable long-term outcomes success
 
USPs:
Evidence based: Study published in the British Journal of HC Management showed 67% reduction in unscheduled COPD admissions & saving of £2,278 per patient pa. (NB: programme continues to deliver same level of savings)
 
Patient-centred: Personalisation of goals, metrics & parameters makes system truly patient centred providing real-time remote monitoring closer to home to improve patient experience & outcomes whilst generating savings
 
Secure & integrated: Data server sits within HSNC enabling it to push-pull data securely between healthcare provider & service users. Includes bespoke integrated secure video-conferencing platform with end-to-end encryption, allowing remote monitoring of medical conditions, improving quality of life & avoiding unnecessary admissions
 
Flexible Modular Architecture: Enables clinically validated question sets re: symptoms, to be easily tailored to specific therapy areas for qualitative data collection
 
Tiered Service: no upfront costs to NHS on PAYG basis:
- Digital platform integrated into existing healthcare pathways
- Light touch triage service informing local health teams of urgent priority patients for interventions
- Fully-Managed digital platform and nurse-led service providing triage & interventions
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 / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
CliniTouch Vie has proven benefits and can be scaled up easily across the wider regions:
  • improved patient outcomes:
  • 67% reduction in COPD emergency admissions;
  • 13% improvement in CAT score
  • 97% of patients using CliniTouch Vie will further reduce distress and discomfort from conditions exacerbations
These were supported by:
  • improved access to healthcare: 24/7 access to healthcare, average 110 interventions per patient per annum (500% increase)
  • targeted and personalised health interventions: 7,250 personalised clinical interventions (data from 66 patients over 12 months)
  • data analytics: real-time clinical dashboards for clinical teams to prioritise patient needs; prioritised only 38% of patient clinical recordings required intervention within a 24-hour period
 

 
Patients are educated and supported to interpret the data to gain an improved understanding of their health status.CliniTouch Vie:
  1. Educates patients: supporting people to make health life choices through improving the understanding of their disease and self-management skills
  2. Enhances care for patients with chronic conditions: informing and engaging patients as part of NHS prevention agenda and creating a patient-provider collaboration
  3. Provides data analytics: making more targeted and personalised health interventions, by using disease specific algorithms to differentiate when one patient’s history or recent environmental exposures indicates a higher likelihood of flare up than another
  4. Improves patient safety: providing real time clinical and well-being data to identify early warning signs of health deterioration, medication adherence and self-management education
  5. Reduces hospital activity: providing real time management of high risk patients to prevent admissions
  6. Supports early discharge: providing hospital level diagnostics and monitoring in the home, enabling early discharge and can be used for remote clinical support post-surgery or in care-home settings
  7. Delivers workload efficiencies: supporting better patient self-management, reducing need for direct interventions and enabling staff to focus on priority patient care
  8. Offers locality wide cost savings: reduced demand leads to reduced NHS activity
 
Initial Review Rating
5.00 (2 ratings)
Benefit to WM population:
The West Midlands priorities that CliniTouch Vie can address are:
  • P2: Long Term Conditions: whole system, person centred approach
  • P4: Wellness, healthy aging and prevention of illness
  • P8: Digital Health
 
Our vision is for CliniTouch Vie to contribute towards and support the West Midlands wider vision to develop a worldwide reputation for delivering healthcare through digital technologies, proven to deliver sustainable improved outcomes and create wealth.  We have already demonstrated that it can deliver on all fronts with high risk COPD patients and is being adopted for Heart Failure, Diabetes, Cancer and Frailty pathways.  With an ageing population, often with co-morbidities, it can be used to support a more patient-centric approach to health care services in the region.
 
CliniTouch Vie supports health and wealth benefits as is a flexible, real-time remote monitoring solution, facilitating earlier discharge, prevent readmissions, reduce risk of future exacerbations and improve self-management through our inbuilt education resources.  CliniTouch Vie delivers a proactive approach to tackling symptoms, preventing exacerbations and slowing health deterioration, resulting in reduced NHS costs.  The system has an extensive data collection of medical, lifestyle, biometric and daily activity.
 
Targeting patients who are at risk or have multiple hospital admissions could significantly reduce the NHS costs to the region as well as freeing up clinic and nurse time to manage a wider caseload more efficiently. With a more collaborative, integrated, patient centred approach, utilising proven remote digital health, the West Midlands could see a potential reduction in admissions by 60%+.
 
CliniTouch Vie is a locked-down tablet, with integrated 3G for intensive monitoring, education and empowerment with integrated direct messaging and video support.  Our dynamic care plans and evidence-based algorithms enable automatic triage for healthcare teams. 
 
The tablet comes in an easy to carry case with the peripherals and can be handed to the patient at home, in clinic or upon discharge and is linked directly to the clinician web-based management portal.  Data within CliniTouch Vie tablet is stored securely within the cloud and hosted on the N3.  This makes CliniTouch Vie easy to scale due to its low technology and estates requirement, whilst delivering a high quality clinical service.
Current and planned activity: 
Current:
Spirit Digital is part of Spirit Health Group and can provide one of the most comprehensive range of solutions to support patients of all ages, IT capabilities & levels of disease severity across a wide range of conditions e.g. respiratory, cardiovascular, diabetes, cancer, frailty.
 
Spirit is establishing research collaborations with academic institutions around evidence generation for AI and machine learning. This includes collaboration on a bid to the European Space Agency to further develop the technology using satellite data.

Planned:
Spirit Digital seeks WMAHSN support ta assist with introductions and marketing of CliniTouch Vie to local CCGs. 
 
Our planned NHS engagement activity programme for the next 12 months will be through a variety of channels:
  • Direct engagement with CCGs and community Trusts
  • Application to Digital Accelerator programme
  • Case study development & sharing
  • Presentations at national conferences
  • Creating user (clinicians & patients) video footage to share with CCGs
What is the intellectual property status of your innovation?:
We hold the IP for the technology and digital health algorithms.  We collaborate with Midlands based businesses, healthcare providers and universities and retain all IP for products and services.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
2
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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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