Sensor Assisted Care. Medical Automation Conference December 12, 2008

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Sensor Assisted Care Medical Automation Conference December 12, 2008

Healthcare Overview Largest Segment of US Economy $1.8 Trillion in 2004 (15% of GDP) $4,178 per capita Pending Crisis Retiring Baby Boomers 35 million Americans over age 65 growing! Shortage of staff One million new nurses will be needed by 2016 more than 587,000 new nursing positions created by 2016 Automation is a tool improve care lower cost

Healthcare Industry Problems Managing preventable conditions Pressure ulcers (stage III & IV) $11.1B Falls - $6.6B Others: infections, DVT, air embolism, poor glucose management Documentation of care 50 75% of healthcare staff time for paperwork Hospitals lose 8-12% of billable items

Healthcare System Evolution

Technology Trends Enable Sensor Assisted Care New sensor elements Converts physical condition to electrical signal Ubiquitous communications links Lower power consumption, smaller size and lower cost computers Embedded computers with system on chip processors Secure network and data entry & retrieval All devices connect to network and internet

Sensor System Information Flow Sensor Element Processing Machine (hardware, software Communications links) Real Time Information (status, alert, alarm) Information Records Interface to other Systems & User Configuration Electrical Signal Raw Data Processed Data Algorithm to Information Algorithm to Event

Light Sensor Real Time Information Processing Machine User Configuration (i.e. Light Limit: 500) Off On Alarm Information Records Light Turned Off at 17:45 Electrical Signal Raw Data Processed Data Algorithm to Information 0 to 5V 0-1024 0-1024 If over 500, On If On for 2 Hrs, alarm Algorithm to Event Mote ID 5, Light Off @ 17:45

Skilled Nursing Facility (SNF) Documentation burden is heavy Under-reporting of care is lost revenue Lack of documentation impacts liability 92% of claims settled out of court with 88% receiving payment, averaging $406,000 Pressure ulcers and falls are major problems Both are on CMS list of preventable conditions Factors in pressure ulcer care movement & wetness It is desirable to both prevent and promptly detect Sensor Assisted Care can help...

Long Term Care Automation System RFID / Smart Card Handheld Terminal (Browser) Fixed Location Terminal (Browser) Movement Sensor Processing Machine (hardware, software & comm links) Wetness Sensor www Data Server Web Page Server

Virginia Tech Fiber Optic Movement Sensor Technology Fiber Optic Sensor Developed at Virginia Tech Senses perturbation caused by movement, data is number Multi-mode optical fiber, laser and camera are components Highly sensitive / Inexpensive Demonstrated in lab tests to detect heartbeat and respiration Wireless data transmission Sensor system detects movement in bed -> occupancy and large movement such as patient turn This sensor addresses bed occupancy and movement / related to pressure ulcers and falls. US Patents 7,189,958 and 7,196,317

Algorithm Development Collaboration of User & Engineers Sensor provides data Experience of user s and technologists combine to define algorithms for processing data into clinically useful information and records Lab Testing by Dutchess Raw data of movement magnitude in time plot Occupancy Status Icons

Skilled Nursing Facility Work Flow A. Caregiver begins work shift by obtaining a RFID bracelet and a "handheld terminal B. Caregiver enters patient's room and waives RFID bracelet to indicate bedside presence. As a result, the caregiver ID, patient bed ID, and time/date are sent to the system. C. The system receives the bed and caregiver information and may then serve authorized access to information and prompt the caregiver in completing tasks compliant with the standard of care. The caregiver performs tasks and enters records either on the handheld terminal or readily accessible fixed location terminals. When practical, sensors confirm tasks such as patient turn have been completed with a secure data messages to electronic medical records, care plan, and accounting.

Impact of Automation in Long Term Care Increase staff efficiency convert scheduled tasks to sensed tasks Example: sense high level movement in bed to verify patient turned Example: sense incontinence event and request service Enter / retrieve information at bed side or anywhere... Better documentation Reimbursement for care provided, increased revenue Tool to manage tasks for preventable conditions Better outcomes Resources converted from documentation to care

Sensor Assisted Care As population, ages the demand for sensor systems to improve healthcare while reducing costs is increased Technology trends enable new systems Sensor elements, computers, communications links, security Sensor Assisted Care: electrical signal from sensor to... Real time actionable information Records for documentation Information Exchange Interface to other systems Expands to accommodate wide variety of sensors (invite collaboration) Collaboration of clinical user s and technologists result in novel automation solutions If it can be sensed and address a healthcare problem, automation is practical

Thank You... Daniel W. Wrappe CEO Wireless MedCARE, LLC dwrappe@wirelessmedcare.com (540) 551-4948 Skype Name: wrappe