How 2018 Will Be The Year You Embrace

Continuous Connectivity

Chief Executive Officer

NERSI NAZARI, PHD

WE ARE CONTINUOUSLY CONNECTED

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Financially

Balances and bills

Parenting

Location and access

Socially

Friends and community

WE ARE CONTINUOUSLY CONNECTED

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Safety

Alerts, remote control

Environment

Habit learning

Utilities

Water usage levels

WE ARE CONTINUOUSLY CONNECTED

Fitness Eating

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Pet Monitoring

CONTINUOUSLY CONNECTED – NO LONGER “NICHE”

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Wearables

&

Health

apps

have tripled

since 2014

CONTINUOUS MEDICAL GRADE DATA?

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ICU

Monitored 100%

Of hospital stay

How do we get physicians to have data at their finger tips

outside of the ICU for a reasonable cost?

Spot Check Only

Unmonitored 97% of stay

General Ward

Check-in via telemedicine

Unmonitored nearly 100%

Post Discharge

$$$$$ $$$ $

TODAY’S STANDARD OF CARE

• 5,700 hospitals

• 4.5 days average length of stay

• $2,000 per hospital day

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Healthcare size and costs keep growing

TODAY’S STANDARD OF CARE

• 70% of costs is for the management of chronic diseases

• 65% of ER visits are not emergencies

• 2 Million patients are readmitted every year

• $27 billion in Medicare costs of readmissions

- 50-75% of Medicare readmits are preventable

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Spending money on expensive care – not fixing the cycle

HOW DO WE CHANGE CARE IN 2018?

• Keep patients OUT of the hospital

• Keep patients healthy at home

• Catch deterioration sooner

• Create more preventative care

• Reduce clerical burden

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X X

HEALTHCARE IS AT A TIPPING POINT

$3.2 Trillion 18% GDP

32% is hospital costs

Population is aging….change is needed

Continuous monitoring will drive this change

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Why CONTINUOUS monitoring?

440,000annual

preventable

adverse

events5

Currently patients are

identified only 15 min

before cardiac arrest6

Frequent spot

checks leave

patients

unmonitored

96% of their

hospital stayEarly warning signs are often present,

but often only recognized retrospectively.

Over 50% of Medicare

readmits are preventable

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WHERE CONTINUOUS COULD BENEFIT

US Statistics on Sepsis

• 12.2% of readmissions - most common

reason for readmission

• Every hour sepsis is diagnosed, 8%

increased mortality rate

• Every 2 mins someone dies from sepsis

• Sepsis contributes to about ½ of all

hospital deaths

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Subtle/early changes in HR

& BR can be detected with

continuous monitoring

Why haven’t things changed?

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If these deteriorations are preventable…..

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Methods we have had up until now are not scalable

We weren’t ready

Developing medical-grade devices is hard

INTENSIVE CARE UNITS – 24/7 MONITORING

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Expensive, inconvenient, uncomfortable

GENERAL WARD MONITORING – SPOT CHECKS

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Manual, disruptive, ineffective

GENERAL WARD MONITORING – SPOT CHECKS

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Limited access to patient data, local only

Why can we change this NOW ?

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TECHNOLOGY has evolved

CULTURE has evolved

HOW HAS TECHNOLOGY EVOLVED?

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CLOUD

ANALYTICS

REAL-TIME

CONNECTIVITY

WEARABLE

BIOSENSORS

ARTIFICIAL

INTELLIGENCE

Ability to

aggregate

data like

never before

Real-time data on

patients is possible

from any environment

Biosensors that

don’t require an

ICU environment

Data that does not

always need a

doctor to interpret

HOW HAS CULTURE EVOLVED?

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XHospital is the last

resort.

Access to data and

services on their

own terms.

Patients want

convenient options for

healthcare services.

BUSY

LIFESTYLESMOBILE

DEVICE USAGE

CHANGING

CENTER OF CARE

CONTINUOUS MONITORING – One Patient Story

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VitalConnect Clinical Study

ECG of Sample Episode 1

RR of Sample Episode 2

CONTINUOUS MONITORING – HF Patients

LINK-HF Multi-Center Study

• Can rehospitalization be predicted post HF

admission using analytics from continuous

multivariate patient data streams via a wearable

biosensor?

• 100 subjects, 4 VA Hospitals

• Continuous monitoring for 90 days

physIQ Clinical Study with VitalPatch biosensor

Presented at:

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CONTINUOUS MONITORING – HF Patients

• Prediction of HF readmissions was ROC AUC of 0.88

compared to AUC 0.58 for equivalent random

decision generator (figure)

• At 85.9% specificity there was 84.2% sensitivity

• Mean time from alert to readmission was 10.8 days

• Median time from alert to readmission was 6 days

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physIQ Clinical Study with VitalPatch biosensor

6-10

days

notice!

Why CONTINUOUS monitoring?

• Tells the full patient story

• Short-term patient stage changes are detected

• Vital signs in context of activity, and other biometric status

• Ability to apply real-time scoring algorithms

• Cost effective for small or large scale

• NOW it is a viable and sustainable solution

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STATE-OF-THE-ART HOSPITALS

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CONVENIENT & COMPLETE CARE CYCLE

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DATA FLOW MUST BE SEAMLESS

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CONTINUOUS CARE SYSTEMS

✓High sensor accuracy compared to standards

- FDA cleared

- Class II devices

✓Anywhere, anytime access to data

✓Protected patient information

✓Trending & analytics for real-time

✓Data storage for future reference

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Accurate, Secure & Robust

Life:100% Upload: OFF Bluetooth: ON Nurse’s LogVistaPoint™Patch ID: B0:08:BF:00:00:00

Disconnect About

Respiration RateBrPM

Heart Rate Live ECGBPM

Skin Temperature°C

PedometerSteps

Posture Fall Detection

18 72

36.1 140 Walking

No fallsdetected

1.0s

0

20mv

-20mv

PATIENT EXPERIENCE: AFib monitoring

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The FutureCurrent Standard-of-Care

PATIENT EXPERIENCE: Sleep analysis

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The FutureCurrent Standard-of-Care

BRIGHAM & WOMEN’S HOSPITAL

• 1st randomized study of it’s kind, n=20

• Wireless biosensor enabled continuous vitals monitoring

• 52% savings for acute episode

• 67% savings 30-days post

• Fewer readmissions (11% vs. 36%)

• More physical activity (209min vs. 78min)

• Upright more & more sleep

• Less use of home-care services (22% vs. 55%)31

Continuous Monitoring for Home Hospital Initiative

David Levine, MD

MERCY VIRTUAL

• 43 hospitals across 5 states

• World’s first Virtual Care Center

• Vision to streamline care and catch

health decline earlier

• Embracing continuous connectivity

to help deliver better care at lower cost

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Continuous Monitoring in the General Ward & Outpatient Populations

HOSPITALS AS THE “HUB & SPOKE”

• Continuous monitoring via a secure platform enables:

- Improved care within hospitals

- Quality care outside the hospital walls

• Care continuum for the

patient changes…

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Past 100 years Next 100 years

TOMORROW’S STANDARD OF CARE

• 5,700 hospitals

• 4.5 days average length of stay

• $2,000 per hospital day

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TOMORROW’S STANDARD OF CARE

• 70% of costs is for the management of chronic diseases

• 65% of ER visits are not emergencies

• 2 Million patients are readmitted every year

• $27 billion in Medicare costs of readmissions

- 50-75% of Medicare readmits are preventable

- $17 billion classified as potentially preventable

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CONTINUOUS CONNECTIVITY

• Save lives

• Improve the patient experience

• Get clinicians back to focusing on patients

• Monitor patients anytime …anywhere

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2018 is the tipping point

Thank You