Technology for Preventative Healthcare. David Carty, Product Owner, CM2000 Adrian Smales, PhD Researcher, Edinburgh Napier University

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1 Technology for Preventative Healthcare David Carty, Product Owner, CM2000 Adrian Smales, PhD Researcher, Edinburgh Napier University

2 Technological Changes

3 The journey so far. Introductions with Interface as the conduit organisation to various Universities, Edinburgh Napier was selected and relationships commenced with their School of Computing Digital Health & Care Institute (DHI) e-frailty project across 2016 researching risk prediction & early intervention through the use of wearables Continuation of DHI funding for e-frailty research supporting medical view of non-medical device data

4 What we are using MEASUREMENTS: Weight Segmental body fat % Segmental muscle mass Body fat % (age 5 99 years) Healthy body fat indicator Total body water % Muscle mass in kg Bone mineral mass Visceral fat indicator Daily Calorie Intake Metabolic age BMI

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6 Edinburgh Napier University Adrian Smales, BEng(Hons), MBA PhD Research Student #technologytoprevent

7 Image: Demographics

8 Population Demographics Projected change in proportion of population aged 75 and over from 2010 to 2035 taken from National Records for Scotland inquiry submission to the Scottish Parliament Finance Committee, nd Report, 2013 (Session 4): Demographic change and an ageing population, The Scottish Parliament.

9 Demographic and Societal Challenges

10 Homeostatic Stasis Old (simple) diagram New Dynamic Diagram

11 Risk Stratification Abstraction Wellness/ Frailty High Level Metrics Physical Condition Activity Level Performance Metrics Body Composition Grip Strength Daytime Activity Sleep Pattern Mobility Mood Cardiac Activities of Daily Living Device Tanita Scales Grip strength meter Polar loop Question H7 CM2000 InForms Data Body Fat (%) Muscle Mass Bone Mass Body Mass Index (BMI) Daily Calorie Intake (DCI) Metaboli c Age Body Water (%) Visceral Fat Weight Grip Strength Reading 1 Grip Strength Reading 2 Grip Strength Reading 3 Date Resting Sitting Low medium high Total sleep restfull sleep Restless sleep inactivity stamps Distance walked Steps taken How is service user feeling today Heart rate BPM R-R Interval (ms) IoRN v2 score Beginnin g IoRN v2 score Middle IoRN v2 score End Trust Level Tier 1 Mandatory Public Sector Data Stores Tier 2 Personal Data store (Devices, IoT, Non-Medical equipment) Tier 3 Personal Data store (Subjective information, how do you feel?)

12 Wellness/ Fra Wellness/Frailty Scale - Physical Condition High Level Metrics Physical Condition Metrics Body Composition Grip Strength Daytime Device Tanita Scales Grip strength meter Data Body Fat (%) Muscle Mass Bone Mass Body Mass Index (BMI) Daily Calorie Intake (DCI) Metaboli c Age Body Water (%) Visceral Fat Weight Grip Strength Reading 1 Grip Strength Reading 2 Grip Strength Reading 3 Date Resting Sitting

13 Wellness/Frailty Scale - Activity Level Wellness/ Frailty Activity Level Performance Grip Strength Daytime Activity Sleep Pattern Mobility Mood Cardiac Activit Grip strength meter Polar loop Question H7 CM Grip Strength Reading 1 Grip Strength Reading 2 Grip Strength Reading 3 Date Resting Sitting Low medium high Total sleep restfull sleep Restless sleep inactivity stamps Distance walked Steps taken How is service user feeling today Heart rate BPM R-R Interval (ms) IoRN v2 score Beginnin g

14 Wellness/Frailty Scale - Performance Performance Sleep Pattern Mobility Mood Cardiac Activities of Daily Living Question H7 CM2000 InForms restfull sleep Restless sleep inactivity stamps Distance walked Steps taken How is service user feeling today Heart rate BPM R-R Interval (ms) IoRN v2 score Beginnin g IoRN v2 score Middle IoRN v2 score End

15 E-Frailty Research Analysis Identifying Risk The Story of Person 10 #technologytoprevent

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17 InForm Assessment Builder / CMBI Assessment developed to capture Tanita scale information Assessment developed to capture Strength Grip information IoRN 2 information captured directly via an InForm assessment Data extracted and presented within CMBI for Provider and Service User/Family members

18 E-Frailty Results

19 Using Quantitative Monitoring Data person 10 Date of visit Planned start time planned end time Planned duration Actual Start time Actual end time Actual duration 01/03/ :00:00 17:30: :24:35 17:48: /03/ :00:00 09:30: :49:07 08:59: /03/ :00:00 09:30: :10:22 10:28: /03/ :00:00 17:30: :15:17 17:31: /03/ :00:00 17:30: :01:27 17:14: /03/ :00:00 09:30: :18:57 09:44: /03/ :00:00 09:30: :10:17 09:26: /03/ :00:00 17:30: :55:28 18:12: /03/ :00:00 09:30: :30:27 10:48: /03/ :00:00 09:30: :15:06 09:34: /03/ :00:00 17:30: :47:40 18:20: /03/ :00:00 09:30: :14:37 10:42: /03/ :00:00 09:30: :07:24 09:39: /03/ :00:00 17:30: :46:00 19:01: /03/ :00:00 09:30: :59:22 10:34: /03/ :00:00 09:30: :39:53 09:55: /03/ :00:00 17:30: :02:39 18:15: /03/ :00:00 09:30: :34:13 08:48: /03/ :00:00 09:30: :59:27 10:27: /03/ :00:00 09:30: :15:32 10:36: /03/ :00:00 09:30: :28:55 09:58: /03/ :00:00 09:30: :33:51 09:56: /03/ :00:00 17:30: :02:33 17:14: /03/ :00:00 09:30: :10:13 09:36: /03/ :00:00 09:30: :43:49 10:12: /03/ :00:00 17:30: :31:11 18:47: /03/ :00:00 09:30: :30:06 09:54:17 24

20 Risk Identification Identification of client who was significantly de-hydrated Identification of risk trends through client weight loss Identification of client restlessness at night therefore ongoing risk during the day Reduction in muscle mass Reduction in strength grip Increasing risk identified by the client themselves

21 Target Patient Groups - Where Risk Identified Known fallers Patients going through a reablement process Patients on the periphery with some low level telecare equipment e.g. community alarm Younger adults with mental health /memory problems Learning Disability/ Supported Living where the challenge has been in a person expressing how well / unwell they are feeling

22 Technology to Support David Carty, CM2000 #technologytoprevent

23 Advanced Risk Modelling for Early Detection Working in partnership with: East Dunbarton Health & Social Care Partnership Inverclyde Health & Social Care Partnership West Lothian Health & Social Care Partnership Dumfries & Galloway Health & Social Care Partnership NHS Highland HRM Home Care Loreburn Housing Association (Dumfries & Galloway)

24 CM2000 s Analytical Platform

25 CMBI Flags Recipient Reports Service User Citizen Family Member Practitioner InForm Builder Smart Devices Polar Loop Service User / Citizen Tanita Scales & Grip Strength Smart Devices

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31 PLAY

32 Q&A Technology for Preventative Healthcare #technologytoprevent

33 Thank you! #technologytoprevent Contact: