http://www.e-ucare.eu/public/files/recap/Dissemination%20events/Hub3/MedeTel%202014%20Docobo%20April2014.pdf

1. doc@HOME
Digital Care Platform
- Improving outcomes and
efficiencies of managing patients
in the community
An EU Success story - From
an RTD Project to a delivered
service
Adrian Flowerday
MD Docobo Ltd
28/04/2014
Copyright Docobo Limited
Not to be reproduced without
permission
1

2. Copyright © Docobo Limited Not to be reproduced without permission
doc@HOME – an FP5 RTD Project
Transpond – an embedded OEM product
provider
– Approached by Estonian Research group to
join a project – proof of concept already
developed
– €2m project – 50% funded
– 3 SME’s and 4 Clinical sites
– Technologists, clinicians and practitioners
Docobo Ltd - SME formed Sept 2001
– to commercialise the output – doc@HOME
– Self funded/project initiatives for
development and validation
UK developer/manufacturer
– EN13485 BSI approved Medical Devices
EU Success Story
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3. Copyright © Docobo Limited Not to be reproduced without permission
Phase 1 Projects to Build Assurance
RTD Framework 5 programme (initial development)
– Design of home monitor and service infrastructure
– Demonstration of service delivery
DTI SMART Award -
– Value added design to FP5 outcome – design adapted to market
– Focus on USP of Patient Self Care Empowerment and Motivation
Quality of Life Programme – REALITY - validation studies
– Determine and demonstrate Socio-economic impact
– Qualify ethical aspects of deploying home monitoring
– Trial service delivery impact - 200 patients monitored over 12
months – Multi disease - create start of evidence base

4. Copyright © Docobo Limited Not to be reproduced without permission
Phase 2 to Establish Evidence
eTEN project – business case and market entry
– Validation study - virtual outpatient clinic for unstable diabetic
patients
– Business case development - Roll out of services
Southampton COPD (Interreg III)
– COPD management in the community
– One of UK’s first successful Telehealth projects
Framework 6 project - (ENABLE)
– New approaches – assistive living – applied services
– Integration of smart sensors / data fusion / control / communications
– Next generation fall detectors
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5. Copyright © Docobo Limited Not to be reproduced without permission
Key Objectives – use case design lasted
Single and Multi-patient use
Configurable for all chronic diseases
Capacity to handle co-morbidities
Key vital signs – ECG, Respiration Rate, HRV,
Aortic Pressure wave
Programmable alerts
Logs interventions
Messaging
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6. Copyright © Docobo Limited Not to be reproduced without permission
Phase 3 widen product range
TSB ALIP1 PEACE and ALIP2 PEACEAnywhere – New product
development
– Develop Android based Medical device
– Develop new Web 2.0 based server
– Develop new comms options
Framework 7 project – (I Don’t Fall)
– Falls prevention and rehab
– Interoperability between Telecare and doc@HOME
– Connectivity to external devices for secure data transfer
Framework 7 project - (eSMART)
– Cross Europe Smart phone based symptom management for patients with
cancer
– Multi Language product range
Commercial success
– Two major Tenders won in UK NHS – Yorkshire and Nottingham City - 1000
patients
– 10 other NHS customers moving to the new solutions
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7. Copyright © Docobo Limited Not to be reproduced without permission
Need-ability Index
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8. Copyright © Docobo Limited Not to be reproduced without permission
ArtemusICS™ - Intelligent Identification
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Secure
Data
Warehouse
SUS Data
Primary Care Data
Tier II Data
GPSI Data
Risk Stratification
Engine
Risk
Score
ArtemusICS
Processing
Engine
Community Data
Social Data
ArtemusICS
• Statistically agnostic
• Web Based LTC Dashboard
• Drill down to CCGs and GP practices
• Filter by disease group and/or Co-
Morbidities
• Commissioned by NHS Surrey
• Predicted costs, vs actual utilisation
• Indentify unknown costs
Identifies
NEED
Intelligent Management
• Medicine Optimisation
• Condition specific optimisation
• Intervention assignment
• Regular refresh
• track change
• benefits realisation
• Intervention tracking - data
entry

9. Copyright © Docobo Limited Not to be reproduced without permission
ArtemusICS – single source of population
health diagnosis and treatments
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10. Copyright © Docobo Limited Not to be reproduced without permission
Understanding Utilisation In Time
1510

11. Copyright © Docobo Limited Not to be reproduced without permission
Options to meet need and ability
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12. 28/04/2014 Copyright Docobo Limited Not to be reproduced without permission 12
Patient & Care Giver
•Elderly
•Poorly
•Symptomatic
•IT Literate
•Mild LTC’s
Diabetes II
Asthma
Case Management Wellness
CarePortal™
Smartphones
DocoboAPP
Encrypted and secure data
Broadband, 3G, 4G
Tablet Browser
Telehealth: Access choice according to clinical need, nurse/patient
preference and cost
TV
Clinical
Database
doc@HOME®
Flexible question selection to enable management of all co-
morbidities and clinical pathways for each patient
DocoboWEB™ (Email/SMS with URL + 2NET)
Health and
Well being
APP’s
NHS N3
Intranet

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Clinicians View
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14. HVI and Rhythm Analysis

15. Sinus Rhythm
Electrical vs mechanical activity

16. Wenkebach + Ventricular Beats
P-R wave gets progressively longer until P drops the followed by shortened P-R
Blood flow follows all typical QRS but is absent following Ventricular beat

17. Copyright © Docobo Limited Not to be reproduced without permission
doc@HOME supporting Care Homes in Sussex
Developed with Sussex Community
Health
Involves Community Matrons who are
assigned to a set of Care Homes
Multi-Patient Unit set up in each Care
Home
– Questions for UTI, Respiratory, Cardiac,
Diabetes
– Different questions for each patient
– Care Home staff take tablet to each
patient on Mon, Weds, Fri
– CM’s monitor remotely via doc@HOME
and pick up negative trends
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18. Copyright © Docobo Limited Not to be reproduced without permission
doc@HOME supporting Care Homes in Sussex
Initial results – 3 months in
– One Care Home that had one of the highest rates of admissions (22 in
2013) – now within the normal range (2 in last three months)
– Patients and their relatives are extremely satisfied
• Patients like the solution
• Patient’s families like the solution and asking for their parents to be put on the
service and those that are using it don’t want it to stop
• Help identify the need for end of life care so the patients died in the place of their
choice
– Care Home is over the moon!
• CQC visited a home using the solution and loved it. Ticks all the boxes from CQCs for
patient involvement.
• Care Home staff are motivated, engaged and more confident
• CM able to educate Care Home staff
– CMs love the solution as it enables them to work closely with the home
staff and patients
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19. AF Screening – Stroke Prevention
Clinical Assessment Centre
Attendance at Flu/other opportunistic event
– Patients over 65
– All patients have 20 second Vital Signs snap shot
• ECG lead I; Aortic arch blood flow; Respiration
• + Dependent variables
– All patients answer symptomatic data question set
– Patients have BP measurement if not recorded in
the last month
– All patients identify concerns about falling

20. AF Screening - Results
Clinical Assessment Presentation
Docobo Assessment
– 851 patients recorded vital signs over 4 weekend clinics
– 3 life threatening conditions were identified and corrective
action taken
– 23 patients with definitive Atrial Fibrillation identified
– 16 patients with borderline Atrial Fibrillation – 8 confirmed by
12 lead ECG
– 12 different arrhythmias identified
Post Study (6 months)
– All patients reviewed and now on appropriate therapy
– No incidence of Stroke reported so far
– No deaths reported so far
– 3 lives saved by prescription of pacemakers
– All high BP patients being reviewed for optimum medication

21. 28/04/2014 Copyright Docobo Limited Not to be reproduced without permission 21
GPRS, 3G
Broadband
Patient & Care Giver
•Elderly
•Poorly
•Symptomatic
•IT Literate
•Mild LTC’s
Diabetes II
Asthma
Case Management Wellness
GPRS, 3G
Broadband
PSTN
CarePortal™
GPRS, 3G
Broadband
Smartphones
DocoboAPP & DocoboWEB™ (Email/SMS with URL
Encrypted and secure data
TabletPCs & Macs Laptop
GPRS, 3G
Broadband
GPRS, 3G
WiFi/Broadband
Telehealth: Access choice
according to clinical need,
nurse/patient preference
and cost
TV
GPRS, 3G
Broadband
Clinical
Database
doc@HOME®
H2020 – what do we want to do
H2020 development: Data
analytics to detect short
and long term trends and
predict onset of
degradation in health
H2020 Development
Intelligent sensors