Better Care was founded in 2004 at Corporació Sanitària Parc Taulí to create, maintain, improve, and innovate tools for patient care. It aims to integrate biomedical signals from various medical devices and incorporate medical knowledge through knowledge fusion. The platform provides advanced alarms, device integration, information system integration, and customizable interfaces for remote and offline monitoring and review. Better Care has been licensed and installed in several hospitals in Spain and is collaborating with medical professionals to adapt the platform to different specialties.

1. Wise Innovations for a
Better Care

2. Better Care Origins
● Company born at Corporació Sanitària Parc Taulí, promoted by
professionals from differents fields from Corporació Sanitaria
Parc Taulí and Fundació Parc Taulí
● Target’s Company: Create, maintain, improve and innovate tools
for patient care in critical and semi-critical environment
Better Care Better Patient Optimization of
Patient Life's Quality Health Resources

3. Chronology (I)
● 2004: Starts as a Final Career Project "System to aid the
creation of medical records" from Bernat Sales computer engineer
and led by Enric Laporte PhD MD and orchestrated by Fundació
Parc Taulí
● 2006: Rethinking of the project: “Integral and universal system
for data collection, integrated with Electronic Medical Record" Led
by Lluis Blanch PhD MD

4. Chronology (& II)
● 2008: Search for company to register Intellectual Property and patents
● 2010: Constitution of the company under Fundació Parc Taulí regulatory framework
● 2008-2010: Agreements with:
○ GMV as a technological partner
○ Catalonia Department of Health
○ Ministry of Defence
● 2011: First licenses sold to Spanish Ministry of Defence

5. Awards
● 2009:"Bioemprenedors XXI" (Bioentrepreneurs) finalist award, organized by BioCat(1),
Barcelona Activa(2), La Caixa(3) , Barcelona city council, Genoma España(4) and Barcelona
Chamber of Commerce.
● 2012: "Fem Industria" finalist award, organized by College of Industrial Engineers of
Catalonia, La Salle Technova Barcelona(5) and Leitat Technological Center(6).
(1) Organization that coordinates and promotes the biotechnology, biomedicine and medical technology sector in Catalonia
(2) Barcelona Activa, a Development Agency
(3) La Caixa
(4) Public foundation devoted to promoting technology development, knowledge transfer and innovative practices, chiefly in the biotechnology sector.
(5) La Salle Technova Barcelona
(6) Leitat Technological Center

6. Better Care
The Team
Bernat Sales
Founding Partner
Technical Director
Computer Engineer
Specialized in mathematical
analysis and signal processing
Jaume Montanyà
Integration Engineering
Computer Engineer
Specialized in medical devices
integration and statistical
analysis
Daniel Alomar The Founders
Director Bernat Sales
Background in Technical Engineering degree in Gastón Murias MD PhD
Telecommunications and Industrial Engineering Lluís Blanch MD PhD
Broad experience in leading companies in the field Glòria Palomar
of telemedicine with high technological component Oscar Esquirol MD

7. What is Better Care? (I)
Knowledge Fusion
Integration of biomedical signals from a wide range of medical devices
incorporating medical knowledge
Monitorization Interface and
systems reports
Decision Advanced alarms
support systems
Synchronization
Integration and
systems HIS integration

8. What is Better Care? (II)
Devices Integrated
Some Medical Devices Integrated by Better Care:
● Dräger: Evita2, Evita2 Dura, Evita4, EvitaXL, Infinity,
Savina, Oxylog 3000+
● Marquette: Solar 7000,8000, Eagle, Centralscope,
● Philips: Agilent M1165/66/67/75/76/77A CMS,
M1205A V24 y V26, Intellivue MP20/40/60/70/90.
● Siemens: Servo-i, Servo-s
● Viasys: All devices with comm capabilities
● General Electric: Engstrom CE, Centiva, Aisys,
Avance, Aestiva, Aespire, 7100, 7900
● RGB: Omicrom FT Plus/Surveyor
● Respironics: NICO, NM3
● Puritan Bennett 840
● …

9. What is Better Care? (II)
Knowledge Fusion

10. What is Better Care? (IV)
Advanced Alarms
Some advanced alarms recorded and analyzed breath-by-breath
ECG
1. Lead quality
2. HR (tachycardia - bradycardia)
3. Extrasystole index
4. Pause
ICU Ventilator
1. Trapped gas at end-expiration
2. Presence of secretions in airways (1)
3. Double-cycling
4. Asynchronies during expiration (experts + EADi validation -ATS 2011)
5. Pulse Pressure Variation > 13% in non-triggered breaths (2)
6. Tidal overinflation (stress index b>1.2 in VCV square flow and non-triggered breaths) (3)
7. Tidal recruitment & collapse (stress index b<0.8 in VCV square flow and non-triggered breaths) (3)
(1) Jubran A et al. Am J Respir Crit Care Med. 1994;150:766-9.
(2) Michard F et al. Am J Respir Crit Care Med. 1999;159:935-9.
(3) Ranieri VM, et al.Anesthesiology. 2000;93:1320-8.

11. What is Better Care? (V)
Platform Layout
Server Directory
Client
Net Server
LAN, gprs, ISDN,
Internet (xDSL, 3G),
Client
Satellite
Net Server
Review (off-line)
Mobile

12. What is Better Care? (VI)
Information System Integration
HL7
HIS
HL7 CDA
BB.DD. HL7
DICOM vwf
Net Server
PACS DICOM vwf Client
DICOM img Plugin
UDIAT
Server HL7
Directory

13. What is Better Care? (VII)
Better Care Client
Integrated Monitoring System Server (bedside monitoring)
Synchronized and
high resolution
signals
Video
integration
Homogeneous, intuitive and
Multiple completely customizable
patients interface
managemet

14. What is Better Care? (VIII)
Better Care Client
Integrated Monitoring System Client (remote monitoring)
Algorithms to detect clinical events not included in any monitoring
device, designed and developed together with clinical staff.
Contextual alarms will give additional information and
recomendations on patient evolution and treatment.

15. What is Better Care? (IX)
Better Care Client
Integrated Monitoring System Client Quickreview (remote monitoring)
Quick review of last clinical
events detected

16. What is Better Care? (& X)
Better Care Review
Integrated Monitoring System Study revision (off-line)
Review of stored data

17. Better Care platform description (I)
Main Functionalities
● Simple and intuitive interface, easily customizable
● Single and homogeneous interface for a wide range of
heterogeneous devices
● Cost savings in the integration of medical devices
● Visualization of biomedical signals from anywhere in the world
with simple Internet connection

18. Better Care platform description (& II)
Main Functionalities
● Configurable alarms as required by the professional.
● Analysis of biomedical signals in offline mode, allowing review of
past events (with Better Care Review software).
● Can be used in teaching environment (with Better Care Review
software)
● Digitization of biomedical signals and integration into the Hospital
Information Systems HIS and PACS through DICOM and HL7

19. Where we come?
Current Projects
● Licenses acquired by the Ministry of Defence of Spain
● Installed on beds in 5 ICU (Intensive Care Units) from 5 Hospitals in a
Spanish Research multicentric project
● Installed in the Simulation Lab and ICUs of Hospital Clínic de Barcelona
● Installed in 8 beds for semi-critical patient care in Parc Taulí de
Sabadell.
● Collaboration with medical professionals to adapt the platform to
different specialties (cardiology, respiratory medicine, neuropsychology,
...)
● Participation in Marató TV3: Neurostimulation in ICU (Research project)

20. Added Value
Scientific Evidence
● Citation in scientific papers:
1. Correger E, Murias G, Chacon E, Estruga A, Sales B, López-
Aguilar J, Montanya J, Lucangelo U, García-Esquirol O, Villagrá A,
Villar J, Kacmarek RM, Burgueño MJ, Blanch L. Interpretación de
las curvas del respirador en pacientes con insuficiencia
respiratoria aguda. Medicina Intensiva 2011;doi:10.1016 /j.
medin.2011.08.005.
2. Blanch L, Sales B, Montanya J et al . Validation of the Better
Care© system to detect ineffective efforts during expiration in
mechanically ventilated patients. A pilot study. Intensive Care
Med doi: 10.1007/s00134-012-2493-4
● Additional papers pending to review.

21. IP and Regulations
● "Method and System for Managing related Patient Parameters
provided by a Monitoring Device” (PCT/EP2008/052458)
Status: Pending
● Finalising the approval of CE mark Class IIb
● FDA on the roadmap

22. Thank you for your time
Wise Innovations for a Daniel Alomar Claramonte
Better Care Director
http://www.bettercare.es