This document discusses common challenges in healthcare including increased patient acuity, pressure ulcers, falls, and staff accountability issues. It then introduces EarlySense, a contact-free sensor system that can continuously monitor patients' vital signs, motion, and respiratory rates. The system has been shown to reduce code blue events by 87%, pressure ulcers by 64%, falls by 44%, and length of stay by 9% based on a clinical trial of over 7,600 patients. It also reduces alarm fatigue for nurses. EarlySense monitoring could save a hospital with 33 beds around £537,400 annually by reducing costs associated with pressure ulcers, ICU stays, and readmissions.

1. Leyton Stevens
Director of Healthcare
BES Rehab Ltd

2. Common Challenges
Clinical:
• Increased acuity & age
• Deteriorating patients with
inadequate monitoring
• Pressure ulcers
• Patient falls
• No increase in staff
Financial
• ICU length of stay
• Increased demand for
Telemetry & ICU beds
(overused?)
• Reimbursement cuts on
adverse events & readmitted
patients
Managerial
• Staff accountability
& critical thinking
• Inadequate management
tools
• Alarm fatigue
• Patient discharge and
readmission prevention
Multi-faceted Challenges in Healthcare

3. • Cost of treating pressure ulcers: £2.1bn annually1
NHS Statistics
1. Bennett, G et al (2004) The Cost of Pressure Ulcers in the UK
2. National Institute for Health and Care Excellence (2013) Falls: the assessment and prevention of falls in older people
3. Tian, Y et al (2013) Exploring the system wide cost of falls in Torbay
4. NHS Confederation (2016) Key Statistics on the NHS
5. Data.Gov.UK (2015) Department of Health: NHS Hospital Stay
‘Harmsfree’campaign
• Cost of falls to the NHS: £2bn annually2
• Falls in hospitals accounted for 324,000 (26%) of all patient safety
incidents3
• Patient deterioration
• Average length of stay in hospital: 7 days4 with per bed day cost £4005

4. What is EarlySense?
Around the clock care,
bed and chair sensors

5. Contact-Free Sensor
What is EarlySense?
Heart Rate
Respiratory rate
Motion

6. The EarlySense Chair Sensor
“Since we started using the chair sensor we
have had zero patient falls from chairs...”
(August 2014)
S. Hughes, RN. Director of Medical
Surgical
Coffee Regional Medical Center,
Douglas, GA

7. 87%
EarlySense Benefits
Reduction in Code Blue events
Reduction in Pressure Ulcers64%
Reduction in Falls44%
Reduction in Length of Stay9%
Based on a 7,643
Patient Clinical Trial

8. What are the costs?
Falls
• Pearson, K.B. & Coburn, A.F. Evidence-based Falls Prevention in Critical Access Hospitals. 2011.
• Australian Commission on Safety and Quality in Healthcare (ACSQHC). Preventing falls and harm from falls in older people: best practice guidelines for Australian community
care. Canberra (ACT): Commonwealth of Australia, 2009.

9. Reducing the incidence of falls

10. 87%
EarlySense Benefits
Reduction in Code Blue events
Reduction in Pressure Ulcers64%
Reduction in Falls44%
Reduction in Length of Stay9%
Based on a 7,643
Patient Clinical Trial
Reduction in Pressure Ulcer Incidence

11. What are the costs?
Reduction in Pressure Ulcer Incidence
• Cost of litigation £180,000 per case on average
• £2 billion pa
• 4% of total NHS budget
• Prevalence of Hospital Acquired Pressure Ulcers is 5% in acute care settings1
• Treatment costs: up to £40,000 an ulcer
1 Lyder et al. Hospital-acquired pressure ulcers: results from the national medicare patient safety monitoring system study. J
Am Geriatr Soc. 2012 Sep;60(9):1603-8.

12. What are the costs?
Reduction in Pressure Ulcer Incidence
1 Lyder et al. Hospital-acquired pressure ulcers: results from the national medicare patient safety monitoring system study. J
Am Geriatr Soc. 2012 Sep;60(9):1603-8.
Pressure ulcers are considered to be preventable;
and Hospital Acquired Pressure Ulcers (HAPU)are
commonly perceived as an indicator of
quality of care
• Stay in hospital longer - 136% higher average length of stay
• More likely to be readmitted within 30 days - 33% more
• More likely to die during their hospitalisation: 2.81 times (181% more)
Patients with HAPU compared to patients without HAPU are1

13. Reducing the incidence of Pressure
Ulcers

14. 87%
EarlySense Benefits
Reduction in Code Blue events
Reduction in Pressure Ulcers64%
Reduction in Falls44%
Reduction in Length of Stay9%
Based on a 7,643
Patient Clinical Trial
Reduction in Pressure Ulcer Incidence

15. Vitals tracking
Critical events are estimated to occur in up to 17%
of patient admissions1
1. The Joint Commission Guidelines
2. Schein R.M. et al, Chest 1990; 98: 1388-92.
3. Franklin C. & Mathew J. Critical care medicine 22, 244-247
4. Young MP et al, J Gen Intern Med. 2003; 18: 77-83
5. Chaboyer W et al (Amer J of Critical Care. 2008;17)
6. Churpek, M et al. (Chest: 2012;141)
Significant number of
critical events are
preceded by warning
signs 6 to 8 hours
prior to the event1
• Heart and Respiratory Rates are most
valuable early detectors of deterioration
risk5,6
• Responding to early warning signs reduces
mortality by 75% and cost by 40%4
• 66% of patients have abnormal symptoms
6 hours before cardiac arrest and the
doctor is informed only in 25% of these
patients3
• 70% of patients have respiratory problems
within 8 hours prior to circulatory arrest2

16. Cardiac Arrhythmia – Case Study
About the Patient:
A 55 year old female with metastatic Lung Cancer. History
of Pneumonia, Embolus and Stroke. Hospitalised for over a
month awaiting rehab placement.
EarlySense Indication:
7:30 AM: High HR alerts (180’s BPM)
Assessment:
Complaints of palpitations and light headedness. The
patient had not reported this, thinking it a symptom of her
condition. An ECG was undertaken and an Atrial flutter
identified.
Response:
Suitable medication was prescribed
Outcome:
The patient returned to normal sinus rhythm.
High Heart Rate Alert Leading to Identification of Atrial Flutter
and return to Normal Sinus Rhythm
Med-Surg Dep., MA, USA
Lines Icons
Respiratory Rate
Heart Rate
High Heart Rate Alert
Multiple Alerts

17. Paperless Recording of Data
along with Trend Analysis

18. EarlySense Reduction in Alarm Fatigue
In comparison with other monitoring solutions designed and
intended for the acute care environment, EarlySense provides
very low alarm rates:
1. Zimlichman et al. Evaluation of EverOn as a Tool to Detect Deteriorations
2. LifeSync: LifeSync Wireless ECG System… Increases ECG Alarm Accuracy
3. Malviya, S. et al., A & A June 2000 vol. 90 no. 6 1336-1340
Monitoring
Technology
Alarms per 100
hours of
monitoring
False alarms per
100 hours of
monitoring
Alarms per nurse
per shift
False alarms per
nurse per shift
EarlySense1 2.8 1.2 1.7 .07
Telemetry2 151.8 82.0 91.1 49.2
Oximetry3 200.0 118.0 120.0 72.0

19. 1. Allman RM, eat al. Pressure ulcers, hospital complications, and disease severity: impact on hospital costs and length of stay. Adv Wound Care. 1999.
2. Milbrandt EB, et al. Growth of intensive care unit resource use and its estimated cost in Medicare. Crit Care Med. 2008. Health Care Utilization
Project (HCUP), Nationwide Inpatient Sample (NIS), Agency for Healthcare Research and Quality, 2008
Model
Analysis
Consideration
Savings Per
Patient
Admission
Annual
Savings
1. Base Case Total cost of intervention effects $710 $1,701,600
1. Conservative
Includes only direct variable cost
Component of final day of LOS
$224 $537,400
Slight, SP et al, Society of General Internal Medicine. 2013
Assuming 33 beds, 2,500 Patients per Unit per Year
Costs Associated for Calculation:
 Pressure Ulcer = $15,229 per case¹
 Medical-surgical Hospitalization = $1,448 per Day²
 ICU Hospitalization = $2,575 per Day²

20. EarlySense cost comparison
With EarlySense
(33 beds implementation)
Without EarlySense
(90 beds)

22. Any Questions?
If you would like to know more about delivering improved outcomes using EarlySense
Please pay us a visit: BES Rehab Ltd on Stand 128