This document discusses how remote monitoring of patient recovery after orthopedic procedures using motion sensors can improve outcomes and reduce costs. It outlines how BPMpathway was developed to remotely and cost-effectively monitor joint range of motion and pain levels during recovery. Regular monitoring allows early detection of potential issues and personalized care. The system has shown promising results in trials, reducing length of stays, follow up appointments, and "bounce back" rates. If widely adopted, it could save the UK NHS £100-200 million per year in reduced costs while improving patient motivation and recovery.

1. Ref: MJG161006 Confidential and copyright 2016

2. How remote monitoring of patient recovery can
transforming patient outcomes and reduce costs
for the NHS
There has long been a need to deliver more
information on the fitness of a joint both in terms of
screening to reduce injury and then to monitor and
improve recovery.
In early 2000 motion analysis was initially developed
as a way to provide screening of athletes, in
particular football players but only 2-3 times a year

3. How to detect potential injuries before they
occur?
Injuries can occur for a number of reasons, but
typically are a result of joints and muscle
performance gradually decreasing over time.
The only way this decrease can be effectively
detected is through daily screening so that trend
data can be obtained. To do this a portable system
was needed so that the players could screen
themselves when away from the training ground.
But how to do this remotely and cost effectively?
BPMpathway was born.

4. How to increase PROM’s, reduce costs and
deliver a patient centric recovery solution post
orthopaedic trauma?
In the world of orthopaedics, there has long be a need to try to reduce costs by:
• Releasing patients as soon to save on over night bed costs and to free up beds
• Applying support services such as physio’s where they are needed, ie a personalised care package
• Reduction of wasted appointments where ‘everything is fine, thanks for coming in’.
• To increase PROM’s so that the hospitals/trust’s can become more efficient
The challenge was:
How to develop a reliable way to measure the recovery performance of a patient, after
they have been discharged, in a manner that was easy for them to use, motivated them
and highlighted potential issues such as infection as soon as possible?
Finally, how could this reduce costs for the NHS?
There has also been a need to increase the motivation of the
patients so that they persist and finish there course of recovery
treatment so that they can return to a productive life quicker and
not become ‘bounce back’s’ due to the condition never quite going
away.

5. By teaming up
with B.Braun we
are able to access
and support all of
the UK trusts.

6. BBC video on Golden Jubilee pilot
Your text here

7. Typical patient recovery results
Month one of recovery
Easy standard position, patient
sat on the floor or their bed,
clean UI.
Alarms are set for sending
automated alerts back to the
hospital.
Initially low and slow ROM
22deg but rose to over 90deg
but still slow. QoM ok
Pain score showing pain under
control but still there
Patient UI
Professional UI

8. Patient recovery results
Month two of recovery
More advanced position,
patient lying on their front
Any indication of infection
would show up as a reduction
in ROM and increased pain
score result.
Now the patient had faster
movements and lower pain
scores and so did not return
at ANY time back to the
physio’s or surgeons.

9. 'BPMpathway will revolutionise how we
collect movement data in orthopaedics'
Consultant Orthopaedic Surgeon Jamie Buchanan, East Sussex
Healthcare NHS Trust
'As orthopaedic surgeons, we often struggle to
accurately capture and record our patients’ range
of movement, particularly around complex joints
such as the shoulder.
BPMpro is a non-invasive novel technology that
uses wireless motion sensors to measure
movement in three planes and presents the data as
easy-to-understand, animated graphics.
BPMpathway is remarkably easy to use with
intuitive software.
Never before has such a simple device collected so
much genuinely useful data so easily.'

10. Other pilot results
Hospitals around the world have been running pilots using
BPMpathway over the past 24months but in the UK, hospitals such
as Castle Hill (Hull) are now doing Total Knee Replacement Surgery
as day cases as a result of being able to remotely monitor and
assess the patients during their recovery phase.
This results in significant reduction in costs while patient
engagement is high.

11. The global market for post-operative assessment is huge. Every year, more than 1.1m
people in the US have hip or knee replacement surgery. 85% of all hip and knee
replacements are carried out because of osteoarthritis, the most common type of arthritis
or degenerative joint disease, which affects 9.6% of men and 18% of women aged 60 years
or older.
Some 150m people worldwide, including 40m Europeans, suffer from the disease. With
lengthening life expectancies and ageing populations, osteoarthritis is set to become the
fourth leading cause of global disability by 2020.
Furthermore, it is estimated that there will be a 174% increase in demand for hips and a
674% increase in demand for knees through 2030.
What is the scale of the potential?

12. UK potential and cost savings to the NHS
EU Country Population (m)
Likely number of
orthopaedic and
spinal cases P.A
Germany 81 236,763
UK 65 189,995
France 65 189,995
Italy 61 178,303
Spain 46 134,458
Poland 38 111,074
Romania 20 58,460
Netherlands 16 46,768
Belgium 11 32,153
Greece 11 32,153
Czech Republic 11 32,153
Portugal 10 29,230
Sweden 10 29,230
Hungary 10 29,230
Austria 9 26,307
Other EU 100 292,300
Switzerland 8 23,384
Norway 5 14,615
Average length of stay on an orthopaedic ward is 3.5
nights, so a reduction of just 1 stay saves £350/night.
Just 1 reduced physio session £50/session.
Reduced ‘bounce backs’, patients who are not fully
recovered and come back, average £2500.
Reduction in wasted follow ups, ie everything was ok
£100 per saved visit/
Potential cost saving:
1 night saving: 190,000 x £350 = £66 million
(£200m if 3 nights are saved)
1 physio session 190,000 x £50 = £9.5 million
Bounce backs 10,000 x £2500 = £25 million
Reduced follow up 50,000 x £100 = £5 million
Total potential saving
£100 -£200 million per year

13. Ref: MJG161006 Confidential and copyright 2016