Wise Innovations for a Better Care

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 Patient

Better Patient Life's Quality

Optimization of Health Resources

● 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

Chronology (I)

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

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

Better Care

The Team

Bernat SalesFounding PartnerTechnical DirectorComputer EngineerSpecialized in mathematical analysis and signal processing

Jaume MontanyàIntegration EngineeringComputer EngineerSpecialized in medical devices integration and statistical analysis

Daniel AlomarDirectorBackground in Technical Engineering degree in Telecommunications and Industrial Engineering Broad experience in leading companies in the field of telemedicine with high technological component

The FoundersBernat SalesGastón Murias MD PhDLluís Blanch MD PhDGlòria PalomarOscar Esquirol MD

What is Better Care? (I)

Knowledge Fusion

Monitorization systems

Integration systems

Decision support systems

Interface and reports

Advanced alarms

Synchronization and

HIS integration

Integration of biomedical signals from a wide range of medical devices incorporating medical knowledge

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● …

What is Better Care? (II)

Knowledge Fusion

What is Better Care? (IV)

Advanced Alarms

Some advanced alarms recorded and analyzed breath-by-breathECG1. Lead quality2. HR (tachycardia - bradycardia)3. Extrasystole index4. Pause

ICU Ventilator1. Trapped gas at end-expiration2. Presence of secretions in airways (1)3. Double-cycling4. 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.

Net Server

Server DirectoryClient

MobileReview (off-line)

Client

LAN, gprs, ISDN, Internet (xDSL, 3G),

Satellite

Net Server

What is Better Care? (V)

Platform Layout

What is Better Care? (VI)

Information System Integration

Net ServerPACS

BB.DD.

DICOM vwf

HL7

ServerDirectory

HIS

HL7

HL7 CDA

DICOM vwf

Plugin UDIAT

Client

DICOM img

HL7

Homogeneous, intuitive and completely customizable

interface

Synchronized and high resolution

signals

Multiple patients

managemet

Video integration

Integrated Monitoring System Server (bedside monitoring)

What is Better Care? (VII)

Better Care Client

Integrated Monitoring System Client (remote monitoring)

What is Better Care? (VIII)

Better Care Client

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.

Integrated Monitoring System Client Quickreview (remote monitoring)

What is Better Care? (IX)

Better Care Client

Quick review of last clinical events detected

Review of stored data

Integrated Monitoring System Study revision (off-line)

What is Better Care? (& X)

Better Care Review

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

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

● 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)

Where we come?

Current Projects

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.

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

Daniel Alomar ClaramonteDirector

Wise Innovations for a Better Care

Thank you for your time

http://www.bettercare.es