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Future-proof Investment

COVID-19 RPM solutions for home, LTC operators and hospitals.

Request for COVID-19 Acute / LTC deck :

@Home / Self-Quarantine Wellness Monitoring

@Home / Self-Quarantine Wellness Monitoring

  • Continuous monitoring of key vital signs including shortness of breath.
  • Monitor and count total number of coughs per day and body aches during sleep.
LTC / Nursing Home Resident Wellness Monitoring

LTC / Nursing Home Resident Wellness Monitoring

  • Continuous monitoring of COVID19 symptoms, promoting real-time medical attention when required.
  • Optional 3rd party “wellness monitoring” service. Real-time and historical data stored and transmitted to hospitals when required.
  • Mitigate liability risks
Acute / Hospital General Ward RPM

Acute / Hospital General Ward RPM

  • Continuous EDD monitoring with custom alert thresholds.
  • Provide physical and mental stress relief for staff.

Key markers for medical attention

Understanding
the symptoms of COVID19

Fever

Temperature higher than 101°F that lasts more than 2 days or fails to respond at least partly to treatment or temperature higher than 103°F under any condition requires medical attention. Xandar Kardian systems does not detect or monitor for temperature. It is also important to note that based on a recent study in the New England Journal of Medicine from Wuhan, China, only 44% of people admitted to the hospital for covid-19 came in with a temperature of at least 99.5 degrees.* In fact, David Thomas, director of the Division of Infectious Diseases at Johns Hopkins University School of Medicine, who cited the journal studies said “So, you’re missing half the cases walking in the door.” According to the CDC, temperature checks are only recommended twice a daily which also means that continuous temperature monitoring may not be necessary.

https://www.nejm.org/doi/full/10.1056/NEJMoa2002032

Cough

Upper respiratory symptoms such as cough and sore throat may appear by Day 3. An increase in the total number of coughs per day is one of the metrics to look for in other types of respiratory disease. Based on a recent journal publication-
“In the total population of healthy adults (44 volunteers) the geometric mean (logsd) number of coughs per 24 h was 18.6 (0.5). Females coughed more than males (geometric mean (sd) 29.5 (0.4) versus 8.3 (0.5).

In the total population of adults with respiratory disease the geometric mean (logsd) number of coughs per 24 h detected using the automated system was 275 (0.37) (15.8-fold; 95% CI 9.7–21.9; p<0.001) greater than healthy controls.
Cough frequency was clearly different in healthy controls and patients with respiratory disease… “

Body ache

Body ache was associated with 15% of the 56,000 initial COVID-10 cases reported in Mainland, China, which was most likely the result of immune cells releasing infection-fighting proteins called interluekins.
First, the inflammation that aggravates our muscles when we’re fighting off an infection typically lasts a lot longer than soreness caused by physical exertion; even if they feel similar to each other at first.

When our immune system becomes stimulated we become more attuned to its activity. By and large, pains caused by our adaptive immune response persist for about two weeks. The physical manifestations of this are often sharp and incapacitating.
Although coronavirus induced muscle pain is often generalized, a sizable portion of patients experience it in their lower back.

During the day, as people are more active, Xandar Kardian does not monitor for body ache. However, during sleep, with consistent body ache- especially in the lower back area, patients have reported to have trouble sleeping. With 4 years of R&D experience in sleep monitoring solutions, Xandar Kardian was able to modify the solution to monitor for body ache by looking for body motion increase index during sleep.

Shortness of breath

Inflammation in the lungs may lead to acute respiratory distress (Day 8-15). This is where “shortness of breath” occurs as the lungs start to fill up with fluid.

Resting heart rate

The heart at the same time, senses that O2 levels are low in the blood and starts to pump faster (increase in BPM). It’s important to note that, with other types of RHR monitoring devices, the “reliability” of the accuracy may be in question since the entire body must be completely still before obtaining heart rate info. Xandar Kardian’s radar solution can scan and monitor the motion of the entire body before getting RHR data, making it extremely reliable.

Created by Nucleus Medical Media.

Why does monitoring of shortness of breath and RHR matter?

Inflammation in the lungs may lead to acute respiratory distress (Day 8-15). This is where “shortness of breath” occurs as the lungs start to fill up with fluid. The heart at the same time, senses that O2 levels are low in the blood and starts to pump faster (increase in BPM).

Increase in RHR (BPM) and Shortness of breath (BPM) are two critical vital signs that alert medical staff of urgent medication + intubation (ventilator) requirement for the patient.

KEY MARKERS FOR MEDICAL ATTENTION

How can Xandar Kardian detect and monitor for coughs?

During still motion phase, Xandar Kardian’s core logic for vital sign requires the radar signals to “lock in” to the chest area to obtain breathing and heart beat frequencies. When a person coughs, there is a suden “spike” of motion emitting from this same area.

This is picked up and recorded as a possible “cough” motion.

Since there is no camera or mircorphone in the device, it is 100% privacy concern free. However, other type of “sudden” motion from the chest can occur during normal routine activity, which may falsely record it as a cough. Keep in mind, that healthy individuals coughs an average of 18.6 times a day, while someone with respiratory disease can cough 275 times a day.

See video demonstration of Xandar Kardian's cough detection

How shortness of breath and RHR deterioration is monitored.

How RHR is obtained

Xandar Kardian’s unique patented radar signal processing technology is able to “lock in” to a person heart and detect the micro-vibration frequencies that it creates as it pumps blood throughout the body. This unique signature is actually the largest continuous motion created from inside the body. Processing 15 million impulses per second, the solution is able to obtain the motion accurately by pin-pointing it through layers of noise.

What RHR of 100+ BPM means

For COVID19 – Resting Heart Rate: 100+ BPM

Researchers found that some signs and symptoms were more common in patients who turned out to have pneumonia. These were a temperature higher than 37.8°C, a crackling sound in the patient’s lungs, and a pulse rate of more than 100 beats per minute (Tachycardia).

We consider a RESTING HEART RATE, meaning the heart rate of someone in complete still motion (lying/standing/sitting still), of 100+ BPM is cause for alarm.

How RR (respiratory rate) is obtained

Breathing Rate (Respiratory Rate)

With radar technology, monitoring for breathing rate is actually – to be honest- one of the easiest. It is looking for the “up and down” motion of the chest as someone breaths. In fact, this is why the majority of Xandar Kardian’s competitors also claims “vital sign monitoring” which in reality is only referring to breathing rate monitoring. However, it is very important to note that breathing signal from the chest can also be confused with other motion (arms, legs, etc.). The other difficulty is in locking in and obtaining breathing (respiration) rate when the patient moves to the side or turns around (backside to the radar). In these situations, some of the competition simply loses the signal and cannot obtain accurate measurements. Xandar Kardian’s breathing rate monitoring solution however is based on patented “auto detect” algorithm that locks in on the breathing micro-vibration signatures even when the patient moves. Accuracy does not deteriorate, even with different body position.

Breathing Rate: >25 BPM

What RR of 25+ BPM means

Shortness of breath (dyspnea)- a respiration rate over 25 breaths per minute while resting is considered abnormal. Among the conditions that can change a normal respiratory rate are asthma, anxiety, pneumonia, congestive heart failure, lung disease, use of narcotics or drug overdose. However, in the case of COVID19, shortness of breath, starting at 20 breaths per minute can be cause for alarm and require medical attention.

See "Shortness of Breath" demo video

@Home / Self-Quarantine Wellness Monitoring

80% COVID-19 patients can self-heal as their immune system kicks in to fight off the virus naturally. After showing some symptoms such as fever, coughing and body aches, these patients get well without medical intervention.

Unfortunately, there are still 15%+ of others who may require immediate medical attention. The key marker for this is knowing when the virus has overwhelmed the antibodies and cause other damages, including inflammation in the lungs which causes shortness of breath. In fact, this is the reason behind CT scans of the lungs to visually see damages in the lungs caused by COVID19 virus attacks. As the virus attacks individuals different, there is no “rule book” in terms of how fast it can cause fatal damages to the organs. It can happen even during sleep!

Xandar Kardian’s system does not stop monitoring for these key symptoms. Optional 3rd party monitoring services are available to help intervene and call medical assistance on the users behalf, even if when used in homes during self-quarantine.

LTC / Nursing Home Resident Wellness Monitoring

Continuous, non-contact, autonomous monitoring

“Staffing” is probably the number one concern for long term care providers in the battle against COVID19. In fact, we believe it has been one of the top concerns even prior to the pandemic. “Check-ins” during the night for occupancy verification, fall detection and general wellness monitoring is a redundant task that not only consumes a lot of staff time but also cause potential disruption in sleep for the residents. With COVID19, providing proper care has never been more challenging.

Especially for some AL and IL, lack of RNs makes it even more challenging to continuous monitor the residents for key health symptoms and markers. Xandar Kardian’s solution is simple and easy to deploy and it will NEVER STOP MONITORING. Occupancy detection in real-time. Cough detection and counting. Body ache monitoring during sleep. All is possible. However, the most critical is the detection and monitoring of elevation of RHR in sync with shortness of breath. By monitoring for coughs, body aches, RHR and shortness of breath, staff intervention can occur faster, and historical data can be sent to hospitals to warrant immediate medical attention.

Risk / Liability Mitigation

“Gross negligence” is a term being discussed by the staff and senior management of various LTC providers around the world. Despite their best efforts, staff can be overwhelmed, and steps / procedures may be skipped unintentionally. Once Xandar Kardian solutions are installed in each of the residents rooms / suites, real-time monitoring begins. Data is stored and monitored securely through a HIPAA compliant server (Medstack) which can also be pushed out to EHR systems for physicians to review when necessary. Prior to that, 3rd party emergency call service providers such as Noonlight have partnered with Xandar Kardian to provide optional monitoring solutions for nursing home operators. Despite having on-site “dashboards” and mobile app alerts, a secondary third party company can also provide real-time monitoring services so that action can be made at the right time. The company will also be able to call the local hospital in charge of treating COVID19 patients with details of the symptoms to merit immediate medical intervention – including ambulances. All of these steps can help LTC providers provide best care possible while also mitigating potential gross negligence liability claims that may arise in the future.

Future Proof Investment

COVID19 may be a pandemic with a potential cure or vaccine several months to a year away at best. However, proper investment into health monitoring systems should outlive the pandemic. Xandar Kardian’s solution provides real-time and continuous monitoring of occupancy and wellbeing “over the air”. This means that spot checks or night-time “check-ins” may be automated, helping to increase staff efficiency and possibly reduce cost.

Real-time Notification via Cloud Dashboard and Mobile App Push Alert.

Secure, HIPAA compliant cloud servers can receive and store health data of residents with the ability to integrate patient EHR data. Furthermore, real-time alerts can be pushed out to various tablets, smartphones or even wearables, making it easier for staffs to get alerts wherever they are.

Get historical data over hours, days, weeks or months which can be provide important information about their overall respiratory and cardiovascular health status. In fact, if the resident qualifies for certain conditions, the entire system can be reimbursed through CPT CODE 99454. Contact us for more details.

See "Cloud Dashboard and Mobile App Push Alert" demo video

Acute / Hospital General Ward RPM

What continuous & autonomous EDD can provide

COVID19 has brought in new attention to the benefits of continuous remote health monitoring of patients in hospitals. The term “EDD” (early deterioration detection) is gaining more popularity as traditional spot-checks of 4-8 hours is proving to be inefficient in monitoring the health condition of patients. Continuous monitoring requires the devices to be securely “connected” and alert medical staff in real-time. However, it is equally important for the system to be staff-intervention free and patient-participation free. This means, staff does not have to “equip” the patient with sensors and also rely on the patient to follow-through with specific instructions.

When COVID19 overwhelms a hospital, everything can become chaotic rapidly. Knowing which patients needs urgent medical intervention can be critical. Spot checks of 4-8 hours is simply not good enough for these situations as some individuals may have deterioration (shortness of breath + elevated RHR) much quicker. Xandar Kardian’s RPM solution is the perfect future-proof system for COVID19 applications and general EDD uses post COVID19. Currently, Xandar Kardian’s vital sign monitoring solution with EDD focus in hospital setting is pending FDA 510(k) compliance clearance by summer of 2020.

Body Ache detection
via Body Motion Index
counting during sleep.

Additional symptom monitoring.

Related Patents & Journal Publications

Method for Maximize Reliability of Measured RHR/BR using Radar

IP Number: 10-1902760
Granted Date: 2018-09-20
International: USA (16/469,882)

Method for Measuring RHR/BR using Multiple Radars

IP Number: 10-1838704
Granted Date: 2018-03-08
International: USA (16/469,882)

Basic Method for Measuring RHR/BR using Radar

IP Number: 10-1777000
Granted Date: 2017-09-04
International: USA (14/748,061)

Non-Contact Health Monitoring Device(Design)

IP Number: 30-1029898
Granted Date: 2019-10-25
International: USA (29/697,348)

Preclinical Evaluation of a Noncontact Simultaneous Monitoring Method for Respiration and Carotid Pulsation Using Impulse-Radio Ultra-Wideband Radar

Scientific Reports, Nature, https://doi.org/10.1038/s41598-019-48386-9, 9:11892, pp.1-12, August 15, 2019.

Authors: J.Y. Park, Y.G. Lee, Y.W. Choi, R. Heo, H.K. Park, S.H. Cho, S.H. Cho, Y.H. Lim
Publication Date: 2019-08
Journal publication: Nature Scientific Report

Validation of noncontact cardiorespiratory monitoring using impulse-radio ultra-wideband radar against nocturnal polysomnography

Sleep and Breathing, Springer Nature Switzerland, https://doi.org/10.1007/s11325-019-01908-1, August 10, 2019.

Authors: S. Kang, Y.G. Lee, Y.H. Lim, H.K. Park, S.H. Cho, S.H. Cho
Publication Date: 2019-08
Journal publication: Springer Nature Switzerland

Non-contact respiration monitoring using impulse radio ultrawideband radar in neonates

Royal Society Open Science, The Royal Society, 6:190149, pp.1-11, http://dx.doi.org/10.1098/rsos.190149, May 20, 2019.

Authors: J.D. Kim, W.H. Lee, Y.G. Lee, H.J. Lee, T.H. Cha, S.H. Kim, K.M. Song, Y.H. Lim, S.H. Cho, S.H. Cho, H.K. Park
Publication Date: 2019-06
Journal publication: The Royal society

A Novel Non-contact Heart Rate Monitor Using Impulse-Radio Ultra-Wideband (IR-UWB) Radar Technology

Scientific Reports, Nature, DOI:10.1038/s41598-018-31411-8, 8:13053, pp.1-10, August 29, 2018.

Authors: Y.G. Lee, J.Y. Park, Y.W. Choi, H.K. Park, S.H. Cho, S.H. Cho, Y.H. Lim
Publication Date: 2018-08
Journal publication: Nature Scientific Report

Vital Sign Monitoring and Mobile Phone Usage Detection Using IR-UWB Radar for Intended Use in Car Crash Prevention

Sensors, MDPI, DOI:10.3390/s17061240, Vol.17, Issue 1240, pp.1-25, May 30, 2017.

Authors: S.K. Leem, F. Khan, S.H. Cho
Publication Date: 2017-05
Journal publication: MDPI sensors

A Detailed Algorithm for Vital Sign Monitoring of a Stationary/Non-Stationary Human through IR-UWB Radar

Sensors, MDPI, DOI:10.3390/s17020290, Vol.17, Issue 290, pp.1-15, February 4, 2017.

Authors: F. Khan, S.H. Cho
Publication Date: 2017-02
Journal publication: MDPI sensors

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