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Future-proof Investment

COVID-19 solution for LTC facility operations.

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Benefits for Residents

Benefits for Residents

  • Peace of mind, sense of security knowing that their health is continuously monitored.
  • Customized alerts based on COVID19 symptoms (option to change in the future).
  • Able to get medical attention from designated hospital(s) at the right time.
Benefits for LTC Operation

Benefits for LTC Operation

  • Autonomous + continuous health & wellness monitoring of residents without staff intervention or resident participation.
  • Energy savings of 30-50% from true occupancy/vacancy detection
  • Efficient staff operation by reducing redundant tasks (ie: check ups during night time).
Future Proof Investment

Future Proof Investment

  • Vacancy alerts during night (ie: wandar alert)
  • Health monitoring focused on respiratory diseases such as COPD, Sepsis, Pneumonia as well as various cardiovascular diseases from long-term RHR value changes.
  • Total body motion per day index provides information about various behavioural health analysis

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).

As fluid collects in your lungs, they carry less oxygen to your blood. That means your blood may not supply your organs with enough oxygen to survive. This can cause your kidneys, lungs, and liver to shut down and stop working.

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.

Current Procedure

Manual symptom
checks by staff

Checked twice a day

call-hospital

DAY 1

Symptom:

High Fever (101F˚)

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Action taken:

Call Hospital

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Instruction Given:

Administer Tylenol to reduce fever and keep monitoring*

Checked twice a day

call-hospital

DAY 2

Symptom:

High Fever (103F˚)

arrow-down-flow

Action taken:

Call Hospital

arrow-down-flow

Instruction Given:

Administer Tylenol to reduce fever and keep monitoring*

Checked twice a day

call-hospital

DAY 3

Symptom:

High Fever (102F˚)
Increased coughing.
Complaints of difficulty in breathing.

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Action taken:

Call Hospital

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Instruction Given:

Confirm shortness of breath by monitoring for RR.

DAY 4

Rushed to
hospital ER

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May require immediate intubation

* Reasoning behind this instruction:

1. To ensure that the potential patient really needs medical attention – 80% of COVID19 patients can self-heal). This is done to prevent overwhelming of medical staff at the hospital.

2. Confirmation of COVID19 – to prevent potential patients from contracting the virus at the hospital.

Real-time monitoring

Autonomous & Continuous
symptom monitoring
by Xandar Kardian

24hr monitoring

DAY 1

Symptom:

High Fever (101F˚)
RHR: 78
RR: 18
# of coughs per day: 67

arrow-down-flow

Action taken:

Administer Tylenol to control fever and pain. Continue to monitor.

24hr monitoring

DAY 2

Symptom:

High Fever (103F˚)
RHR: 85
RR: 17
# of coughs per day: 146

arrow-down-flow

Action taken:

Administer Tylenol to control fever and pain. Continue to monitor.

24hr monitoring

LTC-warning
SMS-text-message_v2

DAY 2.2

5:35AM

Symptom:

High Fever (102F˚)
RHR: 98
RR: 25
# of coughs per day: 198

arrow-down-flow

Action taken:

Automatic Mobile App Push Alert to designated on-premise staff.


(No response for 30 minutes)

Automatic alert to 3rd party monitoring service provider – SMS text message sent to designated on-premise staff.


(No response for 10 minutes)

US-based agent calls the designated LTC facility operator/staff.


(No response for 30 minutes)

911 call initiated (optional).
Resident info + Health info sent to 911 operators PSAP (Optional)

DAY 2.3

7:55AM

Hospitalization – under care by medical staff.

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

Competition comparison

Contact-based vital sign monitoring vs. Xandar Kardian

Contact-based vital sign monitoring

Respiratory rate monitoring is one of the most important physiological data you need to obtain for various health disorders, including, in this case, COVID19. Although it may be as simple as looking and counting chest movement over 20 seconds (20 sec x 3 = BPM), it’s also the most difficult from a machine perspective. Finger-cuff styled SPO2 sensors estimate breathing rate by looking at blood oxygen level changes from the fingertip, nose-clip method air flow sensors can also be used as well as chest straps to get chest “up and down” motion. Conclusion? These are all contact-based sensors which turns a resident into a patient thereby making them bed-ridden and thus lowers the quality of life. It is also very expensive – often costing $2,000 to $20,000 per unit. Even other non-contact sensors, such as BCG sensors through the bed mattress only works when the resident is on the bed and also ranges from $2,000 to $3,000 per sensor.

Xandar Kardian vital sign monitoring

Xandar Kardian’s non-contact vital sign monitoring obtains highly accurate measurements by ensuring that the body is still (XK’s stability scoring system) and measuring chest movement, similarly to the gold standard “chest strap” method. Best thing however, is that the occupant doesn’t have to be lying down or sitting down on one particular furniture. Watching TV, sleeping, reading a book on a sofa, etc., so long as the occupant is in the provided room, XK’s system will be monitoring autonomously and continuously.

Future proof investment

Energy Saving: 35%~50%

Did you know? US Healthcare spends over $6.5 billion on energy each year. Senior housing and nursing homes are often 25-50 years old, with significant amount of older inefficient equipment and infrastructure, making it prime candidates for energy efficient retrofits.

Unlike other health monitoring solutions, all Xandar Kardian’s systems comes with it award winning 99.9% accurate occupancy detection solution. The system has already been proven to provide 35% to 50% in energy savings in various office buildings and hotels around the world. When it comes to senior living, the savings could be on the high side as lights and HVAC systems can run in “occupied” mode for several hours a day while the occupant may be out doing other activities. Optimal temperatures can be maintained with temperature control thresholds so that the room is never too hot or too cold.

Future proof investment

Efficient staff operations

Time saved.

Long term care facilities are more similar to in-patient hospital settings than to home environments. Typically, residents share rooms and the nighttime environment is not conducive to sleep due to frequent noise and light interruptions, which occur several times per hour, on average.* Depending on the city and state, some LTC operations much “check in” on the residents every 2 hours during the night. Studies have shown that majority of noises were traced to nursing staff during the night. Sleep disturbances over a prolonged period can cause sleep disorders, OSA, dementia, high blood pressure and even diabetes. **

If an LTC facility “checks in” to each resident every 2 hours at night, the amount of manpower hours can be very high. Here is an example:

5 trips x 3 min per trip = 15 minutes per resident per night.
15 min x 200 residents = 3,000 minutes / 60 = 50 hours per night.
Potential $ savings = 50 hr x $15 = $750 per night x 30 days = $22,500 per month.

As night-staff are harder to employ and retain, LTC operators can operate with leaner staff, or they can re-direct staff to provide extra care, such as fall prevention during night.***
*** Xandar Kardian’s fall prevention & detection system can provide early bed exit warning for residents who have higher risk of falls.

Even if night “check ins” are not practiced, knowing simple occupancy data (occupied/vacant) can provide operational benefits. Some residents may have sleep walking disorders. Wander alert systems are sometimes used with PIR motion sensors which can have high rate of miss detections. In-resident altercations (fights) can also break out during the night. Irregular vacancy patterns in real-time can be detected and help staff pinpoint which rooms need attention rather than doing room to room searches.

Real-time occupancy and wellness monitoring solution like Xandar Kardian can provide critical data for staffs to act quickly, accurately and efficiently.

Future proof investment

Higher quality of life

Quality of life may well be the primary reason why residents choose to live in a long-term care facility. Both the residents as well as their family members want to ensure that they can be taken care of properly while living comfortably. Whether it’s SNF, AL, IL or even AAL, continuous health and wellbeing monitoring can provide critical early indicators for potential respiratory, cardiovascular or even behavioral health disorders. Continuous and long-term respiratory rate data can help alert staff or residents of potential COPD, Sepsis, Pneumonia or even COVID19 like disorders. Continuous RHR monitoring can provide information about potential artery health related issues. Body motion index monitoring can give insight to behavioral health, including effects of potential prescription medicine.

For IL and AAL facilities, Xandar Kardian systems can even be integrated with other smart IOT devices that can automatically control HVAC, lights, TV, speakers or even robot vacuum cleaners. For example, if the occupant falls asleep on a sofa watching TV, the system can monitor the body motion index and slowing down of RHR + RR from his/her baseline to determine if they have fallen into deep sleep. At this stage, their core body temperature may also fall. In order to maintain their comfort levels, the TV can turn off automatically (IR blaster), lights can be dimmed automatically, and A/C can change the temperature setting to 2-4 F higher than previous setting. This is just a sample of what Xandar Kardian can provide to ensure “higher quality of life”.

Welcome to the future!

Contact us to learn more about our total LTC solution.
Get qualified for C-PACE financing or COVID19 HHS relief funding for SNF. *

* Part of CARES Act stimulus package.

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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