635 - Vital Signs Monitoring Reimagined: Predictive, Not Detective, and Ahead of the Alarm

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Speaker B: Welcome to the Talking Health Tech Podcast. My name is Peter Birch. Today on the show I'm joined by Andy Hurt, head of strategic accounts at Aerocom, and Sam Yang, co founder and CEO at Zander Cardian. G' day gents. How are we going?

Speaker C: Couldn't be better.

Speaker A: Yep.

Speaker D: Good morning.

Speaker B: Nice one. Good to have you here on the show. Looking forward to diving into it on a topic that I don't think we've covered too much in or not in this, uh, amount of detail either. And uh, exploring some of the ways technologies can, can really get in front of some, uh, in ways some people maybe haven't thought about or it might break some of their preconceived ideas on how to do it. So let's kind of dive in. But firstly, let's give some context. Andy, tell us a bit more about you and Ericom and the work you do and we'll go from there.

Speaker C: I'm Andy Hurt. I focus in the Australian, New Zealand market, primarily focused in the health sector. My job is to spend all my days talking to clinicians, facility managers, IT people in the health business, um, understanding their needs and understanding how to improve care models for, uh, each of those different, uh, environments that they're trying to pass on and do every day. Whether it be a workflow in the business to improve, uh, care models or it is introducing technology really just to enhance the ability to see how individual residents or patients are actually, um, performing each day.

Speaker B: Got it. What about you, Sam?

Speaker D: Yeah, so I'm the CEO and co founder for a medtech startup company called Xander Cardian and we specialize in using radars to collect your heart rate and breathing rate, um, health information basically, uh, ambiently so non contact through the air and continuous real time.

Speaker B: Interesting, because when I think about continuous monitoring in healthcare and if my mind went to like, oh, I'm managing a, um, healthcare facility or uh, like a location where I need to know like what everyone is doing. My mind immediately goes to. Well, the technology that we've got available to us is cameras, uh, or wearables or um, you know, or audio, like all the different detection things. But, um, not too familiar with this, um, uh, contactless, uh, monitoring through radar, did you say? Maybe tell us a bit more about the technology there, Sam?

Speaker D: Yeah. So the camera you mentioned, privacy issue. Wearable is compliance issue. But that's the obvious thing. The thing that people don't really associate radars is with the accuracy of the measurements as well as the unique information that you can collect with radar. We are not, you know, trying to have you put down your, you know, smart ring and, and you know, use our device. No, you can do whatever you want. You can use a ring, you can use a wearable, but you're collecting information differently. Now let me explain why. The radar that we use is something called an impulse ultra wideband radar. Now the impulse signature is pulsing about 15 million signatures. So radio frequency signatures per second. And these are 40 times safer. So lower power, 40 times lower power than home WI fi routers. So no, it's not going to radiate you. Like it's not, has no impact. Hearing aids, pacemaker? No, no problem. Right. So it's actually been tested on, in nicu. Uh, we have clinical trials on nicu. So neonatal intensive care unit. So, um, putting this sensor around your bed, so it can be above your bed, near uh, your bedside or whatever, wherever it is, it will automatically collect how you're moving. So first data that we collect is your body motion. So tossing and turning during your sleep, we can use that. If you leave the bed in the middle of the night, bed exit, we can use that information when, how often, how long are you away? But then when you're still, we actually know that you're very still head to toe. So unlike wearable, which is collecting information from one part of the body, like a finger or wrist, we're scanning your entire body. So that means by definition we know exactly when you're very stable and only that's when we start collecting your breathing motion. So unlike wearables where it's, it's guessing your breathing rate through HRV correlation, we are actually looking at how your lung expands and contracts. So your inhale, exhale, motion, that means that we get how deep you're breathing or how shallow you're breathing if you're doing apnea and then if you do rapid breathing, that's all rrv. So respiration rate variability. Now on the heart, we start collecting Your pumping motion. So again, ekg, electrostatic PPG for the wearable, it's blood volume information. But we use radar to collect how your heart is moving so motion. Which means not only are we getting super accurate bpms, uh, we are able to get how like um, how clear your pumping is and also how irregular that is. So yes, everybody knows about arrhythmia afib, but that's once in a while what we do is we collect consistently and see if there is a clarity, uh, score, uh, going up or down. And uh, that gives us the data to predict heart failure, copd, uh, and things like that.

Speaker B: Well that all sounds remarkably fancy, doesn't it? I don't know. I mean the amount of wearables and devices I've got ready to kind of measure what's happening on my finger, on my hand or my whatever. Um, no, the ability to do it um, without wearing anything in an environment. Andy, I, I mean I can start to think what potentially this uh, type of technology has application for in healthcare. But you know, you're speaking to a lot of facilities, not just in, in hospital either. So you know, you, you've got um, connections to all kinds of places that potentially would um, you know, are already doing this but in probably more lo fi, for want of a better term ways.

Speaker C: And that's right. I mean we, I, I spent a lot of my time working with clinic managers and IT people defining use cases because as you can imagine, once you've got that base data, once you've got the information being stored and you can then review it and analyze it and look at what is possible with all of that data, you can then start to really apply that in a use case environment. And let me give you an example for someone who is, or a facility that is trying to make sure they're optimizing the rounds being done by clinicians to ensure we prioritize which one of the 160 patients we're going to go to first overnight. We can see potentially if there was a deterioration in a particular set of, set of um, uh, individual residents and we can prioritize that kind of um, uh, ward round, um, uh, monitoring, um, and so the use case definition and working with the different um, parts of the business really gives us the ability to be able to work with them to see where their insert of this technology can do the most benefit. And so um, it's that continuous monitoring piece that is, that differentiates this. It's the in between um, the ward rounds, um, that normally happens day to day. Where you have a clinician going in and taking, Taking the vital signs of an individual, then going back out. It's in between that, those monitorings where the actual deterioration may well happen. So we're getting some real interest in how do you make sure that you've got that continuous monitoring and the data storing. On top of that, you've got some real regulatory issues that are coming in, or regulatory requirements coming into a lot of those facilities, whether that be aged care or, um, hospitalisation, where, um, we need to be able to, uh, properly govern the data when things happen, how often this happened, and this is being stored and time checked. And so we can actually put some overlays over this. This is revolutionary in a lot of ways, where you don't have to have that and Sam articulated beautifully, where you can combine it with wearables or whatever else, but when you're talking about aged care or palliative care or mental health environments, having wearables and charging batteries and those kind of things is not an option where you can actually put these in play. We're getting some real interest from people that have this challenge every day and they can see something like this, which is contactless, which we call it, um, where we have this ability to better monitor individuals and their vital signs and just three really important pieces, which is the heart rate, breathing and movement. Combine those three together and you can get some really interesting outputs. And we're getting some good sleep information, we're getting good ability to be able to diagnose. And clinicians are loving this.

Speaker B: M well, that's what I was thinking too, because I know Aerocom has got, you know, um, a lot of the work you do across healthcare and aged care and the palliative, like you mentioned, but in corrections too, like, there's all kinds of situations where you need information to be able to inform decisions. But I guess information isolated by itself is only one thing. It doesn't matter how accurate or how clever it is. You kind of need that knowledge and expertise to be able to then tie it all together, work partner with that facility, wherever they are, to be able to say, well, what do you need to know? And like, we've kind of got in the toolkit, the ability to. To pull this together as part of a broader workflow. Is that. Am M. I kind of on the right direction here, Andy.

Speaker C: Absolutely. And one of the things that I emphasize continually, this isn't to replace clinicians or replace existing things. This is to enhance, to be able to ensure that you've got what you need to make the right decisions. This isn't to predict certain things and basically replace um, any of the uh, normal process you have. It is to help with training, help increase the baseline and what you're doing. Give the right information to the right people to give the, give them the ability to make the right answers.

Speaker B: That makes sense to me.

Speaker D: Yeah. Can I actually uh, add to that there, uh, to that comment, I think it's very important. Um, so aircraft is our partner for Australia, but in the US we have uh, now deployed over 49,000, uh, so we have monitored, sorry, 49,000 unique patients and uh, they're all tied to an EMR system in the US called Point Clear Care. And uh, what we have been able to independently validate, uh, is to see how many people are showing signs of deviation from the baseline and therefore being transferred to the hospital. The number came back 75.6% of those people who are hospital transferred, our alarm was going off seven days earlier now. So that's what we call POVC Probability of Baseline change Score. Um, uh, um, so we're informing out of 100 beds on average. So out of 100 beds in a skilled nursing facility we are able to pick out that three to five uh, residents have a deviation from their baseline. Uh, that baseline change is very important because you're not getting heart rate, breathing rate when you're moving, you're just getting when they're still for hours and hours every three seconds we collect. So um, going back to what Andy just said, we are informing the staff which of the residents or which of the hundred that you need to prioritize, you need to focus on care. So take a blood pressure measurement every so often, um, and do more um, intervention. Uh, so we're not replacing but we're ah, assisting. We're the AI uh machine that's basically saying hey, you need to go check out um, Peter, Tom and Barbara because of these baseline changes. So that is our role to inform.

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Speaker B: The uh, point that Andy raised in uh, earlier was around, you know, regulatory requirements, which made me think about, you know, it's one thing to have very cool technology, but hey, we're in health care, so everything needs to be FDA and TGA and X, Y, Z, um, uh, cleared. Um, but you know, you mentioned that you've got a pretty strong presence already in the, or growing presence in the U.S. um, Sam, the um. How does that kind of stack up in terms of your capability and the requirements from a, from a regulatory.

Speaker D: Yeah, so we're class two FDA, uh, cleared, ah, 510k in the U.S. we also have TGA clearance in Australia, uh, as well as uh, four other countries. Canada, uh, Singapore, even Thailand, South Africa. Uh, we're now in uh, in line to be getting South Korea, Japan, Taiwan, China. So we're, we're rapidly expanding. Uh, but we are a full. For Australia. We're, we are a TGA class two.

Speaker B: Well, I mean that, that provides that, that reassurance, that confidence and I guess is with a uh, you know, that assistive tool, I guess as you kind of, you know, alluded to earlier, I feel like that's a real kind of power and a use case for you know, um, AI and uh, other kind of newer technologies. You know, like you've kind of emphasized too, it's that there's the, the scarce resource that we have of human carers and staff that um, you know, all are an investment in time and um, even just cognitive load as well. So the more information we can surface that is meaningful and direct and provides direction, that's, that's um, super helpful. Now with that regulatory piece aside, like you know, with that regulatory piece kind of established, then I guess I think about the, not just the um, return on investment for a particular healthcare facility. You know, the problem that it seems like we're talking about sue is if we can get in front of a particular admission early or you know transfer from a patient into a more acute setting or whatever that has knock on implications to all parts of the healthcare system I'd imagine. Andy, like the, the decision to implement this kind of capability within say one particular setting surely has uh, knock on benefit to other parts of healthcare too.

Speaker C: Absolutely. Look, the flow on effect I think is the right way to put it in that um, there's cost for um early detection and there's cost savings in all of this in so many different ways. But the cost and burden of having to admit someone to hospital, the flow through that um, from the individual all the way through to government care with hospitalisation through ambulance, through transport, through um, the doctor environment, et cetera. I'd like to use a bit of a story um, and that is you know when we've got um, an aged care individual usually they show symptoms at midnight let's say because they've got a urinary tract infection. And this is actually a very common um situation in most aged care facilities where they have already um, exhibited a lot of signs but not necessarily symptoms up until that time. And communicating to an aged carer or someone with limited verbal um, generally is difficult to get that they're just about to really get to a very painful state. Then they have to be transported to hospital. That's the only route because there's no Dr. Environments late at night in most aged care facilities an ambulance is called generally speaking then it goes into um, a stacking problem. In hospitals where they've got multiple ambulance stacking going into and admissions inside a hospital they generally get admitted. They um, then get the standard care of a doctor giving them some uh antibiotics to overcome the urinary tract infection that they've got and the next day they're sent back to um, the aged care centre. The disruption for the individual, the cost for the hospital bed, the cost for the ambulance and the cost for the individual having to be transported and totally uh, out of sync of what they're normally doing. This could all be um, averted by the fact that early signs and symptoms can be detected by the POBC score that Sam uh talked about before where we're talking about the probability of baseline change of individual's heart rate. Breathing and movement showed agitation, showed the heart rate um, going up, showing the breathing um change of the individual in most cases could be days earlier and therefore during normal business hours a doctor could have admitted to the antibiotics and the whole problem would have been averted. So the cost flow is incredibly impacted. Um, if you don't early detect, if you wait for being reactive rather than proactive, it changes everything. So the care models that we're talking about, it just shifts the ability to be able to give that ability back to the clinicians and gives them the ability to prioritize the staffing, the nursing staff, etc. When it is necessary to actually get the best result.

Speaker B: M. That makes sense to me. I did think while, you know, Sam was speaking about, uh, sorry, Andy was speaking about that example and other ones that Sam has too. You know, I think, um, I'm trying to think about how the technology works in practice as well. And the reality is of the more things we have in, say, healthcare that monitor stuff and then alert someone that something is outside of, ah, you know, a reasonable band, the more and more things that we add that can provide alerts, it then creates that, like that awful concept of alarm fatigue and like, well, hey, you know, there's, you know, the everything's okay alarm that from, um, you know, the. That is not overly helpful. So, um, you know, and I think at one point you were talking about, you know, like, it's. It's somewhat real time, and other times you were talking about how it's giving insights over a longer period of time too. Is there kind of a sweet spot in like, is it just observing information over a couple of days and be like, hey, you know, we're pretty confident now, or is there. Is it just different based on whether it's, you know, based on seconds or days or weeks?

Speaker D: Yeah, let me, uh, if I. Let me answer that question. So it's all about longitudinal health data. So actually, let me ask you a question, Pete, please. Do you know your baseline heart rate and breathing? Your true baseline?

Speaker B: My true baseline. I know that mine is. It kind of hovers between. It's quite lower than. I'm like 55 to 60.

Speaker D: Yeah, but I could be wrong.

Speaker B: I just said that confidently. I don't know. You would think. You would think I'd be well across it all with the amount of things I measure, but it just pings me to say that, oh, this is no good.

Speaker D: But there's a reason why I mentioned that, because we collect, uh, about an average of 6 to 10,000 measurements of your breathing and your heart rate every night. Right? Just you go to bed, you wake up and you already collected that many times. But like I said, only when you're at rest mode, which means only baseline. We are the best tool if you want to know what your real baseline is now, you said 55. So for you, if you went from 55 bpm baseline and for eight hours, 12 hours and 6,000 times measured, you went to, let's say 70. Something is not right. Right. You're not talking, you're not moving, but your baseline just jumped up.

Speaker B: Not doing a podcast. You should have asked what the podcast episode BPM is. But, uh, it's a chill state. But, uh. No, I know what you mean, though.

Speaker C: Yeah.

Speaker D: No, but, uh, by the way, that's a good, healthy, uh, number. However you say, hey, doctor. Hey, nurse. Uh, Pete's BPM is 70. What do you think that the doctor is going to say? What do you want me to do? Yeah, yeah, he's fine, right?

Speaker B: 70. Fine.

Speaker A: Yeah.

Speaker D: Uh, so it's, uh. But then for you it's not fine right now. My being a star founder, my probably every founder has a high baseline heart rate. I'm like 85.

Speaker B: Maybe mine was aspirational to be fair, too. I don't want to oversell myself. Uh, maybe I should check my data.

Speaker D: Um, yeah, but if I, If I go from 85 to, let's say 88, I'm totally fine. Nothing wrong with me. So my point is this. You going from 55 to 70 is. Is very concerning. Me going from 85, 80 is not concerning. So then why are we still using that threshold for alerting? Right? So that's the whole basis of this PUBC scoring system. Everybody's different. Uh, and then we are very proud of saying that we are in the business of informing, not alerting. You see, alerting is reactive care. Informing is proactive care. Ah, so alerting is after something happens. Informing is before something happens. There's a trend happening. That's very concerning. That's so wrong. So again, going back to the whole longitudinal data, if we are collecting this true baseline information every single day, thousands of times, day after day after day, that creates the longitudinal data of insight for any clinician physician to see. Hey, for Pete, this is not right. Let's do something. Right. That, that's the whole basis of this

Speaker B: makes so much sense. Uh, the, um. And if I was to take the view of, you know, a, uh, healthcare or a care setting, Andy, that is, you know, it's got their attention and they're like, look, this, these are things that we need to. That we're monitoring now through XYZ capability, or, hey, that, that's striking a chord. Like, what, what are the. At what stage are the companies best to have a conversation with you like, what's the most productive time to have a chat with ericom about how this all kind of fits in with, um, you know, the broader workflow they have.

Speaker C: We're finding that different organizations have the conversation and it's actually easy to interject any new environments at different stages, whether they're building a new facility, whether they're upgrading a facility, whether they're looking to make, um, different decisions about their care models. Now, where Aerocom comes in and differentiates ourselves when we look at technology like this, because it is an ecosystem play, and when you're talking about alerting and when you're talking about other technologies that can be potentially seen in an ecosystem care model for, um, different environments, whether it's residential aged care, whether it's independent living, whether it's at home care, whether it's in hospital or ward care and so on, um, where you've got those different environments. Aerocom come to its own where we can start integrating the cabling system, the data cloud, um, monitoring and bring it into how the different facilities are actually wanting to run. Whether they have a single nursing station, whether they have clinician stations, whether they have remote environments, as Sam was talking about before, where potentially we have, um. It's not all of that information being monitored and dissected on site. It might be off site. So we actually work with different people at different times. Um, and so when would it be necessary? The way that we've found that a lot of people are taking some momentum is finding a use case, finding an environment, doing it in a trial environment, um, where they can actually say, I can see how this technology is going to actually benefit what we're doing and how we work, and then we work with them to actually get the most out of it, it. When, it. When, when they can get those models. Right. So there's no one answer to that, Pete. It actually is a case that different people and as you know, in, in the health industry, it's an incredibly moving, incredible moving target where we've got acquisitions, mergers, acquisitions, changes happening. That's also a good time to actually get some consistent care models.

Speaker B: Yeah, 100%. Um, I'll come back to Andy in a sec for any kind of final thoughts for this discussion, but I thought I'd take the chance to. While you're here, Sam, thinking about, you know, this cool use of, um, new or emerging technology and healthcare, great application and great, uh, opportunity in Australia. What other. What else are you seeing outside of the region that could be interesting to, you know, healthcare leaders in this region or anyone else that's tuning in that you're kind of getting involved with as well.

Speaker D: Yeah. So we're very privileged to be in discussions with various nonprofit organizations in the fight against, uh, Ebola in Africa. Uh, you. You guys maybe have heard, uh, from the news, uh, who is flagging this as a big emergency. Now, Ebola is a virus. Uh, and uh. And just like how Covid, you know, did the whole. Whole, um, devastating, uh, impact to the world. Um, every virus has, ah, an attack on the immune system. And that's why it's very difficult now with Ebola. It's actually even very serious. It's destroying the immune cells. And so, um, it's uh. It's. The death rate is about 47% right now. Um, our sensors are being studied now to be deployed on site in uh, uh, the Congo, uh, in the hot zone because of exactly what we just talked about today. Um, helping to continuously monitor, helping to remove the exposure from the healthcare professionals. Having to go in, in person to get all their measurements and knowing exactly. So informing once again, informing exactly when to re. When there's the uh, tachycardia and you uh, know, the increase of heart rate, increase of breathing. That's when you go and provide IV fluids, provide oxygen so that you hope that the body can naturally fight off this virus. So it's a, ah, extreme privilege and we're very honored to be even talking to them. Um, and fun fact. Two years ago, we were named by WHO 2024 Compendium for Innovative, uh, Medical Devices for Low Resource Settings. Because our devices can be used even without LTE or WI fi. It can be used even on battery power. So if there's um, lack of uh, uh, constant power, no problem. Battery packs just keep replacing it. So, yeah, mission.

Speaker C: Yeah.

Speaker B: Yeah, you got a lot of things going on. No, that's fascinating. It's great to hear, like the, I guess, um, the use case in, you know, the more complicated technology scenarios and right down to when, where you need it most as well. And lastly, Andy, just thinking about the broader suite of stuff that's going on at Aerocom and your priorities. Where are you seeing the ball going? Or where's kind of the. Where's a lot of your attention and effort going to help, uh, healthcare and broader care, um, situations in the next kind of 6, 12, 24 months.

Speaker C: Look, we've been focusing ourselves on the use cases and Sam touched on a couple of really interesting, more um, innovative ways to use this technology. But the fundamental, um, sort of core of what we're trying to do is to give that innovative um, smart room, smart bed, smart environment where we can actually provide that baseline, um, continuous monitoring and data, um, information that gives an incredible amount of rich data to different scenarios and use cases, whether that be in, in aged care, whether that be in the mental health environment, whether that be at um, home in palliative care. There's all different sides of what we're trying to do. And where I see it is instead of technology for technology's sake, but then really spending time with the different healthcare environments drilling down and giving that use case principle of giving the best outcome based on the use cases that they are uh, struggling with giving the best outcome. And in Australia you've got these remote environments, as Sam rightly said in the con, we've got that all over Australia, right? We've got that in the, in the outback, we've got in the, in the remote areas of, of even just New South Wales you've got hospital systems that, that are performing different things to different people every day and they're trying to work that out with giving the best and the lowest cost resource models over the top of that. But when you've got technology that can then overlay that it gives a great outcome. The conversations we're having are uh, now it's keeping me very busy Pete, um, in being able to just talk to the clinicians, the facility managers, it, the executives on how they get the most out of technology like this. And the great part is that it's not ridiculously expensive to actually do it. And this is the great thing, it's worth giving it a try putting it in a POC or Proof of Concept, proof of Value and then let's get

Speaker B: moving with yeah, 100%. Look, um, it's been great to sit down and like dive into a particular capability and um, the, you know, just demonstrate for, from an aircon point of view just the, the breadth of kind of tools in the toolkit that you've got to be able to um, help with, with care facilities and, and love learning more about the technology. Sam on the uh, Zander Cardian side. So all the details will be in the show notes of this episode for people to check out. Ericom's got a listing on our website, uh, as well as company partners. So, so do check it out and I'm sure we'll have some more conversations in the tht community too. But Andy, Sam, I really appreciate you making the time today. Thanks so much.

Speaker C: Andy's been great. Uh, we hope you enjoyed this episode of Talking Health Tech, make sure you

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Speaker B: A lot of activity happening there.

Speaker A: Speak to you next time.