The problem: support of chronic patients during COVID-19 crisis

In the last decades many hospitals adopted an “Hospital face-to-face approach”, which does not foresee any need for social-distancing. Chronic patients, such as kidney and heart disease patients rely frequently on in-hospital follow-ups. In such patients, both diseases frequently coexist and share the same clinical manifestation: fluid congestion, that lead to a concatenation of re-hospitalization events and a high mortality risk. This problem is faced by more than 53 million of patients worldwide.

During the COVID-19 outbreak the existing healthcare system setup has contributed to spread the virus and dramatically increase the overflow of such patients in the emergency department and the increased the pandemic-related mortality.

During the crisis, the hospitals postponed many non-urgent procedures and visits including the kidney and hearth chronic disease follow-up, with consequent inability to receive medical support and poor monitoring of instable or degenerative conditions. The consequence of this situation is an increase in the rate of more severe events and of the mortality which happens even if patients haven’t been infected by COVID-19. If those patients get infected, an even increased mortality is expected.

The solution: remote monitoring of chronic disease patients

BOCAhealth is dedicated to kidney and cardiopathic patients which are at high risk of mortality for COVID-19. With BOCAhealth it possible to avoid medical physical consultation and perform the follow-up of these patients in a faster and more convenient way. BOCAhealth is composed of:

  • a bioimpedance analyser to measure body fluid of patients;
  • a mobile app to enable the patient to perform remote diagnosis and communicate to its reference doctor via text/voice messages;
  • web-based interface for doctors to remotely monitor multiple patients.

BOCAhealth solution allows the doctor to:

  • monitor each patient’s body fluid status (via questionnaire and input of bioimpedance measurement information)
  • monitor each patient’s likelihood of being infected by COVID-19 (via questionnaire an input of relevant clinical data) and follow-up the evolution of the disease

BOCAhealth impact to the crisis

There is no reliable solution to enable the doctors to follow-up on kidney and hearth chronic disease patients, evaluate their body fluids from remote and assess any potential symptom related to COVID-19 infection. Our solution will enable to:

  • re-establish the follow-up of chronic patients and the relationship between doctors and patients, restoring the previous survival rate for this patients’ population.
  • identify potentially infected patients in a timely manner

What we have done during the weekend

We’ve implemented the App functionalities which are specific to COVID-19 pandemics:

  • Questionnaire updated to identify COVID-19 symptoms
  • Ability to share via the App the information related to the saturation (spO2) and body temperature
  • Dedicated Web-interface for doctors to analyse Covid-19-related information
  • Dedicated alerts for doctors for detection of possible COVID-19 infected patients

We’ve refined our value proposition considering the COVID-19 scenario:

  • Telemedicine will be fundamental for the healthcare system and the hospital in the pandemic and post-pandemic scenario.
  • The deployment of the device has been rethought to ensure social-distancing during the pandemic crisis:

We’ve further clarified our business model:

  • Depending on the specific country’s healthcare system, BOCAhealth will be paid for by either the public healthcare provider, or by the private health insurance providers.
  • Our solution will be typically sold to hospitals, which will recover the cost via reimbursement schemes.
  • Doctors’ buy-in is critical to achieve initial adoption.

Product promotion and distribution can be achieved via a business development manager and/or partnership with an established MedTech company.

Next steps for BOCAhealth project

We have a functioning prototype (bioimpedance analyser, smartphone App and web-based App) that has already been preliminary validated on healthy volunteers.

We positively finalized a crowdfunding campaign with the platform thanks to these funds, we have been able to kick-off the product industrialization with the aim to achieve the CE certification as a medical device, including the validation studies. Those activities are including the definition of the necessary security and privacy aspects in order to be GDPR compliant.

The EU commission would support us to take the additional steps required to go to market:

  • country-specific applications to refunding schemes;
  • business development of marketing and sales activities.
  • finalize an agreement with an industrial partner for production of the hardware.

Value and perspectives after the crisis

In 2018, our remote monitoring solution was market-validated among 30 doctors in the private and public healthcare providers from Germany and Italy: even before the COVID-19 crisis, more than 60% of them were willing to use BOCAhealth solution.

After the crisis, the healthcare system needs to re-think itself in order to avoid other global lockdowns; this implies “medical distancing”: the follow-up of the patients should continue to be decentralized, rethought so to limit in-hospital activities. For these reasons our solution is expected to reach an even greater market.

We will assist at a turning point in which the fluid remote monitoring is moving from a nice-to-have to a must-to-have technology, which will allow to:

  • reduce the risk of spreading viruses among patients and medical personnel
  • reduce the daily number of hospitals visits and optimize physician effort per patient

The European Commission in 2018 estimated that the global telemedicine market would reach €37Bil by 2021, with an annual growth rate of 14%. Those numbers are likely to be surpassed as virus concerns will boost demand, making the adoption of solutions as BOCAhealth a daily routing and widely accepted.

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