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"A service design solution to aid the current coronary heart diseases emergencies thanks to the emergent technology The Internet of Things (IoT). The devices that enable this services will save patients lives, improve efficiency in the health system and the quality of patients care."


WRITTEN SUMMARY PROBLEM Nowadays, around 66000 people die every year due to Coronary Heart Disease (CHD). During Cardiac Arrest situations -where the 80% of those occur at home and 20% in public places- the probabilities of surviving are minimal since the help is not requested in time and there is no immediate treatment (CPR).

PROCESS

SOLUTION

During primary and secondary research key problems were identified such as the resources (time, materials, energy, etc) are wasted due to cardiac arrest situations, the lack of communication between stakeholders which affects the life of the victim or the lack of awareness of cardiac arrest situations and how to be able to help in those cases (such as CPR). To put solutions to all those problems, it was necessary to understand the journey of the victim before and after a cardiac arrest situation- and all the factors that affect and that need to be considered.

The solution was to create a circular service -based on the emerging technology “Internet of Things� (IoT) - to prevent Cardiac Arrest or Myocardial Infarction (MI) -heart attack. The objective helpand treat the victim in the most efficient way as possible for those situation (by improving the communication between stakeholders, the awareness of CHD in people and decreasing the amount of resources wasted).

Sensor 2: Watch

Sensor 1: Wristband Home Assistant


1

01- RESEARCH: METHODOLOGY & INSIGHTS This service has been created in order to improve the cardiac arrest emergency care and make it more effective. The improvements have been done looking into the insighs obtained from Secondary Research Data and from chats with nurses and doctors from the Cardiac Arrest Depeartment in A&E.

7 out of 10

Survival rate for heat attack in the UK

STAGE 1

STAGE 2

Identified primary challenges in brief and research different categories in Emergency Care

Focus on Category 1 cardiac arrest patients, as there were the mot common life-threatening incidents. Secondary research for data

The emergency services average response time to a cardiac arrest event related incident in an urban area is 11

minutes

“Sometimes the communication with paramedics it is really hard because they do not have the information that we need. Even sometimes, we need to communicate with people around the scene (family, friends, other,etc) that they do not know the answer to our questions which make everything slower and less effective, putting the life of the patient in risk� (Nurse from Hammersmith Hospital)

2.3million

Number of people living with coronary heart disease in the UK

CHD is responsible for over 66000 deaths in the UK every year on average 180 people a day or one death every minute

STAGE 3

STAGE 4

Explore user journey of Category 1 cardiac patient to identify stakeholders and inefficiencies in patient care and resource use at touchpoint

Every 3 minutes

For every minute that goes by where a victim of Sudden Cardiac Arrest does not receive treatment, their chance of survival decreases by 10%

Every 8 minutes

someone in the UK goes to hospital due to a heart attack

There are more than 30,000 outof hospital cardiac arrests in the UK each year

someone in the UK dies from coronary heart disease Without immediate treatment, 90-95% of Sudden Cardiac Arrest victims will die

Reach out to primery sources for insights and validation of secondary research

80% of Out of Hospital Cardiac Arrest

occur at home; 20% will occur in public

places

Only 22% of people in the UK would be confident in performing CPR on a stranger


02- CIRCULAR CARDIAC ARREST & MI* EMERGENCY CARE All the elements in the service are connected together following a “circle” pattern around the user thanks to IoMT (Internet of Medical Things) Network. In this way, every element is accesible to other element at any moment due to this “circle” connection. The service always starts by the prevention of possible Cardiac Arrest situations by collecting the vital signs of the user -that are send to the IoMT Cloud-, and then advising the user of possible irregularities. In the case that the cardiac arrest situation is produced, then the service goal is to improve the communication and effiency of attending the patient to increase the probabilities of surviving (by calling the ambulance, notifying stakeholders, sending information to the cloud, etc) At the end, when all the steps of the service have been proceded and the cardiac arrest situation is over (the patient is at the hospital and then he/she is sent home), it will start again at the beginning of this circle (taking the vital signs of the user).

APP THROUGH THE APP THE USER (WITH OR WITHOUT HELP OF HER/HIS DOCTOR) SET UP ALL THE NECESSARY TO MAKE THIS SERVICE START WORKING

MIsafe AT HOME

^Myocardial Infarction (MI) = Heart Attack

THE PATIENT WILL NOT NEED TO WORRY ABOUT CHECKING UP ITS VITAL SIGNS AS NOTIFICATIONS WILL BE SEND IN THE CASE OF THOSE SIGN ARE BEING IRREGULARBE SO HE/SHE WILL FEEL SAFE AT ANY MOMENT

AMBULANCE / PARAMEDICS

LESS RESOURCES WILL BE WASTE AS MIsafe WILL PREVENT MANY CARDIAC ARREST CASES AND NECESSARY INFORMATION WILL BE CLEAR & AVAILABLE

ALL THE DATA IS AVAILABLE AT ANYTIME THANKS TO THE IoMT NETWORK

VITAL SIGNS DATA MEDICAL HISTORY

Circular system: Social point of view Circular economy requires of collaboration of people. In the case of MIsafe, to make sure is a circular service, it is needed the collaboration of, not just of the user but also the stakeholders. xcx not just improve the communication between people but creates a better awareness within them. In this way, communities around cardiac arrest situations are created to help to increment the probabilities of surviving of a user. xcx encourage people who does not know CPR, to learn it; and for those who already know, it encourage them to help in those situations

THE SERVICE CREATE MORE AWARENESS OF THE SITUATION BY CREATING COMMUNITIES ABOUT PEOPLE WITH CARDIAC PROBLEMS AND PEOPLE THAT WANTS TO HELP

MIsafe OUT OF HOME

THE SERVICE WILL ALLOW TO NOTIFY THE PEOPLE THAT YOU SET UP THROUGH THE APP IN CASE OF AN EMERGENCY BUT ALSO TO THE PEOPLE OF THE COMMUNITY AROUND THE SCENE

Circular system: Environmental point of view Reusing the material wasted due to Cardiac Arrest situations is really hard as they get contaminated and they need to be incinerated. All these resources are thrown away even if they have not being used by paramedics, as in many ocassion they do not know if they have been contaminated or not, due to a rush of time and bad organisation.

2

MIsafe makes possible the reduction of resources caused by cardiac arrest/ heart attack situations. It prevent users getting into those situations thanks to the constant control of the vital signs of the user but, in the case of a cardiac arrest is happening, it will improve the efficiency of the patient being attended and the commmunication between paramedics, nurses and stakeholders. Therefore, less time is consumed and the necessary resources can be prepared on time so there is less waste of them.

MISCOMMUNICATION BETWEEN NURSES AND STAKEHOLDERS WILL BE SOLVE AS ALL THE TECHNICAL INFORMATION NEEDED WILL BE AVAILABLE IN THE CLOUD

STAKEHOLDERS: FAMILY, FRIENDS, CPR COMMUNITY, OTHERS

CPR AWARENESS WILL INCREASE IN SOCIETY THEREFORE, IN AN EMERGENCY CASE MORE PEOPLE WILL BE ABLE TO HELP AND INCREASE THE USER’S PROBABILITIES OF SURVIVING

HOSPITAL: NURSES & DOCTORS

CONNECTIONS BETWEEN USER AND SERVICE/ PRODUCTS IN DIFFERENT SITUATIONS CONNECTIONS BETWEEN THE DIFFERENT ELEMENTS OF THE SERVICE RESPECTING THE USER CIRCULAR EMERGENCY SERVICE: CIRCULAR CONNECTIONS BETWEEN ALL THE ELEMENTS OF THE SERVICE AROUND THE USER


3

The pattern used is inspired on the connections of the Internet of Things (IoT) network. Apart from the aesthetical view that gives to the devices, it reflects how different elements are connected between each other through Internet. Wireless charging box connected to the electricity of the house. The user will be notified (through the speaker and the app) when the devices need to be charged, just by placing them on their corresponding spot of the box.

PANTONE 2348 XGC

white fabric to make the user understand that it is a speaker that gives notifications

The device will work when the user introduce the code that enables the connectivity between devices to the cloud of iot

PANTONE P 75-1 U

l era t a l 3 them forwtich s s Prebottos to s ond on c e s

PANTONE 417 U

in order to be suitable to all kind of width straps, there are two rectangles that move backwards and forwards to be adjusted to the corresponding width

The light indicates when the box is charging the devices. When it turns green, it means that the devices are charged

colours & pattern

03- PROOF OF PRINCIPLE

the lid is removed in order to introduce the watch’s strap and then it is put back in place

gap where the watch’s strap is introduced. underneath is where the pcb, battery sensors are placed

Adjustable strap

Sensors that detect the vital signs of the user

Gap designed to place a strap in case that the user does not wanth to wear it in the watch


4

04- USER JOURNEY: HOME 80% of Out of Hospital Cardiac Arrest occur at home; 20% will occur in public places

WEARABLE SENSOR THAT THE PERSON USES TO CHECK HER/HIS VITAL SIGNS AT ALL TIMES

HEALTH HOME ASSISTANT RECEIVES ALL THE INFORMATION CAPTURED BY THE SENSOR. IT IS THE BRAIN OF THE SERVICE AND WHAT ENABLES ALL FUCTIONS (CALLS, NOTIFICATIONS, ETC)

SENSOR DETECTS THAT THE USER HAS IRREGULAR VITIAL SIGNS

THE HEALTH HOME ASSISTANT OBJECT LETS THE USER KNOW ABOUT HIS/HER IRREGULARITIES THROUGh PHONE NOTIFICATION AND BY VOICE THROUGH ITS SPEAKER

IF

CALL 999

THROUGH THE APP THE USER HAVE TO:

ER US

user is at home

E TH

USER WITH HEART DISEASE

iot network: at all times the data is send to and taken from the cloud from the different devices.

FEEL SYMPTONS

WALK TO THE HOSPITAL SET UP THE PEOPLE THAT HE/ SHE WANTS TO BE NOTIFIED IN AN EMERGENCY CASE.

SET UP THE RANGES OF THE VITAL SIGNS TO MAKE SURE THE PATIENT IS NOT OVER/UNDER THOSE NUMBERS LINK THE MEDICAL HISTORY (HELPED BY THE DOCTOR)

NOT FEEL SYMPTONS THE MEDICAL HISTORY AND THE vitAL SIGNS DATA OF THE USER ARE AVAILABLE AT ALL TIMES FOR THE PARAMEDICS AND THE HOSPITAL

THE HOME ASSISTANT MAKES THE CALL TO 999 AND PROPORCIONATE THE INFORMATION TO PARAMEDICS AND HOSPITAL

PERSON HELP THE USER WITH CPR

CARDIAC ARREST SUDDEN HEART ATTACK HOME ASSISTANT ENABLE THE LOCATION AND SEND NOTIFICATIONS TO PEOPLE WHO HAS BEEN SET UP IN THE APP (FAMILY, FRIENDS, ETC) BUT ALSO TO THE CPR “COMMUNITY”


05- BENCHMARKING: ANALYSIS 10

10

HIGH QUALITY

HIGH TECHNOLOGY

9

8 5

6 7

8

7

2

5

9

NOT EFFECTIVE

6 EFFECTIVE

LOW PRICE

HIGH PRICE

4 3

4 3 2

1 1

LOW TECHNOLOGY

1- HeartCheck™ PEN 2- Braun iCheck 7 Wrist Blood Pressure Monitor 3- BRIO heart rate monitor 4- BodyGuardian® Heart monitoring system 5- Biovotion VSM 6- Google Home Assistant 7- Alexa, Amazon Home Assistant 8- Apple BPM Wireless Blood Pressure Monitor. 9- EarlySense® Live™ 10- Apple Watch

LOW QUALITY

Benchmarking analysis helped to know and understand what technology is already in the market, their lacks, stregths and areas of opportunity.

Most of these products monitor different vital signs in order to allow the user to control them and in some cases by the doctor.

In order to analyse the benchmarking, as these products offer different services and factors, they have been compared with the factors that the ‘MIsave’ systems offers and the objectives that it achieves, mainly when analysing the effectiveness and quality.

However, they do not offer an emergency system that improves the probabilities of surviving of a user, the efficiency of hospitals and paramedics as well as the communication between them and they do not create an awareness of the problem in our society.


06- MOODBOARD: INSPIRATION

These different products have been the inspiration to create MIsafe.

The objective was to create a serie of products aesthetically pleasing

Avoid the normal hospital/medical stuff and colours (all white) and that evoke something on the user

LOOKING INTO DIFFERENT SHAPES, COLOURS, MATERIALS, CHARACTERISTICS, ETC

Integrated with the environment (user would not mind to have it at home or wearing it)

PACKAGING

CONCEPTS


07- SKETCHES AND 3D FIRST CONCEPTS


08- USER JOURNEY: OUT During the design process, it was necessary to also consider not just the user journey on a cardiac arrest situation at home, but also the user journey outside of the house. Due to the lack of space, it has not been included in the 4 pages of the development process. However, it requires the same importance to understand the whole process, to see the problems and to see how this service can mitigate them and improve the user journey in cardia arrests situations by using MIsafe.

iot network: at all times the data is send to and taken from the cloud from the different devices. 20% of Out of Hospital Cardiac Arrest will occur in public places

LINK THE MEDICAL HISTORY (HELPED BY THE DOCTOR)

THE SENSORS CONNECTS WITH THE HEALTH HOME ASSISTANT WHICH LETS THE USER KNOW ABOUT HIS/HER IRREGULARITIES THROUGh PHONE NOTIFICATION

CALL 999

ER

SET UP THE RANGES OF THE VITAL SIGNS TO MAKE SURE THE PATIENT IS NOT OVER/UNDER THOSE NUMBERS

SENSOR DETECTS THAT THE USER HAS IRREGULAR VITAL SIGNS

US

SET UP THE PEOPLE THAT HE/ SHE WANTS TO BE NOTIFIED IN AN EMERGENCY CASE.

user is OUT OF THE HOUSE

E TH

THROUGH THE APP THE USER HAVE TO:

HEALTH HOME ASSISTANT RECEIVES ALL THE INFORMATION CAPTURED BY THE SENSOR. IT IS THE BRAIN OF THE SERVICE AND WHAT ENABLES ALL FUCTIONS (CALLS, NOTIFICATIONS, ETC)

IF

USER WITH HEART DISEASE

WEARABLE SENSOR THAT THE PERSON USES TO CHECK HER/ HIS VITAL SIGNS AT ALL TIMES

FEEL SYMPTONS

WALK TO THE HOSPITAL

NOT FEEL SYMPTONS THE MEDICAL HISTORY AND THE vitAL SIGNS DATA OF THE USER ARE AVAILABLE AT ALL TIMES FOR THE PARAMEDICS AND THE HOSPITAL THE HOME ASSISTANT MAKES THE CALL TO 999 AND PROPORCIONATE THE INFORMATION TO PARAMEDICS AND HOSPITAL

PERSON HELP THE USER WITH CPR

THE SENSOR CONNECTS WITH THE ASSISTANT AT HOME AFTER DETECTING THE USER CARDIAC ARREST

STAKEHOLDERS

CARDIAC ARREST SUDDEN HEART ATTACK HOME ASSISTANT ENABLE THE LOCATION AND SEND NOTIFICATIONS TO PEOPLE WHO HAS BEEN SET UP IN THE APP (FAMILY, FRIENDS, ETC) BUT ALSO TO THE CPR “COMMUNITY”


09- APP

THE USER INTRODUCES HER/ HIS NAME AND THE CODE THAT IS ON THE PRODUCT TO LOG IN

DOCTOR CONNECTS THE user's MEDICAL HISTORY USER TO THE SERVICE (through iot) and set up the information

Connection of every product to the iot cloud

user sets up his/her emergency contacts

user can check up her/ his vital signs when it is needed

from the community people who is close to a cardiac arrest scene can be able to help

INTERNET of THINGS (IoT)

IoT ALLOWS TO HAVE THE DATA UPDATED AT ALL TIMES AND ACCESSIBLE TO WHO HAS ACCESS TO IT BY CONNECTING THE COMPONENTS THAT ARE PART OF THIS SERVICE


REFERENCES These are the references for the pages with infographics, data, technology, moodboards, benchmarking and definitions (pages 3, 4,7 and 8)

Forbes.com. (2019). A Simple Explanation Of 'The Internet Of Things'. [online] Available at: https://www.forbes.com/sites/jacobmorgan/2014/05/13/simple-explanationinternet-things-that-anyone-can-understand/#592b99451d09 [Accessed 4 Mar. 2019]. Econsultancy. (2019). 10 examples of the Internet of Things in healthcare – Econsultancy. [online] Available at: https://econsultancy.com/internet-of-things-healthcare/ [Accessed 17 Feb. 2019]. Cardiosmart.org. (2019). [online] Available at: https://www.cardiosmart.org/~/media/Images/Infographics/2016/SuddenCardiacArrest.ashx [Accessed 11 Mar. 2019]. Burgess, M. (2019). What is the Internet of Things? WIRED explains. [online] Wired.co.uk. Available at: https://www.wired.co.uk/article/internet-of-things-what-is-explainediot [Accessed 28 Feb. 2019]. Bhf.org.uk. (2019). Cardiac arrest. [online] Available at: https://www.bhf.org.uk/informationsupport/conditions/cardiac-arrest [Accessed 6 Feb. 2019]. Healthcare, G. (2019). The internet of things in healthcare: an overview and its future. [online] Verdict Medical Devices. Available at: https://www.medicaldevice-network. com/comment/bringing-internet-things-healthcare/ [Accessed 17 Feb. 2019]. WebMD. (2019). Heart Attack and Cardiac Arrest. [online] Available at: https://www.webmd.com/men/guide/heart-attack-cardiac-arrest#3 [Accessed 11 Feb. 2019]. Bhf.org.uk. (2019). Heart statistics. [online] Available at: https://www.bhf.org.uk/what-we-do/our-research/heart-statistics [Accessed 11 Feb. 2019]. YouTube. (2019). These Sensors Let You Create Your Own Internet of Things. [online] Available at: https://www.youtube.com/watch?v=d5hTZJlOMRA [Accessed 14 Feb. 2019]. Apple (UK). (2019). Withings BPM Wireless Blood Pressure Monitor. [online] Available at: https://www.apple.com/uk/shop/product/HMJR2ZM/A/withings-bpm-wirelessblood-pressure-monitor [Accessed 14 Feb. 2019]. Services, P. and Technologies, P. (2019). Preventice - BodyGuardian Heart. [online] Preventicesolutions.com. Available at: https://www.preventicesolutions.com/ technologies/body-guardian-heart.html [Accessed 15 Feb. 2019]. AliveCor. (2019). KardiaMobile. [online] Available at: https://shop.gb.alivecor.com/products/kardiamobile?variant=17995438657&gclid=Cj0KCQiAwc7jBRD8ARIsAKSUBHJ 8OSyCWUFx2FrjOmGfkX753-45j3jKSzRvWU8jcvgakvSPS74Vdj4aAiM7EALw_wcB&gclsrc=aw.ds [Accessed 14 Feb. 2019]. Bostonscientific.com. (2019). How LATITUDE™ Works - Boston Scientific. [online] Available at: http://www.bostonscientific.com/en-US/patients/about-your-device/ latitude-home-monitoring/how-latitude-works.html [Accessed 14 Feb. 2019]. Epilepsy Alarms. (2019). Brio - Epilepsy Alarms. [online] Available at: https://www.epilepsyalarms.co.uk/product/brio/ [Accessed 15 Mar. 2019].

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