This UK/Singapore R&D collaboration combines a team of specialist Medical Device Designers, Human-factors, Software/Electronic Engineers, Eye Specialist clinicians to develop an affordable, patented, reliable, and easy-to-use device, the iReact Intelligent Multimodal Digital Ophthalmic Measuring Device with enabled AI Tele-Ophthalmology. Eye tests are a ubiquitous part of modern healthcare. Preservation of sight and the early detection of both eye and other diseases are accomplished by a range of well described tests. False-positive referrals, existing waiting-lists, Covid-exacerbation and ageing populations requiring long-term eye-care is growing without the commensurate number of Ophthalmologists and Clinical resources to meet this demand-pressure on capacity - increasing risk of adverse-outcomes-for-patients. This creates the need for an innovative ophthalmic-technology to reduce-demand and rapidly identify and monitor eye-disease in patients who need it most. iReact technology combines eye imaging assessment and testing bringing it to millions of patients in the UK, Singapore and Global market. Apart from the obvious health and reduction in disability benefits this technology will also bring significant cost savings to health and social care services. The market, and return on investments, is worldwide. Measurements currently only made in specialist eye clinics, will be eventually be available through high street opticians and Primary Care using a sophisticated but simple to operate device. Reducing eye-care outpatient appointments with the iReact, deployed at scale, will save the NHS £millions/year by reducing unnecessary referrals and enabling community/primary care-eye-testing. Ophthalmology is one of the busiest specialties in the NHS, providing over 9 million outpatient appointments per year costing over £1Billion/year. Age-related sight-impairing diseases such as Glaucoma have dramatically increased in prevalence and in treatment costs as the population ages. However, a significant proportion of sight-loss and blindness is preventable if diagnosed early and with careful monitoring. Unchecked, sight-loss and blindness cause a considerable health burden on individuals and the state. Its estimated sight-loss in adults costs the UK economy £28 billion a year. The NHS Long Term plan recognises these demands and supports the need for eye-care services at Community and Primary care that can help reduce unnecessary referrals to specialist eye clinics. Provided at scale, linked via Integrated-Eye-Care-Pathways focusing on early detection, effective referrals and prompt access and treatment helping to reduce unnecessary sight-loss.

This project will develop FlexionFit-Active a personalised movement analysis device connected to a digital APP that will create a functional fitness solution. This aims to address the under-provision in the market of a product and service that supports people as they age, to remain active, independent and socially connected for longer. The FlexionFit-Active technology combines a Functional Fitness Product & Digital Health Community Platform service that users can subscribe to. This will enable users to undertake functional fitness exercises and also take part in live and on demand functional fitness exercise classes within their own home. FlexionFit Active delivers specially created functional fitness movements, breathing and balance exercises developed by therapists that guide training in the most effective way to maximise and maintain functional mobility. These body movements are essential regimes that support healthy ageing and long term fitness as people age. The device provides feedback about the user's movement and activity allowing the user to monitor progress, individualise and update the exercise regimes to meet their needs. Users can join an online community and direct classes and games to keep movement-activities engaging. Evidence supports the need that the repetitive intensive practice of movement requires an engaging platform to enable long term engagement. To achieve this FlexionFit Active focussing on users, building technology on values-based goal setting and meaningful physiotherapy-activities. The project team includes experts in design, user engagement, human centric design, service and product development, cognitive-behavioural change, biomechanics and health & wellness. For mass market adoption FlexionFit Active will be designed around users needs, health informatics and gamification to be valued by users and healthcare professionals alike. The service delivery model will be developed with users to define usability, user interface, user requirements and product cost modelling to create a compelling product offering. This also includes working with retail partners, distributors and FlexionFit online. Our aim is to make FlexionFit-Active an effective, useful health ageing technology that becomes part of users every day activities to remain active, healthy, moving on a daily and to remain socially activity within their community.

Surviving critical illness such as Covid-19 can affect multiple organs in the body and also increases the risk of further illness such as heart attack, stroke, and kidney disease, adding to overstretched NHS and global healthcare systems. Impact is greatest in older people, as hospitals are under pressure to discharge patients early to maintain hospital capacity and minimise infection risks. The FlexionFit-Active innovative solution combines a biomechanical device enabling users to undertake specialised physiotherapy exercises of their breathing muscles and upper body. The muscle activation exercises help with the function of the user's limbs and endurance enabling them to remain at home and living independently. The digital health App empowers the patient with self-management, cognitive support and also empowers clinicians with optional remote monitoring and personalisation. The FlexionFit-Active innovation ensures the usability and motivation to engage patients with intensive home therapy. Developed in co-creation with patients, clinicians and academics ensuring the FlexionFit-Active technology can improve rehabilitation clinical pathways in the NHS and globally and provide patients with 24/7 access to home-based rehabilitation care that will improve patient outcomes and wellbeing. IMPACT FOR EXTENSION FUNDING: This would enable the following activities to take place. 1. Clinical Development - insights into the rehabilitation requirements of patients with Long-Covid and patient groups across the respiratory, stroke and musculoskeletal rehabilitation pathway. 2. Business Model and Commercialisation Activities feedback from the market would enable the formulation of proven a Business plans for FlexionFit-Active. 3. PAS440 Responsible Innovation & BSI Flex – compliance with these standards and methodology will enable the business to formulate a FlexionFit-Active innovation roadmap: Responsible, Sustainable and Continuous Innovation. 4. Prototype manufacturing and Digital Supply chain development. 5. Commercialisation Activities – enabling faster speed to market NHS, regional and International healthcare markets.

Rehabilitation describes a physio-therapeutic treatment patients undertake following orthopaedic surgery (e.g. Total Knee Replacement), stroke, musculoskeletal disorders & trauma. These age-related disabilities increase expenditure on health & social care; treating a significant growing, ageing population with chronic conditions. The requirement for rehabilitation is dramatically increasing; in the UK there are over 3m rehabilitation consultations annually. However, effective rehabilitation in Hospitals is costly for the NHS and inconsistent/inconvenient for the patient due to the current rehabilitation pathway, leading to poor health outcomes. This project will develop ‘Limb Glider’ an Intelligent Rehabilitation Device with patented Assisted Controlled Active Motion, an advanced way to deliver home rehabilitation for lower & upper limbs that critically improves outcomes for patients enabling them to remain active and independent, whilst reducing the cost & resource burden on the NHS. The device provides remote monitoring/management capability through a cloud based data sharing system to complement current rehabilitation pathways. The project will develop the design to incorporate Active-Passive Bilateral therapy to help regain motor function and neurological connections in the brain helping prevent limb paralysis and pain. Clinical trials will test the prototype and integrate the technology and clinical scientific research in biomechanical, stroke and neurology to combine musculoskeletal therapy regimes into the Limb Glider technology algorithms and special sensors. This enables; clinicians to pre-set and remotely monitor m-Health therapy tailored to individuals and patients to engage with their rehabilitation at home, improving outcomes. Clinical utility & efficacy will be tested with users in Knee and Stroke rehabilitation. Output of the project will be a device/system to deliver more consistent, complete, cost effective, rehabilitation to patients globally.

Every year in the UK alone over 1 million people attend Hospital A&E departments suffering from head injuries which can lead to severe brain injury. People can also suffer brain injury if they have a stroke, disease or during intensive care. Pupil monitoring is critically important in the acutely ill patient, it is a regular diagnostic feature in pre-hospital (paramedic), intensive (ITU) and high-dependency (HDU) care. It is part of an important neurological observation routine and a measurement clinicians use to regularly assess a patient as the pupils’ size and reaction to light gives an indication or early diagnosis of potential brain trauma in injured or post operative patients. Pupil response is the only assessment of human condition that is still measured by another human. Current practice is for a Doctor or Nurse to measure pupil size & dilation manually by shining light (using a pen torch) into patients’ eyes - an assessment subjectively affected by their judgement, training, their own eye sight and the light levels around them. The measurement is not accurately quantified and hence cannot be referenced and compared by other clinicians (for example) throughout the patient admission/treatment process. Failing torch batteries and bulbs also impair this critical life threatening diagnosis. Hence the clinical need for improved monitoring and assessment of pupil response was identified and investigated by Newcastle NHS Freeman Hospital Trust. They conceptualised a device obtaining two patents granted on electronically measuring and recording the size and rate of dilatation of a patients’ pupils. It developed a simple prototype and looked to license the technology. ViVO Smart Medical Devices secured an exclusive worldwide license to develop and commercialise this innovative concept - to be called a Pupiloscope. The aim of the project is to develop the Pupiloscope as an important medical diagnostic device for use in the NHS & Global Healthcare Market.