Equilibrium: Preventing Falls in the Elderly

by Joshua Wies

Equilibrium is the first cloud-based, automated analytics platform that takes mobile or wearable sensor data, analyzes and reports on fall risk in order to help carers reduce falls in the elderly.
Baltimore, MD United States

All Team Company Patients Physicians Hospital Partners Mission Innovation Details Supporters Comments Updates

About our project

The problem we solve:
1 in 3 people over 65 have a fall yearly leading to loss of independence, injury and even death. As many as half of these could be prevented if the risk was identified and treated early. An easy, objective and validated method to identify fall risk is needed for carers of the elderly ranging from doctors, physical or occupational therapists, care workers and family members.

About our solution:
Agewell's Equilibrium puts the expertise of a physical therapist into anyone's hands. Using a smart phone or wearable device, Equilibrium is able to classify fallers from non-fallers and determine the best treatment likely to reduce the risk of a fall. Equilibrium can be used in the clinical setting or in the home by a family member with minimal training and will help to ensure peace of mind and safety. Use a smart phone to perform periodic tests or use a wearabe sensor (pendant, wrist or clip-on) for continuous monitoring of physical function and safety.
Progress to date:
The Equilibrium platform currently consists of an Android smartphone application that is used in pilot trials in a range of settings to measure fall risk. Equilibrium has been used in assisted living, outpatient physical therapy, home health and in the community.

About Our Team


Creator: Joshua Wies
Location: Maryland
Education: Sargent College School of Allied Health Profe
Bio: Joshua Wies has been a physical therapy for 25 years and has a passion for helping vulnerable elderly live independently and with dignity. He has worked to develop Equilibrium in order to end the epidemic of injurious falls in the elderly.
Hospital Affiliation: Mount Washington Physical Therapy, LLC
Title: CEO

About Our Company

Agewell Biometrics US, Inc.
Location: 2201 Cross Country Boulevard
Baltimore, Maryland 21209
US
Website: http://www.agewellbiometrics.com
Twitter: @agewellusa
Facebook: https://www.facebook.com/EQScore/
Product Stage: Prototype/MVP
YTD Sales: Working on it
Employees: 3-5

How We Help Patients

We all want to live with quality and health, with dignity and independence and there are many things we can do to help this.  If you've already had a fall, it means you are much more likely to have more falls, but any person at any age can improve their situation and reduce their fall risk.  Using Equilibrium is the first step to peace of mind and safe independence.

Falls and fear of falls are a problem that plagues 1 in 3 people 65 years and older and 1 in 2 people 75 years and older.  Falls are the leading cause of injury related death in older adults and can lead to injury, social isolation, depression, lack of independence, hip fracture and sadly, even death.  Many who fear falling limit their activity and engagement in enjoyable activities leading to loss of strength and balance - ironically, these are the two main reasons people have falls.

The good news is that many falls can be prevented - as many as half of falls could be avoided with simple precautions. But, the first step is recognizing a problem may exist.

The Equilibrium(TM) smartphone app is a simple way to determine fall risk.  The user simply holds the phone against their body or puts it in their pocket and performs a series of movements such as walking across a room and getting up and down from a chair.  Our system does the rest - your results are analyzed in our secure cloud and then sent to your phone. 

How We Help Physicians

Care providers to older adults, whether they are professionally trained or friends and family, know that older adults want to live independently with dignity and quality of life.  Falls are a big problem, causing injury and loss of independence as well as disrupting health and quality of life.  Equilibrium allows you to easily monitor, measure and score fall risk, giving an early indication of risk as well as a way to determine change in physical status.  

For non-professional carers, Equilibrium can alert that you need to bring in professional help such as a physical therapist.  For professional carers, the last thing you want is for a fall to happen to your care recipient.  Equilibrium will let you measure and determine the best course of preventative action as well as provide a documentation of objective outcome measures that are Medicare compliant.


How We Help Hospitals

Hospital acquired injuries from falls and readmissions to hospital due to falls and related injuries represent a huge burden to hospitals and their patients.  With Equilibrium, hospitals can stratify fall risk at admission and monitor during hospital stay in order to minimize and mitigate this risk.  At discharge, use Equilibrium to determine the best follow up - whether it's referral to home health or rehab or whether the person is ready to go home independently.  Hospitals can also use Equilibrium for community outreach and patient engagement as a way to communicate the serious risk of this huge health epidemic.

Falls and fear of falls are a problem that plagues 1 in 3 people 65 years and older and 1 in 2 people 75 years and older.  Falls are the leading cause of injury related death in older adults and can lead to injury, social isolation, depression, lack of independence, hip fracture and sadly, even death.  Many who fear falling limit their activity and engagement in enjoyable activities leading to loss of strength and balance - ironically, these are the two main reasons people have falls.

The good news is that many falls can be prevented - as many as half of falls could be avoided with simple precautions. But, the first step is recognizing a problem may exist.

The Equilibrium(TM) smartphone app is a simple way to determine fall risk.  The user simply holds the phone against their body or puts it in their pocket and performs a series of movements such as walking across a room and getting up and down from a chair.  Our system does the rest - your results are analyzed in our secure cloud and then sent to your phone. 


How We Help Partners

Who are the potential partners for Agewell's Equilibrium platform?  The ideal partner will be a care provider working with older adults:  

HOME HEALTHCARE PROVIDERS:  Assess, monitor, objectively measure function and fall risk using Equilibrium using a smartphone or tablet.  Improve OASIS compliance and support pre-claim review success.  Reduce hospital re-admissions due to falls and declining physical function using Equilibrium's predictive analytics capabilities.  

ASSISTED/INDEPENDENT LIVING:  Keep your residents safe, happy, healthy and independent using Equilibrium.  Help determine how you allocate your staffing resources most efficiently to ensure the best safe environment for residents in your community.

ACCOUNTABLE CARE ORGANIZATIONS:  Equilibrium is a tool for community outreach, patient engagement and to risk stratifiy large populations and identify who will most benefit from an early, cost-effective fall prevention program.  Then use Equilibrium to measure the benefits of your interventions.

PHYSICAL THERAPY PRACTICES:  Improve PQRS and Medicare compliance and keep your patients safer by measuring and monitoring fall risk and using Equilibrium to support the best care planning for your patients.

HOSPITAL SYSTEMS:  Use Equilibrium to risk stratify patients at admission, monitor during admission and to make the best discharge planning decisions based on objective metrics of physical function, activity, strength and balance.

BIG PHARMA:  Use Equilibrium to measure response to drugs on physical function, activity, strength and balance.

ELECTRONIC HEALTH RECORDS:  Integrate Equilibrium into your EHR system to have the functionality of objective measurement, documentation and outcome reporting for PQRS, OASIS and Medicare compliance.


Challenge Mission

Market Size
Equilibrium has consumer and professional products representing a $2B TMO. Consumer Market: There are 47 million Americans 65 years and older (14.5% of the total population; Dept. of Health & Human Services, 2014) and 1 in 3 of those people will have a fall yearly (US Center for Disease Control). Add to those people, their concerned children, friends and family and the total market opportunity is significant indeed. Commercial/Clinical Market: ACO's: As of the end of January 2016, Leavitt Partners, in partnership with the Accountable Care Learning Collaborative, has identified 838 active Accountable Care Organizations covering 8.3 million lives under Medicare. Physical Therapy: There are roughly 10,000 private physical therapy practices in the USA serving 10 million people annually (American Physical Therapy Association). Home Care: There are 10,981 home care agencies providing care to 12 million individuals annually (National Association for Home Care and Hospice).

Projected 3 Year Growth
Total Projected Revenue Yr 3: $50.8 million on a 65% gross margin on our consumer and professional products. Agewell is developing a API/SDK to allow 3rd party device integrations that will allow expansion into analytics on a range of issues beyond falls and supporting healthy aging in place.

How We Will Make Money
Agewell has a simple annual tiered license fee with 3 tiers: consumer, small/medium enterprise & large enterprise. For the SME/L enterprise, the license is calculated on a metered-usage basis depending upon the number of people covered. (For example a package of Equilibrium for 10K patients could cost $5/patient/year and covering 100K patients could cost $2.50/person/year).

About our Competition
Equilibrium is the first automated, cloud-based analytics, monitoring, reporting and recommendations engine for care providers working with the elderly and for consumers concerned with aging in place and fall prevention. Agewell is solving the problems associated with predictable health events such as falls in the elderly using ground truth sensor analytics to support intelligent management and early intervention with older adults in senior communities. Our closest competitors are GE Quietcare and Healthsense costing $90/month plus setup costs, requiring installation of hardware and only working in-home, claiming to assess risk and falls through motion sensors. Philips Lifeline falls alert pendant gives after-the-fact alarm that at fall has occurred, with 800,000 subscribers in the USA at an average monthly cost of $75. GreatCall offers a line of cell phones aimed at the senior market that include fall detection and a support line for health problems on a subscription basis of $50

Innovation Details

Intellectual Property Summary

Intelectual property is trade secret surrounding a method to automatically classify and risk-stratify fallers from non-fallers using a proprietory algorithm and machine learning heuristics.  We currently have no plans to pursue patenting.

Clinical Information

Equilibrium has been validated in a number of unpublished studies.  The initial study was conducted on a group of 'normal' subjects at Cambridge University and determined the ability to classify normal from dizzy subjects using a wearable sensor and a smartphone.  The study also developed a method to normalize data independent of position of the sensor on the body.  The Equilibrium protocol (developed by Joshua Wies, PT) was then further validated in two independent EU-funded trials.  These studies comprised 70 community dwelling elderly who were assessed for function, gait, balance and strength using Equilibrium.  The conclusion of this study was that Equilibrium is able to classify fallers from non-fallers retrospectively; that the program is feasible to deliver using a smartphone by a non-medical person with minimal training.  Pilots have been conducted at a continuing care residence in Baltimore where it was determined that the application was useful in exercise prescription.  Finally, a prospective study is currently under way at the Motion Picture Television Fund community in Los Angelos. 

Regulatory Status

We plan to apply for 501K clearance for Equilibrium.

How we will use the funds raised

We are currently raising $1million in order to refine our current Andoid smartphone application, port the application to iOS, develop a wearable application and an API/SDK for third party integration.  Further use of proceeds will go toward sales and marketing.

Use of proceeds from this program will be for development of the consumer-facing wearable application.

Thank You

Agewell Biometrics' mission is to end the epidemic of falls in the elderly and Equilibrium is our solution to this massive problem that touches us all.  Support us in our mission and you will be helping millions of vulnerable older adults around the world who deserve the opportunity to age in place with dignity and with peace of mind.  

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    Marc Cohen posted on 8th December, 2016

    What about swaymedical?

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