JUNIE

EIS solves the problem of patient agitation, lack of caregiver communication, and well-being tracking. A 2018 JAMDA study found that agitation symptoms increase informal care costs by 17% per month in healthcare settings, creating a substantial impact on costs in the community care setting. This is a $50 billion dollar problem in long-term care alone, according to the BMJ Open 2015. Apart from financial burdens, this issue contributes to healthcare provider burnout/turnover and diminished healthcare outcomes for patients. Bullying and other forms of verbal abuse are particularly prone to underreporting because of lack of communication, but many healthcare workers accept it as "part of the job."  These figures do not include potential markets such as hospitals, rehabilitation centers, or prisons. However, there are no estimates that provide a true insight into the financial and emotional toll patient agitation and care coordination takes on patients, caregivers, and families. Many of these instances go unreported because current methods of communication and documentation between caregivers involve physical notebooks- which are not legible and often misplaced.

At EIS, we create custom well-being software and integrate it with existing IoT devices and live patient monitoring  to provide  relevant predictions regarding the likelihood of an agitation outbreak and to optimize caregiver workflows.

Our software is tailored for caregivers, to collect ADLs of the residents/patients. We collect biomarkers such as location, hygiene, mood, activities, and meals daily. We are also adding a communication transfer log, family portal (to check their loved ones wellbeing ), and reporting on all levels of well-being tracking, compliance, and a quantitative care need scaling system.

Once all phases of our software are installed, we will introduce existing IoT devices into each location. These IoT devices will collect physiological biomarkers that will create predictions of early stage agitation and create an alert that will be depicted through a notification service on our software.Once a prediction is made, caregivers are notified via the application, which will let them take proactive and clinically proven care approaches. This provides healthcare workers with a proactive solution to the systemic problem of patient agitation. By identifying early stage agitation, we can improve the overall experience for residents while also improving safety and working conditions for nurses and caregivers. 

Our primary customers (the buyer) are initially private memory care facilities and assisted living centers focused on serving patients with Alzhiemers, dementia and other memory-loss disorders. Our solution offers caregivers advanced warnings of patients in crisis, so they can act to intervene before the issue escalates. This improves patient outcomes and reduces staff turnover, which has a positive impact on the facility’s bottom line.

There are two primary beneficiaries for the EIS solution. First, and foremost, EIS wants to provide caregivers a technological solution to improve safety, communication, and workflow.

Patients are the other primary beneficiaries. Early notification helps keep patients safer and provides a better overall experience.

An additional beneficiary is the families of loved ones, because EIS and the Administrators can share certain data, such as physical activity levels, sleep quality and overall in a HIPPA compliant way. This gives families more insight into the well-being, and safety of their loved ones.

Nathalya, Krishan, and Rohan have been working together for the past 36 months. Krishan and Rohan met each other in public speaking class 7 years ago in high school. Nathalya and Rohan were in the same biophysics program and have known each other for 5 years. Rohan came up with an initial idea of predicting patient agitation and recruited Nathalya and Krishan at GW to create what is now Early Intervention Systems. We assembled a team to create a proof of concept and won the Best Medical Venture in 2018 at GW’s NVC. 

Our CEO and Co-Founder, Nathalya Ramirez, lost her grandmother who was agitated very frequently due to cognitive decline, but lacked the proper monitoring and tech to notify caregivers. She graduated from GWU with a major in Biophysics. Nathalya has experience in nanofabrication and advanced statistical analysis and will help with prototype/algorithm development. 

Our CTO and Co-Founder, Rohan Patil, had spent many hours shadowing physicians in the Emergency Department at a large hospital institution in Washington, D.C. While shadowing, he witnessed a patient physically attack a member of the healthcare staff. The injuries this staff member sustained rendered her immobile requiring  medical attention. After asking several members in the hospital how often physically outbreaks like this occurred, all of them stated this was quite commonplace. Rohan also learned that his own grandfather, a former psychiatrist, had to retire early due to injuries he sustained from agitated outbreaks. Rohan has experience in developing deep learning algorithms/predictive models with healthcare data. He is currently a medical student at The George Washington University School of Medicine and Health Sciences.  

Our CFO and Co-founder, Krishan Shah, was inspired by one of his friends, Jeff Borghoff, who was diagnosed with early-onset Alzheimer's at the age of 51. Jeff, now our patient advisor, served on the board of directors for the Greater NJ Chapter of the Alzheimer's Association and the Alzheimer's Congressional Team member for his N.J. district. Krishan, a GWU Business School Graduate, has worked for fintech companies, startups, and as a management consultant.

Jeff spoke to us about his frequent episodes of agitation as a person with Alzheimer’s. He was able to shed light on how this information is extremely important for him and his wife (his current caregiver). Through the personal and professional experience of our Co-founders, we believe we are the right team at the right time to solve this patient agitation and healthcare worker safety global crisis. 

We have been fortunate to have very active advisors that have joined us to help solve these systemic problems as well. Our advisors have experience in deep learning, software development, fundraising, medicine, and selling in healthcare. However, every single advisor has had personal experience with caregiving or healthcare safety with an immediate family member.  

This program has peers and mentors have extensive experience working with startups in highly regulated industries. We hope that this program can assist us in connecting with more mentors and peers, while also helping us on business operations and strategy as well. As first time founders, none of us have scaled a patient monitoring company before. Any mentors in the space of patient monitoring would be extremely helpful for us as we continue to scale. As EIS continues to scale we are also going to be raising money. We hope to get introductions to potential investors through our experience with this program. In addition, we would also like to have introductions to any type of strategic partners that might benefit from EIS services. For example, we would want to start licensing our analytics and algorithms to other EHR and monitoring systems in the next few years.

We believe our venture will finally provide healthcare workers with a proactive solution to the systemic problems of patient agitation and caregiver distress. The majority of healthcare systems have implemented ineffective violence prevention programs and antipsychotics. Our company aims to improve the well-being of elders and the safety of their caregivers. Long term care facilities currently operate on the bare minimum needed to maintain each patient’s well-being recorded, which negatively affects their overall life quality. This sector of the healthcare market has long been overlooked and lacks any of the technology needed to deliver proactive and non-pharmacological care. Instead of using ineffective antipsychotics and violence prevention teams, we will bring these facilities to the forefront of healthcare by incorporating wellbeing tech and predictive analytics to elevate the standard of care. Our solution will empower nurses and caregivers by taking the first proactive step to ending patient agitation and improving safety. In the end, we envision a future where healthcare workers around the world no longer say getting hurt is part of the job.

Within the next year we plan to implement additional software features to support caregiver workflow such as an electronic transfer communication log. Currently, caregivers use a written notebook system to do this which is unreliable and has been a bottleneck for caregiver communication. Our systems would be able to address this issue as part of our software upgrades. 

Within the next five years, we plan to have our software integrated with a well-being scoring report to ensure that all residents are receiving the best possible care. We also plan on being the leader in detecting early stage agitation and ensuring wellbeing to avoid ugly events or outcomes while providing a safer, healthier environment for residents and caregivers. We hope to facilitate patient monitoring through our AI tool development that can predict early stage agitation to improve the quality of care for residents/patients. Leveraging the increased demands of medical staff, such as ameliorating the pressures from the nursing shortage, is also one of our top priorities. With more efficient tools that enhance workflow and improve detection, our ultimate goal remains ensuring the highest quality of life for individuals with Alzheimer’s and reducing caregiver burden.

We measure our social impact through measuring the overall increase in well-being after our product is installed. For caregivers, we can measure staff turnover and workflow improvement/satisfaction. Currently, we are seeing turnover rates over 10 caregivers per month in these facilities and reducing that number even by 10-15% is significant in these facilities. 

For the residents/patients, we can measure agitation, sleep quality, hydration, and physical activity. For the families of each resident, we can see how they feel about how their loved ones are being cared for before and after installation of our platform. We will also be looking at a high true positive rate on our prediction model for an overall reduction in agitation in medical facilities. 

We spoke to nurses, caregivers, physicians, patients and families before creating our product. From these conversations, we identified barriers to entry, outcomes, and change. As a result, we focused on creating a solution to a problem that has long been neglected by healthcare executives and will directly impact everyday interactions patients have with providers. To ensure we achieve our longer term outcomes, making healthcare facilities safer and reducing violent outbreaks, we plan to continually listen to patient advocates and end-users. Each patient’s agitation profile is unique and requires us to carefully listen to the insights care providers have regarding agitation in various facilities. We are specifically focusing on a memory care facility so we can better understand agitation as it presents with individuals who share preexisting conditions. These memory care facilities have a very low barrier of entry for most technology since they are not encumbered by regulations often found in hospital systems. The site we’re installed at is particularly unique because they have not implemented any technological solution to their facility and have been dependent on our product to provide automated patient well-being information without pen and paper. This means we have tailored our product to this pilot site in order to ensure greater retention amongst the caregivers and nurses and better collaboration moving forward. As we optimize our service, we can transition to other healthcare facilities and ultimately reach our goal of providing proactive steps to intervene before an adverse event occurs. We believe we can affect change by empowering and listening to providers every step of the way by creating a product that makes their own and their patients and caregivers safety a priority.

Our service uses software, IoT sensing, and validated deep learning models. Our software is custom made to match the workflow of memory-care facilities to ensure that compliance is met while also providing a faster and more accurate solution than pen and paper. Once we collect the necessary ADL’s through our software we will install existing IoT devices to collect additional ADL’s needed to improve care coordination and communication. 

Once we implement all the steps to collect ADL’s, we can update our software to include validated deep learning models to predict patient agitation. However, similar deep learning models rely primarily on retrospective EHR data and have not received widespread acceptance/use in existing clinical institutions in the United States. There have been no studies in the literature that have presented a commercially viable solution that will provide real-time predictions and tailored recommendations using multiple biometric and environmental sensors. Moreover, there have been few studies that have looked carefully into the pathophysiology of agitation, which could be due to its various and complex manifestations. GRU’s appear to be the most efficient means of providing temporal predictions but have not been used to study agitation.

We are a women owned and latino owned startup. In addition, we pride ourselves on a diverse team in terms of age and disabilities as well. For example, Jeff Borghoff, our patient advisor, was diagnosed with early-onset Alzheimer's at the age of 51. We like to focus on programming as a way to promote diversity in the EIS community. We volunteer for many women entrepreneurial networks, and we are heavily involved in the Alzheimer's Association programming as well. These types of programming and events help promote and prioritize diversity in our network. 

Based on our customer interviews, we believe a B2B model that charges Memory-care operators a monthly subscription is the best way to scale our impact. This model can be expanded to rehabilitation centers, assisted living, and home-healthcare. This pricing includes all of our offerings from the AI, Software, and IoT integration. We benefit multiple stakeholders that include administration, caregivers, patients, and families. The administration can get a much more detailed insight at operations and customer satisfaction in each facility. Caregivers have an optimized workflow that significantly reduces time doing paperwork and improving safety. Patients are better tracked and are also safer with our system in place. Families also feel much more comfortable having there loved one in a facility that has our tracking system in place. the  We also plan to add a licensing option for any facility that already has its own EHR/EMHR system in place. Licensing allows EIS to provide value added service in facilities that have already invested in EHR/EMHR systems. 

Our plan is to continue applying for grants, grow our revenue by expanding into more facilities, and raise investment capital. Grants and pitch competitions have been a successful strategy to get us the initial capital to make our MVP and close initial sales. Now we are able to expand to more facilities, we can grow our revenue and raise a large investment round. 

We have been able to win over $50,000 in cash prizes from previous startup competitions. This included grants/prizes from UBS, TiE Global, and the George Washington University. These prizes have gotten us to a recurring revenue stage. Once we begin an equity raise we will be able sustain exponential growth to multiple facilities.