agility4life pitch deck

Agility4Life Quality of Life through

Measured Movement

March 30,

2013

Agility For Life Justin Ho, Uday Chaka http://www.agility4life.com 1

Agenda

Company Overview

Solution Overview

Demonstration

Business Insight

March 30, 2013 2

Who is Agility4Life? Vision – be health monitoring solution for seniors by utilizing

movement signals to predict and enhance health outcomes To help PREVENT adverse events

To help DETECT adverse events

Ultimately – help seniors live independently, away from intensive care or nursing homes

Why now? Aging Population – 10k new seniors / day – existing resources will

be strained to provide sufficient care

Advancements in computer vision technology

Advancements in movement/gait science

Regulatory changes to better incentivize stakeholders to invest in technology to improves quality of care

March 30, 2013

http://newsroom.pamf.org/2012/10/pamf-innovation-

center-developer-challenge-winners/

3

Core Team Uday Kiran Chaka – Founder, Duke MBA

Justin Ho – Founder, Duke MBA

Seshadri Srinivasan, PhD – Founder, Research Lead

Stacy Fritz, PhD – authority in walking science

Tiffany Shubert, PhD – research scientist in Aging

Extended Team Front / Back End Developers

Hardware engineer

Hardware/UI designers

Image Analysis Scientists

Geriatrician

Company Overview Solution Overview Demonstration Business Insight

http://newsroom.pamf.org/2012/10/pamf-innovation-center-developer-challenge-winners/











What is Agility4Life?

Health assessment and risk

detection tool based on

walking speed

March 30, 2013 4

Phase I

Fall Detection/Monitoring System Phase II

- Fall Risk

- Cognitive Declines - Sensory Declines

Advanced Fall Risk Assessment and Disease Prediction Suite based on complex movement patterns

Phase III

Prevention

Prevention

Detection

Prototypes

Built


Key Solution Features

Real-time detection of falls Ability to distinguish between real falls and false positives (e.g.

lying down, sitting)

Daily monitoring and assessments of overall health based on walking speed

Provide early warnings of health deteriorations based on walking speed

Real-time alerts sent to designated care taker(s) in case of fall

Alert protocols include SMS text, Email, and can be customized to integrate with existing facility alarm systems

Ability by senior to easily deactivate alert if fall is not serious

Online health overview dashboard Summarizes captured data to show metrics, warnings, and trends Accessible only by senior and his/her designated caretaker(s) HIPPA compliant platform that can integrate with hospital systems

if need be

March 30, 2013 5


Value of Real-Time Fall Detection

March 30, 2013

* http://usatoday30.usatoday.com/news/nation/ems-day2-cover.htm

6

Value to Senior (and his/her primary caretaker) Peace of mind – when fall occurs someone would be alerted

immediately More likely to recover/survive if falls are detected and treated early

Remaining on floor for >2 hours after a fall increases risk of dehydration, pressure ulcers, rhabdomyolysis, hypothermia, and pneumonia

Special urgency for cardiac arrest issues where “3-minute reduction in call-to-shock time improves odds of survival almost 4-fold” *

Value to Providers Improved quality of care for its members Differentiator to attract new members Helping meet organizational service objective of keeping its seniors

living independently

Value to Payer Annual savings of ~$2MM for 3000 unit facility


Value of Walking Speed Assessment

Value to Senior (and his/her primary caretaker) Opportunity to take control of own health –

Continuous monitoring of a key vital sign – walking speed – to assess health status

Early warning of functional declines and risk of falls – gives opportunity for intervention before it’s too late

Value to Providers Improved quality of care for its members

Differentiator to attract new members

Helping meet organizational service objective of keeping its seniors living independently

Value to Payer Early intervention reduces the likelihood of hospitalization,

disease complications, and moving into nursing homes – saving millions

March 30, 2013 7


A Bit More on Walking Speed …

March 30, 2013 8

Latest medical research confirms that Walking Speed/

Gait Speed is a good indicator of overall health status,

including – Stability and Balance – Risk of Falling

Dementia, Cognitive Status

Motivation and Mental Health

Survival and Well Being

Musculoskeletal Condition, Joints, Motor Control

Sensory and Perceptual Function (Vision and Ears)

Changes in Walking Speed correlate with changes to health. Studies show that for seniors: Average walking speed < 0.6 m/s is indicative of poor

health status

Walking Speed decrease (change of -0.1 m/s) indicates health deterioration

Walking Speed increase (change of +0.1 m/s) shows improvement

See Appendix for a comprehensive list of walking speed implications

“Walking requires

body support, timing

and power. It places

demands on the

brain, spinal cord,

peripheral nerves,

muscles and joints,

heart and lungs, and

… the blood… thus

when organ systems

are not working

property, gait speed

slows.”

- Dr. Studenski S*

Walking Speed is specific, measurable, objective and correlates with health


9

Agility4Life Detectors

capture and assess

movement signals; process

and transmit relevant data

– including position

coordinates, time, identified

movement characteristics –

wirelessly to CPU hub.

March 30, 2013

Unobtrusive Experience

Company Overview Solution Overview Demonstration Business Insights

Point B Point A

Distance

Agility4Life CPU Hub

triangulates data from

multiple detectors and

sends summarized

information – including

detected fall and walking

speed – to Agility4Life

software application in the

cloud. Also contains manual

override button in case of

false alarm alerts.

* Customized based on facility-specific

system and processes

10

Data

Base

Analytics

Engine

Trend

Generator

Personalized Agility4Life Web Site

March 30, 2013

Agility4Life

Application in the Cloud

Push/pull requests SOAP/REST architecture

JSON/XML

Summarized Information

Immediate Fall Alert

SMS Text Message

Email

Existing Facility

Warning System*

Analytics in the Cloud


Privacy / Ease of Use

Secure login so only senior and his/her designated caretaker(s) can see data

A4L does not capture or store images in the cloud – assessment of images done on detector device in real time; images discarded immediately

One time set up – takes about 45 minutes pending number of rooms

Unobtrusive usage – senior does not have to wear anything or modify daily routines

Non-invasive look and feel – small form factor, blends into wall

Simple button to press if fall detected is false alarm

March 30, 2013 11


Validated by Experts

Name Title

Dr. Peter Cheng Physician Lead, Palo Alto Division Geriatric Medicine

Program, Palo Alto Medical Foundation (PAMF)

Stacy Fritz, PHD, PTI Program Director & Assistant Professor at University of

South Carolina – Physical Therapy Program

Dr. Tiffany Shubert, PHD Adjunct professor, Physical Therapy, at UNC, Research

scientist at the UNC Center for Aging and Health

Ken Smith Senior Research Scholar and Director of Academic and

Research Support, Stanford Center on Longevity

Mr. Joachim “Yo” Andersen

Care Center Administrator, Vi Palo Alto, Independent

Living & Assisted Living (IL & AL) Facility

Mr. Al Lewandowski CFO of Secret Harbor, Provider of home care (HC)

services for Seniors

Mr. Jean-Luc Neptune Senior Vice President, Health 2.0

Katy Thomas Fike, PHD Entrepreneur & Consultant, Geriatrics

March 30, 2013 12

Do

cto

r A

ca

de

mic

In

du

stry

IL

/AL/

HC

Fac

ilitie

s

Agility4Life solution has been reviewed positively by a PAMF physician, academics, researchers,

seniors, administrators of Assisted and Independent Living facilities and industry veterans

Runner-Up in PAMF

linkAges Competition!


Demonstration

March 30, 2013 13


Fall Detection Videos show various fall

patterns detected

Falling backwards

Falling forward

Falling straight down

Non-fall (sitting down / slowly lying down)

Walking Speed Assessment See

Appendix for description

Successful Beta Prototype

14

Actual screen shots from the beta website for the participant

Measures Walking Speed accurate to 1/15th of a second

Trends are vivid and easy to interpret

“The charts are easy to understand. They

give valuable feedback and incentive to

exercise” – Angie H (Beta Test Participant)

Participant Profile Name: Angelina H (Patient A) Age: 86 Sex: Female Health Care Provider: PAMF Palo Alto Resident

Lives Alone

Agility4Life signed up a senior to participate in a beta to test the solution to measure Walking Speed

Overview

Trends Risks Details

March 30, 2013


Health Monitoring has business value

Preventative Care: Early detection of potential problems by seniors, care-givers or family members, community programs, and doctors/therapists, by reviewing Walking Speed summaries helps prevent adverse or catastrophic events Better quality of life for seniors

Less dependence on others for daily activities

Delay the onset or reduce the likelihood of transitioning from home to nursing homes

Avoid significant financial burden placed upon family members – avg. of $70k / year

Living at home or in a Low Cost facility with similar care: Providers and Senior Living Facilities deliver higher standard of service at lower cost, realize better occupancy rates and revenues Improved quality of care away from hospitals and physicians means less re-visits for same issue, improving

bottom-line for hospitals

Improved quality of care in senior living centers or assisted living facilities means less flow into nursing homes, where the margins for operators are typically less attractive

March 30, 2013 15

Hospital Nursing Home

Assisted Living

Independent Living

Home

High cost

Walking Test May Predict Heart Surgery Risks

WebMD article

Monitoring activities and health saves money for seniors and health system overall by preventing falls and helping seniors live in lower cost facilities – like home

Low cost


http://www.webmd.com/healthy-aging/news/20101101/walking-test-may-predict-heart-surgery-risks

http://www.webmd.com/healthy-aging/news/20101101/walking-test-may-predict-heart-surgery-risks

Agility4Life - Addressable Market for

Health Monitoring

Two main addressable markets worth $3.5B Seniors living alone in private homes

Independent and assisted living facilities

Private home seniors 11.3M non-institutionalized seniors live alone (1.1M in CA)

Total Market size of ~$3.3B annual revenue in US (assume $50 initial purchase/senior + $20 monthly fee/senior)

Independent / Assisted living facilities ~1M seniors live in ~40k independent/assisted living facilities

nationwide

Top 10 assisted living and top 10 independent living facilities combine to serve ~260K seniors, totaling ~$75M market

Total market size of $250M (assume $1000 initial purchase/facility + $20 monthly fee / senior)

March 30, 2013 16

http://www.consumerreports.org/cro/money/retirement-planning/choosing-an-assisted-living-facility/overview/index.htm


Agility4Life Pricing

March 30, 2013

* http://www.elderlawanswers.com/resources/article.asp?id=8717&Section=4&state

17

Alternatives Monthly Cost

w/o Insurance Monthly Cost w/ Insurance Key Differences to Agility4Life

Full monitoring at

Nursing Homes $7,000 * $7,000

- Loss of independence

- Pain and suffering

Moving into

Assisted Living $3,300 $3,300 - Loss of some independence

Treatment due to

illness/falls $1,600 $400

- Pain and Suffering

- Temporary / permanent decline in

mobility

Get-Up-and-Go

Tests $100 $15

- Monthly Hospital Visits

- May not be as accurate

- No comprehensive historical records

BeClose Full

Monitoring $80 $80 - Does not provide walking speed

Agility4Life $20/senior monthly subscription fee + $20 Wireless access (3G models) $40-50 one-time product price


http://www.elderlawanswers.com/resources/article.asp?id=8717&Section=4&state

http://www.elderlawanswers.com/resources/article.asp?id=8717&Section=4&state

Agility4Life Intellectual Property

Agility4Life has filed a provisional patent on “Fall identification, posture detection, temperature identification and reliable estimation of walking speed using Passive Infrared array and Optical Cameras: Subsequent assessment of general health, including fall risk, using posture, fall history and walking speed”

A broad-based family of patents in this area will protect Agility4Life’s interests in the long term

March 30, 2013 18


Agility4Life – Competitive Analysis

March 30, 2013

Agility4Life is the best solution!

19

Alternatives Features

Agility4Life Stop watch & tape

Motion detector

WebCam/ Kinect

Radar Pedometer, strap-on devices

Accuracy * * * * * * * * * * * * * *

Frequency * * * * * * * * * * * * * * *

Automated * * * * * * * * * * * * * *

Cost effective * * * * * * * * * * * *

Ease of set-up * * * * * * * * * * * * * * * *

Supporting technologies

* * * * * * * * * * *

User Interface, EHR/EMR link

* * * * * * * * *


Agility4Life – Roadmap/ Go to Market

Strategy

March 30, 2013 20

Public Beta Launch w/Partners (ALF), Managed Care Organizations (MCOs)

Pilot: Homes of seniors, Assisted Living Facility (ALF)

Partner w/Insurance companies, Providers

Partner w/Retailers, Medical Supplies Distributors

Public Launch w/Direct sales, Distributors

Improve analytics

Improve person recognition/filtering, add connectors to EMR, EHR, PHR

Add new form factors for detectors

Add new signals, enhance website to improve user experience

Q1/Q2 2013

Q3/Q4 2013

Q1/Q2 2014

Q3/Q4 2014


Agility4Life – Partnership Plan

Current Status - completed proof of concepts, rough prototypes, received validation from experts; now we need to: Validate there’s a need of this product from senior homes If so, continue to invest money, time, energy to build up product for

real trials (~2 month effort)

We want to be a pilot partner of senior living facilities, and conduct beta tests Two Evaluation Trials, each contains:

5 senior units

1 month span

Pre-trial walk through of facility and one time set up of system

Post-trial interviews with senior, caretaker, and facility member(s)

As an initial partner – we will: Customize our solution specifically to your facility so to leverage

existing warning systems/alarms and processes Once productized, free 1 year usage of product for seniors who

participate in trial

March 30, 2013 21


Agility4Life – Founder Bios Uday Chaka

Entrepreneur and management consultant with deep strategy, technology, and execution experience

Co-founded mobile social gaming company, advised Fortune-100 firms on product development and supply chain operations

Worked at Pricewaterhouse Coopers (PwC), Cisco, HP, Infosys

Holds MBA in Health Sector Management from Duke University and BS in Technology from Indian Institute of Technology (IIT)

Justin Ho Experienced healthcare and management consulting professional

Deep product management, marketing, sales operations, and technology experiences

Worked at Accenture, Boston Scientific, Cardinal Health, and Genentech

Holds MBA in Health Sector Management from Duke University and BS in Biomedical Engineering from Johns Hopkins University

Seshadri Srinivasan – Sr. Staff Scientist, Product Lead, Feature Lead & Research Lead

Expert on Image Processing, Medical Imaging & Systems Engineering

Worked at Siemens Medical Solutions and startups

Authored 11 patens overall, including 5 patents on color doppler imaging, all of which were granted: (7946990, 7887484, 7887487, 8047991, 8098910)

Holds Ph.D in Electrical Engineering from Houston University and B.S. in Electrical Engineering from Anna University

March 30, 2013 22


Agility4Life - Summary

March 30, 2013 23

Captures and Analyzes Activity Patterns to

Monitor Health

Improves Quality of Care for Seniors

Helps Seniors Age Independently Away

from Hospital / Nursing Homes

Agility4Life hopes to win the Startup Challenge!

Great team

With a Unique solution

In a Growing market

Social Mission

Preventative Care

Need of the hour


THANK YOU!

March 30, 2013

Contact: [email protected]

24


APPENDIX

March 30, 2013 25

Agility4Life: Summary Screen

March 30, 2013 26

Agility4Life

recommendation for

the senior

Senior

profile

Account

Information

Daily and weekly

average speeds and

changes

Company Overview Solution Overview Demonstration Partnership Opportunities

Agility4Life: Trends Screen

March 30, 2013 27

Trend line of walking

speed over a period

of time

Senior

profile

Account

Information

Large fluctuations

could indicate certain

medical conditions


Agility4Life: Risks Screen

March 30, 2013 28

Risk factors based on

walking speed

Senior

profile

Account

Information

Senior’s risk level based

on the average

walking speed


Agility4Life: Hours Screen

March 30, 2013 29

Does the walking

speed vary widely?

Senior

profile

Account

Information

Does Walking speed vary

widely during the day –

morning vs. mid-day?


Use Case –

Disease Maintenance

March 30, 2013 30

Has

depression,

often times

forgets to

take

medication

Has not

taken

medication

on schedule

the past 3

weeks, and

does not tell

anyone

Depression

worsens in

following

weeks, leads

to general

health

deterioration

Without Agility4Life

Lynn, 68 year old

grandmother, lives alone

in private home, primary

care taker is her son

Thomas, who lives in

another state

With Agility4Life

Thomas no

longer thinks

Lynn can live

indepen-

dently,

moves her to

assisted living

Total Cost: $3,300/month for Assisted Living1 Decreased independence

Lower quality of life

1http://www.assistedlivingfacilities.org/articles/assisted-living-costs.php/

Has

depression,

often times

forgets to

take

medication

Has not

taken

medication

on schedule

the past 3

weeks, and

does not tell

anyone

Agility4Life

sends

warning

signal to

Thomas

Thomas calls

Lynn, asks

clarifying

questions

and finds out

she has not

been taking

medication

Thomas reiterates

importance of

medication, asks

neighbor to check

up on Lynn.

Depression does not

deteriorate, Lynn

stays in her home.

http://www.cdc.gov/HomeandRecreationalSafety/Falls/fallcost.html

http://www.assistedlivingfacilities.org/articles/assisted-living-costs.php/





Use Case –

Disease Maintenance

March 30, 2013 31

Has Multiple

Sclerosis,

knows from

experience

decline in

mobility is sign

of

exacerbation

of disease

But both

Nancy and

Pam do not

notice

visually

minor

mobility

declines

Exacerbation

of MS occurs,

severe urinary

tract infection

develops,

causing pain

and suffering


Total Cost: $1,000 for treating urinary tract infection and MS exacerbation

Pain and Suffering

Nancy, 79 year old

grandmother, lives alone

in private home, primary

care taker is her daughter

Pam who lives close by

With Agility4Life

Has Multiple

Sclerosis,

knows from

experience

decline in

mobility is sign

of

exacerbation

of disease

Pam notices

minor

mobility

declines via

Agility4Life

notification

Pam asks Nancy to

check for common

MS exacerbation

factors and

schedules

appointment with

Nancy’s physician

for checkup

Nancy, along with

her physician

catches the onset

of urinary tract

infection and is

able to treat it

effectively before

it becomes serious

Use Case –

Preventative Diagnosis

March 30, 2013

1http://www.cdc.gov/HomeandRecreationalSafety/Falls/fallcost.html

32

Has minor

dizzy spells

for the

past 3

weeks

During

doc visit:

does not

bring up

symptom

for fear of

being sent

to nursing

home

Condition

worsens –

falls and

suffers hip

fracture


Has minor

dizzy spells

for the

past 3

weeks

During

doc visit:

does not

bring up

symptoms

for fear of

being sent

to nursing

home

But via

Agility4Life

doc sees

average

walking

speed varied

greatly from

past week to

past month

Doc asks

clarifying

questions:

discovers

dizziness;

suspects

vestibular

disorder and

prescribes

physical therapy

Ted follows

treatment – doc

verifies

improvement

with Agility4Life

report – Ted

stays in

independent

living

Total Cost: $20k for treatment/therapy1 Pain and Suffering Decreased long term mobility

Increased risk of fatality

Ted, 74 year old

grandfather, recently

moved into independent

living center.

With Agility4Life




March 30, 2013 33

WS value

(m/s) Functional Link to Walking Speed Author Year Article Title Journal

< 0.6 Dependent in ADL's and IADL's Studenski 2003 Physical performance measures in the clinical setting. J Am Geriatr Soc.

>1.0 Independent in ADLS Studenski 2003 Physical performance measures in the clinical setting. J Am Geriatr Soc.

< 0.6 More likely to be hospitalized Studenski 2003 Physical performance measures in the clinical setting. J Am Geriatr Soc.

>1.0 Less likely to be hospitalized Studenski 2003 Physical performance measures in the clinical setting. J Am Geriatr Soc.

< 1.0 Need interventions to reduce falls

Montero-

Odasso 2005

Gait velocity as a single predictor of adverse events in

healthy seniors aged 75 years andolder

J Gerontol A Biol

Sci Med Sci.

>1.0 Less likely to have adverse events

Montero-

Odasso 2005



J Gerontol A Biol

Sci Med Sci.

>1.0 Less likely to have adverse events Cesari 2005

Prognostic value of usual gait speed in well-functioning

older people-results from the Health, Aging and Body

Composition Study J Am Geriatr Soc.

<.15 d/c to SNF Rabadi 2005

Admission ambulation velocity predicts length of stay

and discharge disposition following stroke in an acute

rehabilitation hospital.

Neural Rehab and

Repair

> 0.15 d/c to home more likely Rabadi 2005

Admission ambulation velocity predicts length of stay

and discharge disposition following stroke in an acute

rehabilitation hospital.

Neural Rehab and

Repair

> 1.3 Extremely fit Studenski 2003 Physical performance measures in the clinical setting. J Am Geriatr Soc.

<1.0

Higher risk for Persistent Lower

Extremity Limitation Cesari 2005




<1.0

Higher risk for Persistent Severe Lower

Extremity Limitation Cesari 2005




<1.0 Higher risk of death Cesari 2005




<1.0 Higher risk for hospitilization Cesari 2005




<1.05 Cognitive Decline within 5 years Inzitari 2007

Gait speed predicts decline in attention and psychomotor

speed in older adults.

Neuroepidemiolo

gy

< 1.0 Death and hospitalization within 1 year Studenski 2003 Physical performance measures in the clinical setting. J Am Geriatr Soc.

<0.8 Mobility and ADL disability at 2 years Ostir 2007

Measures of lower body function and risk of mortality

over seven years follow up Am J Epidemiol.

<0.8 Mortality risk at 2 years and 3.8 years Ostir 2007

Measures of lower body function and risk of mortality

over seven years follow up Am J Epidemiol.

<0.7

Risk of death, hospitalization,

institutionalism and falls

Montero-

Odasso 2005



J Gerontol A Biol

Sci Med Sci.

<0.6 Functional and cognitive decline Studenski 2003 Physical performance measures in the clinical setting. J Am Geriatr Soc.

<0.42 Functional impairments Atkinson 2005 Predictors of combined cognitive and physical decline J Am Geriatr Soc.

<0.42 Severe walking Disability Atkinson 2005 Predictors of combined cognitive and physical decline J Am Geriatr Soc.

<0.2 Extremely Frail Studenski 2003 Physical performance measures in the clinical setting. J Am Geriatr Soc.

<0.15 Institutionalism and high dependence Friedman 1988

A prospective trial of serial gait speed as a measure of

rehabilitation in the elderly. Age and Ageing

~0.67 Self Care Studenski 2003 Physical performance measures in the clinical setting. J Am Geriatr Soc.

~0.89 Husehold Activities Studenski 2003 Physical performance measures in the clinical setting. J Am Geriatr Soc.

~1.11 Carry Groceries, Light yardwork Studenski 2003 Physical performance measures in the clinical setting. J Am Geriatr Soc.

~1.33 Climb several flights of stairs Studenski 2003 Physical performance measures in the clinical setting. J Am Geriatr Soc.

References