The President of Cytta Corp. (OTCBB: CYCA) (OTCQB: CYCA),
manufacturer of the CyttaConnect Open Source mobile monitoring
technology, has issued the following update outlining the Company's
future plans in anticipation of their upcoming licensing meetings
at CES this week.
Cytta Corp. has successfully completed the design, development
and now full scale trial implementation of the world's first open
source special purpose cellular network. Cytta Connect's first
Trial makes available a plethora of exciting, yet affordable and
easy-to-use Bluetooth based medical/health/wellness testing
products and services, which connect through our open source
smartphones. Our smartphones allow people and their physicians to
monitor their personal health, wellness and fitness in addition to
all normal smartphone functionality.
Additionally, while we designed our technology for the
exceptionally high standards of the medical industry, our open
source mobile network is 'any Bluetooth device friendly.' Our
network allows us to connect any data generating devices via
Bluetooth through our proprietarily programmed smartphones and
deliver that data in real time to a web based interface and then
back to the smartphone.
We formed the Company with the idea of revolutionizing the home
based medical testing sector and then we created a new form of
mobile network designed to move generated data seamlessly.
We commissioned Connected Health Pte. Ltd., to create a mobile
phone based monitoring technology. They developed a proprietary
technology utilizing the native programing in our cell phones,
which we call the "Super App." This technology allows our cell
phones to seamlessly connect with Bluetooth medical and other
testing devices and automatically forward that data to our cloud
based database and downstream users.
The Super App technology required that we obtain access to a US
Mobile Network and obtain authorization to alter native phone
programming and create a proprietary special purpose network. We
partnered with Vonify Inc. for a full MVNO (Mobile Virtual Network
Operator) status and assisted with the integration of the Super App
with their US cellular network. Months of arduous testing involving
all elements of the solution including voice, data and SMS have
resulted in an integrated network capability that exceeds any other
alternative. Additionally, we have now secured and fully
implemented a US and International Data MVNO from AT&T which
provides us with backup and additional network opportunities.
Moving medical data that could be directly 'utilized' by medical
professionals required the use of high quality FDA approved
Bluetooth medical testing devices. We were able to automatically
utilize our Super App to integrate into our Bluetooth ecosystem,
the A&D Medical scale, the A&D Medical blood pressure
device, the Nonin Medical Inc. pulse oximetry device and the
"MyGlucoHealth" diabetes meter from Entra Health Systems. However
the Cytta Connect network and smartphones can easily interface with
any information generating Bluetooth device.
We created an internet or Cloud based Electronic Relational
Database to act as a Medical Record for the data from our devices
to populate, since there was no precedent for the real time medical
database the medical devices were now generating. The Cytta
Dashboard or Instant EMR is automatically populated with the
patient's data and provides an interactive and interpretive
interface for review by the patient's providers and caregivers. The
data can be displayed in various numerical formats, it can be
graphed to show trends of these measurements and it may be utilized
to provide early warning signs of dangerous health trends. The
Dashboard can also be used to monitor and issue warnings for any
type of data being generated. Licensing discussions in the Oil and
Gas, Transportation, Security and other industries are ongoing.
Having 'premiered' our technology in the medical monitoring
industry, we needed a medical technical organization to be
responsible for the servicing of the high end medical testing units
being deployed in our Field Trial. We worked with Medi-Home
Individualized Monitoring Systems Corp. (MHIMS) who helped design
the Trial and then implemented the ecosystem of devices to be
utilized by the patients to provide meaningful and timely
information to their caregivers in real time.
We established our initial Pilot Program installation with the
Heritage Provider Network (HPN) Regal /Lakeside Medical Group,
under the auspices of Dr. Terry Olson. HPN is a large full risk,
capitated medical group located in Southern California. Under the
terms of the Trial they completed a 90 day and more recently a 120
day Pilot Study to determine, 'if high cost patients, not well
managed in traditional care coordination programs and traditional
healthcare delivery systems, can decrease cost of care and improve
patient satisfaction, through remote telemonitoring using the CYTTA
Connect Ecosystem and an intense case management process.'
Patient satisfaction and costs reductions were then measured.
MHIMS provided assistance and advice in conjunction with Dr. Terry
Olson's team. Cytta is delighted with the results MHIMS and Dr.
Olson have achieved with our technology in the medical monitoring
field. Their results are set out in the 6 month Pilot Study
Whitepaper by Dr. Olson titled "Biometric remote telemonitoring to
produce a healthy return on investment, decrease resource
utilization, and improve care coordination" is attached as Appendix
A. Also available on request is our Cytta Technical Whitepaper
summarizing the technical aspects of the Trial.
Excerpts from Dr. Olson's Independent Report summarize the Cytta
Technology Pilot Program as follows,
"This trial demonstrated the ability to significantly reduce
costs for high risk patients through use of the CYTTA Connect
Ecosystem. The trial demonstrated the ability to quickly achieve
cost savings, decrease resource utilization, improve care
coordination, and increase adherence to evidence based
guidelines."
"Care costs were reduced on average by $11,078 for each trial
participant through the trial [or $1,846 per member per month].
This trial did not specifically address long term cost of care.
However, these patients were selected for the inabilities of the
existing healthcare system and care coordination programs to cost
effectively address their short or long term healthcare needs. One
trial participant noted he realized more value and benefit in 2
months of trial participation compared to his previous 17 months of
participation in the best available care coordination
services."
"This trial discovered patients view CYTTA Connect and remote
telemonitoring as a special benefit to patients who are encouraged
to retain their relationship with Heritage to continue to access
and build their personal health database. Patients develop a
special relationship with their care coordination team. The
patients viewed CYTTA Connect and care coordination activities as a
value rather than an intrusion because information and advice
generated by the trial were specific to the patient and time
sensitive."
"When compared to other remote telemonitoring services
available, the CYTTA Connect Ecosystem is clearly the most cost
effective, patient friendly system available."
We have designed, built and completed a new technological
product that will improve many lives and will vastly improve the
way healthcare and any other data is transmitted and utilized.
Accordingly, we have determined to be a facilitator of our services
to anyone wishing to move data in a new and hitherto unavailable
manner. We want to partner and will license any organization that
can improve their model with our technology.
Our objective is not to actively enter any specific marketplace,
but to license our technology to partners, who have developed the
considerable expertise necessary sell, deploy and operate in this
sector and others. If you are offering any remote monitoring or
data generating technology let us see how we can work together to
improve the services you are offering.
Gary Campbell, President
Contact: Mr. Gary Campbell, President Direct 702 900 7022 Office
702 253 7499 Website: Cytta.com info@cytta.com
Appendix A Pilot Program Whitepaper
Biometric remote telemonitoring to produce a
healthy return on investment, decrease resource utilization, and
improve care coordination
By Terry Olson, MD August 30, 2012
Background
A large full risk, capitated medical group located in Southern
California with employed and IPA physicians completed a six (6)
month trial to determine if high cost patients not well managed in
traditional care coordination programs and traditional healthcare
delivery systems can decrease cost of care and improve patient
satisfaction through remote telemonitoring using the CYTTA Connect
Ecosystem and an intense case management process. Costs were
realized in savings from:
- Hospital admissions
- Emergency Room Visits
- Urgent Care Visits
- Specialty Visits
Methodology
Twenty-seven (27) patients were identified through claims
analysis with frequent use of primary care and specialty visits,
Emergency Room visits, Urgent Care visits, Hospital admissions, two
(2) or more co-morbidities, and little to no adherence to their
current medical treatment plan. After further review, twenty (20)
patients were enrolled in to this remote telemonitoring program
trial. Resource utilization for the 180 days prior to enrollment in
this pilot program was compared to monthly resource utilization
during this trial. Patient and Provider satisfaction surveys were
sent and interviews were completed with patients, care coordination
staff, and physician providers who utilized the telemonitoring
technology to determine their satisfaction with the program and
case management. Recommendations were formulated at the completion
of the trial.
This was a voluntary program which allowed patients to disenroll
at any point during the trial. Patients who agreed to participate
in the trial completed a 30 minute office orientation session to
introduce the telemonitoring products and review the care
coordination program. CYTTA provided technical resources,
consultation to maintain device performance and all materials and
services at no cost. All HIPPA requirements were incorporated into
program design and care coordination processes.
Patients participated in the trial from their home after
completing the orientation session. Technology performance issues
were resolved remotely and within the patient's home for 4
patients. Biometric measurements were available for blood glucose,
blood pressure, weight, and pulse oximetry. Results were sent via
Bluetooth technology through double FDA approved off the shelf
devices and transmitted to the CYTTA Connect dashboard. Access to
the dashboard and ability to send care alerts were available to all
members of the care coordination team, patients, and designated
physicians/family members/caregivers.
Care coordination was provided by nurse and physician services
through the existing complex case management employees. Alert
programming was established by the Medical Director in association
with discussions with primary care provider, specialty providers,
and evidence based care guidelines. Alert prompts were sent to
nurse care coordinators via email and texts. Nurse coordinators
contacted patients in response to alert prompts and on a regular
schedule during the trial. Face to face patient interaction with
the care coordination team was not required but often transpired
during the trial. Patients were able to participate remotely,
through face to face interactions in the care coordination clinic,
or through face to face home interactions.
Results
Cost of care was reduced by $221,570 for the 20 patients in this
180 day trial. This equates to an average of $11,078 in cost
reduction for each patient in the trial. Appendices 1-6 detail pre
and post-trial costs of care and sites of utilization. Cost
reductions were realized through reduced Emergency Room and Urgent
Care visits, reduced specialty visits, and reduced hospital
admissions. The reduction in hospital admissions was achieved
largely through reduced readmissions. The table below summarizes
utilization for trial members. The use of CYTTA Connect Ecosystem
during this trial reduced utilization in the initial 90 days, but
produced even more dramatic reductions in the second 90 day period.
This supports the belief that patients began to learn how to better
self-manage their conditions as they became familiar with the
program and their care coordinators. The average reimbursement for
a hospital inpatient DRG was estimated at $22,000; Emergency room
visits average $1,200.00/visit; specialty physician visits average
$125/visit while urgent care visits average $90/visit.
Special note is made regarding 3 unavoidable hospital admissions
with prolonged inpatient stays.
1. A member with no prior history of upper gastrointestinal
bleeding developed abrupt hematemesis in addition to their
diagnosis of end stage idiopathic pulmonary fibrosis. The member
was admitted and spent 9 days in the hospital with a bleeding
gastric ulcer.
2. A dialysis member with narcotic dependency, diabetes, and
advanced degenerative spinal disease suffered a traumatic neck
injury resulting in a 69 day stay and quadriplegia.
3. A member with idiopathic cardiomyopathy developed left
ventricular assist device infection requiring hospital admission,
LVAD removal, placement of an intra-aortic balloon pump and
continued inpatient stay until a heart was found and heart
transplantation completed. This resulted in a 73 day inpatient
stay.
Summary of Trial results
----------------------------------------------------------------------------
Last 90 days
Pre-trial Post-trial of trial Change Cost Savings
----------------------------------------------------------------------------
Admits 28 17 3 9 $198,000
----------------------------------------------------------------------------
Readmits 12 5 0 7 $140,000
----------------------------------------------------------------------------
Bed Days 90 143 80 (53)
----------------------------------------------------------------------------
ER Visits 44 26 4 18 $21,600
----------------------------------------------------------------------------
UC Visits 12 4 1 8 $720
----------------------------------------------------------------------------
Specialists 102 92 36 10 $1,250
----------------------------------------------------------------------------
PCP 92 78 18 14 Capitated
----------------------------------------------------------------------------
Total Cost
Savings $221,570
----------------------------------------------------------------------------
Cost Savings per
Member over 6
months $11,078
----------------------------------------------------------------------------
Cost savings per
Member per
month $1,846
----------------------------------------------------------------------------
Value creation was identified in 4 areas during the trial:
1. Improved patient engagement and ability to self-manage
care
2. Improved provider engagement
3. Patient loyalty
4. Improved care coordinating performance
Enrollment criteria identified patients who struggled to manage
their health despite best available resources in our current
healthcare environment. This trial demonstrated these patients were
not able to self-manage their care. The patients visited the
hospital, emergency room, and physician offices in search of a
solution to their healthcare needs. Those efforts were previously
costly and ineffective.
Trial participation and the use of the CYTTA Connect Ecosystem
discovered these patients were rarely engaged or knowledgeable in
self-management of their healthcare needs. Repeated use of
available resources did little to address this deficit. The CYTTA
Connect Ecosystem in association with care coordination enabled the
patient and team to identify and address barriers to
self-management and adherence to evidence based guidelines.
Barriers included knowledge deficits, outpatient monitoring
deficits, absence of prompt and effective care plan revision when
biometric guidelines were not met, and social factors.
Physician providers who participated in the trial voiced
tremendous support for biometric remote telemonitoring. Physicians
noted many of the previously reported home biometric monitoring was
inaccurate, fabricated, or absent. Patients, physicians, and care
coordination team members confirmed that biometric results were
rapidly available and accurate. Sampling error or erroneous results
reporting was not a problem. Physicians and care coordination team
members noted their level of engagement and effectiveness was
tremendously improved with accurate, timely, and frequent reports
of blood pressure, blood sugar, weight, and oxygenation status.
As patients participated in the trial and received customized
care coordination they became more engaged in their healthcare
management and frequently voiced the admiration for effective
service delivery. Patients commonly noted their neighbors, family
members, church members, and others were amazed by the service
delivered and wanted access to the trial. Patients noted they were
not only more satisfied with the service delivered by the medical
group but also noted they would never consider switching health
plans or medical groups because they feared they would lose access
to the CYTTA Connect Ecosystem and care coordination.
The complex care coordination team noted their ability to
effectively manage and their personal satisfaction was tremendously
increased through trial participation. The team noted the absence
of playing telephone tag with patients and the absence of erroneous
home biometric self-reports by patients. The team noted that the
CYTTA Connect alerts required an active care plan which was clearly
understood by the patient, the managing physicians, and the care
coordination team. This was clearly absent prior to this trial. In
addition, standing orders were required to promptly address care
alerts so that blood pressure, blood sugars, weight, and
oxygenation guidelines were met. The trial demonstrated the absence
of effective, real time care plan and medication revision in
existing care programs. The absence of timely care plan revision in
addition to unclear care plans produced significant care team
dissatisfaction. This trial and CYTTA Connect removed that
dissatisfaction while improving care team performance.
Conclusions
This trial demonstrated the ability to significantly reduce
costs for high risk patients through use of the CYTTA Connect
Ecosystem. The trial demonstrated the ability to quickly achieve
cost savings, decrease resource utilization, improve care
coordination, and increase adherence to evidence based guidelines.
Adherence to evidence based guidelines is increasingly important as
CMS 5 STAR ratings garner importance.
Care costs were reduced on average by $11,078 for each trial
participant. This trial did not specifically address long term cost
of care. However, these patients were selected for the inabilities
of the existing healthcare system and care coordination programs to
cost effectively address their short or long term healthcare needs.
One trial participant noted he realized more value and benefit in 2
months of trial participation compared to his previous 17 months of
participation in the best available care coordination services. A
quite handsome return on investment is present if the care
coordination system is priced at less than $2,000 per year.
This trial also demonstrated that home biometric monitoring
using the CYTTA Connect Ecosystem can be easily introduced,
dispensed and utilized in the home setting. Care team training was
easily completed. CYTTA Connect was easy for patients and care
coordinators to learn and effectively use. Technical
troubleshooting was prompt and effective.
Improved patient engagement and ability to self-manage care will
become increasingly important and require new resource allocation
because CMS will soon require Stage II Readiness participation.
Through repeated collection and review of biometric data patients
learn how to titrate medications and adjust behaviors to achieve
target goals which is a cornerstone of CMS 5 STAR performance and
CMS Stage II Readiness. Patients and the care coordination team are
prompted by alerts to evaluate and to intervene in real time. This
produces a patient who is more engaged and prospectively aware of
how they must modify behaviors and medications to meet target
metrics through self-management. Additionally, improved achievement
of target metrics produces significant provider and care team
satisfaction. Efforts of both become both more effective and more
efficient.
Effective use of the CYTTA Connect Ecosystem requires the
managing physicians to develop and communicate care plans and
standing orders to adjust medications to achieve target goal. Too
often the goals of care and associated care plans including
medication administration are poorly communicated or not present.
Patients travel through various sites of service and levels of care
without a clear understanding of the expected behaviors and
medication usage to be executed in the home setting. CYTTA Connect
in conjunction with care coordination resolves this deficit and
allows for care plan and medication revision as the patient disease
processes change in the home environment. Through repeated
measurement and with focused care coordination the patient learns
how to better manage their health care needs. This produces a
patient who is more engaged and prospectively aware of how they
must modify behaviors and medications to meet target metrics. This
also produces a more satisfied patient, physician, and care
coordination team.
This trial discovered patients view CYTTA Connect and remote
telemonitoring as a special benefit to patients who are encouraged
to retain their relationship with Heritage to continue to access
and build their personal health database. Patients develop a
special relationship with their care coordination team. The
patients viewed CYTTA Connect and care coordination activities as a
value rather than an intrusion because information and advice
generated by the trial were specific to the patient and time
sensitive.
This trial enabled physicians and care coordinators to more
effectively manage a larger number of patients. Current care
coordination ratios can be expanded by 20% using biometric remote
telemonitoring through reduced telephone tag and elimination of
unfocused, subjective, generic discussions with patients. Instead
specific biometric data, medication usage, review of the active
care plan, and comparison to target metrics produces a focused
discussion. Patients and care coordinators are taught through rapid
cycle improvement to Plan, Do, Study, and ACT. Barriers to
successful self-management are identified and addressed. Patients
now learn how to revise and update their care management in the
home setting rather than a physician office, emergency or hospital
room followed by an attempt to translate and implement the care
plan in their home setting upon discharge. Patient contacts have
become value oriented with immediate return on investment to the
care coordinators and patient.
Next Steps
We believe the success of this remote telemonitoring program on
managing high risk patients can be replicated and offered to
forward thinking, at risk healthcare organizations. The
telemonitoring success requires careful patient selection,
structured patient enrollment and focused care coordination which
have been developed and tested. Ongoing success requires structured
patient assessment, patient and provider engagement, alert
parameter selection with provider input with standing orders in
response to alerts. CYTTA and MHIMS provides coordination between
the providers and systems to introduce and educate on the use of
the telemonitoring program to reduce ER and hospitalizations usage
with increased patient involvement and increased positive outcomes
in health self-management for high need members. We can identify
high cost members and offer this program to non-high cost patients
who are discharging from the hospital but at high risk for
readmission due to their inability to effectively self-manage their
care in the home setting.
When compared to other remote telemonitoring services available,
the CYTTA Connect Ecosystem is clearly the most cost effective,
patient friendly system available.
Although the pilot study was completed, CYTTA continued to
provide their products which demonstrated additional cost savings
and dramatically reduced utilization past the initial 180 day
pilot.
Contact: Mr. Gary Campbell President Direct 702 900 7022 Office
702 253 7499 Website: Cytta.com info@cytta.com
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