Deployment of Active+me for remote patient support and cardiac rehabilitation for vulnerable patients in isolation, following heart surgery.

Prior to the Covid-19 pandemic, recovery after heart surgery was optimised by engaging the patient in a rehabilitation process, arranged in stages:

* Phase I at the bedside after the procedure.
* Phase II as an out-patient
* Phase III as a series of exercise workouts and lifestyle education classes over 6-8 weeks (conducted by nurses and/or physiotherapists). Some Phase III classes were in hospitals, others in leisure centres.
* Patients were then referred to Phase IV classes, usually in leisure centres. These are supervised by Personal Health Coaches (PHCs) trained to high standards by the British Association for Cardiovascular Prevention and Rehabilitation (BACPR).

Completing a Phase III programme has proven health benefits and is mandated by NICE. Even though the Phase III classes were free, only 50% of eligible patients enrolled. The National Audit of Cardiac Rehabilitation found that women, people from low-income backgrounds and those from ethnic groups were less likely to join these life-changing programmes.

Due to the pandemic, all face-to-face rehabilitation processes have ceased. Front-line care-staff have been diverted to support the treatment of patients with Covid-19 and there is no spare capacity for patients recovering from heart surgery or a heart procedure. Active+me can significantly enhance recovery of these vulnerable patients, who will otherwise have minimal support during their self-isolation. Active+me will provide remote and self-monitoring, remote education delivery, remote exercise classes and virtual chat rooms.

Following a heart procedure, Active+me will support patients who are vulnerable, currently self-isolated and often have multiple medical conditions. While the risk of a second heart attack is only 10%, the risks from other conditions affecting the health of the patient is high (50%). Active+me addresses the major challenge of replacing face-to-face rehabilitation programmes with a novel "activation" service which is delivered remotely, includes a remote monitoring service, delivers a sense of community and achieves this whilst releasing NHS staff to front-line duties.

121,500 patients in the UK each year are eligible for Cardiac Rehabilitation. Women, ethnic groups, patients on low-incomes and those in rural settings have not been fully engaged. Active+me can now be delivered remotely, applying "the six pillars of self-care" developed by Aseptika:

1. Education;
2. Physical exercise (cardiovascular/muscle strengthening/balance);
3. Tools to self-monitor symptoms/physiological signs with "light-touch" remote monitoring;
4. Medication adherence;
5. Learning triggers, and
6. Long-term behaviour change supported by family, peers and non-medical mentors ("light touch" Behaviour Change Theory).

Funding from Innovate UK is required to support roll-out of Active+me.

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ADDITIONAL INFORMTION
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After successfully completing the Active+me REMOTE Cardiac Recovery project with Addenbrooke’s Hospital (Cambridge Universities Hospital NHS Foundation Trust), a development programme for a new version of our Activ8rlives App has been started by the company to support patients recovering from a heart procedure called Active+me REMOTE Recovery Ap. This was a direct outcome of our COVID-19 rapid response project which was completed in August 2020.

The delivery of this new product has become ever more urgent as multiple waves of the COVID-19 virus are now anticipated. As the UK completes the transition period to leave the EU, a new regulatory standard will be applied to medical devices which are used in the UK called UKCA. Funding from this extension supports Aseptika to also implement this new standard alongside its CE mark for the EU (under MDR 2017/745) and FDA approvals for the USA.