Early Recognition of Illness: Guardian - HIT July 2024

Our second presentation involves a project currently progressing under the name "Guardian". It is an early detection system for conditions that require immediate medical attention, such as strokes and infections. Information is continuously collected from a wearable device, storage of medical history, caregiver alerts, algorithm to detect possible conditions. The project is in the stage of building a minimum viable product.

Leading the discussion will be Nima Sarani, MD, Assistant Professor of Emergency Medicine and Assistant Emergency Medicine Ultrasound Fellowship Director at the University of Kansas Medical Center. Dr. Sarani completed his residency in Emergency Medicine in 2014 and worked in the community before deciding to come back to academics in order to complete a fellowship in Emergency Medicine Ultrasound. After completing his fellowship in 2020, he joined the faculty in the department of Emergency Medicine.

1. Early Recognition of Illness: Guardian Nima Sarani, MD

2. Signs of underlying illness is often undetected leading to delayed recognition of illness . Early recognition is key in reducing mortality , improving outcomes Sepsis Time matters: Affects 1.7 million people and results in ≈ 270,000 deaths, and $38B annually in the U.S. 1 Mortality rate increases by 4-9% for every hour delay in antibiotics. 2,3 Infection leading to dysregulated immune response Heart Disease In U.S. coronary artery disease was responsible for 375,000 deaths in 2021. 12% of people with hearth attack die. Annual costs of treating MI is estimated at $21 B (hospitalization, invasive procedures, medications, and follow up care) 4 CHF 1-year mortality rate is 20-30% and is leading cause of hospitalization, ≈ 875,000 with estimated costs of $13B/yr. 5,6 Lung Disease COPD Mortality rate ≈ 33.7 per 100,000 in 2021 Annual costs $24B: inpatient, home health, emergency room costs 7 Early recognition of illness improves outcomes by allowing for timely intervention , reducing complications , lowering healthcare costs , improving prognosis and quality of life 8,9 Regular monitoring is key to early recognition. 5,6

3. Tachycardia: fever, dehydration, anemia, anxiety, cardiac issues Bradycardia: hypothyroidism, heart block, effect of medications Fever: infection, inflammatory, heat-related illnesses Hypothermia: metabolic issues, sepsis, cold exposure Tachypnea: sign of respiratory distress, infections, pulmonary embolism, metabolic acidosis Bradypnea: central nervous system depression due to drugs, head injury, severe hypothyroidism Hypoxemia: can signal respiratory or cardiac conditions, e.g., COPD, pneumonia or heart failure Variability in vital signs: Small, consistent deviations from normal ranges, even if not immediately alarming can indicate underlying acute and chronic conditions e.g., early-stage heart failure, sepsis, renal insufficiency, or hormonal imbalance By monitoring vital signs closely and recognizing subtle abnormalities, intervention can occur early, potentially preventing the progression of underlying illnesses and improving patient outcomes. 1-4 Vital signs: Provide objective data and can signal presence of underlying illness Regular monitoring

4. Guardian A B

5. Delayed recognition of illness: Death, disability, invasive procedure, ICU admission, prolonged hospitalization, increased costs Early Recognition of Illness Individual specific medical history + Mild change in baseline vital signs Moderate change in baseline vital signs Significant change in baseline vital signs = Guardian

6. Leverages data obtained continuously from wearable technology to recognize illness early Guardian 145B 620M 1.2B

7. Survey 1: 212 Medical Professional responders 159 (75%) wear a wearable technology 118 (106 + 12) or Survey 2: 333 General Public responders 236 (70.9%) wear a wearable technology 237 (200 + 37) or Would you purchase if you would have Guardian? 28 Yes for myself 3 Yes for my loved one 6 Yes for myself and my loved one 29 Maybe Would you purchase if you would have Guardian? 5 Yes for myself 1 Yes for my loved one 6 Yes for myself and my loved one 25 Maybe Techs, Nurses, Residents, APP, Attendings 55% of tot interested in purchasing Guardian Willing to pay $12/ mo 71% of tot interested in purchasing Guardian. Willing to pay $37/ mo

8. Survey 1:

9. Survey 1: 212 Medical Professional Survey 2: 333 General Public 55% of tot (106+12) interested in purchasing Guardian (provided contact info for early purchase) Willing to pay $12/month 71% of tot (200 + 37) interested in purchasing Guardian (provided contact info for early purchase) Willing to pay $37/month U.S. 258.3M Adult Population At 55% = 142M At 71% = 183M 75% (159) wear a wearable technology 71% (236) wear a wearable technology U.S. 258.3M Adult Population Market Validation Tot number of potential customers = 63% x 258.3M(adult pop) = 162,729,000

10. Tot Addressable Market: Tot number of potential customers x Av. rev/ yr 162.7M x $144 =$23,432,976,000 Tot number of potential customers = 63% x 258.3M(adult pop) = 162,729,000 Serviceable Available Market: 162.7M x %60 (realistically served by business) x $144= $14,059,785,600 Serviceable Obtainable Market= 162.7M x 60% x 30% (realistically captured by business) x $144 = $4,217,935,680

11. Competitive Analysis My-Vitals HealthRate Ada WebMD Guardian Price free 14.99/m free free $12/m Data monitoring Consider vital signs in diagnoses Consider individual unique history (PMH, PSH, weight, medications, location, etc.) in diagnoses Surveillance mode Manual mode

12. Product road map/go to Market Strategy