In this episode of Raising Tech, our host, Patrick Leonard, has a informative conversation with Nobi's North American Business Development Manager, Ramiro Maldonado, about how Nobi's smart lamps detect and prevent falls in Senior Living communities' residents' rooms so caregivers can provide immediate medical assistance.
Discover why Nobi's smart lamps have been described as "The Smartest Lamps in the World" and how their lamp technology is beneficial both inside and outside of Senior Living communities.
Raising Tech is powered by Parasol Alliance, The Strategic Planning & Full-Service IT Partner exclusively serving Senior Living Communities.
Welcome to Raising Tech, a podcast about all things technology and senior living. I'm your host, Patrick Leonard, and today I'm really excited to welcome our guest, Ramiro Maldonado from Nobi . Ramiro, welcome to the show.Ramiro Maldonado:
Thank you so much, Patrick. So happy to be here.Patrick Leonard:
Really interested to learn more and educate our listeners on our topic today, which involves Nobis innovative technology solution for fall prevention and detection. I was actually fortunate enough a few weeks ago to get a live virtual demo of the solution myself from Ramiro, and it was fascinating. But before we dive in, Ramiro, can you introduce yourself real quick, your background and r ole with N obi?Ramiro Maldonado:
Sure. Yeah. So, thanks so much for that. It was a lot of fun to kind of demo the product to you a few weeks ago. So, my background is, you know, somewhat interesting. So, for a long period of, of, of my professional career, I actually practiced as a clinician, as a physical therapist for roughly a little over 10 years, and I kind of geared my practice towards fall prevention and just fall kind of prevention in the community that I served. So , I got my certification of vestibular therapy and neurotherapy and kind of worked with the , the community in that way. So in that world of physical therapy, I got just kind of exposed to a lot of different kind of technologies that are available to individuals for, you know, improving their, their strength, improving their balance. So, I just really kind of fell in love with the technology side of things. So, I transitioned my career into a more tech -related role. So, for few years I've worked with a few different companies as either their business development specialist or clinical application specialist, where I kind of served a dual role where I was , performed somewhat of a sales role as well as a clinical applications role of training clinicians on how to use these new devices and and rehab equipment. Then, kind of fast forward to me learning about Nobi and my interest and , and kind of , uh, passion towards kind of improving the balance of, of the community. I just really just saw the value of nobody right away. So, it's a device that is able to kind of detect and prevent falls , which is exactly the kind of space where I wanted to, to be, you know to be able to get into a situation where we could start to help improve the health of individuals as opposed to getting them after the fact and trying to rehabilitate them after the fact . Anything that could help beforehand, if I, we could if there's a device that can kind of prevent that larger kind of severity of injury happening is where, where I kind of want it to be. So, that's where I came in and with Nobi as their business development manager for North America, and I've been doing that since August of last year.Patrick Leonard:
Awesome. Thanks for that background. I love to hear people's kind of intro into senior living, into technology and, you know, your physical therapy background is certainly applicable and relevant here, so thanks for sharing that.Ramiro Maldonado:
For sure.Patrick Leonard:
So youtouched on it a little bit and we've, we've said, you know, fall detection, fall prevention, that's such a buzzword right now in this industry, and there's certainly a lot of cool solutions out there, but yours is, is very unique at , at Nobi , um, that I learned, like I mentioned, really in depth a few weeks ago. Can you, from a high level, just tell people what is Nobi ? Where did it come from, and what are you all hoping to accomplish as it relates to its presence in senior living?Ramiro Maldonado:
Sure, sure. So, first and foremost, Nobi, we like to say that Nobi is the smartest lamp in the, in the world, right? So it's a lamp first and and foremost and it's you, it's indiscernible from healthcare technology. You would walk into someone's room, you would see it, you would just say, oh, that's a very nice, nice lamp that functions very nicely. It actually even provides something called circadian light. So , as you start to rise in your morning, it's just a very nice soft light to kind of help you with arousal throughout your day, becomes a little bit brighter, so again, can help with your arousal and, and make sure it's you're awake during your day. At nighttime, it starts to calm back down again because it's allowing the resident to kind of get back into that nighttime routine. So, even just as a lamp, it just functions very nicely, but the smartness behind it, so it's an AI, so artificial intelligence enabled lamp that at its core can prevent and detect falls . So doesn't matter what kind of fall it is, we have feted so many data points that it has learned any kind of fall that can occur. So should a fall occur, fall , you know, w ould it be a fast fall, s low f all, just kind of stumbling to the ground, whatever it may be, i t recognizes that fall. At that point it opens up a two-way communication through the lamp, v ia t he l amp, allowing you an opportunity to now speak to that resident and say, Hey, I heard you had a fall. We ar e, we ar e o n ou r, on our way, you know, uh, s o, yo u k n ow, you ca n s tay relaxed. Caregiver comes in, they can now , uh, do whatever they need to do to help that individual and then also what they receive is feedback of how that fall occurred. So, The caregiver will have a 30 seconds of feedback of footage before that fall occurred until they closed that escalation, so that when they closed that fall, allowing them the opportunity to see what caused that fall. Was it that they tripped on something in the room? Did they just not have the strength to be able to get up or any number of, of , uh, of factors that could have potentially have caused that fall? And what we're finding is that in facilities that have implemented Nobi, they're on average per you know, producing about a one fall preventative measure per a residence's room roughly every six days or so. So if they're able to kind of prevent any type of major falls from, from happening to , and, and , and severity of injury and prevent that severity of injury for their resident, and that's what it does at its core, and this is a , a lot more of other kind of interesting stuff as well . But at its core, that's what it, what it does.Patrick Leonard:
Yeah, that's amazing and that status is impressive. One per resident room every six days. I didn't butcher that too much. That's a huge, huge difference in impact on senior living residents . So that's awesome. Thanks for sharing that.Ramiro Maldonado:
For sure.Patrick Leonard:
So how are I , when I think of something like this, I think of two sides of it, the residents response and then the staff. Can you talk a little bit about both perspectives a little bit? You, you gave us a little, a nice overview of kind of how it functions, but can you dive a little bit deeper? How are residents responding to this? And then on the flip side, how are staff responding to it?Ramiro Maldonado:
For sure. Yeah, so , we have some really interesting , uh, data coming out of some of our pilot studies that have been performed in Belgium. So, you know, small bit of background. So , Nobi is a company founded in Belgium 2018 by a lot of leaders and smart home and elderly care. They got together and developed Nobi , completely manufactured factories in Belgium. We control the process from manufacturing to , you know, just kind of conjuring it up and to getting it out there. So we have full quality control over the, over that device. So, and then in that situation, so we have a pilot study in an assisted living facility in Belgium. I'll start from a resident's perspective. So we do have this kind of really cool test testimonial on the website. I believe the woman's name is, is Helen. She had to enter an assisted living facility because she was just having more, more falls at home, brought her into this facility and actually on her very first day of , of being into , being in this facility, she ended up having a fall. She fell slowly. She was at her bedside and just kind of slowly fell down until both her knees touched the floor, very similar to the kind of fall that she had at home that brought her to this facility, and so because of that, you know, she has a lot of fall anxiety. She was just very fearful of falling and just kind of worried and now, she was in a situation where she just kind of like, oh my gosh, you know, it's happened again. Here I am first day in this facility, and I've, and I've had a fall again, and I, and I just don't know what to do. You know, she knew, she kind of understood that there was a Nobi in the room, but didn't really quite kind of grasp that technology, right? She wasn't kind of there long enough. You had to really have that understanding of Nobi. So within just a few, few seconds of her being on the ground Nobi then asked her, "Hey, Helen, have you had a fall? I don't, I don't, I don't see what I , you know, like , uh, I see that you're not upright," and Helen unbeknownst to her, she's like, "oh my gosh, where is this, you know , voice coming from?" It's like , you know, the voice of the lamp above, and she's, she's just like, "yes, yes, I've had a fall ." So, that nobody responds with okay, help is underway , opens up that two-way communication. The caregiver, the nurses at that site now have an opportunity to help decrease her anxiety levels, letting her know like, Hey, I heard you had to fall. I'm coming to your room. I'll be there at no time flat. So, and we were able to kind of find out what that timing was. So from the incident occurring to caregiver giving help was under two minutes of being able to help this woman off the ground and then help her, you know, with, with the kind of arrangements of the room that caused , to fall in the first place. So that's what we're getting from the resident's side of it, that they just loved the peace of mind, the decrease of anxiety, knowing that they are always going to be helped, should a fall occur, which is you know, that's, that's a big issue with the elderly population and senior home facilities, right? The longer people spend on on the ground following a fall, it's, it's proven that there's higher levels of severity of , of injury. So the sooner we can get to them provide that help, decrease that fall anxiety is extremely important. So that's the kind of feedback that we're getting from, from the resident side of things. Now, on, on the flip side of that, the staffing, the , the clinical staff little bit for that aspect as well, right? So in a lot of these facilities, so let's say in a memory care facility, right, where residents may not have the capacity to let you know that they've had a fall or, or when they've had a fall or, or, or, you know, if it falls even occurred often staff have to enter these rooms roughly every hour, right? So , this is a , a part of their workflow that they don't necessarily enjoy. It takes away from other important tests they could be doing. And on top of that it disrupts the sleep of whoever is in that room every single time you open that door which is, you know, I , not really the ideal case for someone that has memory care issues in a situation where you have Nobi. We found now, the staff can now kind of take a breather knowing that Nobi is in that room monitoring their patients, monitoring their residents, so that should something occur, they're always gonna be notified because of that artificial intelligence within the lamp. We can, we can say that it has, it provides 100% accuracy and fall detection and in the situations where it provides a, you know, a false positive, we find that it's often a situation where the nurses still want it to be notified of that event because they go into that room and it looks like the resident is in a situation where, you know, maybe something is just about to occur. And that's often a situation that we're hearing whenever a false positive has occurred and and so 100% accuracy and fall detection, extremely low false positive rates and in situations where we get a false positive, it's often a situation where nurse is like, you know what? I'm glad I got notified at this event. Now, I could help this in individual, maybe sit back up in a chair a little bit better, or whatever it may be. So to that point , we're finding that there's a lot of really beneficial kind of network effects, right? So , these , the nurses , the clinical staff are now able to kind of focus on, on , on work , that is , that is very valuable and more important to them. So if they could kind of continue caring for all their residents, they're able to intervene sooner , before a major event occurs and then directors of facilities are telling us that this has helped them with their staffing as well. They don't have to staff as much overnight reducing some of those staffing costs as well. So, and that kind of in a nutshell is what we've been finding out from both sides of the, of the camp of the, of the Nobi users.Patrick Leonard:
Awesome. Thanks for providing those two perspectives. Those are some awesome kind of use cases, statistics, testimonials , um, from Helen in particular. I love , I mean, day one, no better. Yeah, unfortunately. I mean , obviously you don't want to, to see a fall happen in the first place, but the fact that you're able to have a response so quickly from the caregivers and going forward , I imagine Helen felt much safer at at Oh , yeah and much more at home after that experience of after getting over that initial anxiety. I'm sure that was, yeah ,Ramiro Maldonado:
Scary . And you think about the anxiety of, of, of her and then also, but the , and then the family, well, the , you know, the family piece, you know, the family hears about what nobody was able to do, and now they all of a sudden you could see the anxiety levels drop there as well. So , um, there is just kind of all the stakeholders that are involved, you know, the , the actual resident in the room, the the clinical staff the, the children of the resident, i t all just kind of really kind of helps everyone just kind of b reathe a little bit easier a nd knowing that their loved one is gonna be, gonna be cared for and a ttended to as quickly as possible. Another interesting stat that came out from that, pi lot study as well was that so they, we outfitted an entire wing with No bis, an d then we had another wing where th ey're w e re, you know, we re w ithout No bis. It just kind of compare and contrasted it two . So the wing without Nobis used there , a standard all preventative measures and what we've found was that the rooms where there were the Nobis that they identified 80% more falls than previous fall preventative measures that they were using beforehand. So that's 80% more falls, right? So that says a lot, right? I mean, you know, CDC even mentions this , that most people have a fall, most falls aren't as severe, necessarily one in roughly five falls is gonna be a severe fall but the highest predictor of whether or not you're going to fall is a previous fall, right? But we also know that most people don't like to fess up that they've, that they've had a fall because it might mean like some type of change and status of what they're living or whatever it may be, that they don't necessarily want to tell people just recognizes it. 80% more falls were recognized, which allowed them to do those preventative measures. So if these individuals can then continue to age where they want to be in, in the setting that they wanted to be in and didn't necessarily have any kind of other , you knows severe effects from, from a fall .Patrick Leonard:
Yeah. That's fantastic. And that kind of leads into, you know, prompted another question as you're talking about that I, I assume you're , and what you just mentioned is you're gathering all of this data, the Nobi is gathering all this data about their residents, their behaviors, and then that data is being used to take preventative measures and provide peace of mind. Can you talk a little bit more about kind of the technology piece of it, you know, what makes it different? What, what, where , what are you all doing with the data? What is the community doing with the data and, that leads into part two, I love part two questions, of course. Mm- hmm, the integration piece, this seems like, I'm sure a lot of this data is valuable in other systems within the community, can you talk about the data and integration side a little bit?Ramiro Maldonado:
Most definitely. Yeah. So , so, you know, so again, we , we like to say Nobi is the smartest lamp in the world, right? So , it has a very strong processor on the lamp itself. What the, the lamp is processing at all times is , you know, what's going on in , in the room? What is the individual doing? Are they just sitting it recognizes, are they just sitting? Are they sitting at edge of bed? Are they laying down bed? Are they just walking around their room? If that kind of data is what's occurring it kind of records this data and as far as , an integration piece, we can integrate , via a API to electronic health records or via Bluetooth to any type of smart kind of device , smart scale , smart , blood pressure cuff, things of that nature. So , in this situation where let's say a wing wants to be notified, again, I'll , I'll use the , example of maybe a memory care unit, maybe in that wing, they want to be notified whenever a resident sits up at the edge of the bed because they know that they're a little bit out of a , a higher risk for falls. You can program the no in such a way that it'll notify the care station. Okay, Hey, John, in room 302 has now set up at the, at the edge of the bed, and you could fully customize that for the entire wing, or even by individual, let's say on the other side, the independent living side, you're fine with just you know, just having it escalate when a fall has occurred. But maybe you wanna know when you know Jane has been in the bathroom for a little bit over , some long, long period of time, you wanna be notified anytime she's been in the bathroom for longer than 15 minutes. Then Nobi again, can also notify you of that situation as well. You could customize that fully by wing or by by individual. All that data is processed on the lamp. Once it kind of does what it needs to, to do with that data, right? Notifying the nurses or putting, you know, some of that, those , that Bluetooth enabled like heart rate detection or blood pressure cuff , blood pressure monitoring into the electronic health record, the data on the lamp is, is purged off. You know, it's important for us that the , that the resident knows that their data is their own, and we're only using the data that's important for their care staff to , to be able to make clinical decisions on. So that data is now purged once we've kind of used it , in , in the capacity that we need to use it in, in a situation of escalation, that's when something gets pushed off into the cloud. That's the only time when you now have those video recordings that I was, that I was mentioning and by video recording it's really more so a second by second snapshot of what occurred prior to that fall happening. Until you close that escalation, and by closing escalation, that means that you've gone to the room address, the individual and I have either closed it onto the app on your phone or onto dashboard on your computer. You now have a video image of that to be able to kind of, again, assess what occurred, why did that fall occur. Even that data that only exists on the cloud for two weeks before it gets purged off of the cloud as well, allowing the, the clinical stats, we able to make the reports and whatever they need to do. Now we've gotten a step further and protecting that privacy as well. By allowing the resident, the resident now has to choose guests to choose how this video is going to present to the clinician. They have three options. They can say, you know what? I am okay with them actually seeing me fully in that video and that way the clinician would then see the full run video. What we see overwhelmingly is the second choice, which is , what, what happens is it breaks down the individual into a stick figure, a stick figure avatar. So an 18 figure , 18 point stick figure where you could see what's going on, but you cannot discern if that's a male, female or any other kind of demographics. But you can figure out what happened in that room and make the changes that are necessary. That has been by far the most widely adopted imaging that nursing homes and, and residents and assisted living facilities have selected. and then on the very end what we're fi we , there's a , we also offer this selection of, I want nothing . I want no images to be shared with my caregivers. I am completely fine with them getting the escalation that I've had a flaw, but that's where I wanted to stop. I don't want them to see any images and at that point, no images get sent to the cloud and it just continues with business as usual and so that's the kind of the data that we can put out there and how we use that data and what we want to do with that data and recognize that that data is owned by the resident. And again, with the, with the integration piece, again, we can integrate with any number of electronic health records or any number of smart devices via Bluetooth on t he smart device end or via A PI into a software or l ike electronic health record e nd.Patrick Leonard:
Great . Excuse me.Ramiro Maldonado:
No worries.Patrick Leonard:
Great. Thanks for thanks for walking us through that. That's super helpful because I know that's a big question you get these days and rightfully so with any new technology installation, you know, you wanna know not only what is it doing on a day-to-day basis, but how we're using the data that's being collected through these innovative solutions and use them to just make the community, the resident and the staff's life easier.Ramiro Maldonado:
Right. Most definitely.Patrick Leonard:
So that leads me to a question around installation and kind of ongoing support that's needed around this. Not to simplify it, but is it as easy as installing a normal lamp in a room? What does that look like from your, your perspective and how did the , from the senior living community's perspective from the resident's room, and how is it, how does it need to be supported on an ongoing basis?Ramiro Maldonado:
Yeah, so great question and I mean, I can honestly say that it really is as simple as just installing a ceiling lamp into, into your room. I mean, I actually happen to have one in my home office that I was able to install myself. It is , l ong as you have electricity and wifi, Nobi can function in a space and again, if there w as already a ceiling light or ceiling fixture or some type of fixture already in place there, t hat is as simple as just swapping that out down the line. We even intend to make this an even easier process of installation. There's some really cool things on the product r oadmap where they're going to have an ability to kind of, you know, s o y ou h ave that ceiling l ight fixture, you can adhere a magnetic plate to the, to the ceiling fixture, and then you could even do that before you even get the Nobi. And then once the Nobi arrives, you just snap it into a place with the magnetic, and then that magnet will also provide the power to the Nobi as well. So, but right now it is as if you're just hanging a normal hanging , ceiling light fixture. As far as kind of installation and ongoing support, we are actively working with our distributors who have a very strong installation network. They have their own level of customer support at the , at the first level. But again, since we control the process of engineering product you know, of manufacturing it from beginning to end, should there be a , a necessary, you know, they need to kind of escalate it up to headquarters. We have a direct line to our distributors, they can call our engineers and they have that level of support right there as well. But , luckily it is truly a very easy and simple device to use. Not a lot of issues with, with things kind of falling apart or anything like that. If typically if there's any issue, it's usually just something like just helping with the wifi connection usually.Patrick Leonard:
That makes sense. Do you need to swap out light bulbs?Ramiro Maldonado:
No, no, no. Light bulb swapping. Yeah, so , the LED I mean, you know, as far as , if it's normal, normal usage, it's, it should have a, a lifespan of, you know, normal LED , normal LED light.Patrick Leonard:
Awesome. So this has been really helpful for me personally to learn more about it. I'm already looking up at my ceiling and wishing I had a Nobi instead of my boring ceiling lamp up here. But thanks so much for taking the time today. I know before, you know, we started chatting today, you'd mentioned, you know, recently being at the, out at the CES show in Vegas, the Consumer Electronics Show, and you had some exciting things, you know, on the horizon. Without sharing any secrets here, are you able to kind of tell us a little bit about what's next for Nobi and any kind of final thoughts or words for our listeners?Ramiro Maldonado:
Yeah, so , um, another really thing that I love about Nobi is that because it is a , a learning device and, we're very much so committed to making sure that individuals in their home have the most up to date and, and kind of highly functioning Nobi. Whenever the AI learn something new or has a new functionality, we're gonna push that functionality out onto all Nobis into the field so that a resident will wake up new the next day and they have this new functionality. So for instance if , uh, a senior home, a senior facility were to purchase Nobis today, they will get our, our newest model of the Nobi and this Nobi looks even closer to just kind of, a really beautifully designed lamp like I was saying before, I, I really enjoy the current design of the, of the lamp, but if you were to see it, you, you might say, okay, that looks like a high technology kind of, kind of lamp. The newer design looks almost identical to something that you potentially purchase at, at like an , ikea. We've added some new hardware to this device as well. So it has radar technology in it as well and what this now allows for the device to do is vital sign detection. So we are now able to do breath rate detection as well as cough detection with the device, and very soon roll, rolling out likely at some point this year, because of the fact that this is alerting device, we're gonna now be able to provide predictive analytics. So we're , we're finding with a lot of the data that we're getting from, from the device and what the device is learning, is that an often 60% of cases , there is a very specific kind of way that individuals are moving that are highly predictive of a fall. So we can now tell the nurses, the nursing staff, the clinical care staff, like, Hey, you know, resident room 302 is acting kind of strange. Again, this is highly very indicative of a fall. You should maybe go, go check on this individual because we could start to provide that and we're gonna start to provide that very soon. So those are some of the cool things that are, that are on the way that are currently in the process. And then, you know, as the lamp new learns more things that , uh, that functionality will be out there so that any owner of a Nobi will always have the most up-to-date version with the highest functionality.Patrick Leonard:
Fantastic. Ramiro, thanks so much again for being with us today. I really enjoyed the discussion and I know our listeners will, will get some great value out of listening as well.Ramiro Maldonado:
Thank you so much. Thank you for your time. It's been, it's been great.Patrick Leonard:
Awesome. And listeners, thanks for tuning into another episode of Raising Tech . I hope you picked up some valuable information today . If there are any other topics you want to hear about or wanna be on an episode yourself , please feel free to reach out on our website at www.parasolalliance.com. Have a good one!