1. Compression Solutions
2014
Compression Holdings, LLC
Compression Solutions Management, LLC

2. Mission Statement
To provide medical products and services that increase patient safety, reduce liability and health care costs through convenient solutions.

3. Why Compression Solutions
CS has been in the DME and DVT business for 22 years.
CS pioneered the DVT take home market
We understand the billing and reimbursement issues.
We understand the challenges with broken, field failures and lost rental equipment.

4. Drug-free DVT Prevention
CS focuses on providing a convenient, cost effective program that increases patient safety by decreasing DVT and related PE.
Triple Play VT is a “drug free” alternative in DVT prevention, and the first portable product to address DVT, cold and compression in a single compact unit.
Comparison picture of triple play alongside the competitor product.
Picture of Wang Zhongmin with the unit on, and a quote from him!
Mark’s reputation is as a visionary, finding the new avenues.

5. What is the problem? DVT
Deep vein thrombosis (DVT) – a blood clot that forms in a vein deep in the body.
Most DVTs occur in the lower leg or thigh.
Pulmonary Embolism (PE) – a blood clot in a deep vein that breaks off and travels to an artery in the lungs, blocking blood flow.
PE is a serious condition. that can damage the lungs and other organs in the body and cause death.
Source: National Heart Lung and Blood Institute (

6. The DVT Challenge DVT is the leading cause of death in the U.S.
Each year, more than 2 million people develop DVT leading to 300,000+ deaths
In the US, more people die each year from PE than motor vehicle accidents, breast cancer and AIDS combined.
DEEP-VEIN THROMBOSIS: ADVANCING AWARENESS TO PROTECT PATIENT LIVES
Public Health Leadership Conference on Deep-Vein Thrombosis
Some Causes of Death in the US
Annual Deaths
Pulmonary embolism
300,000+
AIDS
14,499
Breast cancer
40,200
Highway fatalities
42,116

7. How is DVT prevented?
Prophylaxis is an action taken to prevent disease.
Two types of DVT prophylaxis – mechanical & anticoagulants (blood thinners).
Compression Solutions’ products are a mechanical DVT prophylaxis method.
Source: University of Massachusetts

8. Why Mechanical Prophylaxis?
Studies show that mechanical prophylaxis is just as effective as anticoagulants.
When mechanical and anticoagulants are combined they have a synergistic effect.
Patients with bleeding risks cannot tolerate anticoagulants.
Doctors hesitate to prescribe drugs for moderate to high risk patients.
Mechanical prophylaxis has zero side effects.

9. Increased Patient Care
“Pharma + Mechanical = 75% DVT Reduction”
Eleven studies, six of them randomized controlled trials, were identified. The trials included 7431 patients, in total.
Compared with pharmacological prophylaxis alone, the use of combined modalities significantly reduced the incidence of DVT (from 4.21% to 0.65%; OR 0.16, 95% CI 0.07 to 0.34)
Source: The Cochrane Library 2008, Issue 4. “Combined intermittent pneumatic leg compression and pharmacological prophylaxis for prevention of venous thromboembolism in high-risk patients (Review)”. Kakkos SK, Caprini JA, Geroulakos G, Nicolaides AN, Stansby GP, Reddy DJ

10. The Home Market
Cost pressures continue to drive the healthcare industry toward more “in-home” medical solutions.
Post-surgical patients are at the highest risk for DVT while recovering at home

11. DVT Risk Continues at Home
“…50% of DVT begin intraoperative, with the highest incidence occurring during surgery and on the first postoperative day, and that 75% of DVT develop within the first 48 hours after surgery.” (Spencer. F.A Venous Thromboembolism in the Outpatient Setting.” Archive of Internal Medicine. July 23)

12. Who Says?
75% of all DVTs occur in the first 48 hours following a THA/TKA.
Caprini guidelines recommend 10 days of DVT prophylaxis following major orthopedic surgery.
Studies demonstrate that the peak incidence of a DVT occurs on the fifth postoperative day.
Women are 70 times more likely to be admitted with VTE in the first six weeks after an inpatient operation and 10 times more likely after an outpatient surgery.

13. Preventing DVT After Discharge
According to JACO all facilities should be doing a risk assessment on all patients
It’s not the procedure being performed, it’s the patient’s risk factors
By a simple risk assessment your patients can be protected from life threatening DVT, which reduces the physician’s liability and results in better patient outcomes

14. CHEST Consensus Guidelines 2012
Risk
Caprini Score
*VTE incidence
Prophylaxis
Very low
0.5%
Early ambulation
Low
1-2
1.5%
IPC
Moderate
3-4
3.0%
LMWH, UFH,IPC
High 5+
6.0%
LMWH, UFH + IPC or GS
*Estimated baseline risk in the absence of pharmacologic or mechanical prophylaxis
Gould, MK et al; CHEST 2012; 141(2)(Suppl):e227S–e277S

15. More Cost Effective To Prevent Than to Treat
Mechanical prophylaxis is as effective as pharmacological prophylaxis and has no side effects or risk of bleeding. And when combined with pharmacological prophylaxis can more greatly reduce the risk of postoperative DVT.

16. Mechanical Prophylaxis is as Effective as Pharmacological with No Bleeding  
Mechanical methods of prophylaxis act on the same principle as early mobilization
Intermittent pneumatic leg compression enhances blood flow in deep veins.
Method is virtually free of side effects and particularly useful in patients at risk of bleeding
Compression is as effective as low-dose heparin in patients undergoing abdominal surgery.
Mechanical and pharmacological methods of VTE prophylaxis are both effective and when used in combination have synergistic effects.
In moderate-risk patients when pharma is contraindicated, IPC can be used as an alternative.

17. Mechanical Prophylaxis is as Effective as Pharmacological with No Bleeding
Analysis of studies on the use of mechanical methods has shown that general surgery patients on average have about a 9% chance DVT if compression is used compared with a 20 to 24% chance if no prophylaxis is employed.
University of Massachusetts Medical, DVT Best Practices 2008

18. Mechanical Prophylaxis is More Cost-Effective than Pharmacological
Pharmacological therapy can cost as much as $1800 per month per patient.
Mechanical prophylaxis has fee schedules of less than $400.
Anticoagulant
Typical Dose
Typical Cost/Day
Typical Cost/Monthly
Enoxaparin/Lovenox
40-90 mg
$30 - $70
$900 - $2100
Warfarin/Coumadin
3-6 mg
$3-$6
$90 - $190 + INR testing
Fondaparinux/Arixtra
2.5 mg
$50 - $100
$ $3000

19. Triple Play VT and the Home Market
Compression Solutions’ Triple Play VT was created specifically for the home market
Drug-free alternative in DVT prevention
First portable product to address DVT, Cold and compression in a single compact unit.
Mobile
Patient-friendly, easy to use

20. Triple Play VT ® & EZ-Fit

21. Triple Play VT Continuum of Care
Triple Play VT—1st portable DVT, cold and compression device specifically designed to move from the facility to home throughout recovery
Prevents DVT for any at-risk patient

22. Cold and Compression Therapy
The use of combined cryotherapy and compression in the postoperative period after ACL reconstruction results in improved, short-term pain relief and independence from narcotic use compared with cyrotherapy alone.
Brian R. Waterman, CPT, MC et al., J Knee Surg , 2012.
A recent study showed cold/compression groups reported significantly less swelling and pain than the cold-alone groups.
Schroder D, Passler HH. Knee Surg Sports Traumatol Arthrosc 2(3):158-65, 1994.

23. Patient Benefits Just one product reduces all three.
Prevents DVT
Reduces pain and swelling
No messy ice and water
Re-freezable and malleable joint cold therapy
12 hours of battery life
Mobile device can be used anywhere anytime means better compliance

24. Patient Benefits Easy to use Small, lightweight, quiet
Simple to set up and maintain
Improves compliance

25. Program Details LifeCycle Program No capital outlay No repair costs
No chasing lost equipment
24 hr. Patient Service
24 hr. Quick Swap Program