The 2017 EMS World Innovation Award Winners

The 2017 EMS World Innovation Award Winners

By Jon Bassett Dec 01, 2017

We are proud to announce the recipients of the 2017 EMS World Innovation Awards. This award program recognizes the industry’s most pioneering products of the year that were on display at the 2017 EMS World Expo, held Oct. 16–20 in Las Vegas.

An independent panel of judges consisting of EMS World editorial advisory board members and EMS World Expo faculty met one-on-one with company representatives to see demonstrations of each entry, learn about their application and determine whether they were worthy of this esteemed honor. Their feedback apprears at the end of each listing.

Preview the products and services our judging panel deemed the most innovative developments in EMS this year. And mark your calendars for the EMS World Expo 2018, to be held Oct. 29–Nov. 2 in Nashville.

Badger Medical Collar

Simple design helps immobilize difficult-to-collar patients 

Following an EMS call at a construction accident in 2012—where a bariatric patient fell off a scissor lift—Timothy Andrew Kussow, a firefighter/EMT and professor of sculpture, saw a need for a more effective solution to immobilizing bariatric patients. Kussow’s result—the newly patented Badger Medical Bariatric Collar—consists of a simple polyethylene foam tube with a series of cuts and a nylon fitting/connector, thus ensuring ease of use and the elimination of “towel rolling.”

This device overcomes the frustration and difficulty of attempting to cervically immobilize bariatric patients, as well as other patients who are difficult to collar. The device is floatable, allowing it to act as a water rescue aid; does not restrict blood or air flow; and can twist/tear to fit. It can serve as a rapid extrication collar for “bag and drag” patients and can accommodate packing, dressings, and bed padding of the head. Additional advantages of the weatherproof collar include an unassuming design, ambidextrous side lock, easy removability for airway interventions, and flexibility in patient position application.

“Finally, an answer for one of those most challenging things for prehospital care! This device will allow EMS providers to provide effective care for some of our most challenging scenarios.”

badger medical collar

www.emsworld.com/product/218301

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BEAR-iatrics BEAR Stair Chair

Comfortable, safe transport for patients of size

The original BEAR Stair Chair from BEARiatrics finally made it possible to transport patients weighing 500–700 pounds safely down stairs, reducing patient and provider anxiety.

Feedback from users around the globe directed the design team at BEAR-iatrics to devise a product that becomes part of any transport device in use. The new BEAR-iatrics Safety Support attaches to the bottom of any Stryker or Ferno stair chair seat. The patient sits on the seat, the side support wraps are deployed from the bottom of the seat, and the device comes up and supports what gravity is trying to pull off the chair seat. The simple, reliable system solves the fit and balance issues that arise while transporting large patients.

“Love this device! The inventor has found a way for us to make the transfer of bariatric patients much more safe.”

BEAR stair chair

www.emsworld.com/product/218287

Bound Tree GermAwayUV Sterilizer

Fast, easy sanitation for ambulances and equipment

GermAwayUV mobile units are designed for virtually any room or ambulance that needs air and surface disinfection where permanent fixtures are not practical. This unit can safely sanitize a room or ambulance using UV-C energy in as little as 15 minutes. Ultraviolet germicidal irradiation (UVGI) has been proven through hundreds of independent laboratory tests to successfully disinfect air and surfaces of bacteria, viruses, and mold.

The GermAwayUV mobile UVC surface sterilizer features a professional design with a 0–180-degree adjustable arm for increased UV disinfection. The high-strength alloy structure makes the UV lamp clean, aesthetic, and durable. A security assurance voice prompt reminds users of the device’s starting, which is delayed for 60 seconds to ensure proper safety. A foldable lamp bracket and 360-degree universal wheels provide convenience for storage and transportation.

“In the days of trying to keep our providers safe, GermAway gives us the ability to disinfect ambulances to make certain bloodborne pathogens will not affect our workforce. This is truly an innovative and needed addition to our disinfectant protocols.”

Bound Tree GermawayUV

www.emsworld.com/product/218229

Care 2 Innovations SIPQuik Cervical Splint

Vacuum pump and microbead filling mold to patient anatomy

Current cervical collar designs don’t always fit patients properly—they can restrict mobility and cause possible intracranial pressure, jugular venous distention, and distraction of the cervical spine. The SIPQuik is the only individual, form-fitting cervical collar on the market that stabilizes the cervical spine in place, providing comfort and stability with no negative patient impacts such as cervical traction or inhibition of venous return.

The SIPQuik can be fitted by one EMT. When inflated, the collar molds to the anatomy of the individual’s neck, including pediatric patients, allowing for a quick application. The one-size-fits-all SIPQuik is soft, conforming to the body with a microbead filling so the patient can remain as comfortable as possible during stabilization. A built-in vacuum pump quickly removes the air and locks the collar in place to custom-fit the patient’s anatomy. Leaders in the industry find the SIPQuik to be a true one-size-fits-all device for trauma patients.

“We have all questioned the efficacy of putting rigid collars on patients that cause them more discomfort. Other countries are now switching to soft collars, but does that provide the right support in the right position? With SIPQuik vacuum cervical splint, we now have a custom, comfortable collar that splints into the position that’s right for each patient.”

Care 2 SipQuik

www.emsworld.com/product/217912

ESO Payer Insights

Billing system uses hospital-supplied patient information

Payer information gathered strictly in the field can be unreliable. But with ESO Payer Insights, billers can select their payer information from the best of two sources: EMS and hospitals.

ESO Billing was built to save users time by streamlining the billing process and minimizing the cost for each claim processed. With automated workflows and integrations, teams can focus on what they do best.
But the real game-changer comes when you use it with ESO Health Data Exchange and Payer Insights, giving your billing team in-app access to patient insurance and demographic information directly from the hospital—saving even more time and money. Whether you’re billing for one agency or 100, ESO Billing helps you recover every dollar you’re entitled to, quickly and efficiently.

“EMS systems need to maximize the amount of reimbursement they receive from their payers. ESO Payer Insights allows for systems to get a clear snapshot to understand their process, with streamlined billing to ensure the best reimbursement possible.”

ESO Solutions payer insights

www.emsworld.com/product/218269

FlightBridgeED Ventilator Management Course

Immersive, dynamic education in mechanical ventilation meets today’s strict standards

Mechanical ventilation has been the mainstay for managing intubated patients in the hospital setting for decades. But throughout the past five years, critical care medicine has rapidly progressed in the prehospital environment. Prehospital paramedics and nurses now must have a high-level understanding of mechanical ventilation in these complex ICU patients.

This has pushed EMS agencies and air medical companies to provide the necessary education to manage these patients. Most companies struggle with providing this education and often identify major differences with equipment technology and overall application to the transport environment.

FlightBridgeED LLC has established the only ventilator management workshop in the industry. This highly dynamic course encompasses small lecture components, with the vast majority of the course being breakout stations with hands-on application using the most common transport ventilators on the market. The course is eight hours long and taught in a “live” format. Each student is given the best-selling text Ventilator Management: A Pre-Hospital Perspective.

“This course and its accompanying book fill a clear gap in the skills and knowledge of prehospital providers. Managing ventilators is something I never felt well prepared for. This course, with its incredible lung models, will improve the care you provide.”

FlightBridgeED

www.emsworld.com/product/218258

Global Traffic Technologies Opticom Analytics

Web-based platform identifies areas of congestion for better scene response

Bottlenecks and intersection conflicts can make responding to an emergency slower and more dangerous. Emergency vehicle preemption (EVP) can help speed up responses and minimize risks, but many departments don’t have the data to justify the value of this technology.

Opticom Analytics—a new tool from Global Traffic Technologies LLC—can help provide first responders with details about preemption system performance by using GPS data collected from emergency vehicles. The web-based platform can help departments assess intersection performance, reveal problem areas, and make corrections to provide a faster, safer emergency response. The platform compiles data uploaded from vehicle equipment and presents the information as a summary and map interface.

Users can sort and view performance metrics based on date, speed, travel time, vehicle type, preemption usage, and more. Opticom Analytics gives departments the information they need to maximize their preemption systems’ performance, enabling them to arrive quickly and safely at the scene of an emergency.

“Traveling lights-and-sirens to an emergency call puts a lot of people at risk. We certainly have seen intersection accidents that have cost responders and bystanders their lives. This system allows first responder agencies the ability to minimize damage to vehicles—but, more important, loss of life.”

Global Traffic Tech Opticom

www.emsworld.com/product/218288

H&H Medical H*VENT

Six-port design allows free wound drainage in any direction

Open chest wounds that develop into tension pneumothoraces can be life-threatening if not treated immediately. H&H Medical Corp., a leading provider of emergency trauma products, announces the newest product in the chest seal line: the H*VENT vented chest dressing.

The H*VENT not only treats the presence of air in the chest (pneumothorax) but also allows fluids such as blood to be released from the chest (hemothorax). Its unique six-port design provides a fail-safe system in which up to five ports can become obstructed, yet the H*VENT remains fully operational. This design also allows for unique multidirectional drainage toward gravity, allowing patients to be transported lying on their sides.

Unlike other vented chest dressings that create openings by removing hydrogel, the H*VENT provides a complete seal around the wound area. Its unique dome membrane design minimizes the risk of air or fluid finding an alternative path. The large vent opening allows excellent visual monitoring of the wound, giving first responders quick indications of air or fluid leaving the chest as well as the operational status of the seal.

“Getting a bandage to stick to the chest and provide proper air and fluid drainage has been an ongoing challenge in penetrating chest trauma. The H*VENT solves this problem with strong adhesion and multiple vents.”

H&H Medical H*VENT

www.emsworld.com/press-release/218884

ImageTrend Health Information Hub

Connected data makes true patient-centric care a reality

While emergency responders in the field and healthcare providers in clinics and hospitals often cross paths, patients’ data doesn’t always follow them. ImageTrend’s Health Information Hub (HIH) is an innovative solution that connects data for true patient-centric care.

Health Information Hub (HIH) provides automatic bidirectional exchange of data, connecting EMS with hospital EMRs, HIEs, outcome data, and billing and registry information. Interoperability expands to include the community through integrations with primary care, specialists, and other postdischarge options, such as home care and community paramedicine programs. HIH offers many choices of flexible exchange methods from a variety of standards-based file formats, including HL7, CCD, NEMSIS C-CDA and PDF, for interoperability with hospitals, including hospital-hosted broker, web services, direct message, and VPN.

Now practitioners can make more informed care decisions, free of the limitations of one-way data transmissions and PDF copies of reports.

“This is the answer to the question: ‘What does the data say?’ In today’s era of ensuring patient metrics, outcomes and satisfaction are at the forefront of our business, ImageTrend hits a homer with being able to mine the needed data to make the most critical decisions.”

ImageTrend

www.emsworld.com/product/12084636

IndeeLift Human Floor Lift

Rugged patient lift is custom-built for EMS applications

Steve Powell, inventor and founder of IndeeLift, created the original Human Floor Lift (HFL) to assist individuals, including his own parents, who had fallen and were unable to get up without assistance. Powell went on to design a model specifically for firefighters and EMS personnel.

The Emergency Services HFL-550-E is designed to address the growing problem of first responder injuries related to lifting patients from the ground or floor. With it, ambulatory or immobile patients can be easily and safely lifted from the ground or floor to a height of 21 inches in under 60 seconds, allowing them to stand and walk away or be transferred directly to a wheelchair or gurney. The lift is also designed for patient transport and equipped with safety straps to secure the patient.

Ruggedly constructed for long life utilizing a linear actuator and rechargeable lithium-ion battery pack, the portable roll-around design features all-terrain wheels and folds to a minimal footprint for easy stowage on most apparatus. The HFL also doubles as a dolly for equipment transport or becomes a field chair for extended triage.

“This innovative device will not only make lifting patients from the floor to the stretcher or a wheelchair much more patient friendly but will help prevent injury to EMS providers lifting these patients.”

Indee Lift human floor lift

www.emsworld.com/product/218055

King County EMS Check & Inject Program

Cost-effective, easy-to-administer treatment for anaphylaxis

The most commonly used method for treating anaphylaxis is by administering epinephrine. Most ambulance, fire, and aid services are required to carry epinephrine in their emergency care supplies and are trained in its administration.

Historically EMS providers treated anaphylaxis with EpiPen auto-injectors. But in 2014 the price of the EpiPen rose dramatically, resulting in a financial burden on EMS agencies across the nation. Interest in returning to the traditional method of administering epinephrine via syringe sparked the creation of the Check and Inject kit that King County (Wash.) EMS providers now use to treat anaphylaxis.

These small kits contain supplies to administer at least two emergency doses of epinephrine to an adult or child—a syringe, a minimal amount of epinephrine (to reduce the chance of over-medication), and a checklist to follow in identifying and administering the drug.

To accompany the Check and Inject kit, King County EMS recently developed an online “Check and Inject” training program to teach EMS providers how to recognize the need and administer epinephrine appropriately with a needle and syringe. Documentation requirements and evaluation materials are included to ensure proper and appropriate administration.

The program is available for the minimal cost of $50 for the online training component, $15 per kit and $4 to replace expired epinephrine.

“King Country EMS is sharing its incredible cost-savings solution with the rest of us. Using a simple package and training program, the cost of providing this lifesaving treatment can be greatly reduced.”

King County Check and Inject

www.emsworld.com/product/218243

Laerdal CPRmeter 2

Intuitive, real-time feedback on essential parameters of CPR

The consensus is clear: High-quality CPR has been shown to save lives. But how do you know your teams are consistently delivering high-quality compressions? The CPRmeter 2 is a simple tool to ensure that high-quality compressions are delivered from all providers on scene. The CPRmeter 2 provides real-time measured feedback on depth, rate, and release of CPR, while enabling providers to self-evaluate their performance with event statistics on the spot.

The CPRmeter 2 has two embedded sensors: one measuring acceleration and another measuring force. A sophisticated microprocessor continuously measures both these parameters during each compression, and special algorithms convert the collected data into meaningful information.

New and improved features include ergonomic design with honeycomb pad, larger and brighter display screen, longer use with AAA batteries, and Bluetooth smart technology. The CPRmeter 2 device helps first-response teams optimize CPR performance by providing intuitive real-time feedback on essential parameters of CPR.  

“We know our compressions are not as good as we would like. The CPRmeter 2 helps us improve our technique both in training and real life with a simple and portable tool.”

Laerdal CPR meter

www.emsworld.com/product/218290

Life/form CHARLIE Neonatal Resuscitation Simulator

Lifelike simulation for a range of newborn scenarios

Satisfy all your training requirements for the NRP 7th edition: CHARLIE stands for compressions, cardiac; heat compatible; airway, arterial access via the umbilicus; resuscitation; laryngeal mask capable of oxygen use or PPV; intravenous, intraosseous, intubation; and ECG.

State-of-the-art capabilities and features of the lifelike simulator include airway, breathing, intubation, and ventilation, birth anomalies, chest tube placement, CPR, ECG simulation (must have ECG simulator), gastrointestinal (GI) tube, interchangeable genitalia, intraosseous infusion, IVs in the hand and foot, observation and measurement, palpable manual pulse points in seven locations, a patent umbilicus with venous and arterial access, a PICC site in the arm, and urinary catheterization.

The CHARLIE comes complete with both standard and advanced airways, baby powder, blood, carry bag, defibrillation chest, intraosseous bones and skin, IV bag, IV skin and veins for hand and foot, myelomeningocele, needles, omphalocele, umbilicus, instruction manual and a five-year warranty.

“The Life/form trainers are true to their name and have been proven to provide an incredibly realistic simulation. These trainers are as durable as they are lifelike, providing multiple modifications and secondary skill training devices.”

Life/form CHARLIE simulator

www.emsworld.com/product/218226

Loli-O’s Pediatric Nebulizer

A sweet, anxiety-free way to deliver aerosol medications

Loli-O’s puts the “treat” in treatment. The pediatric nebulizer from Loli-O’s delivers nebulized breathing medications to children while they enjoy a sugar-free and dentist-recommended lollipop. Using Loli-O’s to administer treatment almost completely removes the anxiety most children feel when they are sick, especially when a stranger is trying to hold a mask to their face or keep a hard plastic mouthpiece in their mouth.

The idea for Loli-O’s was conceived over five years ago by a 23-year veteran paramedic while transporting a young child with breathing difficulty who became upset and resistant to breathing treatment.

When used as directed, Loli-O’s can deliver aerosol comparably to a standard mouthpiece device. The lollipops are sugar, gluten, and dairy free, have no added dyes and are manufactured in a peanut-free facility. 

“This brilliant product can actually make a child want to take their medicine. The Loli-O’s nebulizer safely delivers needed aerosolized medication while the child is distracted with the lollipop.”

Loli-O's

www.emsworld.com/product/218261

Lytx DriveCam + GPS Fleet Tracking

Enabling safe driving behavior for improved crew protection

EMS fleets are faced with unique driving challenges that require rapid response times and precautions. Lytx’s DriveCam video safety program + GPS Fleet Tracking pairs industry-leading video telematics with up-to-date fleet-tracking abilities that enable fleet owners, operators, and/or managers to track the status of every vehicle in their fleet to increase productivity and protect assets and drivers.

The DriveCam exception-based video safety program combines video capture of road incidents, such as hard braking or sudden swerving, data analysis of those incidents, and personalized coaching insights to improve driving behavior. 

With the DriveCam program, EMS fleet managers and operators can identify unsafe behaviors within their fleet with the driving event video clips they receive each day, data, and details about the event. They also receive driver and fleet scores to pinpoint areas of improvement, with precise, personalized coaching insights to help drivers become as safe as they can.

“Driver safety is at the cornerstone of safe vehicle operations. The Lytx DriveCam allows for safety to be the primary focus during ambulance operations. Being able to use this as a training tool or to assist in minimizing liability is great for taking your vehicle operations to the next level.”

Lytx Drive Cam

www.emsworld.com/product/218292 

MedAware Solutions mViva

All-in-one communication tool for the entire care team

The mViva from MedAware Solutions is an all-in-one platform that puts the entire healthcare community on the same page in real time. In one app, providers have the ability to send secure text messages, conduct teleconferences, and send medical records, pictures, and recorded messages. The application can be used on iPhones, tablets, and Android-powered devices. This allows community paramedics to solve the problem of communication with the care coordination team. 

The mViva allows for automated delivery of questions to patients at the same time every day, such as “What was your blood pressure today?” or “How much weight have you gained in the past 24 hours?” If a community paramedic is not scheduled to see a patient on that given day but the patient answers a question out of established normal ranges, the paramedic is immediately notified.

“In the days of care coordination, this system allows the caregiver to communicate to all members of the care team at the same time. Functions include texting, telemedicine, photo and video, and automated delivery content, all in one iOS or Android application. This takes communication to the next level.”

MedAware Solutions mViva

www.emsworld.com/product/218140 

Operative IQ RFID Drug Safe

Secure, real-time tracking of medication inventory

Drug safes often contain hundreds of individual items that must be verified each time the safe is accessed. The RFID Drug Safe from Operative IQ performs this operation in seconds.

The RFID Drug Safe takes advantage of radio frequency identification (RFID) to track loose drugs and drug boxes at a department’s distribution point for controlled substances. RFID allows for real-time monitoring of tagged equipment and supplies while producing extremely accurate results and reduced labor.

The RFID Drug Safe is integrated with Operative IQ’s operations management software. Each drug instance is tagged with a passive RFID tag rather than the standard control number tags used today. Drug boxes may also be tagged with either passive RFID tags or BLE beacons to allow for tracking.

The RFID Drug Safe includes a thin backwall RFID reader that continuously inventories the content of the drug safe and compares it to the software record to identify and report any discrepancies. An LED status light mounted to the safe provides visual indication that the contents of the drug safe are accurate (green) or inaccurate (alternating green/red). The system can be delivered complete with a 42-inch 14-gauge steel safe or made to retrofit your existing drug safe. 

“Securing narcotics is a must for every EMS system. This safe brings securing narcotics into the next generation. This ‘smart safe’ allows for real-time monitoring of drugs, equipment, and supplies, resulting in accurate reporting results.”

Operative IQ RFID drug safe

www.emsworld.com/product/218069

Safe Life Defense Body Armor

Multithreat protection that’s as wearable as it is effective

The Safe Life Defense IIIa+ Enhanced Multi-Threat Vest is the most protective soft body armor currently available and addresses the most common threats faced by EMS. Safe Life Defense’s armor protects against bullets, strikes, slashes, and stabs and boasts protection against traditionally armor-piercing rounds (FN 5.7, Liberty Civil Defense, and steel-core 12-gauge shotgun slugs).

The enhanced multithreat system can defend against all these threats at once by using self-structured Kevlar panels. These panels increase protection as well as durability, preventing sagging and curling. Reviewed as the No. 1 most comfortable body armor system, it is as protective as it is wearable.

Safe Life Defense uses set sizing to create a semicustom fit. By sizing users’ height and weight and using sizes 3XS to 6XL, the company can provide armor the same day it’s ordered.

“We have gotten to a time and place where body armor is becoming a needed piece of equipment for our first responders. Hopefully our workforce never needs to utilize this type of safety equipment, but as we know, hope is not a strategy. Safe Life Defense body armor is the answer to the tough question, ‘How do we ensure our workforce gets home safely?’”

SafeLife Defense body armor

www.emsworld.com/product/218127

Technimount Systems Xtension Pro

Additional stretcher space for essential medical equipment 

The Xtension Pro system from Technimount is a long-awaited solution for the EMS and hospital industries. Xtension Pro is a medical tablet that attaches to stretchers. This revolutionary solution was developed to offer a safe way to transport medical devices such as mechanical hearts, defibrillators, and ventilators, as well as perfusion and syringe pumps. It temporarily provides additional mounting space on either side of the stretcher.

The compact, impact-resistant, and lightweight design adapts to fit either side of the stretcher and fits all popular stretcher configurations. Vertical and horizontal locking mechanisms are quick, safe, and consistent. Moving parts are marked in red for quick identification. No modification of medical devices is needed. High-grade aluminum construction is resistant to biological fluids and sodium, does not rust, and comes with a full five-year warranty.

“Securing equipment in the back of an ambulance just became much more effective. This device is a welcome advance toward keeping the patient, provider, and equipment safer.”

Technimount Xtension Pro

www.emsworld.com/product/218294

TOMAR Electronics Revolution Series

High-intensity warning light transforms into LED work scene illumination

TOMAR’s Revolution Warning and Illumination Series solves the important question: “Is my scene safe?” The Revolution Warning Series serves as a full-color warning light while you are responding or blocking the right of way.

When you need more light to work with, they transform into work lights ready to help with your next task. The Revolution Illumination Series revolutionizes scene safety by combining offroad performance lighting into a standardized footprint to rid your scene of chaos. Single, dual, or tricolor options are available, and a wide-angle optical lens delivers maximum light output. Surface-mounted with chrome and black bezels available for a finished, professional appearance. Comes with a no-hassle five-year warranty. 

“Emergency lighting has evolved dramatically over the past several years, but TOMAR takes their solution to a whole new level. The effectiveness, versatility, and design of this lighting system is truly the best of the best. Bonus: Their factory is totally green and has a zero carbon footprint.”

Tomar Revolution Illumination Series

www.emsworld.com/product/218189 

Virtual Education Systems VRpatients

Immersive, realistic environments gauge clinician competency and decision making

VRpatients from Virtual Education Systems is a virtual reality platform for healthcare provider training and competency assessment. The platform immerses the user in highly realistic environments where users interact with virtual patients. Their decision-making processes (cognitive decisions) and competencies are tested and measured in real time.

The training provider can also use the platform’s intuitive authoring interface to customize the content to fit their department’s practices and goals. With this, the educator can create their own training cases without any prior knowledge or expertise in programming or virtual reality. VRpatients is available in web, mobile, and virtual reality platforms. By measuring the user’s decision-making process—in terms of both what decision is made and in what time frame—the educator can obtain an accurate assessment of the user’s competency level.

“VR is the future of simulation training. This incredible product allows providers to be fully immersed in a clinical scenario and perform nearly any skill called for. It allows for easy observation and evaluation and has significant potential for expansion.”

Virtual Education Systems VRpatient

www.emsworld.com/product/218440 


 

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Interviews with end users of EMS products and services.
EMS leaders will gather in Las Vegas, November 13-15, for leadership sessions and the American Ambulance Association's trade show at Caesar's Palace.
The H*VENT vented chest dressing treats not only the presence of air in the chest (pneumothorax) but also allows fluids such as blood to be released from the chest (hemothorax).
ZOLL® Medical Corporation will offer Air Medical Transport Conference 2017 attendees the opportunity to experience the new capabilities of its mechanical ventilation devices.
ESO Solutions, Inc. has acquired FIREHOUSE Software, allowing ESO to provide service to over 13,000 emergency medical services, hospitals and fire departments.
ImageTrend's Open Platform data sharing enables EMS agencies to interchange data and transfer ePCR incidents with agencies using any NEMSIS version 3 certified system.
The awards recognize companies that have produced innovative new products or products that have seen significant changes since August 2016.