Diabetes Prevention
How can people have a better understanding of diabetes and its risks, knowledge of the things they can do to avoid developing diabetes, and support to stay healthy? 

Ideas (Advanced diagnostics, genomics and precision medicine)

Innovation 'Elevator Pitch':
Florence is a sophisticated digital platform used to deliver personalised, targeted behavioural psychology-based messaging, interacting with patients as the friendly non-judgemental persona, “Florence” or "Flo" through familiar & accessible SMS texts
Overview of Innovation:
The NHS owned “Simple Telehealth” methodology on which Flo is based, has challenged clinical thinking about the role & effectiveness of messaging in healthcare, delivering better & faster clinical outcomes by improving patients’ motivation, engagement & adherence to their best practice healthcare regime. 

100,000+ patients on from inception, Flo continues to stand out by consistently producing independently evaluated positive results across wide-ranging clinical applications irrespective of patients’ age, ethnicity, socio-economic background or clinical setting.

With a not-for-profit Community of Practice & extensive independent evidence base, Flo is consistently integrated within treatment pathways across a breadth of diabetic patient cohorts targeting local needs & priorities, some independent outcomes here 

Many of Flo's patients experienced difficulties in managing their diabetes or were at high risk of further complications or exacerbation if their diabetes remained uncontrolled. Patients & clinicians reported experiencing a number of self management challenges that Flo now addresses:
  • Avoidable diabetic diagnosis
  • Adherence to blood glucose monitoring & self management advice
  • Titration of insulin
  • Confidence to administer own insulin as prescribed
  • Understanding diabetes for newly diagnosed patients & how dietary/lifestyle changes can significantly impact on clinical outcomes
  • Motivation to commit to lifestyle changes
  • Compliance with the administration of prescribed medications, including insulin
  • Increased acute admissions due to complications caused by uncontrolled diabetes
  • Management of associated comorbidities eg. diabetic foot care
The Simple Telehealth methodology is based on simple, interactive, practical & academic behaviour change principles designed to deliver a low cost approach for the NHS via an intelligent mixture of the almost invisible technical platform, subtle methods & psychology that invoke responses from patients akin to engagement with their own clinician.

The methodology balances the needs of the clinical community with everyday needs of patients & their aspiration to carry on life as normally as possible despite having a condition that
a) needs regular & consistent management or
b) displays indicators towards a disease diagnosis that may be avoidable with patient sustained behaviour change and/or improved health literacy. 

Flo creates a genuine partnership between professionals & patients, moving towards shared responsibility for health.
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Mental Health: recovery, crisis and prevention / Long term conditions: a whole system, person-centred approach / Advanced diagnostics, genomics and precision medicine / Wellness and prevention of illness / Education, training and future workforce / Wealth creation / Clinical trials and evidence / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
Patients increase their motivation, involvement and therefore engagement in the shared management of their health and consequently improve their clincial outcomes, faster.

Whether this be in becoming more engaged and adherent with pre-diabetic medication, commiting to and sustaining lifestyle changes recommended through face to face clinical contact or post diagnosis management of their diabetes and/or comorbidities. By following clinical guidance more thoroughly and developing what typically become sustained behaviour changes, both the patient and NHS benefit.

Since meeting Flo, patients demonstrate that her relevant, real time advice, aligned to their health is motivating them to become more engaged and regain a feeling of control over their likelihood of becoming diabetic/ their diabetes and consequently lives again. Flo will target the key risk factors for the patient as identified by their clinician, personalising care and prioritising the focus towards that which will deliver the greatest impact.
- Reduction in the likelihood of avoidable diabetes diagnosis as a result of non compliance to healthcare advice
- Reinforcement of management strategies to help patients take control of their lifestyle
- Improved sense of control of patient's own health and avoidance of interia due to feeling overwhelmed
- Improved feeling of support to implement lifestyle changes and accountability to their clinician when going about day to day life
- Can provide clinicians with additional insight into patients’ subjective measurement of their lifestyle changes to inform clinical sessions
- When targetted, improved risk reduction for modifiable diabetic risk factors
- Reduction in costs to the NHS associated with additional clinical sessions required as a result of a prolonged pathway to behaviour change and/or subsequent treatment post diabetic diagnosis.
- Reduction in DNA rate for clinical appointments where poor health engagement increases likelihood of non attendance
Initial Review Rating
4.60 (2 ratings)
Benefit to WM population:
Flo provides a low cost and scalable opportunity for population health coverage targetted at solving local challenges where improved engagament and adherence would impact on both the patient and service. Flo requires the patient to have only a basic mobile phone so is accessible and familiar and has high levels of patient and clinician acceptance. Flo is free for patients to use in the UK.

Flo provides an opportunity for a consistent digital tool to become familiar to patients regardless of their condition as can be applied across many patient cohorts. This also broadens the scope of Flo's use as additional protocols targetted at  subsequent patient and/or service need can be introduced as required.

Pre-diabetic and diabetic patient cohorts where supported by Flo feedback signifcant quality of life improvements as a result not only of becoming more compliant with preventative or treatment regimes but also of not feeling alone, feeling supported and connected to their clinician when the go about their day to day lives.
The reduction in the likelihood of a diabetic diagnosis has wide ranging savings for the NHS. The trajectory toward further complications when diabetes is diagnoses or remains poorly controlled is inevitable . Poorly controlled diabetes increases the risk of amongst others cataracts, glaucoma, various foot complications, cardiac and kidney complications are also more likely. All of these complications can be avoided or have the date of onset delayed by maintaining stable blood glucose levels. The reduction in cost implications and clinical impacts are significant.

Current and planned activity: 
Flo is currently commissioned by NHS organisations to support their patients and services according to local challenges. Once commissioned, support is included to develop pathways integrating Flo targetted at local priorities or to access the learning from existing applications withi the Simple Telehealth Community of Practice. Critically, being part of the Community of Practice means uses need to be evidence based so the design of uses, evidence and sharing studies and evaluation is key to the whole community. The culture is that it is as important to share what doesn't work as what does work and how that has been achieved. Our primary objective is to invest in organisations for the long term to continually increase their capabilities to ensure patients and the organisation benefit from evidence based implementations for the lowest possible cost. Our commitment to do the right thing for the right reasons for the benefit of patients.
What is the intellectual property status of your innovation?:
The NHS Stoke-on-Trent owned Simple Telehealth methodology including patent GB2483829, encompasses the design and methods to implement and exploit a sophisticated digital platform to deliver personalised, targeted behavioural psychology-based messaging, interacting with patients as a friendly, non-judgemental persona
Return on Investment (£ Value): 
Return on Investment (Timescale): 
2 years
Ease of scalability: 
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Lisa Taylor 11/10/2019 - 15:54 Publish Login or Register to post comments

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Florence: Activating Patients to take Control over their Health, to Reduce the Incidence of Avoidable Diabetes Diagnosis has been moved from Initial Submission to Publish 4 months 1 week ago
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