Creation
Draft
Initial
Detailed
Accepted
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Idea Description
Supplementary Information
Innovation 'Elevator Pitch':
We have developed a clinically led digital health solution for warfarin patients at risk of stroke. Our technology enables patients to self-test from their own homes with remote clinical support, communicating their INR in a way that suits them.
Overview of Innovation:
Our INR self-testing service has been rolled out to 5,000 patients, making it one of the largest in Europe. Across the UK, patients on the service are remotely monitoring their INR away from the clinic using a Roche CoaguChek® device. Readings are sent to their nurse via an automated phone call or by logging onto an online portal. Readings automatically go through anticoagulation software where the next dose is determined. A clinician approves the next dose and the patient receives a second form of communication, either an automated phone call or an email informing them of their next warfarin dose and date and time of next test. Find out more here http://www.inhealthcare.co.uk/product/inr-self-testing/.
Our self-testing study concluded patient’s therapeutic range (TTR) improved by 20% for 70% of patients. In comparison a controlled cohort of clinic based patients had seen only 49% of their cohort improve by an average of 2%.This improved TTR predicts to save 400-500 strokes per year.” – Ian Briggs, Associate Director of Business Development, County Durham and Darlington Foundation Trust.

To find out more about INR self-testing in County Durham and Darlington Foundation Trust download our case study here http://www.inhealthcare.co.uk/resource/county-durham-and-darlington-nhs-foundation-trust/.

The service has also been rolled out in Wigan, Ilkley and the Isle of Wight. Read this blog from our CEO Bryn Sage about INR self-testing in the Isle of Wight http://www.inhealthcare.co.uk/isle-of-wight-are-leading-the-way-with-inr-self-testing-for-warfarin-patients/.

Outcomes:
  1. Improved patient outcomes: In a recent 24 month follow up study from County Durham and Darlington Foundation Trust we found over 70% of those on the service improved their time in therapeutic range by 20%.
  2. Improved patient satisfaction: The service is quick and easy to use. Patients do not have to take time out of their day to attend appointments and aren't bound to NHS opening hours. 100% of those surveyed said they'd recommend the service to others.
  3. Increased efficiency: Enabling patients to self-test enables resources to be distributed elsewhere.

 
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)
Similar Content3
Innovation 'Elevator Pitch':
Dip.io, a CE approved product turns the smartphone into a clinical grade device enabling lay-users to test urine in their own home, with clinical accuracy and share results electronically with their clinician. 
Overview of Innovation:
42m urine tests a year are undertaken in the NHS to screen for a wide range of conditions. Currently patients collect a sample at home and bring it to the clinic or provide a sample in the clinic where it is either tested on site or sent to a laboratory. This is inefficient, inconvenient for the patient and presents opportunity for improvement in patient experience, clinical quality and cost efficiency.
 
Healthy.io is the first company to turn the smartphone into a regulatory-approved clinical device. Its first product, Dip.io, uses computer vision and user centric design to turn the smartphone into a urinalysis device. Built around existing semi-quantitative urinalysis dipsticks, Dip.io complements established clinical efforts by empowering patients to test themselves at home with no quality compromise, and securely share results with a clinician.
 
Healthy.io is empowering patients to take urine testing into their own hands, opening up an immense opportunity to improve preventive efforts and enable early interventions. Key pathways in which digital urinalysis has strong potential to improve patients’ lives and reduce cost to the NHS:
  • Antenatal care: women with hypertension or diabetes in pregnancy have a higher risk of developing pre-eclampsia, a leading cause of maternity morbidity. Dip.io has proven through a usability study at Johns Hopkins to improve women’s experience and could reduce outpatient appointments amongst high risk pregnant women. 
  • Chronic Kidney Disease (CKD): Home-based screening of albumin:creatinine (ACR) for people with diabetes or high blood pressure, to increase adherence to NICE CG 182 and diabetes care process beyond the current level of 50%.
  • Urinary tract infections (UTI): opportunity to improve self-management for patients at risk of admission from UTI (e.g. MS), reduce the 5m GP attendances for UTI in primary care and create digital pathways for pre-op assessment  through using digital urine testing, within existing clinical guidelines.
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: 
Long term conditions: a whole system, person-centred approach / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
Benefits to NHS in line with FYFV:
  • Maternity Safety (Proteinuria screening): The Maternity Transformation Programme (Better Births) prioritises improvement in maternity safety and provision of consistent quality. This includes halving the rates of stillbirths, neonatal and maternal deaths by 2025. Around 15% of women with hypertension or diabetes in pregnancy have a higher risk of developing pre-eclampsia, a leading cause of maternity morbidity. Automated home-screening for proteinuria in at-risk pregnancies has the potential to early identify pre-eclampsia, save £1,500 for each avoided false negative, save up to £75m by reducing 60% of outpatient appointments (3rd trimester) and reduce antenatal consultation time by 25%.
 
  • Primary Care (Diabetes and CKD screening): Smartphone enabled self-testing offers a critical complement to existing population health efforts by shifting testing from primary care to the home. Providing alternatives to face-to-face contact frees up GP resources and nursing time. NICE recommends that every person at increased risk of CKD (people with diabetes or hypertension) needs to annually get their urine tested. However only 50% of people with diabetes and 30% of people with hypertension have a regular urine test reported. Over 1 million cases of CKD remain undetected. Diffusing Dip.io to every at risk patient (8.3m) could improve adherence with no additional overhead, reducing CKD cost by up to £1bn.
  • Urgent and Emergency Care (Urinary Tract Infection): Conducting common diagnostic tests at the patient's home supports "improving the ability of patients to self-care for minor illnesses" (UECR).  This includes the need to anticipate recurring conditions such as UTIs. 1-3% of GP visits are UTI related and UTIs accounted for 14% of emergency hospital admissions in MS patients costing the NHS over £43 million. Dip.io offers the opportunity to improve self-management for patients at risk of admission from UTI, reduce the 5m GP attendances for UTI in primary care and create digital pathways for preop assessment within existing clinical guidelines.
 
  • Harnessing technology and innovation: Our solution leverages existing technology to transform care delivery and supports the drive to digital adoption. We easily integrate into other technologies (integrated with PKB and Allscripts) and make sure interoperability is built in. We are replicating this model for our next product to bring innovation to woundcare management.
Initial Review Rating
4.60 (1 ratings)
Benefit to WM population:
Our smartphone-enabled digital urinalysis service aims to improve quality and efficiency of existing pathways, driving better patient outcomes and experience.
 
Main benefits:
 
Maternity safety: women with hypertension or diabetes in pregnancy have a higher risk of developing pre-eclampsia, a leading cause of maternity morbidity. NICE CG62 recommends dipstick urinalysis during each prenatal visit to screen for proteinuria, an indicator of pre-eclampsia. Increasing testing in between regular pre-natal visits could reduce Pre-eclampsia complications. Women with at-risk pregnancies receive 7-10 Dip.io kits. Following a defined frequency, the women conducts the test at home. The clinician automatically receives the results and is alerted if results are abnormal for immediate follow-up care. This model of care is being rolled out across mayor HMOs in Israel and received more than 90% preference in a Johns Hopkins usability study. Dip.io has proven to improve women’s experience and could reduce outpatient appointments amongst high risk pregnant women.
  • Diabetes and CKD screening: NICE clinical guidelines recommend people with diabetes/hypertension need to get their urine tested annually but adherence is low e.g.  only 51% of people with type 1 diabetes tested. Digital testing could improve adherence and reduce costs. Patients with no recorded albumin reading receive our smartphone urinalysis home-test. Results are immediately available to the clinician and those with abnormal results are invited to a follow-up extensive checkup. This model makes it possible to reach people at risk, who have not received appropriate testing, thus increasing adherence to CKD screening.
  • Urinary Tract Infection (UTI): opportunity to improve self-management for patients at risk of admission from UTI (e.g.MS), reduce the 5m GP attendances for UTI in primary care and create digital pathways for preop assessment   through using digital urine testing, within existing clinical guidelines.
Current and planned activity: 
NHS:
  • North East and North Cumbria AHSN with South Tees NHS Trust to test renal clinic at home funded by Northern Counties Kidney Foundation
  • NeuroResponse social enterprise based at UCL on Multiple Sclerosis pathway
  • Modality and Yorkshire and Humber AHSN to test diabetes/CKD screening model
  • Howbeck Healthcare to test rollout diabetes/hypertension/CKD screening model in South Cheshire and Vale Royal
  • Salford NHS Trust rollout for renal patient management
  • Care UK rollout for uncomplicated UTI management
  • Applied to the Test beds, have been invited to the follow-up meeting for at risk pregnancy, UTI and renal models
 
International:
  • Usability study in pregnant women at Johns Hopkins with 92% favourability (soon to be published)
  • US National Kidney Federation and Geisinger Health to improve care for people with hypertension
  • Dutch Kidney Foundation and Dutch Health to test population screening for ACR in at risk population compared to other method
  • Rolling out in two HMOs in Israel for at-risk pregnancy model
Return on Investment (£ Value): 
N/A
Return on Investment (Timescale): 
N/A
Ease of scalability: 
Simple
Regional Scalability:
Our plan is to scale regionally and nationally through a B2B2C business model. We offer several commercial packages that differ in terms of scale, level of integration, agreement timeline and distribution/shipment method.  This allows us to partner with different players within the NHS to provide them full digital capabilities through customised, white label kits, a localised application and access to our algorithm in an end-to-end service proposition. Our vision is to serve as the backbone for smartphone enabled, image based medical diagnostics and enable partners to bring our innovation to their existing user base.
Measures:
Healthy.io and the Dip.io solution work together with healthcare organizations to improve efficiency, value and outcomes by digitizing existing pathways. Measure include:
  • Save outpatient appointment and reduce consultation time to reduce resource pressures.
  • Increase clinical guideline adherence, improving patient safety
  • Improve patient experience (e.g. minimise absence from work and avoid travel expenses)
Adoption target:
Start with a phased roll out to try, test and scale the innovation in a regional NHS organisation. We anticipate that success from this roll out will lead to spreading the implementation of the technology to other specialties within the organisation, other hospitals/GPs within the group and to other providers and partners within the WM area.
Read more
Hide details
Innovation 'Elevator Pitch':
Dip.io, a CE approved product turns the smartphone into a clinical grade device enabling lay-users to test urine in their own home, with clinical accuracy and share results electronically with their clinician. 
Overview of Innovation:
42m urine tests a year are undertaken in the NHS to screen for a wide range of conditions. Currently patients collect a sample at home and bring it to the clinic or provide a sample in the clinic where it is either tested on site or sent to a laboratory. This is inefficient, inconvenient for the patient and presents opportunity for improvement in patient experience, clinical quality and cost efficiency.
 
Healthy.io is the first company to turn the smartphone into a regulatory-approved clinical device. Its first product, Dip.io, uses computer vision and user centric design to turn the smartphone into a urinalysis device. Built around existing semi-quantitative urinalysis dipsticks, Dip.io complements established clinical efforts by empowering patients to test themselves at home with no quality compromise, and securely share results with a clinician.
 
Healthy.io is empowering patients to take urine testing into their own hands, opening up an immense opportunity to improve preventive efforts, enable early interventions and increase optimisation in the outpatient setting. Key pathways in which digital urinalysis has strong potential to improve patients’ lives and reduce cost to the NHS:
  • Antenatal care: women with hypertension or diabetes in pregnancy have a higher risk of developing pre-eclampsia, a leading cause of maternity morbidity. Dip.io has proven through a usability study at Johns Hopkins to improve women’s experience and could reduce outpatient appointments amongst high risk pregnant women. 
  • Chronic Kidney Disease (CKD): Home-based screening of albumin:creatinine (ACR) for people with diabetes or high blood pressure, to increase adherence to NICE CG 182 and diabetes care process beyond the current level of 50%.
  • Urinary tract infections (UTI): opportunity to improve self-management for patients at risk of admission from UTI (e.g. MS), reduce the 5m GP attendances for UTI in primary care and create digital pathways for pre-op assessment  through using digital urine testing, within existing clinical guidelines.
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: 
Long term conditions: a whole system, person-centred approach / Digital health / Person centred care
Benefit to NHS:
Benefits to NHS in line with FYFV:
  • Primary Care (Diabetes and CKD screening): Smartphone enabled self-testing offers a critical complement to existing population health efforts by shifting testing from primary care to the home. Providing alternatives to face-to-face contact frees up GP resources and nursing time. NICE recommends that every person at increased risk of CKD (people with diabetes or hypertension) needs to annually get their urine tested. However only 50% of people with diabetes and 30% of people with hypertension have a regular urine test reported. Over 1 million cases of CKD remain undetected. Diffusing Dip.io to every at risk patient (8.3m) could improve adherence with no additional overhead, reducing CKD cost by up to £1bn.
  •  
  • Maternity Safety (Proteinuria screening): The Maternity Transformation Programme (Better Births) prioritises improvement in maternity safety and provision of consistent quality. This includes halving the rates of stillbirths, neonatal and maternal deaths by 2025. Around 15% of women with hypertension or diabetes in pregnancy have a higher risk of developing pre-eclampsia, a leading cause of maternity morbidity. Automated home-screening for proteinuria in at-risk pregnancies has the potential to early identify pre-eclampsia, save £1,500 for each avoided false negative, save up to £75m by reducing 60% of outpatient appointments (3rd trimester) and reduce antenatal consultation time by 25%.
  •  
  • Urgent and Emergency Care (Urinary Tract Infection): Conducting common diagnostic tests at the patient's home supports "improving the ability of patients to self-care for minor illnesses" (UECR).  This includes the need to anticipate recurring conditions such as UTIs. 1-3% of GP visits are UTI related and UTIs accounted for 14% of emergency hospital admissions in MS patients costing the NHS over £43 million. Dip.io offers the opportunity to improve self-management for patients at risk of admission from UTI, reduce the 5m GP attendances for UTI in primary care and create digital pathways for preop assessment within existing clinical guidelines.
  • Harnessing technology and innovation: Our solution leverages existing technology to transform care delivery and supports the drive to digital adoption. We easily integrate into other technologies (integrated with PKB and Allscripts) and make sure interoperability is built in. We are replicating this model for our next product to bring innovation to woundcare management.
Online Discussion Rating
5.50 (2 ratings)
Initial Review Rating
4.20 (1 ratings)
Benefit to WM population:
Our smartphone-enabled digital urinalysis service aims to improve quality and efficiency of existing pathways, driving better patient outcomes and experience.

Main benefits:

Maternity safety: women with hypertension or diabetes in pregnancy have a higher risk of developing pre-eclampsia, a leading cause of maternity morbidity. NICE CG62 recommends dipstick urinalysis during each prenatal visit to screen for proteinuria, an indicator of pre-eclampsia. Increasing testing in between regular pre-natal visits could reduce Pre-eclampsia complications. Women with at-risk pregnancies receive 7-10 Dip.io kits. Following a defined frequency, the women conducts the test at home. The clinician automatically receives the results and is alerted if results are abnormal for immediate follow-up care. This model of care is being rolled out across mayor HMOs in Israel and received more than 90% preference in a Johns Hopkins usability study. Dip.io has proven to improve women’s experience and could reduce outpatient appointments amongst high risk pregnant women.

Diabetes and CKD screening: NICE clinical guidelines recommend people with diabetes/hypertension need to get their urine tested annually but adherence is low e.g. only 51% of people with type 1 diabetes tested. Digital testing could improve adherence and reduce costs. Patients with no recorded albumin reading receive our smartphone urinalysis home-test. Results are immediately available to the clinician and those with abnormal results are invited to a follow-up extensive checkup. This model makes it possible to reach people at risk, who have not received appropriate testing, thus increasing adherence to CKD screening.

Urinary Tract Infection (UTI): opportunity to improve self-management for patients at risk of admission from UTI (e.g.MS), reduce the 5m GP attendances for UTI in primary care and create digital pathways for preop assessment through using digital urine testing, within existing clinical guidelines.
Current and planned activity: 
NHS:
  • Salford NHS Trust rollout for renal patient management
  • Care UK rollout for uncomplicated UTI management
  • North East and North Cumbria AHSN with South Tees NHS Trust to test renal clinic at home (Northern Counties Kidney Foundation)
  • Modality and Yorkshire and Humber AHSN to test diabetes/CKD screening model
  • Applying to Test beds for at risk pregnancy (Cheshire & Merseyside) and CKD screening (Care City).
  • NeuroResponse social enterprise based at UCL on Multiple Sclerosis pathway
 

International:
  • Usability study in pregnant women at Johns Hopkins with 92% favourability (soon to be published)
  • US National Kidney Federation and Geisinger Health to improve care for people with hypertension- successful increase in adherence (soon to be published)
  • Dutch Kidney Foundation and Dutch Health to test population screening for ACR in at risk population compared to other method
  • Roll out in two HMOs in Israel for at-risk pregnancy model
Return on Investment (£ Value): 
N/A
Return on Investment (Timescale): 
N/A
Ease of scalability: 
Simple
Regional Scalability:
Our plan is to scale regionally and nationally through a B2B2C business model. We offer several commercial packages that differ in terms of scale, level of integration, agreement timeline and distribution/shipment method. This allows us to partner with different players within the NHS to provide them full digital capabilities through customised, white label kits, a localised application and access to our algorithm in an end-to-end service proposition. Our vision is to serve as the backbone for smartphone enabled, image based medical diagnostics and enable partners to bring our innovation to their existing user base.
Measures:
Healthy.io and the Dip.io solution work together with healthcare organizations to improve efficiency, value and outcomes by digitizing existing pathways. Measure include:
  • Save outpatient appointment and reduce consultation time to reduce resource pressures.
  • Increase clinical guideline adherence, improving patient safety
  • Improve patient experience (e.g. minimise absence from work and avoid travel expenses)
Adoption target:
Start with a phased roll out to try, test and scale the innovation in a regional NHS organisation. We anticipate that success from this roll out will lead to spreading the implementation of the technology to other specialties within the organisation, other hospitals/GPs within the group and to other providers and partners within the WM area.
Read more
Hide details
Innovation 'Elevator Pitch':
A functional, digital, patient-centric, diabetes self-test system providing: self-care; patient-professional shared decisions; proactive interventions; complications prevention; data integration pan NHS provider; multi-faceted NHS costs savings.
Overview of Innovation:
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Stage of Development:
Evaluation stage - Representative model or prototype system developed and can be effectively evaluated
WMAHSN priorities and themes addressed: 
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:
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Benefit to WM population:
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Current and planned activity: 
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What is the intellectual property status of your innovation?:
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Return on Investment (£ Value): 
medium
Return on Investment (Timescale): 
2 years
Ease of scalability: 
Simple
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