Help prevent pressure ulcers by keeping on top of pressure releif which would help reduce costs of treatment. Using staff more effectively and the vital packs already invented which will also help with time management. 

The Rehab Me solution has been proven to:

• Reduce unnecessary prescription of medicine
• Reduce the need for costly scans and potential surgery
• Reduce demand on physio appointments
• Improve a GP’s ability to provide relevant MSK advice
• Improve patient activation and compliance
• Improve waiting times for specialist physio appointments
• Support First Contact Practitioners in GP surgeries.

 
There is further opportunity for Rehab Me to reduce demand through earlier preventative treatment, on-going self-management support and improvement in post-surgery recovery and potential length of stay in hospital.
 
The results: a structured 18-month proof of concept across five GP practices servicing c70,000 people resulted in 2300 patients being supported, achieving the following key results.
 

• 89% of GPs said they are now ‘confident’/ ‘extremely confident’ in managing MSK issues, versus 33% at the start
• 70.3% of GPs recommended over 50% of patients to Rehab Me rather than referring to a physio.
• 30.8% of GPs reduced prescribing medication by 50%
• 25.9% of GPs reduced referral for imaging (XR, USS, MRI)
• 19.2% reduced prescribing medication by 70% for MSK conditions
• 50% improvement in patient pain scores, average score of 3/10 to 6/10
• 66.7% of GPs rated the pilot 10/10 (with 10 = fantastic)
• Reduced physio waiting times, from over 7 weeks to just 2 weeks for patients

The Amplitude pro enterprise™ system captures and manages clinical and PROM’s outcome data with the key focus to improve overall quality of patient care.
NHS healthcare professionals are required in many specialist areas, to monitor the long-term effects of treatments.  Historically, these were captured on a macro level and this mass gathering of non-specific data, results in outcomes data that is non-meaningful and without sufficient detail or context, preventing its use in making effective, informed clinical and management decisions.
In addition, due to the paper-based nature of how PROM’s and clinical outcomes were historically gathered, often, data would only be made available months after being gathered and in an aggregated and anonymised format, rendering it out of date and of little value.

With Amplitude pro enterprise™, The NHS benefits from the ability to;

• Capture the clinical outcomes of patients in larger numbers and in an electronic format,
• Effectively measure the quality of care provided by clinicians in real-time
• Measure the efficacy of the treatments being used on a local, national and international level
• Reduce costs associated with carrying out the required questionnaires in a paper format
• Use the data gathered to compare treatment plans and ensure that patients are receiving the best possible care available
• Increase clinical and patient compliance and engagement in outcome data collection
• Meet the challenge to make the NHS paperless
• Opportunity to provide multiple language options; allowing the patient to complete their electronic questionnaires in their native language instantly
• Use Amplitude's unique data exchange tool to automatically upload required registry data when the information is gathered in the Amplitude pro registry™ platforms, thus reducing administration, duplication of effort and importantly, retains the outcomes data at the source pro enterprise™ system, allowing instant insight
• Access to comprehensive reporting tools, that include templated validation reports for individual clinicians, further reducing resource, time and effort

Amplitude pro enterprise™ provides the NHS with a paperless, streamlined data gathering software, that reduces costs, has real-time results, meaningful insights for clinical and managerial decision makers and ultimately improves the overall quality of patient care.

• An efficient way of working for teams that are already stretched, for example one duty nurse can support large populations of people, within existing capacity, delivering up to 100 additional contacts every month. Working in more traditional ways, it would require the appointment of two additional nurses to improve reach to the same level.
• More contact from more new service users across a broader range of issues. This is particularly relevant for certain “hard to reach” demographics, such as adolescent males, who are more likely to ask for health advice and help by sending a message compared with traditional forms of service access.
• ChatHealth is a sustainable solution.  Environmentally, it reduces travel, particularly in rural areas where nurses might otherwise drive up to 90 minutes to visit a particular school. 
• Due to how ChatHealth changes the model of delivery, resources can be better allocated and promote more effective spend of taxpayers’ money.
• Strengthens and complements the universal face to face support offered by Public Health/School Nurses and Health Visitors through a digital offer which could be integrated with other services such as CAMHS, Speech and Language Therapy, nutrition and dietetics.
• Improved access to healthcare for more children and teenagers/parents and carers who would be reluctant to engage directly with health professionals.

 COST EFFICIENCIES EXAMPLE
With safety/security assured, nursing teams can now easily provide industrial scale messaging enquiries services delivering more contact withing existing resources.  Adopting teams usually move to a single point of access model, so just one duty nurse can handle all messaging enquiries from an entire school population, usually only impacting around 0.5WTE capacity.

In a modest example, one public health/school nursing team runs its messaging service with 0.5WTE staff from within existing capacity or a vacant post, at a combined cost (salary and product licensing) of £10k less than a WTE post.  The nurse running the service supports an entire population of up to 85,000 pupils and delivers 50 contacts p.c.m.  These low-cost additional contacts eliminate unnecessary face-to-face contact (more resource intensive, more costly to taxpayers). They say it would take four more staff to deliver the same number of additional contacts face-to-face, costing £150k. 

The biggest benefit of Xuper Clinic to the NHS is the amount of time – and therefore money – it will save as it will allow clinicians to join patient consultations remotely. All of Xuper Clinic’s features were designed to maximise Healthcare Professionals’ efficiency and save them as much time as possible.
Xuper Clinic has a waiting room feature that allows patients to wait in a ‘virtual queue’ whilst clinicians are in video consultations. Once the clinician has finished their virtual consultation, they are able to see the queue, see how long patients have been waiting for, and connect to the patient of their choice. 
If a clinician is running late or is unable to make a certain appointment, they can let their patient know and reschedule the appointment, reducing the build-up of back log for the Trust and lowering the number of people in the waiting room.
By transitioning to a virtual platform for consultations or by deploying Xuper Clinic within the NHS, we are/Xuper Clinic is also preventing the spread of various infections to and from patients and reducing the number of Healthcare Associated or Hospital Acquired Infections.
Furthermore, specialists often have to travel a lot to see a number of patients. This is a big waste of time and money when you could have the exact same consultation from your own office or on the move. Xuper Clinic removes the need to travel as you can connect to your patient no matter where you are.
Clinicians can also maximise their efficiency by sharing documentation, such as patient information, securely and easily over the platform.

Two areas of immediate benefit are the saving of excess bed days for non-medical reasons and the avoidance of re-admission. 

• Many elderly and frail people cannot be safely discharged from hospital without a period of reablement by family members or professional domiciliary carers.  The NHS typically funds this for a maximum of six weeks – at lower cost than the occupation of a hospital bed.  After assessment and transfer of care to social services, continuous monitoring by K-Sockets permits safe discharges a day or more earlier.  This eases the problems of Bed Managers seeking to release beds for new patients.
• During reablement, automatic alerts warn of unusual changes of activity.  They could indicate the risk of unattended falls, dehydration, malnutrition of hypothermia; all costly to the NHS.  Appropriate action could avoid the need for re-admission.  

Kemuri is designed for both family carers and 24/7 response services.  Portable K-Sockets require zero installation time and do not require broadband.  Monitoring and machine learning starts within minutes and any people with consent for data sharing can immediately view the data or receive alerts.
 
Longer-term benefits come from wellbeing monitoring after reablement.  Portable K-Sockets can be replaced by fixed K-Sockets.  The data analysis could reveal medical problems, such as UTIs, and preventive action could avoid more costly treatments.    

We are the pioneer of innovative care delivery and have been widely recognised as the UK’s leader in transforming the sector. So far we have delivered hundreds of thousands of care sessions with a 95% satisfaction rating. Crucially, we are often able to start care within 24 hours when requested; this is markedly faster than other companies who take 3-4 weeks, and means that healthy people do not need to stay in hospital waiting for their care to be arranged.
We are developing a Artificial Intelligence platform that utilises data collected by carers to predict if users are going to experience health deteriorations, such as their blood pressure worsening or the onset of a urine infection. This allows us to escalate a user’s care should they be at high risk of deterioration, or contact their doctor more proactively, potentially preventing adverse health events. We are also developing an artificial intelligence chatbot that provides decision support to carers based on questions they ask. The chatbot aims to transfer some of the knowledge and experience which established carers possess to carers with less experience.

At present, clinical doctors are not involved in the active review of our clients’ data. However, there are several members of our clinical care team that review reports from each care visit through our digital care platform. Furthermore, using our digital care platform - where data is stored and viewable - it is possible for us to allow GPs and hospital doctors to access the information relating to their own clients. This would be after authenticating themselves on our platform and be possible through our portal website. We are exploring partnerships with Clinical Commissioning Groups which would allow these data sharing partnerships to be made possible.  ​

CliniTouch Vie has proven benefits and can be scaled up easily across the wider regions:

• improved patient outcomes:

• 67% reduction in COPD emergency admissions;
• 13% improvement in CAT score
• 97% of patients using CliniTouch Vie will further reduce distress and discomfort from conditions exacerbations

These were supported by:

• improved access to healthcare: 24/7 access to healthcare, average 110 interventions per patient per annum (500% increase)
• targeted and personalised health interventions: 7,250 personalised clinical interventions (data from 66 patients over 12 months)
• data analytics: real-time clinical dashboards for clinical teams to prioritise patient needs; prioritised only 38% of patient clinical recordings required intervention within a 24-hour period

 

 
Patients are educated and supported to interpret the data to gain an improved understanding of their health status.CliniTouch Vie:

1. Educates patients: supporting people to make health life choices through improving the understanding of their disease and self-management skills
2. Enhances care for patients with chronic conditions: informing and engaging patients as part of NHS prevention agenda and creating a patient-provider collaboration
3. Provides data analytics: making more targeted and personalised health interventions, by using disease specific algorithms to differentiate when one patient’s history or recent environmental exposures indicates a higher likelihood of flare up than another
4. Improves patient safety: providing real time clinical and well-being data to identify early warning signs of health deterioration, medication adherence and self-management education
5. Reduces hospital activity: providing real time management of high risk patients to prevent admissions
6. Supports early discharge: providing hospital level diagnostics and monitoring in the home, enabling early discharge and can be used for remote clinical support post-surgery or in care-home settings
7. Delivers workload efficiencies: supporting better patient self-management, reducing need for direct interventions and enabling staff to focus on priority patient care
8. Offers locality wide cost savings: reduced demand leads to reduced NHS activity

 

• Better educatad and up-to-date staff, specific to their practice
• Cost saving on journal subscription costs
• Improved patient care
• Challenges identified and tackled via the Promoted Research feature
• Easy to discover and access research from any smart device
• Links with OpenAthens for instant access to subscribed content. 

Faster response times and time to providing treatment from an average time from referral to treatment of 6 months (24 weeks) down to 4 to 5 days (1 week). With the added benefit if there are more critical underlying conditions then these may be picked up and dealt with quickly
 
Reduction in costs of patients being referred to NHS sleep centres thus less calls and pressure on such specialist clinics e.g.:
 
Reimbursement Tariffs for OSA and Hypertension
Current reimbursement guidelines from the Department of Health are:

• For Ambulatory Sleep Diagnostic Study: ￡391.00
• For 24-Hour NIBP Study: ￡268.00 (UCL NHS Foundation Trust, there is no NHS tariff)
• For 24-Hour ECG Study: Recording - ￡268.00 plus Analysis ￡215.00 (UCL NHS Foundation Trust, there is no NHS tariff)

 
Cost Savings Calculation
Assuming the following:

1. Adult Population of the England is Approx. 45 million
2. BLF figure show approx. 10% of population suffers from OSA = 4.5 million
3. DH figures show that approx. 30% of adult population has Hypertension = 13.5 million
4. Public Health England shows that 1.3 million people have Atrial Fibrillation

 
The cost of referring 1% of the above population to hospital annually, will cost approximately:

1. OSA – 45,000 ￡32 million per year.
2. Hypertension – 135,000 ￡79 million per year
3. AF – 13,000 ￡10.5 million per year

 
Total cost of £121.5 million
Cost of S-Med Service - £38.6 million
Savings to NHS = £83 million per year.
 
Aside from OSA, this equipment can be used for chronic heart conditions studies as well as more longitudinal studies adding a wealth of data for clinicians to inform them of patient’s conditions at work, rest and play without the equipment being intrusive and disturbing as current cuff based systems thereby removing the abnormal results they can provide. Thus, this equipment may also be of benefit to clinical trial units or during treatment to monitor the physiological effects experienced by patients undergoing a drug or other clinical interventions. 

Health is influenced by a range of social, environmental and economic factors which are beyond the remit of the health sector.
 
Health services, social care and housing are all focused on delivering better outcomes at lower cost to public purse and finding ways of improving the effectiveness and better understanding the value of preventative services.
 
Risk Tracker measures the impact of organisations against national outcome frameworks, supporting them to translate the things they do into the outcomes that commissioning bodies are measured against.
 
Commissioners need to identify what services are required to deliver improvements in the prevention, diagnosis and treatment of physical and mental illness in their local population, Risk Tracker provides important data to identify top priorities and opportunities for transformation.
 
It helps commissioners to identify sub groups within their population and consider service requirements across the system, creating the person-centred services patients want and need.
 
Risk Tracker is a useful tool for analysing population data and identifying those who would gain most from the services and interventions being considered, commissioners then use this information to plan, deliver and monitor services for their local population.
 
When contracting for services, commissioners are looking for positive social outcomes, which have a lasting impact with benefits for patients that can be clearly demonstrated.
 
With Risk Tracker, information is used to improve services and influence commissioning decisions. Through recording client issues in a common format Risk Tracker allows the outcomes from disparate services to be compared and contrasted. For example, the cross over in issues that the clients present to substance misuse services, mental health services and housing associations mean that data can be aggregated together.

As all data is stored in a single, secure, compartmentalised system we can create aggregated, anonymised maps of social need. The live data that can be produced records social need and is an essential tool in commissioning services against evidenced social need.
 
Investing in prevention and better health outcomes can be part of the solution to the challenges of increasing levels of need along with shrinking budgets. Effective preventative interventions can reduce health and social care costs and the need for welfare benefits. Better health can also enhance resilience, employment and social outcomes.

InterCare® is a digital healthcare technology that enables NHS professionals, carers and family to be connected to a central user, in their home or assisted living facility.

InterCare® delivers health-data monitoring and alerts, video consultations, multi-disciplinary team messaging, self-care video content, health questionnaires and more, through a TV or mobile interface.  InterCare® TV makes digital healthcare technology accessible to a broad range of patients, including the elderly, vulnerable and others who need support with chronic long-term conditions. 

The NHS benefits from connected, efficient care of long-term-condition patients, in their own homes.  Empowered patients take a proactive role in the management of their health conditions, reducing anxiety and improving outcomes.  The resulting reduction in the numbers of home visits, appointments, A&E attendances and unplanned admissions, delivers significant savings for the NHS across some of the costliest population cohorts.

A recently completed 12-month NHS deployment, connected patients with severe COPD to their community respiratory nurses.  InterCare® TV was installed in the patient’s own houses in South Tyneside and a wide range of functionality utilised.  Wider care and family networks were also connected where appropriate and the following improvements in condition management and outcomes were reported:

• 37% reduction in unplanned admissions
• 33% reduction in home visits
• 43% reduction in follow-up outpatient visits
• 50% COPD users showed improved cat scores
• 62% of patients with reduced anxiety scores
• 43% of patients with reduced depression scores
• 100% usability reported by patients

 
The cost effectiveness of the InterCare solution demonstrated by these reductions is significant, when set against the standard NHS costs for patient interventions in either community, primary or secondary care.

As many people present to service with complex issues it is rare that a single agency can resolve all issues. Where issues are interdependent on each other then it is essential that agencies work together coherently to support an individual. Referral Tool provides an easy method  to identify relevant local agencies and how to make a referral.

This avoids many of the problems of service directories as there isn't a need to keep the referral data up to date, this is manged by agencies. It also does not require someone looking for referral agencies to second guess how to search for agencies 

As all data is collected in the same format Referral Tool can also produce geographical maps of need to demonstrate where commissioning priorities should be set. 

The primary benefits to NHS provided by using MIRA are mostly related to health outcomes, efficiency & cost effectiveness. Thus, MIRA can:

• Supplement staff shortage and reduce waiting times, by enabling more patients to be treated at the same time at the clinic as well as remotely supervised at home
• Reduce recovery time for a large group of patients by increasing motivation for the adherence to treatment through an interactive and engaging exergaming tool
• Reduce costs associated to travel by decreasing the necessary number of visits to the clinic
• Prevent further injury or surgery and thus reduce important costs associated to further hospitalisations and treatment caused by lack of compliance to the initial treatment

 
Quotes from NHS clients
"The [MIRA] concept is that it will replace me, as the clinician, or the therapist who is going to do the exercises with the patient. Not for all of the time, but for a part of the time. So it will supplement what we do and it will also improve patient care because patients will do it better based on the principles of gamification. When I describe it to people, people just go Wow! If this continues, it will change the way modern medicine is practiced"
Mr Bibhas Roy,
Shoulder and Elbow Surgeon, Central Manchester NHS Foundation Trust 
               
“There is huge potential. I give a lot of talks to older people and they are very interested…There is a great need there. You can have a lot of patients using the exergames at home with the physio reviewing and keeping an eye. With the data that is remotely sent to the clinic you can very easily see if individuals are complying, improving, and if they are not improving whether they need a visit.
Emma Stanmore,
Lecturer in Nursing, The University of Manchester
 
“Many individuals over the age of 65 haven’t played computer games before, but those who have been helping us test the technology have given us very positive feedback.”
Emma Stanmore,
Lecturer in Nursing, The University of Manchester
 
 “MIRA is an innovative product that could alter the way therapy is delivered to patients in the future. It has the potential for patients to be more active in their rehabilitation, which should result in improved patient and service outcomes.”
Mark McGlinchey,
Clinical Specialist Physiotherapist, Guy’s & St. Thomas’ NHS Foundation Trust