Digital Technology for Improved Access to Psychological Therapies (IAPT)
How can digital technologies assist in the assessment, diagnosis and treatment of psychological problems in primary care within Adult Improved Access to Psychological Therapy (IAPT) services?

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” through familiar and accessible SMS texts. 
Overview of Innovation:
The NHS owned “Simple Telehealth” methodology on which Florence is based, has challenged clinical thinking about the role and 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, Florence 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 an active not-for-profit Community of Practice & extensive independent evidence base including multi-region economic evaluation, Florence has already been applied within mental health cohorts targeting local needs & priorities, some examples here

The integration of Florence into a psycologyical therapies pathway at King's Mill Hospital, Nottingham has been shortlisted for 2019 HSJ "Innovation in Mental Health" award "Enhancing psychological therapy for cancer and palliative care patients and relapse prevention: a digital health intervention" I am happy to introduce you to the Clinical Psychology Lead, Dr Sam Malins for an independent discussion.

The Simple Telehealth methodology is based on simple, interactive, practical & academic behaviour change principles designed to deliver a low cost approach for the NHS.  It is the intelligent mixture of the almost invisible technical platform, subtle methods and psychology that invoke responses from patients akin to engagement with their own clinician that results in such high satisfaction and efficacy.  The methodology balances the needs of the clinical community with the everyday needs of patients & their aspiration to carry on life as normally as possible despite having a condition that needs regular and consistent management. 

Florence allows clinicians to design specific protocols for large cohorts or an individual patient, where a patient’s health will benefit with improved health literacy or improved adherence to a shared clinical management plan.  Once enrolled, interactions can be personalised to suit the complex needs of an individual patient or left to follow templated best practice guidance, such as for diagnosis of hypertension. 

Florence creates a genuine partnership between professionals and 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 and engagement in the shared management of their mental health and consequently improve their clincial outcomes, faster. Whether this be in becoming more compliant with medication, putting into practice new techniques learned through face to face contact or many other applications, by following clinical guidance more thoroughly and developing what become sustained behaviour changes, both the patient and NHS benefit. As an example NHS Highland report that they improved the CBT Beating the Blues programme completion rate by 30% with Flo wrapped around.
  • Reduction in the likelihood of crisis episodes as a result of non compliance
  • Reinforcement of management strategies which help patients cope with symptoms
  • Can provide clinicians with additional insight into patients’ subjective measurement of their mental health condition to inform clinical sessions
  • Improved risk reduction for modifiable risk factors
  • Reduction in costs to the NHS associated with additional clinical sessions required as a result of a prolonged treatment pathway due to previous non compliance
  • Reduction in DNA rate where poor engagement increases likelihood of non attendance
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
Florence 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.
Mental health cohorts where supported by Flo feedback signifcant quality of life improvements as a result not only of becoming more compliant with treatment regimes but also of not feeling alone, feeling supported and connected to their clinician when the go about their day to day lives.
Improved mental health has significant, known benefits to other social ascpects of both personal lives and contribution to society. 
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 08/10/2019 - 16:47 Publish Login or Register to post comments

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