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 (Patient and medicines safety)

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 http://www.simple.uk.net/system/app/pages/search?scope=search-site&q=mental+health

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): 
high
Return on Investment (Timescale): 
2 years
Ease of scalability: 
4
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Lisa Taylor 08/10/2019 - 16:47 Publish Login or Register to post comments
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Innovation 'Elevator Pitch':
BrowseAloud is our online accessibility tool which makes website content practically accessible for people with a variety of Neurodiverse conditions such as dyslexia, low literacy, English as a second language and visual/cognitive impairments.
Overview of Innovation:
BrowseAloud is a simple piece of Javascript code that is placed within the CMS of a URL. Once we activate that URL in our system, the BrowseAloud toolbar will appear and be usable within an hour or two. The end user can easily adjust the settings of the toolbar features for their own requirements, such as reading speed, screen mask colour etc. It works on most CMS systems such as Wordpress and is also available in a condensed version for mobile phone usage, which provides Text to speech and Translation support. The actual customer of BrowseAloud will be given access to the BrowseAloud customer portal in which they can determine various things such as where BrowseAloud sits on their site and how it appears to the end user, as well as a number of other things.
It contains a range of features. There are two options for Text-to-speech, “hover to speak” mode means that the software will read the sentence of paragraph that the mouse cursor is hovering over, whereas “Speak the current selection” will read a selected or highlighted section of text. The text is also Highlighted in Yellow and blue contrast, to aid people with dyslexia and also with tracking issues. You can translate the webpage content into over 100 different languages, 40 of these languages have an accompanying voice and therefore the content can actually be read aloud in those languages as well, providing really strong support for people with English as a second language. MP3 Maker easily converts the written text into Audio format so the user can listen to the information at a later date instead of having to spend the time reading it. The Digital Screen mask feature helps with visual impairments, low vision and visual stress, you can even enter a RGB code for a specific colour tint that works for you. The Screen mask feature is very customisable, really benefiting the end user as best as possible. Text Magnifier enlarges the Text across the top of the screen in a sort of Karaoke style banner that also allows reads the text out loud and highlights it in the yellow and blue contrast, great for the elderly population and those with low vision. Simplify provides a means of helping those that struggle with cognitive load issues. Enabling them to make text heavy or image heavy web pages much cleaner. With Simplify, the user can strip back any images and get a concise summary of what that webpage is trying to get across, without changing or creating any new information itself.
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: 
Wellness and prevention of illness / Education, training and future workforce / Wealth creation / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
BrowseAloud can benefit NHS organisations in various ways. It can help Trusts to meet their AIS requirements and other web accessibility requirements such as the EU Web accessibility directive.
However BrowseAlouds features can also have great cost saving benefits for the NHS. For example, BrowseAlouds translation ability means that Health information providers can save money on third party translation services and the fact that it works in online PDF files means that Trusts that provide online versions of their patient information leaflets are totally covered for their diverse patient population (In our experience, Trusts have in some cases paid between £500 and £1,000 to have a single document translated by a third party). As well as this there is also the ability to save on third party audio generation and communicate via MP3 audio files with patients, the MP3 maker easily converts the information into audio format, so patients who prefer audio format or with a visual impairment or low vision, may listen to the information instead of reading it.
Furthermore, implementing BrowseAloud onto the website can help Trusts gain a favourable CQC rating and we also have the ISO-27001 certificate for information and data security meaning that we comply with the highest standards and are a safe company to work with.
 
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
BrowseAloud can help support the West Midlands as its features and benefits can benefit the entire regions population to gain access to their health information in alternative accessible formats. The West Midlands is made up of large and culturally diverse cities such as Birmingham but also has a wide geographical reach with plenty of rural and more isolated areas. BrowseAloud can cater for the large populations of the cities with its translation functionality but can also care for those harder to reach patients that are more remote by providing them with more alternative and accessible formats for consuming their health information.
Current and planned activity: 
Currently engage with the NHS through events, webinars and campaigns, but also by reaching out to the communications departments within each organisation in order to arrange a meeting for a demo and a presentation with the wider board of decision makers.
Immediate plans are to host a Health literacy webinar in October, to attend the Excellence in Healthcare event in November and to focus on contacting the GDE’s and the Fast Followers.
What is the intellectual property status of your innovation?:
All IP is wholly owned by Texthelp Ltd
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
Simple
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Aidan Kelly 04/10/2019 - 17:39 Publish Login or Register to post comments
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