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Innovation 'Elevator Pitch':
Improve patient comms, increase PROMs returns, decrease DNAs, improve patient engagement
Overview of Innovation:
ADI's MyPathway platform connects patients to healthcare providers, to facilitate increased patient activation, informed choice, and participation in their own care; to help support behaviour change and adherence to treatment in conditions from MSK to diabetes; and to provide data-driven personalisation and optimisation of services. MyPathway is an intelligent patient communications engine that connects patients digitally to services. It delivers unprecedented levels of patient uptake and engagement by automatically orchestrating, tailoring and synchronising all digital interactions to each patient's clinical events, patient health data, etc. to give immediacy, relevance and value to each interaction.

http://mypathway.healthcare/short-introduction-video/

MyPathway has already been proven in Musculo-Skeletal (MSK) clinical applications, having been chosen in December 2017 by Sheffield CCG through an OJEU procurement as the preferred solution to serve all their MSK patients (47,000 referrals per year). It has been highly successful, with \>50% of all patients referred already using MyPathway. This has reduced admin costs within the MSK Single Point of Access by 12%, as well as reducing the average time between referral and confirmation of first appointment from 12 days to 5 days, and increasing the rate of PROM return from around 2% to 45%, opening the way to outcomes-based contracting and data-driven service improvement.
However, MyPathway is not specific to MSK, and its rules-engine based architecture means that it can be easily adapted by healthcare providers to any clinical need where digital patient engagement can help improve outcomes and/or reduce costs of delivery.
E.g. MyPathway is also being used by Leeds CAMHS service, and in Barcelona's Hospital Clinic in support of their "pre-habilitation" programme preparing people for elective cardiac surgery. ADI are also in discussions with Diabetes UK and the team responsible for the DiRECT diabetes programme who recently demonstrated that their structured, supervised nutritional intervention programme resulting in weight loss of \>10kg produces remission for a significant fraction of people with diabetes Type 2.
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
Overview of Innovation:
StepUp! is a digital service that integrates with CAMHS pathways. It allows young people, supported by professionals and parents to assess their needs, set goals, develop plans and strategies to self-help and measure how their mental health is changing via an app.
 
The referral is assessed and triaged and an invitation to join StepUp! is sent via a linked clinical platform to the individual who accepts and installs the app.  An introduction, preliminary resources, strategies and self-help material can be pushed by the clinician or selected by the user prior to the first appointment.
 
The content and look of the service has been designed by service users through a range of workshops. Content includes:- Questionnaires: the user responds to questionnaires which produce PROMs for the clinician; How to Help: captures what helps the user, things they find difficult, what makes things worse – information that the user writes about themselves and their condition that they can choose to share with other people; Goals: make and store plans for what the user needs help with and record progress; Notes: records things that the user wants to remember about the issues they need help with and appointments they have; Resources and Strategies: set of trusted and evidence-based digital tools targeted to help users self-care.
 
The clinician can check progress in the clinical portal. The app returns data analytics which can be reviewed pre-appointment to improve the effectiveness and efficiency of the consultation time and post-appointment to monitor outcomes.  StepUp! enables personalised care plans to be constructed using evidence-based resources and approaches for a young person and their family.
 
The service is currently in the trial phase across CAMHS in Leeds Community Healthcare NHS Trust, and is showing the potential to deliver significant improvement in the effectiveness and efficiency of service delivery.
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Innovation 'Elevator Pitch':
Enabling patients to self-rehabilitate with clinically evidenced treatment plans to improve the speed of recovery and enhance patient outcomes. Reducing unnecessary prescription of medicines, scans and surgery; along with GP and Physio workloads.
 
Overview of Innovation:
Rehab Me offers GP’s a tool to help advise and support their patients without necessarily referring them to a physio for a scan or prescribing pain medication. It provides easy to access evidenced based advice sheets, treatment plans and interactive prompts to support compliance and outcome tracking, as well as signposting patients to further support and prevention pathways.
 
How it works: A simple digital solution, accesses on-line or via a downloadable all which operates on a stand-alone basis or be integrated into existing GP systems.
 
Step 1 - patient injury or MSK condition identified by GP who then prints off the relevant advice sheet from the Rehab Me website. This provides evidence-based exercises and advice regulated by standard physiotherapy practice and directs patient to the Rehab Me website for the patient to register.

Step 2 - patient registers on the Rehab Me website and selects the treatment plan advised by the GP. This will then provide scheduled exercises including frequency and number of repetitions across the treatment plan period. This is automatically linked to the patient’s calendar to enable reminders and prompts over the treatment period which can be anywhere between 6-10 weeks.
 
Step 3 - the patient can access the plan via the website or a downloadable app. The patient will be prompted each day and guided by their virtual physio with the use of easy to follow HD videos and/ or detailed descriptions.  Patients track their own adherence and progress through the website or via the app. They can also record and track pain each day to help assess progress and provide PROM data for their GP.
 
Step 4 – at any time the GP can view progress and results for a patient on a treatment plan; and if appropriate advice on a new exercise plan virtually so the patient can progress without the need for another appointment.
 
Step 5 – during or after a course of treatment, Rehab Me can signpost access to other relevant resources to encourage people to adopt exercise into their everyday lives to prevent relapse. This includes a social prescribing section encouraging patients to join gyms, walking clubs etc.
 
Part of the service provided by Rehab Me includes educational training on MSK issues as part of the process to this new pathway for GP’s to adopt in their practice.

The Rehab Me data platform adheres to appropriate NHS data IG and GDPR requirements, with all data securely stored on a cloud based server.
 
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 / Digital health / Innovation and adoption
Benefit to NHS:
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
Initial Review Rating
4.80 (2 ratings)
Benefit to WM population:
For Patients
  • Immediate and faster recovery time
  • Improve health, well-being and pain management
  • Increased confidence and empowerment to re-habilitate.
  • Reduced inconvenience and travel time for appointments
  • Avoid risks and side effects of anti-inflammatories, analgesics or other medications    
  • Potential surgery avoidance or painful injections
  • Easy and convenient solution access.
For GP’s
  • Increase knowledge and confidence to support patients with MSK conditions
  • Reduction in prescribed medicines
  • Reduction in physio referrals
  • Reduction in imaging and consultant referrals
  • Reduction in GP appointments
  • Ability to track patient activation and PROMS
  • Increased practice efficiency.
For NHS Physiotherapy clinics and other referral departments
  • Reduced number of referrals
  • Reduced wait times to enhance intervention effectiveness
  • Improved prioritisation of serious patient referrals
  • Enhanced quality of service and care
For Commissioners
  • Better resource utilisation
  • Increased capacity at lower cost
  • Alignment to the GIRFT programme
  • Strong ROI based in increased capacity and reduced medication / scan costs
For the Economy
  • Local employment - potential to build software development team locally
  • Local office - commercial office space
Current and planned activity: 
The Rehab Me solution has been supported By NHS England through its Clinical Entrepreneur programme and identified by Dr. Tony Young, (National Clinical Lead for Innovation) as a lead example of a new and exciting digital solution for scaling across the NHS.
 
The Rehab Me platform has been developed to Beta release level and is now ready for further development to ensure a robust and scalable software solution which can be easily integrated into other NHS systems.
 
The next stage requires effective engagement with appropriate PCN or GP Federations or CCG to secure financial commitment to embed the solution, support its development and assist in further case study creation and cost benefit analysis. This will then enable a comprehensive sales and marketing drive across England.
What is the intellectual property status of your innovation?:
Copyright of all content owned by Surrey Physio along with software design
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
Simple
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Innovation 'Elevator Pitch':
MedsMinder is designed to help people improve their medications taking with behaviour change principles so that they can fully benefit from the medications their doctors prescribe for them. Reducing wastage, facilitated by pharmacists and SBRI

 
Overview of Innovation:
MedsMinder is designed to help people improve their medications taking so that they can fully benefit from the medications their doctors prescribe for them. The NHS works hard to help people improve their health, yet much of the drugs budget is wasted, and people’s health deteriorates when people forget to take their medicines correctly, and we want to help patients and the NHS to improve.
medsminder is being developed by ADI in Saltaire, Bradford, under the SBRI-Healthcare programme funded by NHS England. Its purpose is to develop effective ways to help people improve their adherence to prescribed medication, which will both improve their health and help the NHS avoid waste.
It builds on the behaviour change work of Dr Ian Kellar, Associate Professor of the School of Psychology at the University of Leeds. For more information, contact Dr Kellar ati.kellar@leeds.ac.uk.
The programme is being facilitated by Prescribing Support Services (PSS)
Secure integration into clinical systems  and pathways. Allows trusted two-way flow of information between patients and professionals such as pharmacists and clinicians, that can be relied and acted upon.  Data on adherence, per medication dose, is available to clinicians/pharmacists via the clinical portal. Clinicians can message users individually or as a group.
 Much more impact on long-term patient engagement and  adherence than “free”, timer-based apps. The psychological basis is founded upon Behaviour Change principles supplied and guided by Prof Ian Kellar, University of Leeds: Essentially this aims to involve the user in creating and maintaining a routine that supports his/her personal lifestyle. 
Specifically:
  • Planning - the user decides when to schedule medication doses not based on clock time, but on routine event cues, such as meals or other daily activities. 
  • Logging - this is self-monitoring of medication taking, which is known to report actual adherence far more accurately than retrospective self-reporting.
  • Routine awareness - the app knows when and where you actually take doses, and adapts and learns what normal behaviour is over time, thereby allowing more appropriate reminders and prompts.
  • Multi-language support 
  • Digital ordering of repeat prescriptions.  ( which is flagged to clinicians and pharmacists). 
Stage of Development:
Close to market - Prototype near completion and final form may require additional validation/evaluation and all CE marking and regulatory requirements are in place
WMAHSN priorities and themes addressed: 
Wellness and prevention of illness / Wealth creation / Digital health / Innovation and adoption / Patient and medicines safety
Benefit to NHS:
Estimation only as under evaluation:
  1. Summary of  financialsnd your estimate of ROI for the CCG
    • Estimated ROI for CCG :
      • Meds Companion users show improved  average adherence >15% vs baseline, across a range of medications ( Ian Kellar).. Translates into  different benefits and savings for the CCG eg improved control of type II diabetes using monotherapy and concomitant reduction in more expensive dual/triple therapy. (see example). Estimate minimum £250,000 in-year cash savings to Bradford CCGs with 50% takeup of the Meds Companion service, as well as longer-term improvement in outcomes from better adherence.
      • Meds Companion users have increased and convenient engagement with the repeat prescription ordering process, synchronising this with actual logged consumption, thereby reducing oversupply and enabling instant switchoff of unwanted repeat ordering.   Estimate minimum £50,000 in-year cash savings to Bradford CCGs from unwanted or premature repeats based on 50% usage of Meds Companion
=> estimated total in-year savings of £300k.
Online Discussion Rating
6.00 (1 ratings)
Initial Review Rating
3.80 (2 ratings)
Benefit to WM population:
There a great need for prescription waste reduction across all CCGs, the AF Programmes of care with new drugs is also key.
With regards to AF, adherence 
Current and planned activity: 
We are keen to work with any CCG, NHS Trust which is looking to reduce wastage, has an AF or Diabetes programme that needs some adherence tools for patients or has programmes which suite the MedsMinder app.
What is the intellectual property status of your innovation?:
ADI own the IP
Return on Investment (£ Value): 
medium
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
2
Regional Scalability:
Please describe how the innovation could be scaled across the WM region. Have you implemented at scale in any other regions?
Measures:
What outcomes are you hoping to achieve and what are the measures that you will use to gauge the success of the innovation and how will these assessments be made? Please ensure that you have quality, safety, cost and people measures.
Adoption target:
What are the targets for adoption across the WM and what are the minimum viability levels?
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