Digital patient appointment letters (#2942)

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Innovation 'Elevator Pitch':
Patients instantly receive digital letters straight to their smartphone and can confirm/cancel/rebook with 1 click. NHS Trusts are reporting 51% postal cost savings and automation frees staff of repetitive tasks. Translation options in 99 languages.
Overview of Innovation:
Patients can access their digital appointment letter anytime, anywhere and with no paper, print or postal costs, NHS Trusts are reporting cost savings of over 50%!

The solution is inclusive to all demographics, so if the digital letter is not accessed within 24 hours, a postal letter is automatically sent. Staff love it too; their time is no longer wasted on inserting envelopes and coordinating post and can focus on patient care.

Access from: Smartphone, tablets and desktops

Digital letter features:
  • Provides all hospital appointment details including date, time and location
  • Patients can confirm, cancel or rebook with 1 click and responses are reported back to the Trust instantly, freeing up slots for waiting list patients
  • The appointment can be added directly into patient’s digital calendar as a further reminder prompt
  • Attach clinic specific instructions, essential reading and hospital information
  • Patients can add speech, reading and translation options in 99 languages to letter content
  • Delivery is instant: in some instances, patients receive postal letters with little notice until the scheduled appointment and are unable to arrange time off without significant disruption e.g. work, child minding
  • Can include a barcode/QR code to enable patients to self-check in for a smoother arrival process for staff and patients
  • Interactive home to hospital Google map with live travel info to reduce on the day delays
Trust benefits
  • Significant postal cost savings reported between 40-51% from the reduction of postage, paper and automation of manual admin tasks
  • Trackable communications: the Trust obtain a digital receipt that the patient has opened the letter
  • Multi language audio and text options reduce accessibility barriers and Trust translation costs
  • Links to online content can be included within the letter, rather than posting out e.g. newsletter, saving £100,000’s more in postal costs.
  • Fully automated: the intelligence recognises who to send a digital letter to and automatically follows up with a postal letter if not accessed within 24/48 hours
  • Missed appointments reduce with patients receiving appointment communications in time to arrange attending.
Explainer video

In 2 minutes, Henry explains all the benefits of receiving a digital letter for his upcoming NHS appointment.
https://youtu.be/yHLEMTgeCHM

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':
The Silhouette® solution enables integrated care ,closer to home, for patients with diabetic foot ulcers, using digital wound imaging and objective wound healing data available remotely in real time, to improve patient care and reduce system costs.
Overview of Innovation:
Digital Silhouette® solution for diabetes foot management improves clinical objectivity and patient experience 
 
Diabetes is a major health challenge in the UK with a rapidly increasing number of people affected. Active disease of the foot is a crisis situation for a patient with diabetes and requires timely referral and management. A proven solution for reliable and remote monitoring of diabetes foot ulcers, Silhouette, is available to support integrated care, releasing capacity in acute out-patient clinics and supporting safe care in community settings. 

An EMAHSN-supported demonstrator established with Derby Teaching Hospitals NHS Foundation Trust and Derbyshire Community Healthcare Services Trust has led to improvements in clinical management and patient experience:

Clinical Lead, Professor Fran Game, Consultant Diabetologist, Clinical Director R&D, Derby Teaching Hospitals NHS Foundation Trust:
“As a result of implementing the Silhouette system, we have been able to safely transfer an increasing portion of patients for treatment in community clinics and have improved waiting times in our out-patient clinic. Importantly, patients are happy with the new model of care. In a survey following introduction of digital ulcer assessment, 71% of patients reported a greater confidence in the care they had received.”
 
Service User, Patient Experience:
Patient A.S. from Kilburn said; “We only live just down the road from the clinic and it saves so much time for us, it is much closer to home than the hospital is, which means we are not spending so much time getting to and from appointments.”

Innovation Solution Deployed:
  • Silhouette® digital wound imaging & information system deployed as a telehealth solution, to build community capability for on-going treatment.
  • 3D measurement technology accurately maps ulcer size, enabling clinicians to assess wound progress & response to treatment with objective data
  • Enables reliable & remote monitoring of patients with active DFU & chronic complex wounds
Impacts to date:
  • EMAHSN independent qualitative and quantitative evaluation
    –Over-whelming improvement in patient experience
    –Positive feedback from clinicians
    –Reduction in acute Out-Patient over-crowding
     
    First year 462 (7.4%) appointments moved to community
    First year 5 camera, total investment £66k, first year savings £35k
    Business case based upon reduction in treatment/tariff costs

SilhouetteStar Camera


Dr Bruce Davey - CEO ARANZ Medical with SilhouetteStar Camera

 

 
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 / Wealth creation / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
The Silhouette digital solution for diabetes foot management has been successfully deployed in an EMAHSN-supported Demonstrator. The deployment of Silhouette is enabling an integrated diabetes foot pathway in Southern Derbyshire , linking care across acute and community.
A Business Case is available on request from EMAHSN, please email Dara.Coppel@nottingham.ac.uk 
The reported benefits to date include:
Patient outcomes: Greater convenience for patients, through treatment in community, less time waiting, less travel, with remote oversight by specialists to provide joined up care
Efficiency gains: health care professionals can access the secure Silhouette digital data quickly and in real time allowing escalation and de-escalation from community to hospital based on objective clinical data on ulcer status and risk. Adminstration reduced with automated reporting of patient's ulcer treatment and progress to GPs, reducing admin time and cost of letters to GPs.
Cost-effectiveness: A shift of hospital treatment appointments to community, trending at 8% has yielded savings on tariff costs across whole system. Cost reduction on adminstration involved with reporting to GPs.  
Online Discussion Rating
5.00 (1 ratings)
Initial Review Rating
4.80 (2 ratings)
Benefit to WM population:
Health: Using objective clinical data on ulcer healing to building efficiency in acute out-patients, building community capability for care closer to home to support improvements in patient safety, experience and outcomes.
Wealth: Better use of NHS funds to enable staff to manage patients with a focus on outcomes rather than activity 
Growth of a UK SME to create jobs and new solutions for the NHS.
Current and planned activity: 
Current activity: 
Entec Health and ARANZ Medical are actively engaging with expansion of Silhouette deployment across Derbyshire county as part of the Derbyshire NHSE Diabetes Transformation programme. In addition, a number of other NHS Diabetes Foot Services are working with us to develop and deploy a Silhoeutte-enabled MDFT in Nottinghamshire and Cambridgeshire & Peterborough. These initiatives involve CCG /STP stakeholders to support sustainability plans for the innovation and transformation work for long-term gain for patients and the NHS.
Planned activity
We are seeking to work with CCGs/STPs and NHS Providers who have a vision for deploying Silhouette in diabetes foot ulcer management and chronic wound management to drive forward a patient-centred, outcomes-led, service. 
What is the intellectual property status of your innovation?:
Silhouette digital wound assessment and information management system is developed and manufactured by ARANZ Medical Limited, based in New Zealand, with ARANZ Medical Limited having ownership of IP for Silhouette brand and Silhouette technology.

 
Return on Investment (£ Value): 
medium
Return on Investment (Timescale): 
2 years
Ease of scalability: 
Simple
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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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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Innovation 'Elevator Pitch':
The Zesty patient portal is simple to use, designed for mobile devices first and very cost effective. Patients love to use it, with adoption rates by specialty of more than 50%.
Overview of Innovation:
At Zesty we've been working hard with a group of NHS trusts to digitally transform outpatient appointment management.

Our patient portal has been built from the ground up with appointment management as its core function, ensuring a secure, robust and friction free patient experience. We deliver significant cost savings and overall efficiency gains via -
  • Full EPR integration – our system is read & write enabled.
  • A best in class user experience – support for all devices with a strong focus on smartphone.
  • Complex workflow management support, including support for integrated reporting and other downstream process management.
  • Support for first appointment, follow ups, remote consultations and ERS.
  • e-Broadcast – fill cancelled slots with patients further down the waiting list.
  • Intelligent SMS and notification support.
  • N3 secure hosting and access.
  • Complete control of RTT target times and slot publishing rulesets, customisable by specialty.
Digital Letters 

The Zesty patient portal provides patients access to their letters instantly and give them the ability to ‘opt out’ of paper completely.
  • Seamless integration with your existing HL7 messaging or document management system.
  • Instant document view on any device – optimised for smartphones.
  • Support for all letter and document types.
  • Automated suppression of paper letters, for those patients who have opted to go paperless.
 
Real world savings
 
We're committed to driving both tangible cost reductions and incremental revenue via the use of our portal. We can support the business case process with independently verified cost saving data, based on the % of patients who use our portal. We target a minimum 3:1 ROI.

We enable savings via
  • Less phone calls
  • Less paper, stamps and associated fulfilment charges
  • Lower in person administrative support
  • More accurate patient pathway management
  • More accurate patient demographic data
We generate income via
  • Increased attendance rate (lower DNA's)
  • Enabling remote appointment management – at the new tariff rate
Zesty is live across 11 NHS Trusts, our flagship NHS Trust is Milton Keynes University Hospitals.
 
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: 
Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
We don't measure success on paper based savings, we deliver actual, real world, cost reductions.
 
We're committed to driving both tangible cost reductions and incremental revenue via the use of our portal. We can support the business case process with independently verified cost saving data, based on the % of patients who use our portal. We target a minimum 3:1 ROI.
In addition to the significant benefits for patient experience, the main financial benefits being realised are :
 
  • Reduction in paper letters, stamps and fulfilment costs;
  • Reduction in administrative head count;
  • Lowering inbound call volumes and reducing time to answer calls;
  • Capacity and efficiency improvements around outpatient appointment slots;
  • Reduction in DNA’s;
  • Increase in perceived transparency surrounding medical record access.
Online Discussion Rating
5.50 (2 ratings)
Initial Review Rating
5.00 (2 ratings)
Benefit to WM population:
The Zesty patient portal supports the delivery of the Five Year Forward View at both a local and national level. Our portal completely supports the ability to deliver better health, better patient care and improved NHS efficiency.
 
Zesty understand Acute NHS Trusts face ongoing financial pressures, therefore they need to take action as soon as possible to ensure patients, their families and carers are empowered to take more control over their own care and treatment.
 
For example… 
 
Better Health– 
 
Improve access to secondary care, acute and outpatient services
 
Increasing the ability to support people in their own homes
 
Better Patient Care– 
 
use of digital technology for pre visit and post treatment. Enables care providers to deliver better care by capturing both clinical and non-clinical data from patients.
 
Providing digital solutions for self-care, virtual consultations and interoperability to increase patients’ access to information and reduce duplication and travel.
 
Improved NHS Efficiency– 
 
unlocking cash saving benefits 
  • Less phone calls
  • Less paper, stamps and associated fulfilment charges
  • Lower in person administrative support
  • More accurate patient pathway management
  • More accurate patient demographic data
 
Current and planned activity: 
Zesty are currently engaged in a number of direct conversations with NHS Trusts and via channel partners. We are planning to exhibit at and attend the main NHS focused conference and events in 2019.
What is the intellectual property status of your innovation?:
Zesty Ltd owns 100% of the IP for our products.
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
Regional Scalability:
The Zesty portal could be scaled across WM once direct EPR/PAS integrations have been acheived.

Zesty has experience of scaling products regionally, for example in 2017 Zesty was part of the consortium that won the 9 Year Pan London Sexual Health Digital Transformation Programme.

The new service is the result of a unique collaboration of 29 London boroughs who commission sexual health services and has been developed following comprehensive consultations with patients and clinicians.

http://ssha.info/london-sexual-health-transformation-programme-may-briefing/
Measures:
In addition to the significant benefits for patient experience, the main outcomes we focus on are :

* Reduction in paper letters, stamps and fulfilment costs
* Reduction in administrative head count
* Lowering inbound call volumes and reducing time to answer calls
* Capacity and efficiency improvements around outpatient appointment slots* Reduction in DNA’s
* Increase in perceived transparency surrounding medical record access
 
Adoption target:
Adoption rate targets are 30% of patients within 6 months.
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