Digital Outpatients
How can better use of digital technology and data improve the experience and outcomes for people traditionally attending hospital outpatient appointments, and how can the NHS drive down the cost of meeting their needs?

Ideas (Mental Health: recovery, crisis and prevention)

Innovation 'Elevator Pitch':
Glooko provide the Diasend product to 92% of secondary care diabetes clinics in the UK & have been recognised in the NHS England National Diabetes Audit as one of the factors for the best patient outcomes - we would like to bring this to primary care
Overview of Innovation:
Glooko provide the Diasend product to 92% of secondary care diabetes clinics in the UK and have been recognised in the NHS England National Diabetes Audit as one of the contributing factors to achieving the best outcomes for patients.

Digital management of long term conditions not only has the potential to improve the health of patients but also increase efficiencies by saving financial resources and clinician time.

Diasend is the only System capable of downloading over 170 medical devices and aligning the data so both patients and clinicians can gain better insights to influence medication and lifestyle decisions 

As previously stated Diasend is well established in Secondary Care and as a result this provides a great opportunity to strengthen the link between them and primary care for efficient, yet secure, data sharing and collaborative working.
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 / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
  • improved patient outcomes
  • meeting STP goals around digital healtchcare
  • ability to conduct virtual clinics for massively improved efficiency 
  • smoother referral process
  • full support
  • colaborative working between secondar care specialists and primary care
Initial Review Rating
4.60 (1 ratings)
Benefit to WM population:
  • improved patient outcomes
  • improved access to their medical data
  • ability to attend virtual clinics for convenient healthcare
  • smoother referral process
  • full support
Current and planned activity: 
Currently used daily in 92% of seconday care diabetes clinics in the UK 
Looking to expand the benefits to primary care
What is the intellectual property status of your innovation?:
Glooko Ltd own the IP
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
Simple
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Matt West 04/10/2018 - 15:33 Archived 4 comments
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Innovation 'Elevator Pitch':
Medopad's remote monitoring platform provides clinicians with insight into patient progress in between clinic appointments. This can prevent unncessary outpatient appointments or bring forward appointments for patients who are not progressing well. 
Overview of Innovation:
The Medopad app is a health ecosystem with a patient view and a clinician view. It is very intuitive and user-friendly, having been designed with Apple in their Cupertino, California labs. 

Patient app
Patients interact with Medopad through a single smartphone app or via connected devices and sensors. Instead of multiple apps for each disease, patients have a single, centralised point of access via the Medopad platform. The Medopad app is composed of different modules and divided into four user-friendly and intuitive sections: patient profile, data collection, patient dashboard, and learning & education. Medopad provides 100+ data collection modules ranging in functionality: medication and symptom trackers, photo and video capture, tele-consultation, and questionnaires. We also provide activity-based modules for specific disease indications including the 6-minute walk test, used by cardiovascular patient cohorts to avoid travel into clinic. We can also integrate devices and sensors, i.e. glucometers and spirometry. To enable self-management, we can provide in-app videos and digital leaflets for patient education. Equally important, patients have access to their dashboard, providing a visually engaging view of trends in their own health and wellbeing data.

Clinician dashboard
The Medopad platform is built specifically for each clinician and their patient cohort via a custom integration. Clinicians monitor and manage their patient cohort through a web-based dashboard, where they can view trends in patient data that otherwise were not available to them before. Empowered with increased information, stakeholders can create customised alerts to identify patients who are progressing poorly. By extension, data availability allows clinicians to provide a high level of personalisation in between clinic appointments by sending patients customised notifications to support self-management.

 
 
 
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 / 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:
Medopad's solution enables clinicians to spot health deterioration sooner, preventing costly complications.  To name a few, we are working the Royal Free NHS Teaching Hospital, Guy's and St. Thomas's, Royal Salford, and Chelsea and Westminster.

At Guys' and St. Thomas' hospital, we are working with both community nurses and hospital vascular consultants to monitor venuous leg ulcer healing. While there are no estimates for the total cost burden of venous leg ulcers specifically, the total cost of acute and chronic wounds to the UK NHS is estimated to range from £4.5 to £5.1 billion, with 78% of costs falling on community NHS services for chronic wounds (Guest et al 2015). This pilot is currently underway. Patient's leg ulcers are photographed by themselves or the community nurse during wound dressing changes. Patients' acitivity is also tracked, as increasing mobility is a sign of a healing leg ulcer. This pilot is being used by vascular consultants to identify deteriorating wounds earlier, which may necessitate a move from a community-based management to hospital-based interventions. 

At the Royal Salford, we are working with consultants to monitor patients with renal disease. In this pilot, patients are completing tasks at home that would normally be done by the nurse. Specifically, patients are monitoring weight, blood pressure, and completing a urine test at home using Healthy IO's urine dip stick test. This saves the nures time when the patient does travel into clinic, where the nurse needs only complete the remaing blood test. Apart from saving nurses time during clinic, renal consultants are able to monitor patient progress in between appointments. If patients' blood pressure and weight are not deteriorating, the consultant may postpone the appointment, and equally, if indicators seem to be worsening, the consultant can provide timely care by bringing the patient in sooner. Renal disease is a costly condition; the NHS in England spent an estimated £1.45 billion on CKD in 2009–10. By monitoring patient progress, there is potential to reduce some of these costs by reducing disease progression and complications. 
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
The Medopad platform provides clinicians with insight into patient progress in between clinic appointments, this has the potential to provide patients with preventative and timely care by spotting problems sooner (as described in the previous section). For the patient, prevention of further deterioration means improved quality of life. Additionally, the platform has the potential to reduce unnecessary clinic appointments for patients.

At the Royal Free, patients with peripheral arterial hypertension (PAH - a rare disease) are using the Medopad smartphone to avoid travelling into clinic for appointments. Instead, patients complete a six-minute walk test (a measure of disease progression) at home. Since it can be done from home, patients can do this more frequently, on a weekly basis, which provides clinicians with richer data on which to assess patient progress. Due to the nature of the condition, PAH patients suffer from symptoms like breathlessness that are made worse with activity. By avoiding long distance travelling to one of seven specialist PAH centres, patients' health is improved and they have a better experience of care. 

At the Harley Street Clinic, we have worked with children that have a rare form of brain cancer (DIPG). Parents recorded videos of their child performing certain tasks and recorded additional health data. The clinician was able to more frequently monitor the children's progress without putting additional undue strain on both parent and child. Using the platform in this way was particularly improtant for vulnerable patients, such as these children, not to mention reducing the burden on parents.  
Current and planned activity: 
As mentioned in the previous sections, our solution and deployments have been co-developed with clinical experts and innovators across several top UK NHS teaching hospitals. 

We are currently looking for partners in the West Midlands, such as the AHSN, clinicians, and nurses, to engage in several pilot projects across a range of disease areas. Medopad is offering pilot projects free of charge for 12 months as a way to gather evidence of effectiveness and cost-effectiveness for our solution. As a part of the project, we include implementation and ongoing support.

In the longer term, we are looking to provide a transformative experience of care by providing intelligent and AI-powered clinical support systems to move the needle from reactive to preventative care. In that vein, we are looking for motivated and committed health care professionals to work with us in this journey. 
What is the intellectual property status of your innovation?:
Medopad's IP is related to its smartphone app and clinician web-portal. 
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
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Marija Trachtenberg 02/07/2018 - 19:34 Sign Posted Login or Register to post comments
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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)
WMAHSN priorities and themes addressed: 
Mental Health: recovery, crisis and prevention / Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
MyPathway helps improve communications with patients as they move through their treatment or between services. Keeping the patient informed of their care helps improve compliance, reduces DNA's and improves overall outcomes. 
MyPathway reduces the need for paper based communication therefore reducing administration processes, improving efficiency and saving costs on paper, printing and postage.
MyPathway enables improved data collection, which allows better reporting on an individual clinician level. This can help with performance management, reporting on service outcomes for ease of local auditing and demonstration of KPIs achievements to commissioners. The reporting engine can be tailored to each service's need 
MyPathway can be used across a wide variety of services and if a patient is being seen by more than one service they can view all services on one timeline. 
MyPathway also helps to reduce the waiting times for the patients, as administration is streamlined and as a combination of referral and fast digital PROM returns enable "right first time" appointments, making better use of clinical and patient time. The patient is also informed of progress along the pathway in a more timely fashion.

Information is easily and instantly shared to the patient, either by auto-trigger according to pathway requirements or pushed to the patient by the clinician via the clinical portal. This information could include maps to clinic locations, information about the clinic, the service or the procedure, self-help media and educational videos, information about the organisation, qualitative questionnaires such as Friends and Family Test etc.

MyPathway also supports Virtual Clinics, allowing patients to be assessed remotely, with f2f appointments only being made where necessary.

Digital information available on a portable device is available to service users at the touch of a button and increases their compliance with their rehabilitation, promotes and sustains lifestyle change and self-management if they live with a chronic condition. Improved self-management leads to wider health economic savings such as reduced GP appointments and reduced prescribing.

Results to date have shown up to 44% take-up of the digital option; PROM/PREM return improvements from <2% to 35%; reductions in patient processing time from 7 days to 1 day; reduction of patients in the administartive booking system from 641 to 58
 
Online Discussion Rating
6.00 (2 ratings)
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
MyPathway can help to keep the population of the West Midlands informed and involved in their own health. It will allow patients to hold a toolkit to their health and a one-stop visual record of their appointments and interactions with the service. 
Appointments appear in the timeline and give patient notifications and reminders to attend, links to addresses, contact numbers, booking systems, clinic and procedure information, maps and other useful information. This reduces non-attendance and makes it easier for those unable to attend to cancel and change appointments in a timely manner.
According to NHS England 6.9 million outpatient hospital appointments are missed each year in the UK, costing an average of £108 per appointment. Reducing DNA’s and short notice cancellations will enable services to be more effective, efficient, increase capacity, save money and ensure people complete their course of treatment.
Using MyPathway to support those who live with long term conditions gives them all the information needed to remind them how to manage their condition as well as the tools to track their symptoms such as blood pressure or blood glucose which will automatically feedback to the clinical portal for their clinician to use at their next appointment.
Wider economic benefits of improved health and sustained lifestyle change are well documented and MyPathway can play a key role in changing the dynamic of healthcare. Keeping the patient informed of where they are in the care pathway, engaging the patient by connecting them with their clinician or service, receiving pathway specific information and resources, patient reported outcome measures (PROMs) and allowing the recording of condition specific data such as weight, peak expiratory flow scores and medication usage etc. will allow the patient to understand and better manage their condition as well as being more engaged in their health. 
Current and planned activity: 
ADI have several digital products which are at various stages of commercialisation. MyPathway is currently deployed at scale, city-wide in Sheffield, with over 10,000 active users. Roll outs in North West Boroughs and Hospital Clinic of Barcelona are also underway. MyPathway is ready for wide scale roll out across a range of service areas, including Hepatolgy, Cancer Service, Fracture Clinics, Diabetes etc.

Our other products are:
PainSense: an online chronic pain management tool, deployed in Leeds and and nationally through Pain Management Solutions. Painsense is avialble for wide-scale rollout.

LMSU! (LetMeShowU): supports children & young people with severe disabilities (and their families) in communicating with their carers, peers, education providers etc. The App is in beta-test in Leeds and ready for other test sites.

StepUp! has been developed to support CAMHS services. Again in pilot in Leeds, we are looking for other CAMHS services who would be interested in testing StepUp!
 
What is the intellectual property status of your innovation?:
Advanced Digital Institute owns all intellectual property of MyPathway. Any third party licensing agreements for the use of information, questionnaires or outcome measures will incur additional costs. 
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
Simple
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Judith Clarkson 23/05/2018 - 11:06 Sign Posted Login or Register to post comments
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Innovation 'Elevator Pitch':
​​​This innovation empowers chemotherapy patients to undertake leucocyte monitoring in their own home. A small-scale trial has been completed showing positive feedback from patients, clinicians and carers potentially saving time, lives and money.
Overview of Innovation:
Dignio helps Health Providers (Hospitals, Clinics, Home Nursing etc) to achieve better outcomes for their patients and reduce the need for traditional face to face consultations and admissions via an integrated Telehealth, Remote Patient Monitoring, eCBT and ePROMs platform.
The side effects of chemotherapy seriously impact cancer patients’ daily lives. Managing them effectively is a long-time concern for doctors and clinicians.
Dignio Prevent is a secure, off-the-shelf, cloud based, device agnostic, Remote Patient Monitoring and Telehealth Solution. Dignio can be deployed very quickly with no input from, or impact on, current IT structures, software or licensing services. For chemotherapy patients Dignio can provide a complete remote patient vital signs monitoring solution which included an innovative, Bluetooth enabled, home based, white blood cell monitoring device.
By combining daily Remote Patient Monitoring of vital signs with CBT and frequent home based white blood cell measurement, healthcare providers can follow the patient in real-time and quickly catch any deterioration in the patient’s health and decrease the number of outpatient visits and reduce chance of hospital re-admission. 
Patients and their carers prefer to be at home, they feel more secure, more in control and less stressed. They begin to learn about and understand how they are responding to chemotherapy and begin to modify their behaviour and manage themselves.
This solution can be delivered on a "per patient per month" subscription basis.
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 / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
Instances of Cancer are increasing and it is estimated that there will be 300,000 new diagnoses a year by 2020. Following publication of the Cancer Taskforce report in July 2015 there is pressure to drive down waiting times, increase diagnostic capacity and reduce outpatient visits.

Dignio Prevent can help healthcare providers to quickly catch any deterioration in a patient’s health helping to reduce treatment cost, decrease hospital readmission and improve patient experience and outcomes saving time, saving lives anbd saving money.
Online Discussion Rating
5.00 (1 ratings)
Initial Review Rating
4.60 (1 ratings)
Benefit to WM population:
Every year, around 31,300 people are diagnosed with cancer in the West Midlands.
The Children’s Cancer Trials Team at the University of Birmingham-based Cancer Research UK Clinical Trials Unit is the only one of its kind in the UK.
Birmingham is at the forefront of childhood cancer research with the team engaged in ground-breaking cancer research, testing and clinical trials across the UK and internationally.
By combining daily remote monitoring of both somatic vital signs and mental health combined with frequent white blood cell measurement at home we can follow the patient almost in real-time and quickly catch any deterioration in the patients’ physical and mental health and decrease the chance of hospital re-admission.
Current and planned activity: 
We are currently engaged with the NHS Test Bed program across a number of use cases in multiple NHS regions.
What is the intellectual property status of your innovation?:
Source code is protected, UI design protected, branding protected
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
6-12 mon
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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Ken Garner 25/04/2018 - 11:06 Sign Posted Login or Register to post comments
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