Identification, prevention and management of diabetes
A waterfall starts with one drop of rain, help us to make a waterfall by sharing the differences that you have made, which could be spread across the region, to improve the lives of people with diabetes - either through identification, prevention or the management of the condition.

Ideas (Digital health)

Innovation 'Elevator Pitch':
MyDiabetesMyWay is a proven, scalable, cost-saving self-management platform/app empowering people with diabetes to take ownership of their disease, data and treatment; delivering tailored support from NHS health record/ home recorded data.
Overview of Innovation:
MyDiabetesMyWay (MDMW) has been running since 2008 in NHS Scotland and is now being implemented in NHS England (e.g. Somerset, Manchester, NW London). MDMW is a cost saving (ROI>4:1) online web-based platform with over 50,000 registrants (covering all types of diabetes) funded by NHS/ government, giving patients access to their institutional (NHS) health records, integrating with home-recorded data, utilising algorithms and data linkage to drive highly tailored self-management advice and reports, communications tools and education resources.

MDMW has peer reviewed published evaluation and is an international exemplar having won many quality awards e.g. European ehealth adopters award (2017)/ Diabetes UK self-management award (2015)/ UK Quality in Diabetes Care award (2013). MDMW impacts on clinical outcomes e.g. HbA1C, is low cost (£1-2 per population patient per year license) and offers savings through reductions in complications/ efficiencies in care for NHS providers, and can be rapidly scaled across regions and countries.

THE PRODUCT:
MDMW is a portal/ app encompassing:
  • >200 digital educational resources (text, video, interactive content)
  • Patient electronic health record access (institutional NHS data)
  • Patient self-management decision support with data-driven tailored advice/web links
  • 6 QISMET accredited structured education courses (GDM, Type 1, Type 2)
  • Personalised care planning documents
  • Personalised care quality reporting (e.g. DUK 15 Care Measures)
  • Patient goal-setting tools
  • Communication tools; secure messaging with health care team/ peer discussion groups
  • Remote glucose monitoring support (community upload and sharing of home blood glucose (sugar) readings and feedback).
  • External social media channels
  • Responsive and accessible web/mobile platform design
"Patient access to diabetes records through My Diabetes My Way has meant a step change in the care and understanding of my condition to a level that it has never been. I am much more in control of my condition but importantly I now understand the goals that I should be achieving and am able to have a constructive discussion with my consultant. "

MyDiabetesMyWay is now being rolled out in sites across NHS England.

MyDiabetes Clinical is a complementary clinician facing platform delivering a EHR, automated clinician guidance driven support, and individual and population analytics

http://www.mywaydigitalhealth.co.uk/
E: david.garrell@mwdh.co.uk
M: 07739 529737
E: debbie.wake@mywaydigitalhealth.co.uk
M: 07904154101
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 / Wellness and prevention of illness / Digital health
Benefit to NHS:
MyDiabetesMyWay is a novel patient facing intervention which can directly impact on clinical outcomes, quality of life, and improve efficiencies in service delivery. Diabetes is growing health problem with high treatment costs affecting 9.6% of the WM population. Good patient self-management driven by education, empowerment and motivation is key to good outcomes. Diabetes spending may rise over 10 years to c. 17% of the NHS budget.

People with diabetes only spend a few hours per year with health care professionals. The rest of the time, patients self-manage their condition; i.e. - blood glucose monitoring, medication adjustment, appropriate daily foot care, weight management and dietary and activity choices. Self-management is key to reducing costly long-term complications such as ulcers, amputations, blindness, kidney disease, heart disease, stroke/ vascular disease, mental health disorders, sexual dysfunction and neurological complications.

MyDiabetesMyWay delivers cost savings and better outcomes for patients (ref: published evidence), it also improves data transparency for practitioners across primary and secondary care and can reduce the need for face to face education and consultation, improving efficiency in working practices. Regular knowledge updates, feedback on results, motivational support and flexible access to health care staff are key to supporting patients, reducing costly clinic visits, hospitalisations and death due to secondary complications, leading to longer healthier lives with significantly reduced costs.

Technology approaches in diabetes care work well, particularly if they are personalised. Low cost population based solutions are appealing in the current climate of rising prevalence on a shrinking NHS budget. Long-term conditions management needs to evolve to reap the potential benefits of data driven approaches. There is massive potential for wider lifestyle/home monitoring/institutional big data analytics to drive push notifications and automated decision support in real time to patients, which could transform care delivery. Our product development supports this evolution.

MDMW can contribute to the local implementation of the NHS Long Term Plan. EG:

3.81 supporting delivery across primary care to enable more to acheive treatment targets
5.9 & 5.13 People seamlessly empowered by digital tools information and services/digital structured education.

Demonstrable through Tests 2/3/4 (£ releasing/reduce demand for care/reduce of unwarrant).
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
Diabetes is growing health problem with high treatment costs affecting 9.6% of the WM population over the age of 16. Good patient self-management driven by flexible access to good quaity information (available in a range of languages), structured education courses, empowerment and motivation is key to good outcomes. MDMW supports acheivement of local 3 treatment (BP, cholesterol and HbA1C) and structured education targets.

People with diabetes (PWD) only spend a few hours per year with health care professionals. The rest of the time, patients self-manage their condition; includes blood glucose (sugar) monitoring, medication adjustment, appropriate daily foot care, weight management and correct dietary and activity choices. Self-management is key to reducing costly long-term complications such as ulcers, amputations, blindness, kidney disease, heart disease, stroke/vascular disease, mental health disorders, sexual dysfunction and neurological complications.

MDMW delivers cost savings and better outcomes for patients and improves data transparency for practitioners across primary and secondary care and can reduce the need for face to face education and consultation, improving efficiency in working practices. This combination of empowered PWD and practitioners with a more complete picture can lead to more frequent co-production of health with the patient at the heart of decision making.
               
Identification, prevention and management of diabetes
 
We fit firmly in the management of diabetes section, but as we are continually developing our resources – we have a prevention structured education course in development.
Current and planned activity: 
MDMW is currently deployed throughout NHS Scotland. MyWay Digital Health are now implemented/ing MDMW in sites in NHS England, including Somerset, NW London and Greater Manchester. We were selected as one of 11 NHS innovation accelerator programme fellows (2018 cohort) and the Digital Health London accelerator, both of which are supporting adoption.

We continue to develop the product including Artifical intelligence/machine learning, decision support and a corresponding clinician platform through Innovation funding.

This will further enable delivery of the long Term Plan and section 5.29:

"Decision support and AI ... technologies need to be embraced by the NHS, but also subjected to the same scrutiny that we would apply to any other medical technology. In the coming years AI will make it possible for many tasks to be automated, quality to increase and staff to focus on the complexity of human interactions that technology will never master.
See files for company skill profile.
What is the intellectual property status of your innovation?:
Intellectual Property for MDMW is fully assigned to the company from the University of Dundee for exploitation.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
2 years
Ease of scalability: 
Simple
Regional Scalability:
Implemented at scale across NHS Scotland since 2008 (currently> 35,000 registrants), Implementing in Somerset CCG and across NW London STP. Working on applications in Greater Manchester and other areas.
Measures:
Previous Assessment in NHS Scotland:

MDMW clinical impact has been assessed (April 2017) using time-series analysis comparing HbA1c of active users with those in the inactive background patient population (control cohort) matched by age, duration of diabetes, socioeconomic status and gender (7147 interventions (registrants and active users) vs 36020 matched subjects). My Diabetes My Way (MDMW) users demonstrated a sustained 4 mmol/mol HbA1C reduction. Further health economic analysis based on UKPDS complications models and £1 per diabetes population annual charge/ 5-10% registration, suggests a return on investment of around 6:1. User surveys; 90% feel MDMW supports diabetes knowledge, self-management and motivation.

Ongoing Assessment:

- Identifying strategies/ barriers for successful implementation and uptake.
- Gather feedback on new product feature to assist in ongoing product development
- Assess changes in health outcomes, complications prevention and health economic benefits 
- Assess changes in working practices/ care delivery efficiencies e.g. impact on consultation numbers, face to face education, unnecessary screening tests

*Outcomes will be added to the health economic model
Adoption target:
We would aim to offer to everyone in the region with diabetes and rapidly onboard 5-10% of the entire diabetes population in your area in the first 12 months. Our intervention USP is low cost and scalability (at no additional per person cost).
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David Garrell 18/09/2019 - 15:45 Detailed Submission Login or Register to post comments
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Innovation 'Elevator Pitch':
Changing Health address signficant barriers to access by providing X-PERT diabetes education on line together with personalised evidence based telephone coaching to enable sustained behaviour change leading to improved clinical outcomes.
Overview of Innovation:

Changing Health offers the 1st evidence based digital education and personalised support programme for people living with Type 2 diabetes. Our digital diabetes prevention programme is currently under evaluation by Public Health England to be launched in September.

Our high quality service is based on evidence gathered from research led by Prof. Michael Trenell’s team at Newcastle University and the Newcastle Hospitals NHS Foundation Trust, conducted over 8 years and funded largely by the NIHR and MRC. This background has been licenced to Changing Health and combined with other state of the art structured education.

The service has been reviewed by NHS England Right Care, Public Health England, as well as other national stakeholders. Furthermore, it has undergone cluster based control trial, reviewed by NHS England and NICE, and submitted to be included in the first wave of approvals for mobile digital services.  Exclusive instant online access to X-PERT, the only Type 2 diabetes education programme proven to have clinically meaningful impact on weight and glycaemic control, together with ongoing learning via a referenced knowledge base. Re-designed for delivery through mobile and web apps, content is delivered in a variety of formats - including cartoon animations, interactive exercises and article text - supported by a personal coach.

Key features:
  • Evidence based behaviour change tools, including: the ability to create goals, make specific plans and self-monitor by tracking physical activity directly from the phone, record food intake, weight and other important data.
  • Communication with a personally assigned coach trained in evidence based behaviour change techniques, with the ability to book coaching sessions over the phone.
  • Online education modules in behaviour change for healthcare professionals, accredited by the Royal College of Physicians, equipping them with evidence based tools to help their patients better self manage. These modules are designed to be used alongside the aforementioned patient-facing tools, enabling HCPs to hold informed dialogue.
Recognising important cultural and linguistic diversity, Changing Health has collaborated with the South Asian Health Foundation and Diabetes UK to make services available in English, Punjabi, Gujarati (Bengali/Urdu dialects) and Polish languages.

The service is offered by the Modality Vanguard and is ready for wider adoption.



Evidence & Research
https://www.changinghealth.com/evidence.html
 
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 / Wellness and prevention of illness / Education, training and future workforce / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
Type 2 diabetes is characterised by progressive weight gain, driving the worsening of glycemic control. Changing Health directly targets this by providing evidence based weight management services through a digital platform. Excess weight is the greatest factor influencing the development of Type 2 diabetes, with over 80% of people overweight or obese. In the first five years post-diagnosis, a person with type 2 diabetes has a twofold increase in their risk of a stroke. They also have an ongoing risk of CVD twice that of a person without diabetes - and CVD is responsible for 52% of deaths in people with Type 2.

Changing Health’s service creates value for money by:
  • Delivering better health outcomes: Audit results demonstrate that X-PERT provides a sustained reduction in HbA1c (-6mmol.mol) and weight (-4.4kg).
  • Reducing spend: Over the first 6 months, X-PERT has been shown to generate an 8.3% reduction in prescribing costs equating to average savings in prescribing costs at £131,052 per 1,000 people attending, per year.
  • Improving care quality: Reducing variation in care through a standardised and proven approach, coupled with personalised coaching.
  • Opening access: Reducing barriers to access by making our services available anytime, anywhere, in English as well as the five most prevalent foreign languages.
  • Engaging patients in self-care: Providing patients with the education and tools to self manage their diabetes.
  • Supporting commissioning: Tracking outcomes easily and efficiently.
  • Providing the opportunity for effective investment of resources.
  • Supporting care teams: Providing evidence based online education modules, and freeing up healthcare professional time - such as enabling DSNs currently providing education to provide care and support to colleagues as well as patients.
  • Helping people early with their diabetes: The younger someone is diagnosed with diabetes, the greater their lifetime cost of their condition. This younger group are also more likely to access digital tools, creating an optimal method of engagement.
Online Discussion Rating
5.00 (1 ratings)
Initial Review Rating
5.00 (2 ratings)
Benefit to WM population:
Public Health England estimate that there are 433,000 people with Type 2 diabetes in the West Midlands.

At current levels of attendance for education, there is a substantial unmet need addressed by our services for people with Type 2 diabetes. Today there is little, if any, coaching support to empower people to achieve the changes in behavious which are proven to improve outcomes. Changing Health offers the facility to address this need by substantially improving access: it has the capacity to do so across the West Midlands region.

Changing Health addresses signficant barriers to access of supported self management for patients with Type 2 diabetes, making information and evidenced based support available anytime and anywhere and in 6 languages, including 5 South Asian Languages (2 Bengali dialects, Punjabi, Gujarati and Urdu) and Polish. These will be phased in during the 4th quarter of 2017.

Changing Health is currently being used in Birmingham in conjunction with the Modality Vangaurd, working with the Connected Care Partnership https://modalitypartnership.nhs.uk
 
Current and planned activity: 
Changing Health's innovative service is currently deployed in 7 georgraphies including West and East London, Birmingham and Manchester.

Our prevention service is currently being evaluated by Public Health England and is expected to be deployed in September 2017.
What is the intellectual property status of your innovation?:
The intellectual property of our behaviour change techniqes has been licenced exclusively to Changing Health by the NIHR and MRC.

X-PERT Health has exclusively licenced its programme to Changing Health to be made available in a digital format accessbile via a mobile, tablet or computer.  
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
Simple
Regional Scalability:
Our ability to scale has been recently & satisfactorily tested by Public Health England. The digital elements of our service are designed for scale. We have capacity to provide personalised coaching services for up to 500,000 people.
 
Public Health England estimates 433,000 people with Type 2 diabetes in the West Midlands. At current levels of attendance of education, there is a substantial unmet need addressed by our services for people with Type 2 diabetes. Today, there is little if any coaching support to empower people to achieve the changes in behaviour which are proven to improve outcomes. Changing Health offers the facility to address this need by substantially improving access: it has the capacity to do so across the West Midlands. 
 
Together with Diabetes UK & the South Asian Health Foundation we are currently translating our modules into 5 South Asian Languages: 2 Bengali dialects, Punjabi, Gujarati & Urdu as well as Polish. These will be phased in during 4th quarter 2017
Measures:
Changing Health would report process and output measures:
  • Referrals received
  • Patients enrolling
  • Patients completing
  • Complaints received/resolved
  • Patients empowerment scores
  • Patient experience questionnaires
For people with Type 2 Diabetes would like clinicians to gather and report:
Weight and Hba1c at referral, after 6 months and 12 months.
 
The X-PERT reporting processes include other metrics including cholesterol and blood pressure. We’d welcome this being reported too.
 
The metrics for the Diabetes Prevention Programme are being developed by Public Health England. A substantial data set is already in place for the face to face programme. The digital dataset is yet to be determined. 
Adoption target:
433,000 people with Type 2 in WM. NICE/NHSE/DUK all advocate education and support with parliament stating that CCGs should plan for radical expansion and improved access.  The unmet need is substantial. As a digital and telephone service we can operate at scale. Capacity is likely to be set by the funding available.
 
Min level is 250 people per CCG
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John Grumitt 03/05/2017 - 11:39 Sign Posted 8 comments
Innovation 'Elevator Pitch':
The Sound Doctor has over 250 high quality short educational films. Evaluations show they work by changing behaviours and improving outcomes to help people get the best out of life with long term conditions. 
Overview of Innovation:
The Sound Doctor is the leading provider of film and audio content for patients in the UK. Our content is thought to be unmatched in quality, range and production values and evaluations show it works by changing behaviours.and improving outcomes to help people get the best out of life with long term conditions.
 
Our films are endorsed by leading charities and adhere to NICE guidelines.
Conditions covered are COPD, Diabetes, back pain, dementia and weight management surgery.  A large series on heart conditions including cholesterol and hypertension, will be made shortly. 
There are over 250 films in our library so far and it is constantly growing.
We also create animations. We have a range of health and wellness short animations which are now being used in pharmacies and GP surgeries around the country. 
In addition, the team also devised and produce Health Today, a national radio programme for NHS England – nhs.uk/healthtodayradio
 
We have evidence that patients with diabetes, for example, have changed their attitudes towards diet and exercise as a result of watching our films. People with COPD are more confident about dealing with exacerbations at home. We also know that across all conditions they are considered a valuable part of people’s health care and improve patient experience.
 
The aims of The Sound Doctor, and there is evidence of this as well, are:
 
1. To reduce the number of avoidable admissions (and readmissions) to hospital
2. To reduce the need for face to face contact with consultants, physicians, nurses, physiotherapists and others (and to improve the quality of meetings which do take place)
3. To address the issue of co-morbidities by creating a multi-condition library
4. To improve medicines management and compliance with medications
5. To improve the quality of care for patients (and patient experience of their care)
6. To help people get the most out of life through effective self-management
   
About us:
The Sound Doctor was founded by Dominic Arkwright and Rosie Runciman and is a registered social enterprise.
Dominic worked as a reporter at the BBC for more than 20 years, mostly on Radio 4 's Today Programme as well as Newsnight and PM. He also presented discussion programme 'Off the Page' and 'The Call' on Radio 4.
Rosie Runciman also worked at the BBC for more than 20 years on Radio 4's Today programme, Newsnight, Radio 5 Live and at The World Service. She was Editor of Newshour and Assistant Editor at Five Live.
 
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 / 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:
  • For clinicians  
    • Complements and supports sessions
    • Sessions more focused and efficient to achieve better health outcomes
    • Reduces appointments, admissions and DNAs
  • For providers  
    • More efficient caseloads, better outcomes for patients, reduced waiting lists
    • Money saved through reduced numbers of GP appointments, hospital admissions and DNAs
Return On Investment (GPs)
Cost of TSD per patient per annum = £5.00
 
Average number of GP visits pre TSD = 3.7 appointments Average number of GP visits post TSD = 0.42 appointments
 
3 fewer appointments per TSD user x payment for each appointment of
£23.50 (NHS tariffs) = £70.50 per patient; an ROI of 1:14
 
Average number of GP DNAs pre TSD = 2.5 appointments Average number of GP DNAs post TSD = 0.5 appointments
 
2 fewer DNAs per TSD user x cost of each DNA of £36 (Kings Fund) = £72 per patient; an ROI of 1:14
Initial Review Rating
3.80 (1 ratings)
Benefit to WM population:
  • Empowers and encourages people’s engagement with their condition
  
  • Improves medicines adherence
  
  • Improves overall quality of care
  
  • Improves people’s experience of and satisafaction with their care
Current and planned activity: 
Who’s using The Sound Doctor
•  CCGs 
  • Barnsley, Gloucestershire, West Leicester, Wirral, Newcastle, Central London Community Health Trust
  
  • Hospital Trusts  
    • Guy’s and Tommy’s NHS Trust
    • Liverpool Heart and Chest Hospital
  
  • Other  
    • Philips Healthcare
    • All South London pharmacies
    • Jhoots Pharmacies
    • NAPC Practice Innovation Network
What is the intellectual property status of your innovation?:
We own the IP on all our content
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
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Dominic Arkwright 26/09/2016 - 16:14 Publish Login or Register to post comments
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Innovation 'Elevator Pitch':
This CGM will involve a warning system for preventing Hyper and Hypo glycaemic episodes
Overview of Innovation:
CGM connected to GPS and the NHS database to take the CGM a step further than the product developed by IBM-Watson/Meditronic system.
Stage of Development:
Ideas stage - Early concept and ideas stage
WMAHSN priorities and themes addressed: 
Digital health / Innovation and adoption / Patient and medicines safety
Benefit to NHS:
This will stop costly intervention after the event ( hypo or hyper glycaemia) and also cut the time it takes to reach out to the vulnerable diabeteic patients
Benefit to WM population:
Same as above
Current and planned activity: 
Early stages of concept but an adaptable technology
What is the intellectual property status of your innovation?:
currently not patented
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
Simple
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Bensley Selvan 03/06/2016 - 12:21 Sign Posted Login or Register to post comments

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