Creation
Draft
Initial
Detailed
Accepted
Adoption
Idea Description
Supplementary Information
Innovation 'Elevator Pitch':
A co-ordinated communications programme using traditional, digital and social media, to promote understanding by professionals and service users of the benefits of joined-up, tech-enabled health and social care
Overview of Innovation:
The Connected Care Programme has been conceived by Boilerhouse to promote and support individuals and organisations working to develop and deliver integrated, digitally enabled health and social care to local communities across UK.
 
A current initiative is the Care Apps Programme, which is a collaboration with ADASS nationally, supported locally by ADASS West Midlands/Improvement and Efficiency West Midlands (IEWM) The programme provides an online showcase for Care Apps hosted on the Boilerhouse website exchange.publicservicedigital.com.
 
Apps and innovations uploaded to the eXchange include those:
  • supporting personal independence
  • supporting wellbeing
  • commissioned by professional and institutional users to support their work
 
A selection of apps uploaded will be chosen to feature at a live event on March 7 in Birmingham designed to attract a large audience of health and social care professionals and care provider organisations.
 
Case studies, video interviews and other content about apps and digital innovations will also feature in Boilerhouse online publications including publicservicedigital.com, healthcareinnovationmonitor.com and theinformationdaily.com
 
These publications have an established following but content readership is also promoted by direct marketing, social media promotion and featured organisations own promotional activity.
 
We are working with IEWM on a programme of activity to support health and social care integration as well as improvement in the provision of online information and advice to social care users. We have created website visualisations, events, research and other activity as part of this work, which is reaching health & care professionals across the West Midlands.
 
We have created community platforms, online tools, and research into online information provision for ADASS regional organisations in the West Midlands, East Midlands, East of England, and Yorkshire & Humber. Connections through these networks are an important asset to the Connected Care Programme.
 
Our ability to further continue innovating and delivering via the Connected Care Programme is based on the track record of our:
 
- health and social care-related communications consultancy
- research design, delivery and publishing credentials
- web development and data visualisation/innovations
- experienced suppliers to local government and NHS organisations
- in-house online publications with established following
- engaging video output
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 Content5
Overview summary:
The Long Term Conditions (LTC) Network has delivered a stream of programmes to encourage uptake of remote delivery of care for LTCs and adverse lifestyle habits. These include options for delivery of care such as Flo simple telehealth, video consultation, Closed Facebook Groups, apps and aid to diagnosis.
Challenge identified and actions taken :
Lack of clinicians’ awareness of viable options for TEC; competence and confidence in their usage:
  • good practical examples described and signposted in LTC Network bulletin to clinicians
  • publications in national journals
  • support for development & launch of national training module 
Lack of patients’ awareness of viable options for TEC;competence and confidence in their usage
  • good practical examples described for patients 
  • pilot upskilling course for patients 
  • support set up and usage of health professional supervised Closed Facebook Groups by three specialties in acute healthcare settings (and a few local Patient Participation Groups (PPGs) in practices
  • support medical students Year 5 to encourage patients to sign up to Patient Online to access their own records 
  • write article for citizen readership in the North Staffordshire Sentinel newspaper 
Confusion about universal approach to shared management of care of LTCs between providers of care and different modes of remote delivery of care:
  • Create LTC shared management website, with clinician and patient sections; 
Lack of leadership across health economies in relation to synchrony/sharing of remoted modes of delivery of care
  • create example interaction across Staffordshire in relation to videoconsultation for clinical consultations
  • shared learning of usage of TECs 
Impacts / outcomes: 
Facebook:
UHNM closed Facebook groups – a total of 354 members, MS (168), AF (91) and cardiac rehab (95)
Public pages – AF – 895 reach per month/498 post engagements per month; Cardiac rehab – 2099 reach per month/791 post engagements per month
 
Twitter: Over 97,000 accounts reached from tweets
 
Manage your Health App: 330 users
 
Flo Simple Telehealth: 652 protocols registered across the West Midlands region
 
Telehealth E-learning course: Since December 2016 when the RCGP CPD course went live there has been 236 registrations with 42 people having completed the course.  Users have rated the course 4.3 out of 5 stars.
 
Publications:
‘Digital Healthcare: The essential guide’, (Authors: Chambers R, Schmid M, Birch-Jones J), 2016
http://www.otmoorpublishing.com/publications/digitalhealthcare
‘Clinicians rise to the social media challenge’ – Primary Care Commissioning CIC
https://www.pcc-cic.org.uk/sites/default/files/comm_excellence_june_2016_aw_web.pdf
‘How video consultations can benefit patients’ – GP Online
http://www.gponline.com/video-consultations-benefit-patients-nhs/article/1401346
‘How to set up a Skype consultation service’ – Medeconomics
http://www.medeconomics.co.uk/article/1401405/set-skype-consultation-service
‘GPs launch Skype to care homes project in Staffordshire’ – Fabsnhsstuff
http://fabnhsstuff.net/2016/06/26/gps-launch-skype-care-home-project-staffordshire/
‘How should we respond to negative comments on social media’ (Authors: Ruth Chambers, Marc Schmid):
http://www.pulsetoday.co.uk/your-practice/dilemmas/how-should-we-respond-to-negative-comments-on-social-media/20032472.article
‘How a Skype trolley saves GP time’ (Authors: Ruth Chambers, Marc Schmid)
http://www.pulsetoday.co.uk/your-practice/focus-on/how-a-skype-trolley-saves-gp-time/20032834.article
Evaluation report, Autographer plus Flo (Authors: Sue Molesworth, Lisa Sharrock)
http://www.simple.uk.net/home/casestudies/casestudiescontent/mental-health-memory-support-for-mild-cognitive-impairment-or-mild-to-moderate-dementia
Stoke and North Staffordshire leading the way in hi-tech help for patients:
http://www.leek-news.co.uk/8203-stoke-and-north-staffordshire-leading-the-way-in-hi-tech-help- for-patients/story-29733613-detail/story.html
‘Revamp your website to reduce demand’ (Authors: Ruth Chambers, Marc Schmid)
http://pulse-learning.co.uk/practice-business-finance-modules/practice-business-finance/revamp-website-reduce-demand
‘Helping the elderly take tablets’ (Authors: John Marszal, Aoife Donnelly, Ruth Chambers)
http://www.health21.org.uk/2016/11/01/old-people-will-use-tech-if-clinicians-let-them/ 
‘Promoting best practice in COPD management’ (Authors: Rosie Piggott, Elaine Cook, Faye Foster, Alwyn Ralphs, Lucy Teece, Roger Beech)
https://www.bjpcn.com/browse/editorial/item/1943-promoting-best-practice-in-copd-management.html
Video: ‘COPD patient avoids A&E and acute admissions through self-management with Flo’ (Author: Ann Hughes)
https://sites.google.com/a/simple.uk.net/community/home/casestudies/casestudiescontent/copd-patient-avoids-a-e-and-acute-admissions-through-self-management-with-flo
The Health Foundation - The Power of People
Video: Introducing Flo: Telehealth with a human touch
http://healthfdn.org.uk/4Y2-4MPPC-35ITUGKE86/cr.aspx
E-Learning: Telehealth, telemedicine and telecare: an introduction to “TECS” (Technology Enabled Care Services)
http://elearning.rcgp.org.uk/mod/page/view.php?id=4117#register
BMJ – Link to back pain article (STarT Back Tool)
http://www.bmj.com/content/356/bmj.i6748
Year 5 Medical Students x 4 Patient Online Initiative – North Staffordshire & Stoke-on-Trent CCG newsletter publication –
www.stokeccg.nhs.uk/news/staffordshire-students-help-patients-to-log-on-to-gp-services-online-4028/<http://nhs.us6.list-manage.com/track/click?u=ef12432f7b285a04d0bfe1494&id=21f44def52&e=33cdefcc95>
Video: https://vimeo.com/206196885/4a38152bac
WMAHSN LTC Network Newsletter – Publication commenced in January 2017 to 500+, the database has now increased to c.750.
Staffordshire Sentinel – weekly ‘Ask the Doctor’ health articles:
http://www.stokesentinel.co.uk/search/search.html?searchType=&searchPhrase=Ruth+Chambers&where=
‘GP praises Endoscope-i’: https://vimeo.com/191810628?ref=em-share
 
Conferences:
Person Centred Care Conference held in Birmingham on 6th May 2016 – 60 delegates
 
‘Making Change Happen with Simple Telehealth and Florence’ held in Stoke-on-Trent on 25th January 2017 – sharing success and best practice with breakout sessions for Acute, Community and Primary Care – 82 delegates
 
Which local or national clinical or policy priorities does this innovation address:
GP Forward View (New models of care/patient empowerment) Underpin delivery - clinical management of key LTCs: Asthma, COPD, diabetes, hypertension, AF
Supporting quote for the innovation from key stakeholders:
Marc Schmid – Digital Expert, Redmoor Communications:
“The programme has brought patient networks together around MS, cardiac rehab and AF and stroke, providing peer to peer support and regular information from clinicians. The introduction of video consultations has enhanced the care available as well as improving the efficiency of service delivery”.

Luke Bracegirdle – Head of Digital & Business Analytics, Keele University School of Pharmacy:
“West Midlands Academic Science Network part funded a development project to extend work on the Manage Your Health app, to include additional content on long term conditions. Prof Ruth Chambers (Clinical lead Long Term Conditions Network, WMAHSN) has been very supportive and used the network to connect our development team with partners with complementary skills as well as link to further initiatives in the region to promote patient information resources in the area of Atrial Fibrillation”.

Phil O’Connell – Chairman & Chief Innovation Officer, simple.uk.net:
"The WMASHN Long Term Conditions (LTC) Network has provided invaluable support for clinical teams, helping to raise awareness of practical and pragmatic remote delivery of care options.  The LTC Network has worked with us, encouraging evidence based uptake through clinical peer to peer sharing of case studies and evaluation across traditional organisational boundaries of the techniques and methods used by our members to address LTCs and adverse lifestyle habits.
International dissemination of the learning, evaluation and case studies developed through the 'Simple Telehealth' programme of work including Florence in the UK, has been greatly assisted by the practical clinical applications and evaluation made possible by the WMAHSN.  The techniques and methods evaluated have achieved replicable positive clinical and productivity outcomes that are now being studied for implementation in Ireland, USA and Australia."

Jodie Williams – Stroke Prevention Clinical Nurse Specialist, University Hospitals of North Midlands NHS Trust:
“The AHSN has widely supported the AF Stroke Prevention Team over the last 2 years.
It has supported the provision for expert advisory for Atrial Fibrillation, its education and management throughout both Primary and Secondary Care.  It has supported the promotion of an online GP Masterclass for Atrial Fibrillation to GPs in Primary Care to continue education and evidence based management for AF patients reducing the risk of AF related stroke. The AHSN has supported the AF stroke prevention team in becoming champions within both Primary and Secondary Care enhancing self care management, reducing major disabling strokes with a positive impact to the Local Health Economy”.
Plans for the future:
  • Continue with pan-Staffordshire rollout of video-consultation option for clinician/patient follow up interaction in all healthcare settings; extend to social care settings as appropriate; share learning and urge adoption across the region
  • Promote the impact/how to overcome inertia to remote options for delivery of care at all levels of NHS across West Midlands and beyond via events, conferences (e.g. focus on CVD and diabetes 10.5.17; quality improvement 13.6.17), publications, LTC Network bulletin, Twitter, etc.
  • Evaluation of Trust-wide rollout of Flo Simple telehealth Sandwell & West Birmingham Trust; county-wide rollout of videoconsultation; use of Facebook in general practices
  • Develop online learning resources and simple course for citizens to use to enhance their confidence and competence in personal use of TEC for their own LTC(s)
  • Promote or develop online learning resources for clinicians to enhance their competence & confidence in adoption of TEC
Tips for adoption:
  1. Inertia is common in the NHS in relation to any new way of working – persist in engaging all those who are vital in making change happen.
  2. Don’t keep what you’ve learnt about the adoption of an innovation to yourself - evaluate, promote, disseminate it. 
Contact for further information:
Ruth Chambers - LTC Network Clinical Lead 
Ruth.Chambers@stoke.nhs.uk

Sue Wood - LTC Network Project Manager 
Sue.wood@wmahsn.org

Marc Schmid - Digital Expert, Redmoor Communications Social Media
Marcgs72@gmail.com

Luke Bracegirdle - Head of Digital & Business Analytics, Keele University School of Pharmacy - Manage Your Health app
l.bracegirdle@keele.ac.uk

Chris Chambers - Telehealthcare Facilitator, Stoke-on-Trent and North Staffordshire CCGs - Flo telehealth
chris.chambers@stoke.nhs.uk
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Overview summary:
WIN is a group of professionals and enthusiasts passionate about utilising digital technology to improve the healthcare. It collates information and provide guidance on health informatics solutions. It facilitates discussion forums through social media, website, workshops and conferences to discuss and disseminate learning around priority areas in health informatics. We will also support educational initiatives to enhance health informatics knowledge and research programmes that will transform the delivery of healthcare services.
Challenge identified and actions taken :
Despite an initial surge in membership of clinicians and academics following the development of the network, growth decreased considerably. In order to address this, steps were taken to ensure that the reach of WIN extended beyond those initially deemed relevant:
 
  • Widened geographic reach to include and individuals / organisations that may wish to do business within the West Midlands
  • Increased industry engagement to include different forms of health provision
  • Increased local authority engagement to address aspects of integrated health and care
  • Development of public sector, industry and academic databases for targeted communications
  • Updated Advisory Group terms of reference to incorporate multi-stakeholder representation
  • Formalised policies and processes, with professional marketing material.
Impacts / outcomes: 
  • A continually growing membership of 644 members as of December 2015
  • A dedicated website with online discussion forums and events
  • Active engagement from the informatics community across healthcare, academia and industry
  • A health informatics educational needs assessment has been undertaken
  • An elected advisory group now established
  • Significant reputational benefits to WMAHSN by successful, well-attended regional events and presentation at national events, including EHI Live
  • Over 250 attendances at WIN events in 2014/15: WIN National Conference in December 2014 with 81 delegates, WIN industry event in January 2015 with 78 delegates and 95-100 attendees at the November 2015 event
  • Raised profile through membership and social media presence (Twitter, LinkedIn).
Which local or national clinical or policy priorities does this innovation address:
Harnessing the Information Revolution
Supporting quote for the innovation from key stakeholders:
Professor Theodoros N. Arvanitis, Head of Research, Institute of Digital Healthcare, WMG, University of Warwick and Co-Director of the Digital Theme, West Midlands Academic Health Science Network: “The West Midlands Health Informatics Network (WIN) is passionate about health service improvement, education and research in the health informatics domain. Our aim is to support the NHS and affiliated healthcare organisations in adopting information technology solutions in order to provide effective, efficient and high quality healthcare for patients/carers. We do this by connecting health informatics experts, professionals and enthusiasts across geographical, organisational and professional boundaries to work towards the goal of achieving in West Midlands and beyond. This is an independent network, with a culture of reciprocity, mutual respect, sharing good practice, support, equal access and shared responsibility.”
Plans for the future:
  • New website to allow members to access knowledge and expertise within the network.
  • Consideration of implications of digital health / justice
  • Increased networking activities to promote best practice and innovation.
Contact for further information:
Theo Arvanitis
t.arvanitis@warwick.ac.uk 
02476 151341
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Innovation 'Elevator Pitch':
Recap Health enables NHS clinicians and social care professionals to efficiently deliver personalised, relevant, timely and up-to-date digital health and social care content (videos, leaflets, website pages etc) direct to selected patients/clients. 
Overview of Innovation:
                                  

Recap Health is a cloud hosted patient education and clinical information delivery application. It enables clinicians to quickly find and send relevant digital health content to their patients, helping patients to become better informed and better able to manage their own health effectively.

Clinicians
Clinicians select relevant digital content (videos, leaflets, web pages, third party apps, events etc ) from a library of pre-approved digital content. Content can be searched by health condition, age, language and media type etc. Content can also be packaged into pre-defined 'bundles' to facilitate speed of use. At the click of a button clinicians can send content to individual patients.

Clinicians can favourite content for future use. They also can see what content their peers use and they can see clinician and patient reviews and rating of content. 

Patients:
Patients with Recap Health accounts receive an email notification, alerting them to the arrival of new content. They login and see their personalised content (videos, leaflets, apps, website pages etc), in an attractive personalised webpage. As well as consuming the content, patients also can hide content, rate and provide feedback on their content and share it electronically with family and friends.

Organisations:
Recap Health records whether and when a patient has accessed their content which enables organisations to classify patients in relation to how 'activated'/engaged they are.

In future, organisations will be able to set a series of time or behaviour based rules associated with how patients relate to their content. Rules can trigger in-app messages, emails and or offers of live chats.  In this way Recap can become a platform for engaging with 'at risk' or newly motivated patients in a more proactive way.

In addition, short online surveys can be presented to individual patients to measure knowledge and motivation to self care, both pre and post accessing content. 

Recap Health has been developed in partnership with a Mental Health and Community Trust but we believe it can also be used also by Acute Trusts, Community Trusts, GP Federations and Local Authorities. It also can be a vehicle for health and social care economies that wish to foster clincial collaboration across professional and organisational boundaries, to achieve shared self-care and patient engagement objectives expressed in STPs, NMCs and/or digital roadmaps. 

 
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 / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
In general terms, by using Recap Health, NHS organisations can raise patients' health literacy levels and their ability to practice effective self-care. Clinicians also can extend their relationship with their patients beyond the boundaries of face-to-face encounters.  

More specifically, NHS organisations can realise some or all of the following benefits:

Cost Savings:
- Less demand as more knowledgeable patients become more motivated and better able to practice effective self care
- From the digital storage and electronic distribution of large volumes of patient information

Quality:
- Better version control of patient information and a tighter focus on the nature of the information itself
- Better relevance and timeliness of patient information sent to patients
- Access to ongoing patient feedback about the quality and relevance of information sent to them 
- Access to data reporting on which content is most popular, most used, most revisited etc.

Intelligence:
- Access to data identifying the extent that individual patients consume content, which allows patients to be stratified into activation cohorts 
- Audit trail ​of information interventions

Cultural:
- Makes collaboration across a health and social care economy more likely as clinicians from multiple organisations use Recap to communicate with 'shared' patients
- Empowers frontline or generalist staff as they gain the ability to find and distribute content traditionally distributed only by specialists (often after an appointment)
- Accelerates the 'media shift' trend away from traditional information leaflets towards short videos
- Supports the drive towards a paperless NHS 
Online Discussion Rating
5.00 (2 ratings)
Initial Review Rating
4.20 (1 ratings)
Benefit to WM population:
By accepting electronic invitations to join Recap Health, patients in the West Midlands will:
  • have easy access to personalised, timely and accurate healthcare information 24/7 
  • have a much better opportunity to become more knowledgeable about their condition / healthcare situation and what appropriate self care strategies are
  • feel more connected to the clinicians and NHS organisations that serve them
Current and planned activity: 
Recap Health is being trialled at scale by a Community and Mental Health Trust in another region. 

We plan to start marketing Recap Health across the UK in mid March 2017. Our preference though is to work with WMAHSN to find one or more suitable early customers and to work closely together to:

1) better understand the value proposition and associated technical and legal risks; 
2) further develop the product to optimise value
3) determine appropriate price points and licencing terms
4) explore the potential for sourcing validated 3rd party content at scale to supplement locally generated content 
5) develop appropriate implementation support services informed by the experience of early adopters.

On the product side we have a highly detailed and fully costed technical roadmap for developing out new features and improving existing usability, features and design. We are pursuing this on an ongoing basis, with pace dictated by when cash becomes available to us.


 
What is the intellectual property status of your innovation?:
Recap Health has been created by Health2Works Ltd. As such we own and control use of all software code. 
Return on Investment (£ Value): 
medium
Return on Investment (Timescale): 
2 years
Ease of scalability: 
2
Regional Scalability:
Recap Health can scale very easily, both in terms of numbers of users and distinct implementations. For example a version for a new customer can technically be cloned and deployed with a few hours.
 
There will however be technical work for H2W to do to serve a multi-organisation customer. Either we will need to deploy separate instances of Recap Health and retrospectively connect them together or we will need to do this work prior to commencing deployments. The work involves determining identities and permissions for organisations, job roles and shared patients and associating these with bespoke views of the content library.
 
Implementation for customers is more time consuming than technical deployment. Customers will need to develop and resource an implementation plan, focused on 1) content curation and review, 2) service roll-out, 3) product awareness sessions, 4) clinician account generation processes etc. We plan to offer an implementation support service at cost to new customers.

 
Measures:
We believe Recap Health has the potential to help NHS organisations realise at least 12 tangible benefits associated with Cost Savings, Quality Improvement, Data Acquisition and Culture Change. These benefits are already listed in the Benefits to NHS section of this submission.
 
The measures associated with these potential benefits will need to be identified and agreed with customers and ideally a local University research unit. We have a good relationship with Keele University (our local University) and we are in discussion with them about the possibility of Keele offering independent research support to new Recap Health customers in the West Midlands.
Adoption target:
Our aim is to have 4 NHS organisations as customers in the next 12 months, with one being multi-organisation in nature.

We prefer to focus entirely on the WM region, however we plan to start UK wide marketing activity in mid March, unless a strong focus on West Midlands looks like it will meet our needs.
Rejection Reason:
​The panel felt that while Recap Health was a strong and versatile proposal, it didn’t sufficiently focus on diabetes prevention. There were also concerns that the need for professionals to prescribe specific bundles would make the implementation phase dependent on significant clinicians engagement activity before any benefits could be realised. On that basis, the panel decided not to recommend the product for this specific challenge.
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Overview summary:
Technology Enabled Care Services (TECS) can transform the way people engage in and control their own healthcare. One method is Florence Simple Telehealth (Flo), a mobile phone text service. WMAHSN has supported Flo as an exemplar of technology in healthcare, providing resources and training for participating organisations.
Challenge identified and actions taken :
The UK’s diversity means that traditional methods of communication between clinician and patient are changing. Technology Enabled Care Services (TECS), such as telehealth and self-care apps, have the potential to transform the way people engage in and control their own healthcare, allowing citizens to monitor their health and activity levels by themselves, so the need to take up valuable clinician time is no longer necessary. One TECS method is Florence Simple Telehealth (Flo), a mobile text service to communicate with patients. A free mobile texting service, it is easy to use and was designed by NHS professionals to provide support and advice for patients to manage their own health conditions. Flo give prompts and advice and helps to monitor vital signs. Flo is being promoted to the whole population of West Midlands via all 22 CCGs and some acute and community trusts, alongside other forms of TECS:
  • CCG intelligence packs
  • Staying Independent online checklist
  • apps (COPD, asthma and diabetes type 2)
  • Skype and social media online toolkits (with some direct expert support)
  • general awareness of Flo with some support and resources for COPD and asthma.
Impacts / outcomes: 
  • Integrated care development continues across participating organisations and now with other interested organisations e.g. interest from community pharmacies in Flo protocols to support the delivery of their New Medicines Service and Medication Use Reviews to support patients, better medicines optimisation and improved patient experience, and avoided healthcare usage
  • A vision of how TECS underpins integrated care has been published (Tackling Telehealth 2) which describes different definitions of integrated care and how Flo and other TECS fit in. The draft paper received broad acknowledgment from clinicians around the country and key TECS leads at NHS England. This paper covers the transformative role that TECS can play in creating integrated health and social care systems based around the patient
  • Since organisations (CCGs/trusts) took out WMAHSN-related project licences - between April 2014 and March 2015 - 2,489 patients had signed up to Flo, with some CCGs and trusts initially piloting Flo on Stoke-on-Trent CCG’s overall Flo licence prior to their own project licence being funded
  • The service hosted events across the West Midlands region - Stafford, West Bromwich, Coventry, Shrewsbury and Worcester - to raise awareness of the range of technology that can support common long term conditions, including COPD, asthma and diabetes, and redress adverse lifestyle habits, using social media, apps, Skype and telehealth. The events were aimed at general practice teams (practice managers, practice nurses and GPs), CCGs and acute and community trust staff. The events covered creating TECS in the NHS and digital delivery in workplace. The events were attended by more than 200 delegates from a wide range of health professionals, GPs, practice nurses, CCG managers and trust representatives. The project team was also pleased to have received the support from the Managing Director of the WMAHSN, who attended the Shrewsbury event
  • Heart failure (HF), diabetes and community pharmacy Flo protocols are ready for use. The HF protocols are related to an integrated care project between acute and primary care to upskill GPs in the titration of HF medication. Flo protocols have also been developed with a mental health trust and are now being deployed for pre-vascular dementia, mood management and depression. Pilot protocols being evolved or used are pre-bariatric surgery weight loss, multiple sclerosis, community and secondary care pharmacies– new medicine and medication review services, wound fluid discharge, enuresis and informal carers’ stress.
  • There is a wealth of additional interest and further innovations:
  • primary care interest in proactive/preventative monitoring of acute HF patients through monitoring of patient submitted data, blood pressure, weight etc.
  • wound fluid discharge monitoring in a community setting, alleviating time for clinician to attend patient home purely for this purpose
  • acute pharmacy interest in stratifying patients through A&E attendance due to medication issues and using Flo to support the patients with their medicines regime for a period of time post discharge
  • anxiety/stress management for carers to support their wellbeing, therefore reducing the chance of failure of care
  • Matched funds from Stoke-on-Trent CCG has supported the evolution of the TECS Staying Independent Checklist, a resource to allow health and social care and other professionals, during assessment of an individual’s support needs, identify what TECS are available and suitable for them
  • Organisations are keen to learn about broader work around TECS and the programme provides a good opportunity to share, promote and relate learning including Skype, child and adult asthma avatar apps, the TECS referral pathway and other WMAHSN projects including STarT Back, the Manage Your Health app and COPD primary care training, so the Flo programme has developed a wider TECS scope
  • The extensive networking undertaken created further interest, links and opportunities in the Flo exemplar project and related TECS
  • The capture of patient outcomes has been included in the evaluation with standard feedback captured at point of patient sign up to Flo and at termination and determined points in the Flo protocols.
  • The team is also working with each participating organisation to capture and evaluate their patient case studies to build a body of qualitative evidence to share and use to promote further the benefits of Flo
  • The Flo data will be used to review patient adherence to protocol/pathway and, dependent upon the LTC, determine any sustained patient outcomes e.g. blood pressure, improved inhaler use
  • There is a focused evaluation underway.
Which local or national clinical or policy priorities does this innovation address:
From the NHS Five Year Forward View: • Incentivising and supporting healthier behaviour • Targeted prevention • NHS support to help people get and stay in employment • Empowering patients • Out-of-hospital care needs to become a much larger part of what the NHS does • Services need to be integrated around the patient • We should learn much faster from the best examples, not just from within the UK but internationally • As we introduce them, we need to evaluate new care models to establish which produce the best experience for patients and the best value for money.
Supporting quote for the innovation from key stakeholders:
Jeff, Flo service user: “FLO resembles a friendly, good natured and trusted member of the family. I feel more able to cope and more confident about the future. Most importantly, it helps me cope with my situation.”
 
Sarah, Lead Nurse for respiratory medicine (general practice): “The app has excellent content, is quick to download and ensures patients have their asthma management plans with them all the time, rather than at the back of a drawer. Inhaler technique is key to managing asthma and the avatar demonstrates this perfectly. This app could help prevent hospital admissions and deaths.”
 
Dr Ruth Chambers OBE, GP principal, Stoke-on-Trent, Chair, Stoke-on-Trent Clinical Commissioning Group, Honorary Professor, Keele and Staffordshire Universities and Clinical Lead for Long Term Conditions, WMAHSN: “The importance of what we are trying to help teams deliver cannot be overstated. Demands on our services are continuing to increase. Utilising technology will not only enable us to shape services to suit the needs and preferences of individual patients; embracing it will also help us take on the challenges we face every day.”
Plans for the future:
  • To drive person-centred care through the use of TECs (with Flo as an exemplar) to span patient pathways across different healthcare settings with general practice teams and other providers prioritising applications that best meet the needs of their population, at specific points on those pathways
  • To drive regional spread/deployment of  Flo within organisations to disseminate the knowledge and learning achieved from previous deployment and successes to support the move towards a culture shift/perception of TECS for asthma, COPD, medication adherence and hypertension
  • Development of other Flo protocols ready for 2015/16 to support other LTCs beyond the project’s initial launch protocols.  
Tips for adoption:
To take TECS forward at pace we need to:
  • establish and support leaders and champions of TECS throughout the commissioning cycle to communicate the benefits and drive change
  • enable patient and public involvement and engagement
  • use digital modes of delivery such as Skype, telehealth, telecare, teleconsultations or telediagnostics to drive person-centred, integrated care rather than standalone solutions
  • focus digital delivery of care on areas in patient pathways where enhancing self-care has a substantial impact by improving patients’ clinical outcomes and/or reducing avoidable healthcare usage  
  • anticipate consequence costs such as increased frequency of clinician alerts
  • train health and social care professionals: enhance workforce competences and capabilities for the rollout of technology enabled care
  • match the mode of digital delivery of care to suit the patient population – selected mode or individualised for their needs and preferences
  • rigorously evaluate any implementation or trial of TECS and use this information to underpin any future business cases
  • utilise improvement tools to underpin commissioning and service improvement – leadership, transformational change and service redesign
work closely with all stakeholders to integrate technology in care to improve outcomes for all services; redress ongoing issues in constructive ways before progress with rollout is stalled.
Contact for further information:
Dr Ruth Chambers
ruth.chambers@stoke.nhs.uk
0121 371 8061
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Innovation 'Elevator Pitch':
Medstars' aim is to increase access to quality paid-for healthcare. To create a trusted platform for patients to compare, connect directly with and book paid-for appointments with independent registered health practitioners.
Overview of Innovation:
We are experienced healthcare professionals creating innovative digital health systems which improve access to regulated paid-for healthcare in the UK. Our starting point is a curated online directory and booking platform, and a personalised health concierge service delivered by medical experts.

The Problem
  • The NHS is increasingly rationed & shrinking with fewer non-essential procedures available to patients. This means that more people are looking to paid-for solutions to their physical and mental heath problems.  
  • Confusion Paid-for healthcare in the UK remains confusing, fragmented and difficult for patients to navigate. It has been heavily criticised for lacking trust & transparency. Patients have to rely on sketchy and unreliable information to select a healthcare professional.
  • The traditional UK health insurance market is slowing with fewer benefits offered by employee heath schemes. This means that a key source of patients for independent health practitioners is reduced.
 The Market
  • 75% UK population search on-line for health information in 2015. (Nuffield)
  • 90% would like to use an on-line service to book thier appointments. (Nuffield)
  • £6 Billion - the value of private medical healthcare with £1.5 Billion as specialist fees. (Mintel 2015)
  • 16 Million private medical appointments booked in 2015. (The King's Fund)
The Solution
  1. Medstars - a digital health booking platform 
    1. Patients browse & contact health specialists 24/7 with clear upfront medical fees.
    2. Curated healthcare professionals can subscribe to Medstars & promote their services online at reduced costs.
  2. Medstars Concierge A personalised health concierge service for individual patients to communicate directly with a Medstars medical specialist, who will direct them to the most suitable expert or healthcare service for them.
  3. Partnerships with cash plan insurers for their members to use Medstars platform to get the best value for money and quality from their policies.
  4. Innovative fintech products to increase affordability and access to paid-for healthcare (under development).
Founders
  1. Dr Mahnaz Hashmi 
    1. Consultant psychiatrist at University Hospital Birmingham Queen Elizabeth. Award for clinical excellence
    2. BMJ finalist Mental Health award, HSJ award for NHS innovation.
  2. Dr Barry Lambert
    1. Consultant paediatric anaesthetist at BIrmingham Children's Hospital. Award for clinical excellence.
    2. Experience in private and public sector
    3. Developed award-winning anaesthesia app sold world-wide
Each has 20+ years healthcare experience.
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: 
Wealth creation / Digital health / Innovation and adoption
Benefit to NHS:
Due to political and economic drivers, the resources of the NHS are stretched, with a growing focus on urgent and emergency care, and rationing of non-essential treatments. Paid-for regulated healthcare, which includes physiotherapy, psychology, optometry, and dentistry, as well as private medical and surgical appointments is often perceived as inaccessible or unaffordable. Despite maintaining quality, access to NHS care can be subject to long waiting times, exceeding the targets recommended by NICE and the Department of Health and on a backdrop of financial austerity more severe than at any other time in the history of the health service (QualityWatch 2016)

Yet a simple one-off consultation, second opinion or course of brief therapy can be surprisingly affordable when pricing is made transparent. Additionally, employees with work health insurance policies tend to underuse the care available to them, or choose more costly or inappropriate care due to a lack of guidance.

We want Medstars to improve the quality and cost-effectiveness of healthcare that is already available to people with health insurance or the individual resources to access this. Encouraging people to make maximum use of their own underutilised resources, via signposting, guidance and simplified access will reduce their dependence upon the NHS for non-essential and simple healthcare. We believe that across the health economy as a whole, the goal should be to improve the capacity of NHS provision where it is most needed.

Medstars is starting in the paid-for healthcare sector. However the principles of patient choice, transparent information and ease of accessibility apply in both the public and private sector. Current public sector digital solutions are fragmented, localised, and have not kept up with digital, mobile and wearable technology use amongst a tech-savvy UK population .

The Medstars brand will be tested in paid-for healthcare and be established as a quality kitemark for patient choice. Our systems and products will expand based on our values of transparent and accessible healthcare. These values were born from decades of dedication and service to the core principles of the NHS. As the NHS becomes more consumer-driven, tightly resourced, technologically advanced and focused on patient choice, we believe we can integrate the learning, data & products developed by Medstars in the paid-for health sector back to the NHS thereby creating a more joined-up and cost-effective health ecosystem.
Initial Review Rating
4.20 (1 ratings)
Benefit to WM population:
Medstars is a Birmingham-based start-up. Product focus and early partnerships will initially be in the West Midlands and provide a valuable online health resource for its population seeking healthcare. It will also be a cost-effective marketing tool for regional health specialists and clinics.

Health professional recruitment will initially be focused in the West Midlands region. Medstars Concierge will connect patients from across the UK and abroad to health specialists and clinics. By working with independent West Midlands health providers, we will grow our local networks and open up their services to customers from outside the region and abroad who may not have previously considered coming to the region for healthcare.

Partnerships with insurers with high levels of customer membership in the West Midlands region, will give their customers a better understanding of how to use their personal healthcare resources to best effect and improving their access to healthcare.
Current and planned activity: 
  1. Recruitment of expert health practioners to the Medstars digital platform and to grow this customer base.
  2. Launch of UK Medstars Concierge to the UAE by Feb 2017. Seeking key partnerships in the UAE region and UK.
  3. Patient-focused rebranding of Medstars web app with user-interface upgrades
  4. Development of partnerships with health insurers
  5. Scoping, development and pitching of innovative fintech products to increase accessibility to paid-for healthcare
Medstars is founded by two senior doctors currently working in the NHS. Whilst Medstars currently does not work with the NHS the company's ethos and vision is one which would seek to develop opportunities to enhance NHS service provision at the earliest opportunity. 
What is the intellectual property status of your innovation?:
The Medstars' online platform IP is wholly owned by Medstars Limited. Medstars Limited name and logo has a UK and European trademark for classes 35,38 and 44. 
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
2 years
Ease of scalability: 
2
Co-Authors:
Regional Scalability:
Medstars' online platform has been built to be scaleable from conception. We intend to scale firstly across the West Midlands, UK and then to international markets.  Commercial partnerships with organisations, for example cash plan health insurers will be key to growth.
 
The Medstars concierge is location-naive and independent, finding patients the best and most appropriate healthcare for their specific needs from anywhere across the UK. We are now developing a potential network of clinicians who will support this service as demand grows. These will largely be general practitioners with a minimum of 5 years post-accreditation experience who have been personally vetted and recruited by ourselves to represent our brand values.
Measures:
Outcomes for success include:
  1. Health practitioner numbers and engagement with the Medstars platform. Conversion ratios to paid subscription.
  2. Revenue from patients using Medstars Concierge
  3. B2B partnerships to drive the 2 revenue streams from practitioners (subscription) and patients (purchase of concierge services)
  4. Patient traffic to the Medstars site, number of enquiries generated through the website, social media engagement.
  5. User feedback.
Adoption target:
Targets for West Midlands year 1
  1. 300 practioners signed up in West Midlands, 200 active paid subscribers
  2. 50 concierge patients
  3. 1 major partnership with a cashplan insurer & 1 partnership from corporate/travel/hospitaity industry.
  4. Consistently growing patient traffic to Medstars platform and social media engagement.
  5. 90% positive customer experience
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