Data Analytics to support better mental health and care
How can the NHS make better use of data analytics to improve mental wellbeing, to drive improvement in delivering mental health services, and optimise users' experience and outcomes?

We are looking for innovations that are already available or could be adapted to better inform decisions that affect peoples' mental wellbeing, to improve service design and delivery and to enable people to take more control over their mental health. 

Ideas (Publish, Detailed Submission)

Innovation 'Elevator Pitch':
SaccScan - a tool for rapid, accurate & affordable diagnosis & clinical management of major psychiatric disorders. Identifies eye movement abnormalities to objectively diagnose illnesses such as schizophrenia, bipolar disorder & severe depression
Overview of Innovation:
The Diagnostic Problem
Delivering an accurate and timely diagnosis remains one of the most pressing challenges of modern psychiatry. 1 in 4 adults suffer from mental ill health during their lifetime but around 50% of cases are misdiagnosed. There are still no objective diagnostic tests to validate the decision. Diagnosis and clinical management are based solely on the patient’s history, symptoms, and behaviour. Treatments are available that allow patients to resume normal functioning in society but clinicians struggle to make accurate diagnosis, match therapy to condition and provide timely care.
 
It is common in psychiatry to find that symptoms are insufficient to give a clear diagnosis and a lengthy consultation period of several years may be necessary. Delays in receiving a diagnosis can significantly impede delivery of the most effective treatment plan, exposing the patient to risk of further deterioration in well-being, reduction in quality of life leading to job loss, family breakdown, and self-harming.
 
Ultimately the wider economy shoulders the burden from loss of economic output, commitment of healthcare resources, and out-of-pocket expenses incurred by patients and their families.
 
SaccScan is a novel eye movement test, designed as an assistive point-of-care tool for diagnosis and clinical management of psychiatric disorders.
 
Using high specification eye tracking technology, and access to a proprietary clinical reference database, the diagnostic tool utilises eye-movement abnormalities as objective clinical diagnostic biomarkers for illnesses such as schizophrenia, bipolar disorder and severe depression. The test can be completed within 30 minutes in a standard consulting room. A shorter version of the test is being developed for use in primary care settings to assist with differential diagnosis of psychosis from mood disorders, better informing referral of serious mental illnesses to secondary care services.
 
SaccScan not only reduces the overall cost of managing psychiatric illness but will improve patient outcome.



A Step Change for Psychiatry
SaccScan has been demonstrated to detect schizophrenia with better than 95% accuracy (> 90% sensitivity & specificity) and has been extended with the same precision to bipolar disorder and major depression illnesses. No brain imaging, serology or DNA test approaches this level of performance (sensitivity, specificity and repeatability).
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: 
Mental Health: recovery, crisis and prevention / Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Wealth creation / Clinical trials and evidence / Digital health / Person centred care
Benefit to NHS:
Initial Review Rating
4.60 (1 ratings)
Benefit to WM population:
The benefits of early intervention
It is widely accepted that early intervention in psychosis services not only produces better outcomes but is also cost effective.
 
Primary care - nearly 500,000 people are on GP registers for a serious mental illness. (Care Quality Commission (June 2015), Right here, right now)
 
The demographic inequalities in the prevalence and risks associated with mental health problems are reflected in treatment. People who are white British, female or in mid-life are more likely to receive treatment, while people in black ethnic groups have particularly low treatment rates. People with low incomes are more likely to have requested but not received mental health treatment.
Current and planned activity: 
Current
Research and clinical validation towards CE marking through NHS Grampian, Lothian, Tayside, Glasgow & Greater Clyde with Scottish Borders and clinics in Peterhead & Fraserburgh added in April 2017 targeting >1,000 patients & controls.
 
SBRI contract to survey 50 GP surgeries as part to scope introduction of test in primary care

Planned
  • Seeking trial sites in the WM region to pilot the test in clinical settings to support CE marking
  • Ongoing refinement of the value proposition for clinical adoption and to support service user involvement by NHS e.g. final design of diagnostic report template
  • Dr M. Kumar (Consultant Psychiatrist) and ward staff at the Sth Staffs & Shropshire NHS Foundation Trust, has expressed interest in becoming a lead pilot site in WM region for clinical validation studies.
  • Wish to develop projects with MoD on PTSD using SaccScan technology. Require funding to set up St George’s Hospital as field trial site in collaboration with Clinical Trial Unit at Keele University
What is the intellectual property status of your innovation?:
Currently developing technical file for CE mark class I submission.
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
2 years
Ease of scalability: 
Simple
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Madhu Nair 11/04/2017 - 16:45 Publish Login or Register to post comments
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Innovation 'Elevator Pitch':
ConCERT-D is an integrated clinical & research solution designed with Dementia leading clinical experts specifically for the treatment, identification & management of dementia patients, providing results and medication management. 
Overview of Innovation:
ConCERT-D displays captured mental assessment scores for tests including the Mini Mental State Examination (MMSE) in a graphical way enabling Clinicians to relate fluctuations in scores with events that would have happened in the meantime

The medication module allows Clinicians to keep track of the patient diagnosis, prescribed drugs, related side effects, allergies and other conditions. The in-built drug formulary is specially geared towards dementia patients. The accumulative anticholinergic cognitive burden (ACB) is automatically calculated allowing Clinicians to take better decisions, ultimately reducing the risks of cognitive impairment & death

The medication module enables Clinicians to check the dosages for antidepressants and anti-psychotics being taken by the patient as a percentage of the maximum dosage set for these medications

A Research Register for Clinicians to inform Clinical practice
The ability to easily identify patients and carers that match a clinical trial’s participation criteria provides a highly effective tool to increase participation in research. Researchers can build the appropriate participation criteria for clinical trials in ConCERT-D. The system can automatically report on patients that are eligible for participation in studies

Once a patient is identified the clinical researchers speaks to their carers for advice. In some cases internal background checks, tests and screening are carried out. If a patient is found to be suitable and willing to take part he/she is enrolled onto the clinical trial. On the other hand if found unsuitable the reason why is logged and the patient is automatically excluded from subsequent participant searches for that trial

ConCERT-D facilitates accreditation in programs including as The Memory Services National Accreditation Program (MSNAP) allowing hospitals to benchmark their services against national standards and provide quality assurances. MSNAP also enables staff to ensure they are making a meaningful difference to people’s lives as well as supporting implementation of national clinical excellence guidelines. ConCERT-D supports Clinicians to capture MSNAP information during interactions with the patient & then generate reports with the information gathered

These reports allow the identification of trends, assessment of completeness & are of great use for assessors when rewarding accreditation. This functionality can be adapted to other similar accreditation programs
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 / Wealth creation / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
Standard  ConCERT-D Features
  • Easily displays results and key information for Clinicians on dashboards.
  • Allows Clinicians to keep track of the patient’s diagnosis, prescribed drugs, side effects, allergies, investigations, chronic conditions and lifestyle.
  • Enables Clinicians to relate fluctuations in assessment scores with events (medical, trial participation, etc.) that happen to the patient between assessments.
    This would be used to assist with identifying those about to go into Crisis
  • Reporting allows identification of trends within cohort and helps to manage consent better.
  • Automatically calculates the accumulative anticholinergic cognitive burden for drugs the patient is currently taking
  •  In-built drug formulary is specially geared towards dementia patients, where drugs includes the ACB scale 
  • Allows Clinicians to check the dosages of antidepressants and antipsychotics as a percentage of the dosage set for these medications
  • Allows the R&D department to list eligible participants and to manage consent for new or ongoing clinical trials that were never approached to take part in research. 
    • Linking people with dementia with high quality research has historically been very problematic. Registering an individual’s interest has proved very effective in earlier pilot work with DemReg but the new ConCERT-D system will allow us to embed the register fully in clinical practice as it acts as both a Research Register and an Electronic Patient Record. This will allow even more people to gain access to the high quality dementia research we undertake. 
      Dr Craig Ritchie - Honorary Consultant and R&D Director, WLMHT, Senior Lecturer, Imperial College London
  • Captures and manages consent by patients and carers
    Would  assist with the requirement for multi agency collaboration and gaining access to appropriate information to facilitate Crisis Care or data analytics
  • Facilitates accreditation in programmes such as MSNAP (Memory Services National Accreditation Programme)
Attached please find cost and financial benefits documents as a validation and evidence of time and cost savings.
 
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
Campaign Features
Whilst assisting the treatment and management of Dementia Patients the in a truly integrated clinical and research solution,  the software to provide reports to support the identification of trends that would assist with / facilitate a solution to the Meridian Challenges ‘Data Analytics to support better mental health and care’ and ‘Mental Health Crisis Care’ in providing a solution or stepping stone to provide ‘predictions of when a crisis is likely to occur’ as well as other aspects that are listed e.g.
  • Alerting Clinical & Mental Health professionals when risks of crisis are elevated
  • New ways for users to interact with care professionals through our presenting of valuable and up to date information - Service Transformation
  • Access for West Midlands service users, carers this level of access could be developed along with the other requirements outlined within the campaign. Many of these can be supplied via integration with our management tools and platforms.

6PM ConCERT-D solution would support the requirements within the ‘Data Analytics to support better mental health and care’ and ‘Mental Health Crisis Care’ campaigns.

With ConCERT-D and the other 6PM product suite including ‘Lilie’ (Sexual Health), Climate-HIV (HIV management tool), StrokePad, by utilising the mental health aspects and those aspects of these conditions that may have a bearing on their mental condition and subsequent reactions etc. These solutions would be enhanced with other products including CareSolutions™, a powerful data management and processing engine to enhance the Information Management environment related to Mental Health Crisis Care.
 
These solutions could either stand separately supporting these regional clinical areas or be bundled together to provide faster, appropriate care that safeguards patients and whilst answering may of the challenges mentioned with two or more of Meridians campaigns as indicated above.  
 
A secondary affect to adopting 6PM solutions would be to strengthen our position not only with UK but with the UK team, which is based within the West Midlands. We could see the 6PM UK team expanding with our products get a stronger foundation in the UK. 6PM would support the delivery and any potential development or customisation of solutions to accommodate regional and multi-agency requirements.
 
Current and planned activity: 
Currently
6PM is  currently supplying software solutions to 24 NHS trusts with a variety of healthcare products, including r the sexual health product ‘Lilie’ that is currently used by over 15,000 sexual health and HIV professionals throughout the UK
 
ConCERT-D has been operational at West London Mental Health Trust (WLMHT) since July 2014.Curent

Planned / required activity
  • Procurement / Adoption of our products: -  Require additional acute and community and specialist clinic sales and marketing products to CCGs and specialist clinical groups dealing with Dementia. Fully integrated with JDR to increase joint sales.
     
  • Evaluation / Validation / Clinical Trial – Would like to gain additional validation seeking a trial centre of this product (or any others).
     
  • Campaign Solution Developments Interested to hear and discuss how 6PM current solutions can be used or developed to meet ‘Meridian Campaigns’.
What is the intellectual property status of your innovation?:
ConCERT-D is jointly owned by 6PM Group & West London Mental Health Trust
Return on Investment (£ Value): 
medium
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
2
Regional Scalability:

Yes ConCERT-D can be scaled across a region.  It is a multi-tenant solution able to take a number of tenants (i.e. trusts) in one hosted solution where each tenant can have a number of sites.  Permissions allow for different options with regards to visibility of patient information between trusts.  The administration function of the system is managed centrally.   

Measures:

There is c.670,000 people living with dementia this is expected to double over 30 years. Only 40% of people with dementia receive a formal diagnosis, according to the Alzheimer’s Society two-thirds of people with dementia are cared for in the community.The ability exists to consolidate & enhance patient data already captured by clinical staff in existing primary/mental health software clinical applications. ConCERT-D is able to enrich dementia patient data & create a virtual electronic dementia patient record combining research tools. Additional clinical benefits is the ability to use real time patient data in clinical practice increasing quality of patient care. Issues include maintaining isolated dementia patient data within separate clinical software applications & not consolidated with research data, rather than in a seamless integrated solution to inform improvements in clinical practice by organisation, network & region or across England/UK.
 
ConCERT-D improves patient clinical outcomes by improving the data points on which the research is based. By collecting additional patient data from existing mental health solutions to integrate with clinical trials research, the research findings become more robust.
 
1 Additional patient data captured on specific medications management/prescribing allows patterns of reaction & clinical diagnosis to be monitored by fluctuations in assessments scores with events, this then allows for trending analysis
2 Research, by the selection & monitoring of patients for various clinical trials to be consented & monitored for adherence to accreditation programmes as MSNAP
3 To have collective “one stop” enriched combined dementia patient data (database) which can be extended across other organisations, networks, regions & UK
4 Analytical reports & patient search facilities for extending clinical trials & cohorts of patients including query database with ‘what-if’ options to understand clinical factors & trends leading to Dementia

Adoption target:

N/A

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Daphne Tabone 29/02/2016 - 18:30 Detailed Submission Login or Register to post comments
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Innovation 'Elevator Pitch':
Technology to assist older people living independently with declining cognition, who are at risk of hypothermia, dehydration, malnutrition and unattended falls.
Overview of Innovation:
Many older people want to live independently for as long as possible, causing anxiety for family and friends.  They are often in denial of their declining capacity, proud and won’t wear pendants. Especially with impaired cognition, many suffer from hypothermia, dehydration, malnutrition or unattended falls.  They are admitted to hospital needing longer treatment for poorer health outcomes and greater risk of transfer into a care home. 
 
To make sure that service users are warm, drinking, eating and moving around as normal, Kemuri checks every hour and provides actionable information and alerts for the families and carers.  It increases peace of mind in addition to better outcomes and reduced costs for services users, families and the public sector.
 
Kemuri looks like a Familiar Power Socket to the service user; no changes to life style, plug in kettle and microwave, not stigmatising, not intrusive and tamperproof.
 


Technically it is mains-powered, continuously monitoring five sensors and sending data via a mobile phone connection to the Internet.  It has internal battery back-up to report power loss. 
 
The Wellbeing Monitor App is designed for the families and carers of older vulnerable people who:
  • Want to live independently
  • Reject or forget pendant alarms
  • Deny declining capacity
  • Show symptoms of dementia
  • Remove things they don’t understand
  • Need daily monitoring
  
 
Predictive analytics check every hour for changes to patterns of motion and power usage.  If there are many changes, then alerts may be sent to families, carers or 24/7 response centres.
 
As stated by a Commissioning Manager at a County Council, “ ... this is a unique product ….  I think there’s potential here for both self funder and LA funding as a potential option that fills a gap that conventional telecare does not.”
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: 
Mental Health: recovery, crisis and prevention / Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Clinical trials and evidence / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
The Kemuri Wellbeing Monitor is used the context of the care of older people living alone who are losing their ability to undertake Activities of Daily Living (ADL).  Research by the Institute of Ageing shows the range of pathways that people take before they are unable to live independently

Kemuri is effective when people are less mobile, possibly showing early symptoms of dementia.  They do not need, or welcome, daily contact and cannot, or will not, use pendant alarm systems.  They can be encouraged to continue living as actively as possible and maintain a reasonable quality of life for more years.  If people stay in the right hand side of the curve, average saving is £1900 per year.  People on the left hand side cost an extra £15,500 per year.

Kemuri’s hourly analysis of multiple sensor data enables people to gain insight into the risk of hypothermia, dehydration, malnutrition, unattended falls and power loss.  It is preventive telecare; unlike alarms that are reactive telecare.

The most common telecare service is the provision of pendant alarms.  Out of 1.6 million issued, 32% are never worn, only 8% are worn all the time, as prescribed.  These 500,000 unworn pendant alarms are ineffective for identifying falls, strokes or coma.  This wastes as much as £80 million per year.  Kemuri is passive telecare that continuously monitors ambient conditions and use of electrical devices e.g. kettles and microwaves.  

 
After an emergency admission into hospital, discharge to a residential care home is 2.5 times longer than discharge to independent living at home.
 

 
Including cost of stabilisation, treatment and excess bed days, this costs an average of £5000 more per non-elective hospital stay.  Preventive telecare with a wellbeing monitor and family intervention will help to minimise the number of patients suffering from hypothermia, dehydration, malnutrition and unattended falls.  People admitted in a healthier state are less complex to treat, have improved health outcomes and less likely to be readmitted.  
 
Kemuri is specifically designed for a cohort of older people who are often in denial of their declining ability.  Typically they won’t use their pendant alarms, reject wearable devices, have memory lapses and resist any changes to their normal routine.  Some may show other symptoms of the onset of dementia.  Many will be over 85 years old and not receiving regular visits from family or friends.
 
Initial Review Rating
2.80 (2 ratings)
Benefit to WM population:
West Midlands has a population of 5.6 million people covering an area of more than 5,000 square miles.  It is a region full of contrasts and diversity.  It includes the second largest urban area in the country (Birmingham, Solihull and the Black Country) yet over 80% of the area is rural.  It is the second most ethnically diverse region in the country after London.  There are probably 40,000 older people who might be suitable for passive wellbeing monitoring.  Many of these are admitted to hospital and may not be able to return to their own homes. 
 
Kemuri wellbeing monitoring can extend the period that older people can continue to live independently at home.  It avoids the stigma of wearables and unfamiliar sensors that can be damaged or removed.  A power socket is a very familiar device and installation does not require changes in patterns of normal behaviour.  They are easily installed into kitchens of sheltered accommodation.  Wardens or housing scheme managers can easily check wellbeing daily and avoid some of the tragic outcomes of unattended falls. 
 
Peace of mind is the greatest value for many families.  They can check daily, or even hourly, that people are living normally, fitting in with their own daily routines, from anywhere in the world.  They can be alerted if there are lots of changes that may give them concern.  Alerts can also be directed to 24/7 response centres.  They can confirm that domiciliary carers have provided drinks and meals at the time they were ordered.
 
Families spread over the world can be part of an older person’s care plan.  Social contact with the older person can be more directed and appear less intrusive.  You can ask if somebody had a nice day in the garden or slept well, in the full knowledge of activity in the kitchen at that time of day. 
 
Caring for older people is very time consuming and costly if professionals are used.  However, there are probably four times as many unpaid carers providing care on a voluntary basis.  There are also examples of people who have to give up their jobs in order to care for their vulnerable parents, this represents a loss to the local economy and taxable income.  Regular checks with the Kemuri well-being monitor could allow people to have more time for paid employment.  
Current and planned activity: 
After the completion of the Proof of Concept, Kemuri is now scaling up manufacture for B2B sales through accredited telecare service companies.  The first is Welbeing (Wealden and Eastbourne Lifeline), which has the telecare service contract for Staffordshire.  They have the capacity to install Kemuri anywhere in the Region.  Welbeing provides telecare for statutory bodies and self-funders.  The latter are increasing in number as many local authorities are reducing budgets for adult social care.
 
We are building batches of 100 units.  Many of the first batches can be made available for trials by health and social care clients.  Trials are necessary to collect evidence that preventive wellbeing monitoring does actually improve health outcomes and reduce time until discharge.   
What is the intellectual property status of your innovation?:
Kemuri has patents pending; GB1417259.7, effective date of 30 September 2014 and PCT/GB2015/000275, International Filing Date of 30 September 2015. 
 
Note that the patent applies to more devices than a power socket.  It covers the internal electronics and components, which could be incorporated into any equipment consuming significant amounts of power. 
 
Kemuri and KemuriSense are registered trademarks.  
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
2 years
Ease of scalability: 
2
Regulatory Approvals:
The product has been prototyped and progressing through the Certification process. EMC compliance has been achieved and final Safety report for CE certification is expected in Feb 2016. 
 
It is not a medical device since it only measures ambient conditions.
Regional Scalability:
The production of smart power sockets is scalable from batches of 100 to 1000 per month in the production facilities in Woking.  Larger volumes could be obtained by second sourcing the manufacturer in the UK or overseas.
 
The Web technology is cloud-based and can be very rapidly scaled by commissioning more servers and storage at very short notice. 
 
The installation can be performed by our telecare service partner, Welbeing.  They are a growing company with over 60,000 service users in NHS Trusts, Social Services, sheltered housing and care agencies throughout the UK, including the West Midlands.   They offer a nationwide telecare service with 24/7/365 monitoring facilities in a TSA accredited contact centre.  
 
Kemuri is building up the operations support as it is recruiting more engineering and IT staff.
Measures:
In co-operation with an academic research partner, we expect to plan the following measures:
 
Quality
  • Continuous reliable operation
  • Avoidance of false alerts
  • Recognising unattended falls, strokes or other episodes that result in a carer taking action that saved time and cost for medical intervention.
  • Peace of mind achieved for families and carers
  • Identifying trends that indicate the risk of hypothermia, dehydration and malnutrition.
  • Identifying activity at unusual times of day that lead to helpful family or medical intervention
 
Safety
  • Electrical safety of products after installation in kitchens.
  • Security of personal data and avoidance of data loss.
 
Cost
  • The cost target is £2500 for each older person involved in the trial.  This would include the costs of selection, installation, monitoring, service support and questioning families throughout the trial.  Note that this includes detailed data analysis, medical services, the final report and communications.
  • The final operational cost target is £2 per day, to include installation, Web services, smartphone apps, technical support and reseller profit margin.   
 
People
The target group for research is a cohort that has these attributes:
  • Reject pendant alarms
  • Deny declining capacity
  • Want to live independently
  • Show symptoms of dementia
  • Need daily monitoring
A percentage will be used as a control group who are not included in the Trial. Finding these people may require the inspection of medical and social care records, which will need approval by an Ethics Committee.  
Adoption target:
Assuming that there are 500,000 unused pendants in the UK, there are approximately 30,000 candidates for Kemuri wellbeing monitoring in a West Midlands population of 5 million.   
 
The reasonable viable number is 300 (1% of WM total) – with an expectation to grow to 12,000 service users within 5 years (20% of WM total).  
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Leonard Anderson 26/01/2016 - 14:35 Publish Login or Register to post comments
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