Idea Description
Supplementary Information
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
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Innovation 'Elevator Pitch':
The MyCognition App is co-designed with patients and trialled with academics to monitor, prevent and treat mental well-being by measuring, monitoring and improving cognitive health.
Overview of Innovation:
Cognitive functioning (attention, episodic memory, executive function, working memory and processing speed) are tightly linked with mental health.  Research shows that cognitive deficits are significant predictors and major risk factors for mental illness e.g. depression, anxiety and stress. Poor cognitive health has a negative impact on our emotions, our coping strategies and tendency to ruminate and catastrophise. Alternatively, robust cognitive health contributes to building good psychological resilience, self-management and control, which are major protective factors for prevalent mental diseases. Cognition deficit affects all ages. It is manifest in young children and adolescents affecting school performance and mental well-being. It is also prevalent in preretirement populations where patients present with unexplained symptoms often categorised as psychosomatic.

MyCognition App provides digitally delivered assessment, cognitive training, coaching and behavioural change programmes. It is an easy to use and patient friendly app that can be used with any device. It is a fun and engaging App designed for all age groups for use in everyday settings.
The App has three programmes:
  1. MyCQ – a five-domain, 15 minute, cognitive assessment tool based on a clinically validated version.
  2. AquaSnap – a fun cognitive training tool, programmed by MyCQ to train all five cognitive domains. The training is personalised, designed to improve and boost an individual’s cognition where they have greatest need.
  3. A digitally delivered coaching programme to raise awareness of cognitive health and to educate and train people in healthy habits encouraging positive behavioural change.
The MyCognition App is a resource which patients can use remotely in their own homes, in residential stay or whilst in hospital. It is scalable across the whole patient community to support cognitive health. It can also be deployed in secondary care environments to support in-patient stays, occupational therapy and rehabilitation patients; and be recommended for use to patients entering step-down-care into the community, e.g. oncology and critical care.
The App also provides carers and professionals with personalised reports showing the cognitive health of individuals and of patient cohorts vs the general population, alerts on patients at risk and progression over time. We recommend patients and their family members/carers also use the App to encourage social interaction and shared experiences.
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 / Wellness and prevention of illness / Digital health / Person centred care
Benefit to NHS:
MyCognition offers a self-care digital solution to assess, monitor and treat mental health and well-being by addressing a person’s cognitive health. The MyCognition App improves cognitive function in as little as eight weeks and improves mental resilience and mental health symptoms across a range of mental health disorders. From studies with patients with conditions, such as Depression, Anxiety, Schizophrenia, Post-traumatic Stress Disorder, as well as Parkinson’s and cancer-related cognitive impairment.
MyCognition is a self-care solution that patients can use remotely in their everyday lives to help address their mental well-being. It is ideal for use in patient waiting to be refereed to NHS services where is there is extended waiting time. It is also suitable for patients in residential stay. It is scalable across the whole patient community to support cognitive health in a range of disease areas. It can also be deployed in secondary care environments to support in-patient stays, occupational therapy and rehabilitation patients; and be recommended for use to patients entering step-down-care into the community, e.g. oncology and critical care.
MyCognition has led five years of research in clinics and local institutions, demonstrating the validity of the assessment and training paradigms adopted and the positive outcomes on users’ cognition, mental health, and consequent quality of life. MyCognition is collaborating with major international universities and clinics, such as Amsterdam Medical Centre (NL), Maastricht UMC+ (NL), UZA Antwerp (BE), McGill University (CA), UCL and the Royal Free Hospital Children’s School in London. We are running studies with patients with different mental health conditions, such as Depression, Anxiety, Schizophrenia, Post-traumatic Stress Disorder, as well as Parkinson’s disease and cancer-related cognitive impairment.
Initial Review Rating
4.00 (2 ratings)
Benefit to WM population:
MyCognition is committed to preventing and treating mental illness. Our strategy is aligned with the West Midlands Mental Health Strategy Boards recommendations in its 2017 report ‘Getting It Right First Time’ Prevention of Mental Illness. 
The 2017 Report by the West Midlands Mental Health Commission states that over 25% of the West Midlands population is suffering from mental illness. It highlights that people with an increased risk of developing mental health problems and/or for whom access to effective help is problematic are:
  • Unemployed people
  • People with long-term physical health conditions
  • Carers
  • Young children of school age*
  • Homeless people and people living in poor quality housing
  • People from Black, Asian and Minority Ethnic communities - Lesbian, Gay, Bisexual and Trans people
  • People with disabilities, including learning difficulties and sensory impairments
  • Young people leaving care
  • Survivors of sexual, emotional and physical abuse
  • People experiencing severe and multiple disadvantage.
*50% of mental health problems start before the age of 14 and 75% before 18
The aggregate economic and social cost of mental health problems in the WMCA is estimated at around £12.6 billion in 2014–15, equivalent to a cost of about £3,100 per head. With 28% being directly attributed to care costs of the NHS and Social Services costs. The employment costs are rising and equate to £4 billion per annum with human cost accounting for £5 billion. 
MyCognition have designed its technology to be integrated with NHS healthcare, social care, educational and workplace systems to help provide accessible self-care support for populations across the West Midlands. We wish to work with stakeholders to ensure there are as many community touchpoints for MyCognitions as possible. And provide adequate prevention and triage for at risk populations so they can reduce their risk of mental health development and deterioration.
MyCognition offers low cost personalised support to help these people deal with their mental illness. Offering them the opportunity to self-care, manage and reduce their symptoms and avoid ‘crashing’ in to the NHS for more serious and costly intervention. And more importantly lead productive and fulfilled lives.
Current and planned activity: 
MyCognition is working with several AHSNs evaluating the App in various clinical scenarios & patient pathways (rep. early 2019). Plans to roll out these clinical models with AHSNs’ support across the NHS.
Engaged in NHS test bed wave 2 programme and in discussions to test suitability for addressing mental health & wellbeing in schools, supporting referral to CAMS and adult mental health services, treatment of medically unexplained symptoms & diabetic self-care.
Running UK studies with NIHR, extending evidence base for MyCognition and also contributing to the global evidence base linking cognitive, physical & mental health.

Wish to test App & Platform’s performance in several clinical settings & pathways with West Mids. partners to generate additional data & build successful business models for NHS
  • like assistance with Procurement/Adoption & contracting with CCGs
  • further studies, seeking research partners to assist in NIHR funding proposals
What is the intellectual property status of your innovation?:
MyCognition is unique in the market place. We have full copyright of the code written for the app.

MHRA CE Marked Medical Device
Return on Investment (£ Value): 
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
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Innovation 'Elevator Pitch':
QbTest reduces delay to ADHD diagnosis, improves patient and family experience and saves significant clinical time required to rule in or rule out the disorder.  
Overview of Innovation:
QbTest is an FDA cleared objective testing system that simultaneously measures attention, impulsivity and motor activity, a core requirement of diagnostic criteria in both DSMV and ICD10.  After a 15-minute test, the individual patient’s performance is then compared to an age and sex-matched control group (n = 1307).  A comprehensive report is available on test completion. Reports are in a readily understandable format and outline whether a child is more active, impulsive and inattentive than a group of age and gender-matched controls (children without ADHD).

QbTest results in a more accurate and timely clinical diagnosis. This includes ruling out ADHD as well as confirming ADHD.
QbTest includes a Data Management System to help demonstrate clinical/service outcomes through automatically collected data and is underpinned by a Professional Training Programme for quality assurance.
In 2017, the EMAHSN supported the delivery of 1231 QbTests within different pathways in three Trusts across the East Midlands. Time from assessment to diagnosis was reduced by 153 days. Costs were reduced by 32% by releasing 20% of the clinical time (median figures). 85% of patients found the results helpful and 94% of clinicians reported greater understanding of patient’s symptoms.

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 / Advanced diagnostics, genomics and precision medicine / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
ADHD affects approximately 4-8% of school-aged children and is characterized by symptoms of inattention, impulsivity and hyperactivity.
At present, the process for diagnosing ADHD extends over multiple steps.  Assessment is based on the clinician’s judgement, supplemented by subjective reports from parents, teachers and the young person.  These reports can be contradictory, incomplete and not returned within a timely manner leading to delays in diagnosis. 
Children in the UK wait 18 months (average) to obtain an accurate diagnosis. Multiple clinic visits over this period drive significant costs to the health service estimated at £23 million. These costs exclude wider healthcare system costs (school observations) and social and economic costs (parental work loss, parental stress-related illness and increased childcare expenses).  Quality of care is highly variable across England.
Patients: quicker diagnosis, so faster access to appropriate treatment or an alternative care pathway. Improved understanding of symptoms and communication with teachers/ schools.
Clinical staff: 
Increased satisfaction and confidence in decision-making and supports the delivery of the NICE recommended ADHD pathway for Children & Young People. Reduction in time to diagnosis, thus savings in consultation minutes and patients moved off caseload quicker, earlier treatment decisions.
Reduced costs, staff efficiency and client (family) satisfaction. Reduction in numbers of patients being allocated to the wrong treatment pathway or misprescribed medication.
Removes unnecessary outpatient appointments from the system with cost savings if risk/gain sharing agreed locally with providers resulting in new tariff.
Parents and schools:
Unintended benefits include quicker diagnosis resulting in faster SENCO / appropriate education support to prevent educational failure linked to ADHD.  Fewer appointments mean children miss fewer school hours and parents see reduced time off work.
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
There are 490,459 children aged between 6-18 years old within the West Midlands based on 2018 nomis data.  From experience in the EMAHSN Demonstrator project 0.4% of this population will be evaluated for ADHD each year, n = 1962 .  There will be a reduction of approximately 1 clinic visit required to rule in or rule out ADHD, significantly reducing delay to diagnosis and time to effective treatment.   Early intervention to treat and support patients and families with ADHD is proven to improve academic and social functioning and avert the potential development of further mental health conditions i.e. depression and anxiety and associated social costs.
There are approximately 18-21 NHS clinics managing ADHD in the West Midlands.  With a mean saving per year of £84K the estimated return on investment to Trusts will be approximately £1.5-1.7M/pa
A complete calculation of the NHS and Social benefits in the West Midlands will be possible through the Budget Impact Model – Nov 2019.
Current and planned activity: 
Qbtech is engaging directly with NHS Trusts through online marketing, social media campaigns, face to face meetings and demonstrations.  Qbtech and EMAHSN are also committed to a series of roadshows to support adoption and spread in each AHSN area.  An implementation toolkit, developed together with the EMAHSN will be complete by the end of November 2019, as will a budget impact model developed by KSSAHSN for use at a National, Regional, AHSN and Trust/clinic level.  The toolkit will include national context for ADHD and the fit with stategic prioririties, funding case preparation and submission, workforce planning and pathway optimisation and evaluation support.  We will also provide contacts for support, a communication package and FAQs.
What is the intellectual property status of your innovation?:
QbTest is proprietary and trademarked medical device wholly owned by Qbtech.
Return on Investment (£ Value): 
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
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