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Innovation 'Elevator Pitch':
Dip.io, a CE approved product turns the smartphone into a clinical grade device enabling lay-users to test urine in their own home, with clinical accuracy and share results electronically with their clinician.
Overview of Innovation:
42m urine tests a year are undertaken in the NHS to screen for a wide range of conditions. Currently patients collect a sample at home and bring it to the clinic or provide a sample in the clinic where it is either tested on site or sent to a laboratory. This is inefficient, inconvenient for the patient and presents opportunity for improvement in patient experience, clinical quality and cost efficiency.
Healthy.io is the first company to turn the smartphone into a regulatory-approved clinical device. Its first product, Dip.io, uses computer vision and user centric design to turn the smartphone into a urinalysis device. Built around existing semi-quantitative urinalysis dipsticks, Dip.io complements established clinical efforts by empowering patients to test themselves at home with no quality compromise, and securely share results with a clinician.
Healthy.io is empowering patients to take urine testing into their own hands, opening up an immense opportunity to improve preventive efforts and enable early interventions. Key pathways in which digital urinalysis has strong potential to improve patients’ lives and reduce cost to the NHS:
  • Antenatal care: women with hypertension or diabetes in pregnancy have a higher risk of developing pre-eclampsia, a leading cause of maternity morbidity. Dip.io has proven through a usability study at Johns Hopkins to improve women’s experience and could reduce outpatient appointments amongst high risk pregnant women.
  • Chronic Kidney Disease (CKD): Home-based screening of albumin:creatinine (ACR) for people with diabetes or high blood pressure, to increase adherence to NICE CG 182 and diabetes care process beyond the current level of 50%.
  • Urinary tract infections (UTI): opportunity to improve self-management for patients at risk of admission from UTI (e.g. MS), reduce the 5m GP attendances for UTI in primary care and create digital pathways for pre-op assessment through using digital urine testing, within existing clinical guidelines.
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)
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Innovation 'Elevator Pitch':
Dip.io, a CE approved product turns the smartphone into a clinical grade device enabling lay-users to test urine in their own home, with clinical accuracy and share results electronically with their clinician. 
Overview of Innovation:
42m urine tests a year are undertaken in the NHS to screen for a wide range of conditions. Currently patients collect a sample at home and bring it to the clinic or provide a sample in the clinic where it is either tested on site or sent to a laboratory. This is inefficient, inconvenient for the patient and presents opportunity for improvement in patient experience, clinical quality and cost efficiency.
 
Healthy.io is the first company to turn the smartphone into a regulatory-approved clinical device. Its first product, Dip.io, uses computer vision and user centric design to turn the smartphone into a urinalysis device. Built around existing semi-quantitative urinalysis dipsticks, Dip.io complements established clinical efforts by empowering patients to test themselves at home with no quality compromise, and securely share results with a clinician.
 
Healthy.io is empowering patients to take urine testing into their own hands, opening up an immense opportunity to improve preventive efforts, enable early interventions and increase optimisation in the outpatient setting. Key pathways in which digital urinalysis has strong potential to improve patients’ lives and reduce cost to the NHS:
  • Antenatal care: women with hypertension or diabetes in pregnancy have a higher risk of developing pre-eclampsia, a leading cause of maternity morbidity. Dip.io has proven through a usability study at Johns Hopkins to improve women’s experience and could reduce outpatient appointments amongst high risk pregnant women. 
  • Chronic Kidney Disease (CKD): Home-based screening of albumin:creatinine (ACR) for people with diabetes or high blood pressure, to increase adherence to NICE CG 182 and diabetes care process beyond the current level of 50%.
  • Urinary tract infections (UTI): opportunity to improve self-management for patients at risk of admission from UTI (e.g. MS), reduce the 5m GP attendances for UTI in primary care and create digital pathways for pre-op assessment  through using digital urine testing, within existing clinical guidelines.
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Long term conditions: a whole system, person-centred approach / Digital health / Person centred care
Benefit to NHS:
Benefits to NHS in line with FYFV:
  • Primary Care (Diabetes and CKD screening): Smartphone enabled self-testing offers a critical complement to existing population health efforts by shifting testing from primary care to the home. Providing alternatives to face-to-face contact frees up GP resources and nursing time. NICE recommends that every person at increased risk of CKD (people with diabetes or hypertension) needs to annually get their urine tested. However only 50% of people with diabetes and 30% of people with hypertension have a regular urine test reported. Over 1 million cases of CKD remain undetected. Diffusing Dip.io to every at risk patient (8.3m) could improve adherence with no additional overhead, reducing CKD cost by up to £1bn.
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  • Maternity Safety (Proteinuria screening): The Maternity Transformation Programme (Better Births) prioritises improvement in maternity safety and provision of consistent quality. This includes halving the rates of stillbirths, neonatal and maternal deaths by 2025. Around 15% of women with hypertension or diabetes in pregnancy have a higher risk of developing pre-eclampsia, a leading cause of maternity morbidity. Automated home-screening for proteinuria in at-risk pregnancies has the potential to early identify pre-eclampsia, save £1,500 for each avoided false negative, save up to £75m by reducing 60% of outpatient appointments (3rd trimester) and reduce antenatal consultation time by 25%.
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  • Urgent and Emergency Care (Urinary Tract Infection): Conducting common diagnostic tests at the patient's home supports "improving the ability of patients to self-care for minor illnesses" (UECR).  This includes the need to anticipate recurring conditions such as UTIs. 1-3% of GP visits are UTI related and UTIs accounted for 14% of emergency hospital admissions in MS patients costing the NHS over £43 million. Dip.io offers the opportunity to improve self-management for patients at risk of admission from UTI, reduce the 5m GP attendances for UTI in primary care and create digital pathways for preop assessment within existing clinical guidelines.
  • Harnessing technology and innovation: Our solution leverages existing technology to transform care delivery and supports the drive to digital adoption. We easily integrate into other technologies (integrated with PKB and Allscripts) and make sure interoperability is built in. We are replicating this model for our next product to bring innovation to woundcare management.
Online Discussion Rating
5.50 (2 ratings)
Initial Review Rating
4.20 (1 ratings)
Benefit to WM population:
Our smartphone-enabled digital urinalysis service aims to improve quality and efficiency of existing pathways, driving better patient outcomes and experience.

Main benefits:

Maternity safety: women with hypertension or diabetes in pregnancy have a higher risk of developing pre-eclampsia, a leading cause of maternity morbidity. NICE CG62 recommends dipstick urinalysis during each prenatal visit to screen for proteinuria, an indicator of pre-eclampsia. Increasing testing in between regular pre-natal visits could reduce Pre-eclampsia complications. Women with at-risk pregnancies receive 7-10 Dip.io kits. Following a defined frequency, the women conducts the test at home. The clinician automatically receives the results and is alerted if results are abnormal for immediate follow-up care. This model of care is being rolled out across mayor HMOs in Israel and received more than 90% preference in a Johns Hopkins usability study. Dip.io has proven to improve women’s experience and could reduce outpatient appointments amongst high risk pregnant women.

Diabetes and CKD screening: NICE clinical guidelines recommend people with diabetes/hypertension need to get their urine tested annually but adherence is low e.g. only 51% of people with type 1 diabetes tested. Digital testing could improve adherence and reduce costs. Patients with no recorded albumin reading receive our smartphone urinalysis home-test. Results are immediately available to the clinician and those with abnormal results are invited to a follow-up extensive checkup. This model makes it possible to reach people at risk, who have not received appropriate testing, thus increasing adherence to CKD screening.

Urinary Tract Infection (UTI): opportunity to improve self-management for patients at risk of admission from UTI (e.g.MS), reduce the 5m GP attendances for UTI in primary care and create digital pathways for preop assessment through using digital urine testing, within existing clinical guidelines.
Current and planned activity: 
NHS:
  • Salford NHS Trust rollout for renal patient management
  • Care UK rollout for uncomplicated UTI management
  • North East and North Cumbria AHSN with South Tees NHS Trust to test renal clinic at home (Northern Counties Kidney Foundation)
  • Modality and Yorkshire and Humber AHSN to test diabetes/CKD screening model
  • Applying to Test beds for at risk pregnancy (Cheshire & Merseyside) and CKD screening (Care City).
  • NeuroResponse social enterprise based at UCL on Multiple Sclerosis pathway
 

International:
  • Usability study in pregnant women at Johns Hopkins with 92% favourability (soon to be published)
  • US National Kidney Federation and Geisinger Health to improve care for people with hypertension- successful increase in adherence (soon to be published)
  • Dutch Kidney Foundation and Dutch Health to test population screening for ACR in at risk population compared to other method
  • Roll out in two HMOs in Israel for at-risk pregnancy model
Return on Investment (£ Value): 
N/A
Return on Investment (Timescale): 
N/A
Ease of scalability: 
Simple
Regional Scalability:
Our plan is to scale regionally and nationally through a B2B2C business model. We offer several commercial packages that differ in terms of scale, level of integration, agreement timeline and distribution/shipment method. This allows us to partner with different players within the NHS to provide them full digital capabilities through customised, white label kits, a localised application and access to our algorithm in an end-to-end service proposition. Our vision is to serve as the backbone for smartphone enabled, image based medical diagnostics and enable partners to bring our innovation to their existing user base.
Measures:
Healthy.io and the Dip.io solution work together with healthcare organizations to improve efficiency, value and outcomes by digitizing existing pathways. Measure include:
  • Save outpatient appointment and reduce consultation time to reduce resource pressures.
  • Increase clinical guideline adherence, improving patient safety
  • Improve patient experience (e.g. minimise absence from work and avoid travel expenses)
Adoption target:
Start with a phased roll out to try, test and scale the innovation in a regional NHS organisation. We anticipate that success from this roll out will lead to spreading the implementation of the technology to other specialties within the organisation, other hospitals/GPs within the group and to other providers and partners within the WM area.
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Innovation 'Elevator Pitch':
65m urine specimens analysed annually in the UK breaks down to 250,000 every working day, of which 45,000 will be unreliable. This means 45,000 patients daily who will not be treated for urine-based infections. Peezy Midstream means they can.
Overview of Innovation:
Peezy Midstream can save the NHS £30m in reduced retesting of the most common diagnostic procedure.

It is a simple but innovative device that automatically captures clean-catch urine from men, women and children (from toddler age). It is especially valuable for the elderly and pregnant women for whom accurate urine screening is essential.

The average national mixed growth rate reaches from 0.38% to over 70%; the average is 18% - that's nearly 1 in 5 patients who will not receive accurate right-first-time treatment from their urine specimen.

Peezy Midstream reduces mixed growth rates to 1.5%, which means many more patients will be treated right-first-time, saving the NHS as a whole over £30m in direct retest costs and over £1bn indirectly through saving repeat staff and resource time.

Peezy Midstream captures urine specimens hygienically - it prevents spills and splashing, improving infection control in healthcare settings. It can be held by the tube if help needs to be given - the assistant does not risk becoming soiled either.

Dignity is implicit; easy Peezy is comfortable, quick and removes the need to start-stop-start when giving a midstream urine specimen.

There is no down-side to using Peezy Midstream. It saves lives, saves time and money and reduces unnecessary broad spectrum anitbiotic prescribing. Peezy is poised to make novel cancer urine tests more efficient too.

Each Peezy kit costs just 87p on the NHSSC; use ten for every retest. Available on the NHS Supply Chain and on the UK Drug Tariff - growing in popularity with midwives and care givers to the elderly.
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: 
Advanced diagnostics, genomics and precision medicine / Wellness and prevention of illness / Clinical trials and evidence / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
Peezy Midstream delivers huge cost and efficiency savings plus clinical benefits:

(See attached WM mixed growth data and separate cost savings model)
  • Reduction of average West Midlands mixed growth rate of 17.5% to 1.5%
  • West Midlands direct savings of £307,798
  • West Midlands indirect savings of £12,339,337 (see attached WM cost savings model)
  • reduced urine specimen mixed growth from West Midlands average  to 1.5%
  • right-first-time urine analysis, diagnosis and treatment - don't see the same patient twice for the same problem
  • delivers specimen into 10ml tube that fits most automated laboratory urine analysers (no decanting in lab)
  • no soiling, dry tube, clean toilets: more hygienic for healthcare professionals
  • targeted prescribing, reducing need for broad spectrum antibiotics
  • improved infection control: no spills or splashing of urine
  • works equally for men, women and children (from toddler age)
  • excellent for pregnant women where antenatal screening must be super-accurate; they don't have to see the funnel is in place - they can feel it
  • antenatal screening accuracy for maternal diabetes, pre-eclampsia
  • excellent for the elderly prone to UTI, which can affect both wellbeing and behaviour
Initial Review Rating
4.20 (1 ratings)
Benefit to WM population:
  • West Midland Patient Savings of £90 (please see attached WM cost savings model, Patient Savings tab)
  • Accurate urine specimens mean prompt, accurate diagnoses
  • Patients will no longer need to visit their GP more than once for urine-related illnesses
  • They will receive the correct, targeted antibiotic, helping the fight against anitmicrobial resistance, encouraged by over prescribing of broad spectrums
Current and planned activity: 
  • Peezy Midstream is on the NHS Supply Chain at 87p (Peezy, tube, genital wipe)
  • It is approved by NHS Prescription Services and on the Drug Tariff for prescribing
  • Quality Improvement Audit at Barts (London) shows reduction in mixed growth from 17.5% to 1.5%
  • Quantative clinical study results pending from Stanford Medical School
  • Peezy currently part of MS Rapid Diagnostics Pilot, London
  • Prescribing growing amongst antenatal population
  • In use within some NHS departments: urology, outpatients, pre-admission, antenatal, A&E, Ambulance Services
What is the intellectual property status of your innovation?:
Patent and trademark granted:
  • UK
  • USA
  • Europe
  • China
  • Australisa
  • Asia
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
Simple
Regional Scalability:
Easy; Peezy is available through the NHS Supply Chain
Forte Medical is happy to attend your location and brief staff on usage and instructions if necessary
Measures:
Reduced mixed growth
Reduced retesting
Reduced repeat appointments
Cost and efficiency savings
Adoption target:
6 months
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Innovation 'Elevator Pitch':
Medopad's remote monitoring platform provides clinicians with insight into patient progress in between clinic appointments. This can prevent unncessary outpatient appointments or bring forward appointments for patients who are not progressing well. 
Overview of Innovation:
The Medopad app is a health ecosystem with a patient view and a clinician view. It is very intuitive and user-friendly, having been designed with Apple in their Cupertino, California labs. 

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

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

 
 
 
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Mental Health: recovery, crisis and prevention / Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Education, training and future workforce / Wealth creation / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
Medopad's solution enables clinicians to spot health deterioration sooner, preventing costly complications.  To name a few, we are working the Royal Free NHS Teaching Hospital, Guy's and St. Thomas's, Royal Salford, and Chelsea and Westminster.

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

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

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

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

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

In the longer term, we are looking to provide a transformative experience of care by providing intelligent and AI-powered clinical support systems to move the needle from reactive to preventative care. In that vein, we are looking for motivated and committed health care professionals to work with us in this journey. 
What is the intellectual property status of your innovation?:
Medopad's IP is related to its smartphone app and clinician web-portal. 
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
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