NHS Innovation Accelerator (NIA)
The NHS Innovation Accelerator, or NIA, supports uptake and spread of proven, impactful innovations across England’s NHS, benefitting patients, populations and NHS staff.

Ideas (Long term conditions: a whole system, person-centred approach)

Innovation 'Elevator Pitch':
Artificial Intelligence for the detection of skin cancer from dermoscopic images taken by a smartphone camera. For use within primary care to help identify the appropriate patient pathway. 
Overview of Innovation:
Skin Analytics proprietary AI system, DERM can identify a range skin lesions from melanoma and NMSCs to benign lesions from dermascopic images. 

We offer a service to primary care to enable patients to be assessed by DERM and identify:
  • the appropriate pathway for skin cancer referrals
  • lesions that can be treated in primary care such as Actinitic Keratosis
  • benign lesions for discharge
The use of Skin Analytics service allows primary care to reduce onward referrals into Trusts and improve the patient experience while reducing operating costs for skin cancer.
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
Benefit to NHS:
By enabling dermatologist-quality screening in Primary Care within current appointment times and without the need for expensive equipment, Skin Analytics’ solution
supports:
  1. More accurate identification of melanoma, leading to potentially better health outcomes and reduced treatment cost
  2. Less onward referrals to secondary care, reducing strain on specialist clinics and lowering the cost of finding melanoma
GP practices are provided with a dermascope and image capture device. This can be used during a consultation to capture an image of any pigmented lesions a GP would select for referral. An artificial intelligence (AI) algorithm identifies: suspected melanoma, common types of nonmelanoma skin cancer, benign (noncancerous) lesions.
Initial Review Rating
4.20 (1 ratings)
Benefit to WM population:
Challenge/problem identified:
Some areas of the UK have 0.64 dermatologists per 100,000 population, compared to the Royal College of Physicians recommendation of 1.6.
Skin Analytics’ solution can therefore relieve pressure on a specialism which in 2014 required more than 13 million GP appointments*.
Anecdotal evidence provided by Skin Analytics’ dermatologist partners suggests that over 90% of two-week referrals they receive are in the wrong patient pathway. By providing an accurate way to stratify referrals by suspect melanoma and suspect nonmelanoma skin cancers, GPs are empowered to refer through the appropriate channel,
thereby reducing the demand on two-week wait referrals.
*http://www.bad.org.uk/shared/get-file.ashx?id=2348&itemtype=document
Impact:
  • Based on the 2015 NICE Melanoma Evidence review, GPs operate with a sensitivity and specificity of 60% and 72% respectively when assessing melanoma. Using dermoscopy, where trained, this increases to 75% and 78%. Skin Analytics’ solution operates at >95% sensitivity and >70% specificity (comparing well to dermatologists at 88% and 90%)
  • Reduced onward referrals by around 50% where trialled. An NHS study conducted in Bristol in 2011, found that reducing the onward referral around this level can save £43,000 per 100,000 population
Current and planned activity: 
We're currently seeking to engage with CCGs who would like to streamline their dermatology pathways and reduce the cost of identifying skin cancer while improving cancer wait times.
What is the intellectual property status of your innovation?:
We own our IP.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
4
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Neil Daly 03/04/2019 - 15:10 Publish Login or Register to post comments
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-99999
Innovation 'Elevator Pitch':
Digital behaviour change platform for people with type 2 diabetes and prediabetes providing goal-focused education, personalised resources and support to implement a lower carbohydrate lifestyle. 
Overview of Innovation:
The Low Carb Program is an award-winning digital health intervention for people with type 2 diabetes, prediabetes and obesity. The Low Carb Program provides the education, resources, and, most importantly, support required when reducing the amount of sugar (or carbohydrates) in the diet.

The platform is available in the NHS Apps Library and is an NHS Innovation Accelerator Fellow for 2019. The platform is QISMET approved to be provided as structured education for people with type 2 diabetes and prediabetes.
 
The platform comprises:
  • Education: members participate in a core 12-week structured therapeutic nutrition and wellness program, personalised to disease type and profile
  • Community peer support with over 400,000 members
  • Behaviour change mentoring, goal identification and setting
  • Library of personalised resources, including culturally-specific meal plans, food swaps and over 1,000 searchable recipe ideas
  • Data insights and AI-led feedback to support sustainable behaviour change
The Low Carb Program was developed with Dr David Unwin in 2015 (NHS Innovator of the Year 2016, RCGP National Champion for Collaborative Care in Obesity and Diabetes), and the feedback of 20,000 people with diabetes. 

DDM is conducting a three-year study on a randomly selected cohort of people who joined the Low Carb Program. One-year outcomes have been published in JMIR Diabetes with two-year outcomes are currently under review. The first evidenced benefit is a 71% platform retention at 1-year, which is unrivalled for any digital platform. Engagement within the platform is critical as without engaging users, behaviour change is not possible. The retention evidenced by the Low Carb Program is pioneering.
 
For people with type 2 diabetes who complete the platform, outcomes are:
  • 7.4kg weight loss
  • 13mmol/mol HbA1c reduction
  • 39% place HbA1c under type 2 diabetes threshold, with 26% placing type 2 diabetes 'in remission'
Remission is defined as an HbA1c under type 2 diabetes threshold and on no medication or metformin only.
 
In addition, to this:
  • 40% of people on medication eliminate at least one treatment from their regime
  • 60% of people on insulin eliminate or reduce it from their regime
The Low Carb Program has tiered licencing costs, with a patient licence cost of £90, which lasts 3 years. Given the affordability of the platform the Low Carb Program offers significant cost-savings from the perspective of reduced medication through improved patient health and reduced GP burden.
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Education, training and future workforce / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
The Low Carb Program is scaling type 2 diabetes and prediabetes remission and benefits are most immediately seen in reduced medication dependency through improved HbA1c. A three-year study is underway on a randomly selected cohort of 1,000 people who joined the Low Carb Program. One-year outcomes have been published in JMIR Diabetes. The first evidenced benefit is a 71% platform retention at 1-year, which is unrivalled for any digital platform. Engagement within the platform is critical as without engaging users, behaviour change is not possible. The retention evidenced by the Low Carb Program is pioneering.
 
For people with type 2 diabetes who complete the platform, outcomes are:
  • 7.4kg weight loss
  • 13mmol/mol HbA1c reduction
  • 39% place HbA1c under type 2 diabetes threshold, with 26% placing type 2 diabetes 'in remission'
Remission is defined as an HbA1c under type 2 diabetes threshold and on no medication or metformin only.
In addition, to this:
  • 40% of people on medication eliminate at least one treatment from their regime
  • 60% of people on insulin eliminate or reduce it from their regime
A conservative cost-saving medication deprescription analysis was conducted on this cohort of users, and calculated at £835 per-patient, per-year in reduced medication deprescription savings.
 
Given the affordability of the platform, particularly when compared to competitors, the Low Carb Program offers significant cost-savings from the perspective of reduced medication through improved patient health and reduced GP burden.

There is clinical evidence of the Low Carb Program in practice, where it is being used with patients by NHS Symphony Healthcare health coaches with patients with type 2 diabetes in Yeovil in a blended care approach.

Currently, clinical data demonstrates improvements in HbA1c and weight for the majority of patients using the platform.
Benefits of engaging within the education are truly brought to life by many of the 400,000 members' stories, including:
Initial Review Rating
5.00 (2 ratings)
Benefit to WM population:
Adoption of the Low Carb Program will significantly improve patient and population health of people with type 2 diabetes and prediabetes in the West Midlands. 

Benefits are most immediately seen in reduced medication dependency through improved HbA1c. A three-year study is underway on a randomly selected cohort of 1,000 people who joined the Low Carb Program. One-year outcomes have been published in JMIR Diabetes. The first evidenced benefit is a 71% platform retention at 1-year, which is unrivalled for any digital platform. Engagement within the platform is critical as without engaging users, behaviour change is not possible. The retention evidenced by the Low Carb Program is pioneering.
 
For people with type 2 diabetes who complete the platform, outcomes are:
  • 7.4kg weight loss
  • 13mmol/mol HbA1c reduction
  • 39% place HbA1c under type 2 diabetes threshold, with 26% placing type 2 diabetes 'in remission'
Remission is defined as an HbA1c under type 2 diabetes threshold and on no medication or metformin only.
In addition, to this:
  • 40% of people on medication eliminate at least one treatment from their regime
  • 60% of people on insulin eliminate or reduce it from their regime
A conservative cost-saving medication deprescription analysis was conducted on this cohort of users, and calculated at £835 per-patient, per-year in reduced medication deprescription savings.
 
Given the affordability of the platform, particularly when compared to competitors, the Low Carb Program offers significant cost-savings from the perspective of reduced medication through improved patient health and reduced GP burden. 
Current and planned activity: 
The Low Carb Program is currently being showcased through the NHS Innovation Accelerator. It is also a member of the RCGP Innovation Mentorship Programme. Ascensia Diabetes Care lead implementation of the Low Carb Program within local areas once commissioned, including on-site healthcare professional training and support, patient onboarding resources and Key Manager 24/7 support. 
What is the intellectual property status of your innovation?:
All copyright and IP belongs to Diabetes Digital Media (DDM). Patents pending.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
Simple
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ARJUN SINGH PANESAR 25/03/2019 - 13:30 Publish Login or Register to post comments
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-99999
Innovation 'Elevator Pitch':
Kemuri portable K-Sockets have a 500% return on investment in one year.  Use them to accelerate hospital discharge of elderly or frail people into reablement by social services.
Overview of Innovation:

Kemuri K-Sockets are power sockets with multiple sensors that continuously measure:
  • Movement of people in the kitchen;
  • Electrical power for kettles, microwaves or toasters;
  • Room temperature;
  • Power supply.
They send data via the Internet via GSM mobile phone communications.  Kemuri software learns patterns of normal activity and analyses Activities of Daily Living (ADLs) every hour.  As soon as the system identifies too many changes from normal, it automatically alerts people who need to respond to possible risks.  Responders can be families, carers or 24/7 alarm response centres.

The WebApp gives evidence of reablement of the service users.  It gives confidence to responders who have been given informed consent to view the data.  For example:
  • Wandering or unattended falls: Kemuri alerts non-return to kitchen;
  • Nutrition & Hydration: Kemuri alerts risk of dehydration or malnutrition;
  • Engaged the Community: Kemuri apps are free to authorised family, carers or voluntary sector;
  • Active in the home: If people can eat, drink and move around in warm surroundings – then they are performing key ADLs.
Portable K-Sockets are allocated to discharge teams as part of the normal hospital discharge process. Families or other carers have to respond to alerts and determine the action to be taken.  The devices are re-allocated to patients every 6 weeks. Thereafter fixed K-Sockets can be installed in kitchens as wellbeing monitors. 

The cost is less than £500 per year, and the notional saving on bed days is approximately £400 per day.  By using a unit eight times per year, more than £3200 budget is released for more patients.  This represents more than 500% return on investment in one year.  This must be worth a trial in the region.  Additional benefit can come from reduced re-admissions.

Surrey County Council have awarded a grant of £50,000 for measuring the reablement process and subsequent wellbeing monitoring.





 
Stage of Development:
Evaluation stage - Representative model or prototype system developed and can be effectively evaluated
WMAHSN priorities and themes addressed: 
Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
Two areas of immediate benefit are the saving of excess bed days for non-medical reasons and the avoidance of re-admission. 
  • Many elderly and frail people cannot be safely discharged from hospital without a period of reablement by family members or professional domiciliary carers.  The NHS typically funds this for a maximum of six weeks – at lower cost than the occupation of a hospital bed.  After assessment and transfer of care to social services, continuous monitoring by K-Sockets permits safe discharges a day or more earlier.  This eases the problems of Bed Managers seeking to release beds for new patients.
  • During reablement, automatic alerts warn of unusual changes of activity.  They could indicate the risk of unattended falls, dehydration, malnutrition of hypothermia; all costly to the NHS.  Appropriate action could avoid the need for re-admission.  
Kemuri is designed for both family carers and 24/7 response services.  Portable K-Sockets require zero installation time and do not require broadband.  Monitoring and machine learning starts within minutes and any people with consent for data sharing can immediately view the data or receive alerts.
 
Longer-term benefits come from wellbeing monitoring after reablement.  Portable K-Sockets can be replaced by fixed K-Sockets.  The data analysis could reveal medical problems, such as UTIs, and preventive action could avoid more costly treatments.    
 
Benefit to WM population:
Most older people want to return to their own homes as soon as possible after treatment.  Unfortunately, for some independent people, they cannot be discharged because there is no care provision at home.  Perhaps they have no local family or friends.  Consenting to reablement monitoring by K-Sockets could accelerate their discharge and improve health outcomes. 

Families also obtain peace of mind, whether they live locally or at great distances.  At any time of day, people can be alerted to possible problems and respond appropriately.  Most frequently it may only require a reassuring phone call.  On other occasions it could be an unattended fall or medical event that needs clinical action.  Earlier treatment leads to better health outcomes.

It may be possible to reduce the costs of domiciliary care with more-timely and less frequent visits. 
This is an example screen:



A green day shows normal activity.  An amber day shows more changes from normal activity – but may not be cause for alarm.  Red days are alerted during the day and are a call for action.  Viewers can drill down to more detail, and the screen below could indicate the risk of hypothermia.



K-Sockets are invaluable as passive monitors to supplement active telecare devices, such as pendant alarms.  The latter are not worn continuously by 90% of the people who have them and they need reasonable cognition to use them when necessary.  K-Sockets are not stigmatising and do not require any change of lifestyle.

For more information and downloads see http://www.kemurisense.com
Current and planned activity: 
Cornwall Council is trialling 20 portable K-Sockets for reablement.  In one case, an alert was sent to a family member before they knew about an unattended fall.
 
Surrey County Council have awarded a grant for TECS Innovation.  The plan is to supply 40 portable K-Sockets for reablement and then supply 100 fixed K-Socket to vulnerable people for six months.  Social Care will perform assessments as part of their normal case management.  An anonymised log of each service user should provide evidence of the bed days saved.  Statistics of readmission or transfer to full-time residential care can be compared to current averages.
 
Many K-Sockets are operational in small trials and some are still operational after years of use in private houses and housing association properties.  They could collect data for several years in long-term trials for clinical trials, such as for drugs for relieving the symptoms of dementia.
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. 
 
Kemuri, KemuriSense, K-Sockets and K-Fobs are registered trademarks. 
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
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Leonard Anderson 28/09/2018 - 16:46 Sign Posted Login or Register to post comments
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)
WMAHSN priorities and themes addressed: 
Long term conditions: a whole system, person-centred approach / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
Benefits to NHS in line with FYFV:
  • 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%.
 
  • 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.
  • 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.
Initial Review Rating
4.60 (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:
  • North East and North Cumbria AHSN with South Tees NHS Trust to test renal clinic at home funded by Northern Counties Kidney Foundation
  • NeuroResponse social enterprise based at UCL on Multiple Sclerosis pathway
  • Modality and Yorkshire and Humber AHSN to test diabetes/CKD screening model
  • Howbeck Healthcare to test rollout diabetes/hypertension/CKD screening model in South Cheshire and Vale Royal
  • Salford NHS Trust rollout for renal patient management
  • Care UK rollout for uncomplicated UTI management
  • Applied to the Test beds, have been invited to the follow-up meeting for at risk pregnancy, UTI and renal models
 
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
  • Dutch Kidney Foundation and Dutch Health to test population screening for ACR in at risk population compared to other method
  • Rolling 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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Anonymous 03/04/2018 - 15:43 Detailed Submission Login or Register to post comments
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Innovation 'Elevator Pitch':
FREED is an innovative, evidence-based care package for 16 to 25-year-olds with an eating disorder of up to 3yrs duration. It reduces waiting times for treatment, tailors treatment to the needs of young people, and improves outcomes at low cost.
Overview of Innovation:
Eating disorders are severe mental disorders with high levels of disability and mortality. The first 3 years offer a critical window for achieving recovery. Beyond this, outcomes are much poorer.
 
FREED (First episode Rapid Early intervention for Eating Disorders) is an innovative, evidence-based, specialist care package for 16 to 25-year-olds with a first episode eating disorder of less than 3 years duration. FREED overcomes barriers to early treatment and recovery and consists of a service model (incorporating rapid screening and assessment protocols) and a care package that can be adapted to service needs (including print and electronic patient resources that specifically attend to the needs of young people and their families). It was developed to be compatible with any existing evidence-based eating disorder service, and complements rather than replaces existing eating disorder treatments.

FREED was developed at the Maudsley hospital (South London and Maudsley NHS Foundation Trust) with support from The Health Foundation and has since been scaled to 3 additional sites in London and Leeds. These cover a population of approximately 7 million from urban, sub-urban and rural catchment areas. The Maudsley has provided a consultancy model with access to protocols and tools plus expert coaching in implementation and ongoing supervision.
 
Evaluation data show that FREED reduces waiting times for treatment by approximately 50%, compared to matched audit patients. It also improves treatment uptake (100% with FREED vs. 73% with audit) and, once in treatment, mean symptom scores for FREED patients reduce below clinical cut-points by 6 months. For patients with anorexia nervosa, 60% of FREED patients may be expected to reach a healthy weight by 12 months vs. 17% of audit controls. 
 
FREED is also low cost, as all implementation material is available free of charge. The cost to services is that for a band 7 FREED champion, at 0.6FTE (£20k/yr) for a large service seeing 100 FREED patients/year. In-year savings are feasible due to the 35% reduction in day-care and inpatient care seen with FREED compared to treatment as usual / audit data. This translates to a cost of £112k per 100 patients seen through FREED. Modelling analyses suggest longer term savings of £2-5 per £1 spent, due to reduced treatment re-presentations and early achievement of full recovery.
 
FREED is scaling around England in 2018 with support from the NIA.
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 / Innovation and adoption / Person centred care
Benefit to NHS:
Available data show improved clinical outcomes at reduced cost (please see prior section for details).

Standard waiting times for eating disorder treatments for adults routinely exceed 6 months, and it is established that patients waiting for treatment tend to deteriorate and become at higher risk of a chronic disorder course. FREED addresses this.
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
Available data show improved clinical outcomes at reduced cost (please see prior section for details). FREED was co-designed with patients and carers and we are consulting with patient representatives around the country.
Current and planned activity: 
FREED has received support from The Health Foundation and NHS Innovation Accelerator. We are working with AHSNs around the country as well as specific clinical services and service user groups/charities.
What is the intellectual property status of your innovation?:
No intellectual property copyrights - we are sharing materials.
Return on Investment (£ Value): 
medium
Return on Investment (Timescale): 
1 year
Ease of scalability: 
Simple
Regional Scalability:
We have already successfully scaled FREED from the South London and Maudsley NHS Foundation Trust to Central and North West London NHS Foundation Trust, North East London NHS Foundation Trust, and Leeds and Yorkshire Partnership NHS Foundation Trust. In so doing, we have gained experience with implementation and helping teams adhere to the core principles of FREED whilst also making necessary adaptations to local requirements. FREED now serves a population of over 7 million from urban, semi-urban and rural areas and has been delivered by professionals with a variety of training backgrounds.

Our Leeds partner site has also scaled FREED to two further services in Yorkshire, providing evidence for the regional scalability of the model.

The Gloucestershire all ages eating disorder service (2gether NHS Foundation Trust) is confirmed as an additional, new partner site for 2018 with training occurring in April. Discussions are underway with a further 3 sites around the country.
Measures:
We will measure waiting times for assessment and treatment, the percentage of patients who take up treatment and the percentage of patients who complete treatment, as well as those that need inpatient or day care treatment on top of outpatient work.

Pre and post-treatment measures will be conducted as part of routine clinical assessment processes but we are asking all partner sites to use the following 3 well-established and well-validated measures for this; the Eating Disorder Examination-Questionnaire; CORE measure of depression and anxiety; and Clinical Impairment Questionnaire. We will also monitor changes in Body Mass Index.

Outcomes with FREED will be compared to pre-existing, baseline outcomes for each service. We will undertake the audit evaluation of these baseline outcomes, with support and consent from services.
Adoption target:
All adult eating disorder services offering evidence-based treatment are potential adoption sites. The specific goal for 2018 is to scale FREED to 8 new sites, 2 from each of the regional England teams.
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Karina Allen 19/03/2018 - 17:45 Detailed Submission Login or Register to post comments
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Innovation 'Elevator Pitch':
CMC is an NHS urgent care planning service designed to capture a patient’s preferences for their care in one single version of the truth. The care plan is available digitally to all the clinicians involved in their care and emergency services 24/7.
Overview of Innovation:
The service was started in 2010 and currently serves Greater London. It is commissioned by the 32 London Clinical Commissioning Groups. There are currently over 50,000 CMC care plans in existence.
 
CMC fast facts:
  • The CMC service has been developed by NHS clinicians for NHS patients
  • Developed on the foundations of patient centric care, clinical integrity, information governance, data protection and security
  • Helps reduce unnecessary and unwanted hospital admissions, readmissions and associated ambulance transport costs and hospital stays
  • 76% of patient who have a CMC plan and place of death recorded, die in their place of choice
  • Where patients have a CMC care plan 19% died in hospital compared to the national average of 47% and 53.6% in London
  • Data suggest that the NHS saves on average £2,100 per patient who dies with a CMC care plan in place
  • For healthcare professionals it’s the confidence that the important and sensitive work they have documented with the patient is accessible to emergency services who may not know them as well
  • For patients it’s the knowledge that they are at the heart of planning and decision making around their own healthcare and that they will not need to repeat themselves repeatedly
 
The service is constantly evolving with an ongoing focus on interoperability with other healthcare IT systems and allowing patients to start to create their own care plan on a new patient portal myCMC. For more information please visit www.coordinatemycare.co.uk or call 020 7 811 8513.
 
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 / Education, training and future workforce / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
The key benefits to the NHS include:
  • A higher quality of care for patients during the out of hours period with all the healthcare professional teams joined up and the patient's own preferences at the heart of the care delivered
  • Fewer unplanned hospital admissions and the associated costs with hospital stays
  • Lower costs with an estimated £2100 saved per patient with a CMC care plan
  • Meeting the NHS goals of digital, interoperable and paperless systems
Initial Review Rating
4.20 (1 ratings)
Benefit to WM population:
Similar benefits to London where we are established:
  • Greater connectivity of the multidisciplinary team working around the patient
  • Greater involvement of the patient in their own care delivery
  • An online care plan accessible to all healthcare professionals and emergency services representing one single version of the truth
  • Cost savings
Current and planned activity: 
Key priorities for Coordinate My Care include:
  • Interoperability with all GP, hospital and community IT systems
  • Taking CMC into wider regions across the UK
  • Supporting the myCMC patient portal for more patients to start their own care plans ratified by their clincians upon consultation
What is the intellectual property status of your innovation?:
The intellectual property of CMC has two components;
  1. The ‘wrap around’ that consists of teaching, training, monitoring, clinical and information governance, reporting and analytics. (Intellectual property of CMC/NHS)
  2. The IT platform on which the system is hosted and maintained (Intellectual property of InterSystems)
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
Simple
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Professor Julia Riley 07/03/2018 - 17:32 Publish Login or Register to post comments
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Innovation 'Elevator Pitch':
RespiraSense demonstrated a potential for 6-12 hours earlier detection of patient deterioration when compared to the standard of care. Putting that into context, for every 30-minute delay in treating Sepsis, increases the risk of mortality by 7%
Overview of Innovation:
RespiraSense is the world's only continuous respiratory rate monitor. Respiratory rate is the earliest and single most sensitive indicator of patient deterioration, more so than heart rate if systolic blood pressure. In fact, 26 breaths per minute are considered the earliest point of divergence between Spo2 and respiratory rate. Giving rise to 12+hours of false security is accurate RR is not measured. 

The standard of care remains the manual counting of breaths per minute, which has been shown to be biased and prone to error. With evidence showing no change in the quality of measurements for over 170 years (1846SirHutchenson) (2017Badawy). 

RespiraSense gives medical teams the advantage of being able to intervene early, thus reducing time to intervention and improving outcomes. Outcomes such as Average Length of Stay, Average Unit Cost of Care, and Patient Safety targets can be achieved. 

RespiraSense is a simple, wireless, and discrete wearable monitor, placed on at admission and worn/measuring continuously for up to 7 days. Each patient receives a new sensor and a reusable electronic device or Lobe. See how the system works @ https://www.youtube.com/watch?v=u6KB1hBPQbM  
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Education, training and future workforce / Wealth creation / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
Each year, there are approximately 500,000 admissions of Sepsis and Pneumonia with an average unit cost of £4,600 per admission. These two conditions are increasing in incidence and often lead to an escalation of care due to the risk of undetected deterioration. It's shown that a 5% reduction in the escalation of care of these two pathways alone, through the use of continuous Respiratory Rate monitoring triggering decreased time to interventions (Fluids, Oxygen, Antibiotics, Steroids), can reduce the average unit cost by £300 and the average length of stay by 0.5 days. This translates into a total Net cash saving of £115m and 250K bed days. Popular opinion suggests that as high as 20% reduction is achievable - Evidence pending. 

Each event prevented, having an average cost of £25,000, will pay for a whole year's supply of sensors for one year.
Initial Review Rating
5.00 (2 ratings)
Benefit to WM population:
West Midlands Trusts are driving the awareness of Sepsis through their ambulance services, patient awareness campaigns, and in-hospital initiatives. With 44,000 lives lost each year attributed to Sepsis, it is important to Prevent, Diagnosis Early, and Effectively Treat the condition. RespiraSense focused on the area of Diagnosis Early. Research suggests that NEWS2 is a more sensitive indicator of deterioration due to Sepsis than QSOFA. Both of which have Respiratory Rate as a critical parameter to measure. There is clinical and economical value in monitoring this essential vital sign accurately and clear additional benefit to having it monitored continuously. RespiraSense achieves both with low impact of False alarm due to its innovative design, boasting advanced motion-tolerance. 
Current and planned activity: 
PMD Solutions is working with Nursing Times to launch an educational campaign on the clinical science and importance of respiratory rate monitoring in acute care clinical practice. 

In addition, PMD Solutions is looking for Respiratory and Emergency teams to partner with and create a culture of Peer Leadership in the development of best practice for respiratory rate monitoring. 
What is the intellectual property status of your innovation?:
RespiraSense is positioned to be the new industry standard in respiratory rate monitoring. It is patented in Europe, United States, China, Hong Kong, and Japan. 
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
Regulatory Approvals:
Please describe any current regulatory approvals you have achieved and how they were met/ in progress/planned.
Commercial information:
Please describe how the product/service is being developed commercially, whether in development, trials, pilot or full commercial delivery. Include the results you have from any market/demand surveys and forecasts . Please include any research you have on the broader commercial opportunity for the innovation both within the health sector nationally and internationally.
Investment activity:
Please describe what stage of investment you have reached and whether you are seeking additional rounds of investment. Please include cash investment as well as investment of soft assets such as access to specialist equipment, knowledge, trial base etc. and indicate the types/sources of your investment such as grants etc.
Regional Scalability:
Please describe how the innovation could be scaled across the WM region. Have you implemented at scale in any other regions?
Measures:
What outcomes are you hoping to achieve and what are the measures that you will use to gauge the success of the innovation and how will these assessments be made? Please ensure that you have quality, safety, cost and people measures.
Adoption target:
What are the targets for adoption across the WM and what are the minimum viability levels?
Investment sought:
What investment are you looking for in order to support wider adoption of this innovation and what have you managed to secure to date? Please provide a breakdown of these costs if possible.
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Myles Murray 02/03/2018 - 21:21 Publish Login or Register to post comments
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Innovation 'Elevator Pitch':
Oviva Diabetes Support and Prevention are QISMET-accredited education and behavioural change interventions for people with or at risk of type 2 diabetes, which have demonstrated signficant improvements in uptake and clinical outcomes.
Overview of Innovation:
Oviva’s services for people with or at risk of type 2 diabetes are now available in 18 CCGs across England, and have demonstrated improved uptake and outcomes in comparison with traditional models of care.

Oviva services offer accessible, evidence-based, personalised care
All Oviva services combine:
  • High-frequency, 1-to-1 coaching from a diabetes specialist dietitian to drive behaviour change and tackle psychological barriers, delivered over the telephone or using the Oviva app.
  • Supporting materials for participants to access in their own time, including videos, podcasts, and written guides, which explain more about type 2 diabetes. Participants retain access to resources for life, and they are available online or as hard copy booklet and/or DVD. All Oviva resources reflect NICE and NHS guidelines and are reviewed by a clinical advisory board regularly.
  • Optional use of the Oviva smartphone app, which participants can use to maintain a food diary and access learning resources. This app links to the dietitian’s electronic patient record to enable the dietitian to provide feedback.
  • Activation call from Oviva patient pathway coordinators, who are trained in motivational interviewing and focused on driving uptake.
This approach is tailored to meet the needs of different patient cohorts, as described below.

Oviva Diabetes Prevention: an 8 week intensive education and behaviour change programme with follow up care at 3, 6 and 12 months, focused on weight loss and reducing HbA1c levels (for patients with non-diabetic hyperglycaemia). This service has recently been adopted as part of the NHS Diabetes Prevention Programme in England, and real world data will be available for analysis soon.

Oviva Diabetes Support: an 8 - 10 week QISMET-accredited structured education and behaviour change programme, focused on supporting patients to meet diabetes treatment targets, lose weight, and develop sustainable self-management skills. Real world data demonstrates an average HbA1c reduction of 13mmol/mol at 6 months, weight loss of -4.5%, whilst patients report that their average confidence in managing their diabetes increased from 4/10 to 8/10 (clinical outcomes from 85 patients). Uptake in 1453 referrals is c.70%, compared with c.30% in traditional models.

Oviva Diabetes Support has now been selected by NHS England to join the NHS Innovation Accelerator and the Digital Diabetes Coach Test Bed.

To view our Information Pack - click here.
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
Benefit to NHS:
Oviva Diabetes Support and Prevention benefit the NHS by widening access to effective care, and generating improved patient outcomes for people with or at risk of type 2 diabetes. In turn, this drives efficiency savings in terms of avoiding preventable utilisation of services in primary and secondary care, along with medications and treatment costs associated with disease progression and diabetes complications.

As described in the overview, service uptake is c.71%. By contrast, the National Diabetes Audit indicates that uptake of structured education for people newly diagnosed with type 2 diabetes is c.7.4% (2.9% in the West Midlands), and uptake of the National Diabetes Prevention Programme is 49%. Increased accessibility and flexibility enables people unable or unwilling to access traditional face-to-face courses, along with supporting commissioners and clinicians to meet targets associated with attendance at diabetes structured education included in the NHS Improvement and Assessment Framework and Quality and Outcomes Framework.

Moreover, real world data (85 Oviva Diabetes Support patients) demonstates an average HbA1c reduction at c.6 months of 13mmol/mol, and bodyweight loss of 4.5%, supporting the achievement of diabetes treatment targets (also included in the Improvement and Assessment Framework and Quality and Outcomes Framework).

These clinical outcomes can drive a return on investment for CCGs; Frontier Economics modelling indicates that based on existing clinical outcome data, provision of Oviva Diabetes Support for 500 participants achieves £219k of year 1 savings, rising to £550k by year 5. This is comprised of avoidance of 72 admissions, 100 outpatient and 280 GP visits, along with avoidance of more than £17k of prescribing costs. Targeting the service at patients receiving or likely to need high cost medications (including insulin, SGLT-2, and GLP-1) could drive additional savings of more than £800 per participant per year.

Oviva Diabetes Support and Prevention also offer commissioners a 'payment by engagement' cost model, ensuring that commissioners only fund the service for active participants. This contrasts with the block contract model of traditional face-to-face group courses, which offers commissioners limited recourse to challenge poor uptake locally.
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
By providing an accessible, flexible and effective approach to improving outcomes for people with type 2 diabetes Oviva Diabetes Support and Prevention can impact on the WM population (7.7% of whom have type 2 diabetes, and 11% of whom are likely to be at risk) beyond the local health economy by:
  • Reducing the need for people with or at risk of type 2 diabetes requiring time away from work to attend education courses or future appointments associated with the treatment of complications, thus contributing to maintaining productivity and the local economy.
  • Providing participants with personalised and remote care widens access to cohorts identified as less likely to attend traditional programmes, such as working age men, BME groups, or rural communities, particularly essential in diverse populations such as the West Midlands. Evidence of accessibility can be seen in the success of Oviva Diabetes Support in areas such as London and Devon.
  • Reducing the impact on the environment associated with delivery of traditional models of care, which drives a number of journeys for patients and staff and the environmental costs associated with physical premises.
  • Improving outcomes enables people with type 2 diabetes to remain in work; Diabetes UK has estimated that the costs of reduced productivity at work due to people with diabetes not working because of death or poor health, or working at a lower level of productivity are estimated at nearly £9 billion.
Current and planned activity: 
Oviva Diabetes Support is currently in pilot or commissioned in the following areas: North West London collaborative of CCGs, South West London collaborative, NEW Devon CCG, Chiltern and Aylesbury Vale CCGs, Swindon CCG, Somerset CCG, Leicester, Leicestershire and Rutland CCGs, and Salford CCG. Oviva Diabetes Support will soon be available to self-referral nationally as part of the Diabetes Digital Coach Test Bed. Oviva Diabetes Support is supported through NHS England through the NHS Innovation Accelerator, and has been rewarded a research grant via Innovate UK and the digital health catalyst to evaluate our clinical outcomes with King's College London.

Oviva Diabetes Prevention is part of the NHS England Healthier You - Diabetes Prevention Programme digital stream, recently launching in North West London, Somerset, and Chiltern and Aylesbury Vale CCGs.

Oviva is keen to explore opportunities for adoption of our service in the West Midlands.
What is the intellectual property status of your innovation?:
All intellectual property is owned by Oviva.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
Simple
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Olivia Hind 27/02/2018 - 18:14 Publish Login or Register to post comments
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Votes
-99999
Innovation 'Elevator Pitch':
MyDiabetesMyWay is a proven, scalable, cost-saving self-management platform/app empowering people with diabetes  to take ownership of their disease, data and treatment; delivering tailored support from NHS health record/  home recorded data.
Overview of Innovation:

MyDiabetesMyWay (MDMW) has been running since 2008 in NHS Scotland ,and is now being implemented in NHS England (e.g. Somerset, Manchester, NW London). MDMW is a cost saving (ROI>4:1) online web-based platform with over 50,000 registrants (covering all types of diabetes) funded by NHS/ government, giving patients access to their institutional (NHS) health records, integrating with home-recorded data, utilising algorithms and data linkage to drive highly tailored self-management advice and reports, communications tools and education resources.
MDMW has peer reviewed published evaluation and is an international exemplar having won many quality awards e.g. European ehealth adopters award (2017)/ Diabetes UK self-management award (2015)/ UK Quality in Diabetes Care award (2013). MDMW impacts on clinical outcomes e.g.HbA1C, is low cost (£1-2 per population patient per year license) and offers savings through reductions in complications/ efficiencies in care for NHS providers, and can be rapidly scaled across regions and countries.
 
THE PRODUCT:
MDMW is a portal/ app encompassing:
  • >200 digital educational resources (text, video, interactive content)
  • Patient electronic health record access (institutional NHS data)
  • Patient self-management decision support with data-driven tailored advice/web links
  • 6 QISMET accredited structured education courses (GDM, Type 1, Type 2)
  • Personalised care planning documents
  • Personalised care quality reporting (e.g. DUK 15 Care Measures)
  • Patient goal-setting tools
  • Communication tools; secure messaging with health care team/ peer discussion groups
  • Remote glucose monitoring support (community upload and sharing of home blood glucose (sugar) readings and feedback).
  • External social media channels
  • Responsive and accessible web/mobile platform design
"Patient access to diabetes records through My Diabetes My Way has meant a step change in the care and understanding of my condition to a level that it has never been. I am much more in control of my condition but importantly I now understand the goals that I should be achieving and am able to have a constructive discussion with my consultant. "

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

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

http://www.mywaydigitalhealth.co.uk/
E: david.garrell@mwdh.co.uk
M: 07739 529737  
E: debbie.wake@mywaydigitalhealth.co.uk
M: 07904154101
 
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Long term conditions: a whole system, person-centred approach / Wealth creation / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
MyDiabetesMyWay is a novel patient facing intervention which can directly impact on clinical outcomes, quality of life, and improve efficiencies in service delivery. Diabetes is growing health problem with high treatment costs affecting 9.6% of the WM population. Good patient self-management driven by education, empowerment and motivation is key to good outcomes. Diabetes spending may rise over 10 years to c. 17% of the NHS budget. 

People with diabetes only spend a few hours per year with health care professionals. The rest of the time, patients self-manage their condition; i.e. - blood glucose monitoring, medication adjustment, appropriate daily foot care, weight management and dietary and activity choices. Self-management is key to reducing costly long-term complications such as ulcers, amputations, blindness, kidney disease, heart disease, stroke/ vascular disease, mental health disorders, sexual dysfunction and neurological complications. 
 
MyDiabetesMyWay delivers cost savings and better outcomes for patients (ref: published evidence), it also improves data transparency for practitioners across primary and secondary care and can reduce the need for face to face education and consultation, improving efficiency in working practices. Regular knowledge updates, feedback on results, motivational support and flexible access to health care staff are key to supporting patients, reducing costly clinic visits, hospitalisations and death due to secondary complications, leading to longer healthier lives with significantly reduced costs.
 
Technology approaches in diabetes care work well, particularly if they are personalised. Low cost population based solutions are appealing in the current climate of rising prevalence on a shrinking NHS budget.  Long-term conditions management needs to evolve to reap the potential benefits of data driven approaches. There is massive potential for wider lifestyle/home monitoring/institutional big data analytics to drive push notifications and automated decision support in real time to patients, which could transform care delivery. Our product development supports this evolution.

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

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

Demonstrable through Tests 2/3/4 (£ releasing/reduce demand for care/reduce of unwarrant
Initial Review Rating
5.00 (2 ratings)
Benefit to WM population:
MyDiabetesMyWay can directly impact clinical outcomes such as HbA1C, quality of life, motivation and knowledge, and improve efficiencies in service delivery (ROI at least 4:1)- see published evidence. Diabetes is growing health problem with high treatment costs affecting 9.6% of the WM population over the age of 16. Good patient self-management driven by flexible access to good quaity information (available in a range of languages), structured education courses, empowerment and motivation is key to good outcomes. MDMW supports acheivement of local 3 treatment (BP, cholesterol and HbA1C) and structured education targets.
People with diabetes (PWD) only spend a few hours per year with health care professionals. The rest of the time, patients self-manage their condition; includes blood glucose (sugar) monitoring, medication adjustment, appropriate daily foot care, weight management and correct dietary and activity choices. Self-management is key to reducing costly long-term complications such as ulcers, amputations, blindness, kidney disease, heart disease, stroke/ vascular disease, mental health disorders, sexual dysfunction and neurological complications. 
 
MyDiabetesMyWay delivers cost savings and  better outcomes for patients and  improves data transparency for practitioners across primary and secondary care and can reduce the need for face to face education and consultation, improving efficiency in working practices. This combination of empowered PWD and practitioners with a more complete picture can lead to more frequent co-production of health with the patient at the heart of decision making.

Regular knowledge updates, feedback on results, motivational support and flexible access to health care staff are key to supporting patients, reducing costly clinic visits, hospitalisations and death due to secondary complications, leading to longer healthier lives with significantly reduced costs. 
 
Technology approaches in diabetes care work well, particularly if they are personalised. Low cost population based solutions are appealing in the current climate of rising prevalence on a shrinking NHS budget.  Long-term conditions management needs to evolve to reap the benefits of data-driven approaches. There is massive potential for wider lifestyle/ home monitoring/ institutional big data analytics to drive push notifications and automated decision support in real time to patients, which could transform care delivery. Our product development supports this evolution.
Current and planned activity: 
MDMW is currently deployed throughout NHS Scotland. MyWay Digital Health are now implemented/ing MDMW in sites in NHS England, including Somerset, NW London and Greater Manchester. We were selected as one of 11 NHS innovation accelerator programme fellows (2018 cohort) and the Digital Health London accelerator, both of which are supporting adoption.

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

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

"Decision support and AI ... technologies need to be embraced by the NHS, but also subjected to the same scrutiny that we would apply to any other medical technology. In the coming years AI will make it possible for many tasks to be automated, quality to increase and staff to focus on the complexity of human interactions that technology will never master.
See files for company skill profile.
What is the intellectual property status of your innovation?:
Intellectual Poperty for MDMW is fully assigned to the company from the University of Dundee for exploitation
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
2 years
Ease of scalability: 
Simple
Co-Authors:
Regulatory Approvals:

IGToolkit was secured in late January 2018. We’ve adopted ISO 27001 policies and procedures (inc. provision for GDPR) and completed the Stage 1 assessment in early Feb 2018; the date for Stage 2 is May 2018 . The first big implementation of our system outside NHS Scotland is in Somerset, the Caldicott Guardian for Somerset CCG recently signed-off on our system, and it was endorsed by the Local Medical Committee as well as senior clinicians across the county. We aim to begin securing ISO 13485 as well as CE Device Marking later in 2018. We recently underwent a thorough successful regulatory review as part of the ITP assessment process (through ourmobilehealth)- report can be sent on for review.
Commercial information:
We already have a market ready My Diabetes My Way patient portal (operating at scale) although new features continue to be developed including remote monitoring and communication tools (July 2018) and a dedicated smartphone app (May 2018). We are also developing 2 new products MyDiabetes*Clinical (clinician diabetes EHR and quality improvement/ dashboard tools), and MyDiabetes*IQ (machine learning platform to support model building and decision support algorithms leading to alerting and notifications for patients and clinicians). 
for more information see; http://www.mywaydigitalhealth.co.uk/products/
Regional Scalability:
Implemented at scale across NHS Scotland since 2008 (currently> 35,000 registrants), Implementing in Somerset CCG and across NW London STP. Working on applications in Greater Manchester and other areas
Measures:
Previous Assesment in NHS Scotland:

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

Ongoing Assessment:

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


*Outcomes will be added to the health economic model
 

 
Adoption target:
We would aim to offer to everyone in the region with diabetes and rapidly onboard 5-10% of the entire diabetes population in your area in the first 12 months. Our intervention USP is low cost and scalability (at no additional per person cost).
Investment sought:
No investment sought currently
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Deborah Wake 27/02/2018 - 16:34 Publish Login or Register to post comments
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Innovation 'Elevator Pitch':
ORCHA is the world’s largest Health App library ORCHA has been designed to offer local targeted app stores to engage populations and to support professionals to recommend the best apps to their patients.

Overview of Innovation:
ORCHA, the Organisation for the Review of Care and Health Applications, is an SME specialising in the rapidly developing world of health and care mobile applications and related digital health services. The medical and wellbeing app market is growing fast, offering the prospect for clinicians and patients to better monitor, report and manage multiple health challenges. Apps exist and are in development for a wide array of users, ranging from solutions that remind and assist people with essential activities, to approaches that monitor key physiological parameters to improve management of multi-morbid long term conditions and to improve quality of life through enabling social interaction.


 
There is growing evidence that apps can improve outcomes for populations and patients, however, there is currently little independent review to ensure their effectiveness, safety or value to users and professionals. This limits user and professional confidence, the growth of app businesses, and also constrains the opportunity for the UK population to take advantage of apps to address major health demographic issues while potentially reducing load on public resources. The sheer scale of emerging apps in health and care also actively inhibits the use of these services, as patients, carers and their health and care professionals struggle to find the right solutions. Finding a clear and trusted pathway through these congested waters is a critical enabler of any wider digital health strategy.  ORCHA provides the solution. It delivers a clear and robust approach to the review, validation and dissemination of these services and through this core capability creates an attractive powerful and multifaceted digital health hub that patients, carers, health and care professionals and developers themselves are all able to utilise to drive this critical agenda.
 
The ORCHA platform has been designed to consist of multiple ‘white labelled’ variants, which are all driven by a common repository of review information and associated data. Through this approach it is possible to create solutions targeted for particular geographies, conditions or cohorts, enabling the key ORCHA components to be seamlessly integrated into existing public facing and professional facing solutions.
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 / Person centred care
Benefit to NHS:
The key benefit of the ORCHA solution is to individual patients & citizens in supporting them to find solutions they can trust to improve their health & wellbeing & in also supporting clinical professional groups across health & care providers, who wish to recommend, prescribe & clinically implement apps.  We have hundreds of GPs, clinicians & carers who are using this feature to prescribe apps to their patients & clients. For example, we are working with in primary care where local practices are using the system to recommend the best smoking cessation app to their patient lists known to smoke. We are also working with care assistants who prescribe apps as a part of health checks & we are working with Mental health services, where patients are provided with an app at their GP appointment & along the IAPT or CAHMs pathway. Here apps have been seen to reduce patients need for therapy, drugs & have also been used to achieve better outcome measures across the whole pathway.
 
The ORCHA tool is the first scalable assessment of health-apps, enabling clinicians to recommend & end-users to benefit from apps of guaranteed quality & safety. Through research-oriented design, ORCHA enables clinicians & commissioners to provide solutions in areas of unmet need, gauge the opinions/experiences of users & evaluate impact of services against patient-level outcomes. By making evidence central to activities, ORCHA is slowly transforming mHealth, from a largely uncertain prospect, to a valued tool in the armoury of clinicians & patients alike; mitigating risks & improving the likelihood of TECS embedding themselves as valued components of clinical pathways.
 
ORCHA are:
  • Increasing the availability of evidence-based services to those otherwise unable to fully benefit from face-to-face services, enabling care from home & helping the NHS maintain ‘equal access for equal need’
  • Increasing trust among those using & commissioning app-based services, by informing users of the risks & benefits of over 3,500 health-apps to date
  • Working with East Lancashire, West Lancashire, Bolton & Salford health economies to ensure those quitting smoking, still receive adequate support following the reduction or withdrawal of funding for smoking cessation support
Initial Review Rating
3.40 (1 ratings)
Benefit to WM population:
The key benefit of the ORCHA solution is to individual patients and citizens in supporting them to find solutions they can trust to improve their health and wellbeing and in also supporting clinical professional groups across health and care providers, who wish to recommend, prescribe and clinically implement apps.  We have a growing number of GPs, clinicians and carers who are using this feature to prescribe apps to their patients, and clients.
 
We work at regional and local level to activate populations to access a local library of health apps to support their health or health needs, activate patients through their trusted professional and upskill the professionals communities with a wide range of apps and the ability to prescribe these solutions to create a digital health offering which is reportable, managed and governed.
 
We also support health and care app developers. ORCHA not only provides these individuals and organisations with a ‘route to market’ outside the very crowded and commercially challenging confines of the various major app stores, but it also provides an environment for solution improvement, collaboration and the creation of critical interfaces that not only drive greater interoperability between complimentary solutions, but also starts to enable the creation of shared standards and common protocols around key issues such as data privacy and control.

ORCHA are:
  • Highlighting that working in schools is a viable & sustainable approach to activating young people & their families to use health-apps for health promotion; with the average child registering with ORCHA subsequently recommending 6.4 apps to others, 61% resulting in a download
  • Supporting KS4 students in raising awareness of taboo subjects including sexual/mental health through the use of apps. Students are now using ORCHA to extend their advice to include additional apps (not just period trackers) to attendees of the shool based clinic
  • Enabling North West London CCG to identify barriers to implementing TECS, promote efficiency & extend the effective reach of existing care; gaining user feedback to overcome these barriers & realise the benefits of TECS across North West London
  • Demonstrating, through our academic research published in BMJ:Evidence-based mental health, that contrary to popular belief, app quality is not correlated with both prior download figures & user-review scores, providing prospective app-users with useful information to minimise blind faith in popular apps[3].

 
Current and planned activity: 
Health app activation is a real challenge for health care systems. The ORCHA Solution enables customisable App Libraries that can help you to promote reviewed Apps to a specific population. These tailored App Libraries, “ORCHA Microsites” have been designed to enable them to be configured to meet your specific requirements. ORCHA Pro-Account works with the Microsites & is in essence a prescribing solution for health/care professionals. The service supports organisations that have commissioned App Licenses (an increasing trend) to manage the distribution of licenses by their staff & the ProAccount provides the core infrastructure for managing & monitoring Health App prescribing more broadly. The act of recommending an App via the Pro-Account feature is a key tool where individuals are 10 times more likely to respond positively to a prompt from healthcare professionals than if they arrived on the site via a direct search. Engaging clinical communities is a core feature of our solution.
 
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
2
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Liz Ashall-Payne 27/02/2018 - 13:54 Publish Login or Register to post comments
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