LIAISE: Efficiency finding platform (#1827)

Creation
Draft
Initial
Detailed
Accepted
Adoption
Idea Description
Supplementary Information
Detailed Submission Data
Innovation 'Elevator Pitch':
​LIAISE is a cloud-based platform that harvests information from publicly available and third party sources and auto-combines with your own spreadsheet data to identify accessible efficiencies 
Overview of Innovation:
In an ideal world, cash would be available for investment in new services and models of care.
 
In reality, however, almost all of next year’s fund - £1.8bn of it – will be spent on bailing out NHS providers in deficit, leaving just £339m to fund ‘transformation'
 
With this in mind and alongside the Lord Carter of Coles' report on Adjusted Treatment Cost (ATC) we have been conscious that Trusts need some help in unpicking what this all might mean for them.
 
The Health Service Journal analysis published on January 5th gave you a potential savings figure using reference costs.
 
Several observers have commented that they were expecting something a little more sophisticated. 
 
We’d like offer you a share of the benefits achieved with other NHS Trusts and public sector bodies by use of our LIAISE platform.
 
Others have commented how we have brought into clear view a number of savings opportunities that were hidden - even though they can be identified from a sophisticated analysis of publicly-available data and cross comparison to in house spreadsheet data
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':
Software that automatically engages with stakeholders to track performance & risk and identify continuous improvement opportunities in campaigns and/or contracted out services.
Overview of Innovation:
Do you find it difficult to track and measure contract or campaign performance? Compared to well-managed contracts/campaigns, unmanaged or poorly managed contracts/campaigns can lead to costly inefficiencies, poor performance and an increase in risk.
ContractsWise is now offering its innovative, cloud-based contract management tool: ECMS, (available via the Crown Commercial Services G-Cloud Framework Agreement if required). Designed by experienced contract managers, ECMS can increase performance and savings, improve service quality, and mitigate risk, with an automatically backed-up database to prevent loss of data.
Some of ECMS’s features include:
  • A  register to record all contracts/campaigns and associated documents in a secure database
  • A dashboard that can be individually configured for each user, with information on performance and risks
  • Compatibility with any device with a web-connection, including tablets and smartphones, without the need to download additional software
  • Actively and automatically engage with stakeholders.
For those who don’t need all of ECMS’s features, there’s ECAS, an administration system that is scalable to your needs and will help improve control of information and documentation.
ECAS’s Entry Level Plan features include:
  • Searchable database of your information and documents
  • Automated reminders for important dates
  • Secure cloud storage with automated data back-up which frees up physical space
  • Archive old information
  • Online tutorials and help documents.
All of ECAS’s features are included in ECMS.
Understanding contract management and how to improve performance can be difficult, which is why ContractsWise also run an online training course: An Introduction to Contract Management, which combines theory and best practice to give you a comprehensive understanding of the subject.
For more information on the ways that ContractsWise can help please visit www.contractswise.com
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 / Advanced diagnostics, genomics and precision medicine / Wellness and prevention of illness / Education, training and future workforce / Wealth creation / Clinical trials and evidence / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
There is an increasing body of evidence that shows that organisations incur significant unplanned costs, don't achieve expected savings or service quality as a result of a lack of effective contract/campaign management.
Research by the International Association of Commercial and Contract Management (IACCM) has quantified the value of these losses at the equivalent of 9.2% of revenue.
All organisations want to achieve the maximum value for every pound spent but in the NHS this is critical. ContractsWise provides low cost tools that will enable the NHS ensure that best value is achieved, risks are identified and mitigated and opportunities for continuous improvement are identified.
A business case template is available to download for free from our website www.contractswise.com and the return on investment will include: avoidance of unplanned costs; never miss a contract termination or renewal negotiation opportunity; realise planned cost savings or revenue improvements; reduce administration time; improve internal and external stakeholder relationships; redice risks; improve compliance; improve reporting.
Initial Review Rating
3.80 (1 ratings)
Benefit to WM population:
Users of the NHS in the West Midlands will receive improved services and will be able to contribut eto the continuous improvement of services.
Providers of services will have greater control over their budgeted expenditure or revenue.
Current and planned activity: 
Our software has recently been adopted by Western Sussex NHS Trust.
Following a full review of software available on the market The Chartrered Institute of Procurement and Supply (CIPS) chose our software and has been operating with it since February 2015.
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
Regional Scalability:

Being cloud based with minimal training required,the software can be easily scaled nationally and internationally.

Measures:

The goal is to maximise the performance and minimise the risks associated with the delivery of services by a 3rd party. Maximising performance will ensure that value for money is also maximised and will increase end user satisfaction rates. Minimising risks will reduce the possibility of unplanned costs that have not been budgetted for and will help ensure that any planned savings are actually delivered.
Users of the software will be able to continually measure performance and risk using the tools and dashboard built into the software. The users have full control over what it wants to measure so these can include quality, safety, cost and people.
ContractsWise limited will also measure the satisfaction of our customers through engagement with key stakeholders and work with them to maximise the benefits achieved by using the software in order to generate compelling case studies.

Adoption target:

Any organisation, part of an organisation or project whose measure of success relies upon the delivery of services from one or many 3rd parties.

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Innovation 'Elevator Pitch':
An app, designed by doctors, to promote safe and effective handover both within and between teams. With the inforamtion captured for handoer, clinical leaders can better review and manage patient flow through their team and the wider organisation. 
Overview of Innovation:
Careful is an app designed by clinicians. It helps doctors, nurses and allied health professionals share and protect critical patient information.

At its heart, it answers two pressing questions - who is currently looking after the patient and what is their clinical plan? It uses our Handover® system to keep track of the former and for the latter it provides a job-tracking system, with free-text clinical updates.

It has been designed to be simple, easy to use and mobile-first — so it can replace traditional paper-and-memory handover sheets.

This information, gathered from clinicians at the bedside, provides an exceptionally rich set of data that is currently lost in handover sheets and verbal order, or is buried in notes. By making this accessible, the app provides an overview that allows clinical leaders to review and manage the flow of patients through their team and the wider organisation.

By capturing structured information about actions and patient diagnoses, the system also creates the opportunity for 'clinical coding at the bedside' - a potentially huge cost saving.

Finally, we are developing a patient-centred app to enable patients to access and contribute to their own record and to communicate directly with the teams looking after them.

They will also, in response to the General Data Protection Regulation which comes into force in May, have direct oversight of their own record, ensuring that they can identify who has accessed it, and exercise control over who views the information.

We have tested and revised the first version of the system and are now ready to deploy version 2 of the clinician app. This is developed and ready for deployment in 2018. We need further support so that we can ensure that it is refined in response to customer feedback and to add further features. We also need funding for the patients’ app.
 
Stage of Development:
Close to market - Prototype near completion and final form may require additional validation/evaluation and all CE marking and regulatory requirements are in place
WMAHSN priorities and themes addressed: 
Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
The NHS is facing an unprecedented strain on its resources - particularly in secondary care. Many hospitals stuggle with patient flow. The object of this app is to allow doctors, nurses and other team members to share the clincial plan for patients - making the status of patients much more visible and improving the handover of clinical data. It is estimated that in the average 400-bedded trust, as many as 120 patients may be ready for discharge. We aim to improve the visibility of this information.

The cost-savings from effective patient flow managment in secondary care could run into billions, and this app will be a useful tool both to improve trusts' understanding of patients' status and to make handover more effective for the teams involved.
 
​It will also significantly benefit patients. - We know, from the investigation of serious incidents, that communiation is a prominent factor in around 80% of the thousands of incidents in which patients die each year in hospitals from preventable harm. It is also acknowledged that handover is a time of great risk for the loss of critical information.

The Careful app is designed to improve the communication and handover process between clinicians - and to encourage multidiisciplinary use, where doctors, nurses and other professionals all have access to the same information. We believe that it can save lives - although this will, again, be hard to quantify.

Finaly, the Careful app can help with the transfer of care between organisations. Becasue it is cloud-based, it is 'organisation-agnostic' and can therefore allow the transfer of patient records between organistions as easily as between teams in the same organisation. This is a perennial 'tough nut to crack' - as any clinician will tell you. We belive that the Careful app can do this without the inherent issues found in paper, fax and phonecalls. The cost and patient safety implications of this are significant.
 
Initial Review Rating
4.00 (2 ratings)
Benefit to WM population:
Our intention is to use this app with Birmingham Children's Hospital. We have contacts there but have not, as yet, secured an agreement - largely because we have other trusts in Yorkshire and the South East who are further ahead in their adoption.

We would use any money raised through this process to ensure that the app was made available to all hospitals in the West Midlands.
Current and planned activity: 
We have recently finished Version 2 of this app - which has significant information governance and privacy improvments (we have attached our Privacy Impact Assessment for more information). The app has also had a complete overhaul of its user interface (UI). We have also recently completed the status-flow elements of the app, allowing us to provide overivew patient-flow data at the organisation level.

We are testing this in two NHS trusts and two private hospitals in the next 3-6 months. These trials are 'pre-revenue', designed to refine the app before being launched on the wider healthcare market. The outline terms and benefits of this trail are provided in one of the attachments.

We intend to use any further funding to expand our user base to organisaitons that will pay, and to start the devleopment of the patient app.
What is the intellectual property status of your innovation?:
We own all intellectual property in the form of code and design. We also own the Careful and Handover trademarks in the UK.
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
3 years +
Ease of scalability: 
2
Co-Authors:
Regional Scalability:
Our businss model is based on scalablity. The app runs in the cloud (in a Microsoft Azure implmentation) and allows new organiations to be added with no overhead. Moreover, the design of the app is expressly to allow inter-organisational referrals and information sharing across the normally tight boudnaries between primary/community care and hospitals.

Scaling is 'built-in' to this app.

.
Measures:
For the business, the main meausre are user adoption and, of course, revenue. However, for the users themselves, the measurable benefits would depend on their role (see below).

Primarily, however, the financial / cost-benefit is improvement of flowand reduced length of stay

Benefits are: 

1) Juniror doctors - pimarily time-saving
  • Less time ‘polishing the list’
  • More accurate and timely communication about patient jobs and patient status / location 
2) Senior doctors and clinicians - primarily patient safey measures
  • More clarity on the individual patient status
  • No more ‘safari ward rounds’
  • Ability to monitor individual clinician activity
  • With ‘action bundles’ - the ability to standardise care for patients with particular conditions 
3) Site practitioners/Bed managers - time saving and improved flow
  • Less walking-the-floors to determine what is happening to patients
  • Clarity on the status of beds and patients throughout the organisation
  • Faster bed-turnaround times 
4) Finanical / service managers
  • Shorter length-of-stay
  • Higher bed utilisation
  • Patients admitted and discharged more efficiently
5) Information governance leaders
  • Ability to provide granular data to patients, in accordance with the General Directive on Data Protection (GDDP)
  • The ability to control which clinicians see what patient data.
  • No more IG breaches from handover sheets 
6) Coding departments
  • Faster coding - using machine-readable medical input
  • 'Codling at the bedside' in later versions
Adoption target:
As described, we want to use this in Birmingham Children's hospital initially, but we would like to see it adopted in all hopstials in the region.
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Innovation 'Elevator Pitch':
 
Lincus Integrate is a codevelopment collaboration between Rescon, Worcestershire Telecare, the Council and NHS that will analyse and share information from services, software and devices to improve clinical outcomes and stimulate regional growth. 
Overview of Innovation:
Lincus Integrate will create an integrated digital hub that surrounds a patient/service user and can connect with different health and social care systems, software applications and devices. It will analyse individual and grouped data providing insights through targeted visualisation to individuals, carers, health and social care professionals, managers and commissioners. Each user type will have customised access permissions and a user interface that has been co-developed with them and is appropriate for their needs.

Worcestershire Telecare (Worcstelecare) are rapidly expanding and to fulfil their ambitions to provide high value health and social care services to service users/patients they require a digital technology that will integrate with a range of  systems, digitial products and devices. Through a formal market scoping exercise they have selected Lincus, an at-market CE marked software as a platform product, to realise their goals.

Rescon’s Lincus platform has been chosen as the development platform as it has been codeveloped with end users and health and social care customers in the UK since 2011, and has numerous accreditations and awards. Rescon are working with Worcstelecare to integrate and develop the Lincus telehealth product to meet their full requirements (see attachments).

Lincus already integrates multiple digital evaluation technologies including patient self reporting, structured clinical and social care observation, and wireless devices including wearables and remote sensors. Currently there are 3600 users and 700 health and social care workers on the platform. As well as subjective and objective measurement of user health and wellbeing, it incorporates alerts for changing health and wellbeing markers, educational content, a calendar with reminders, planning, video and email/SMS communication functionality and meets high accredited information and clinical governance standards.

Lincus Integrate requires development work to further develop connections between services, other digital products and devices. It requires further refinement of user types with more discrimination between different service providers including GP, specialist, nurse, OT, physiotherapist, teleservice operator and community nurse specific interfaces.

Health Innovation funds will accelerate the development, adoption and delivery at scale of this unique integrated service proposition improving patient outcomes and generating wealth and employment for the West Midlands.
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 / Clinical trials and evidence / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
Lincus Integrate will build on previous work by Rescon and Worcstelecare that has demonstrated improved health and social care outcomes. Lincus is an NHS AHSN Atlas Product (http://atlas.ahsnnetwork.com/lincus-improving-self-care-and-wellbeing/) and has been used in assisting the delivery of health and social care services to people with Long Term Conditions, Learning Disabilities and Homelessness since 2013. For hypertension screening and support services Lincus use in partnership with a local service delivery charity produced at 3.21:1 return on investment in year for the Liverpool CCG.

Our Worcstelecare and Lincus integrated health and social care system solution is expected to save significant costs to both NHS and local government services whilst improving patient/service user outcomes. Preliminary modelling demonstrates a 10% across the board saving in social care provision through decreasing care needs. In addition, as lack of coordinated social care provision is a common cause of delayed discharge, we forecast that Lincus Integrate will decrease hospital inpatient resource load by at least 10% whilst decreasing readmission rates by 20% freeing up NHS resources to deal with those who need acute clinical care.

The Lincus Integrate system is applicable to multiple long term conditions and care needs. Using COPD as a working example Lincus Integrate is compliant with NICE Guidelines (CG101,2010) and will reduce non-elective inpatient COPD admissions (£1960/admission), or nationally >£160 million per year, (CG101, NIHR 2011 addendum).

Lincus Integrate will realise these savings through
1.) Sharing patient vital signs and other in community evaluation information across systems where
it will be used for better informed decision-making;
2.) Sharing and preemptively addressing social care issues prior to, or at the point of, potential admission;
3.) Creating a robust and continuous audit trail relating to patient data;
4.) Presenting information in a way that all the appropriate people in a patient’s care pathway (include patients and carers) can act on in a timely manner; and
5.) Integrating alerts and notifications for either routine, or rapid responsive, use.
The team is already working with the local STP and Council who are receptive and supportive of our approach including our evaluation of 10% reduction in social care needs, 10% reduction in bed days per admission, and 20% decreased readmissions whilst improving the health and wellbeing of citizens.
Initial Review Rating
4.60 (2 ratings)
Benefit to WM population:
Worcstelecare has an exemplar telecare service which has been accredited to the highest level and has been selected as a partner with the local council to integrate health and social care service delivery in Worcestershire. They currently deliver services to 17,500 service users with mixed health and social telecare needs from West Midland bases, including their head office in Kidderminster. As a result of this partnership Rescon has also created a base in Kidderminster, and a staff member in Little Malvern, to further support their West Midlands activities.

Worcstelecare’s unique partnership agreement with Worcestershire County Council, formalised in January 2018, is addressing health and social care needs across Worcestershire. A 55 person scale-up pilot is commencing in April to test the new integrated model of care which has the aim of exceeding the care, discharge and admission metrics described above. This will be expanded across the West Midlands improving individual, community and population health whilst decreasing the load on the health and social care system and creating wealth and further jobs in the region.
 
Worcstelecare and Rescon's reach extends both nationally and internationally and there is interest from both partners existing customer base to extend the model to other regions. This will result in growth of both businesses amplifying the wealth and employment benefits to the West Midlands.
For Rescon a three year forecast of the impact of the Lincus Integrate project will have on company revenues has been uploaded in the attachment section.
Current and planned activity: 
Rescon are actively engaging and working with Worcstelecare to develop and implement the long term vision of Lincus Integrate (see attachments). The partnership has been engaging with the council over the last few months which has extended to working with local clinical teams. The first clinically driven issue the combined Worcstelecare, Rescon, Council and NHS partnership is working on is that of "frequent flyer" admissions. 

Rescon and Worcstelecare are due to commence formal work in the last week of January, but have limited resources to realise the ambitions of the project over a short time frame. The attachments outline the planned work in both infographic format and as a top level project plan. The direct development cost of this activity to Rescon is £130,000. Worcstelecare have secured £55,000 to commence activities however there is a considerable shortfall which the Innovation Fund would directly address, accelerating speed to market and revenue generation.
What is the intellectual property status of your innovation?:
The combined integrated service and technology delivery model will be owned in partnership with Rescon and Worcstelecare. The working model is that the service delivery intellectual property will be retained by Worcstelecare whereas the technology intellectual property will be retained by Rescon.
Specificallty relating to intellectual property owned and being developed by Rescon all related trademarks (Lincus, Rescon, Wellbe, One Precious Life, Rescon Technologies, -tracker, IoT-Med), IPR and copyright of source code, designs and algorithms that will be utilised for Lincus Integrate are owned by Rescon.

Lincus Integrate will utilise 2 granted patents: Medical symptoms tracking apparatus methods and system (US8941659, 9754075)

It will also leverage technologies developed from the following pending UK and International patents including:
Differentially weighted modifiable prescribed history reporting apparatus, systems, and methods for
decision support and health (IT: 20160379511) and Session Limited Passcode for Re-authentication
(US62468359)
All the searches carried out for prior art have indicated that there is freedom to operate.

Strategy for knowledge protection:
Our knowledge protection strategy involves frequent IP audits with literature scanning including patents.
We make protection decisions on the basis of patentability, defensibility, costs and exploitability. The intellectual property realised by Lincus Integrate will be secured in accordance with the above strategy.

Regulatory requirements:
Lincus Integrate software will be developed out of Rescon's existing software platform technology which has multiple accreditations including being a CE marked Class 1 Medical Device, GDPR compliance and IG certifications. Our CE marked Class 2 diagnostic algorithms relating to arrythmia detection may also be utilised by the platform depending on further engagement and requirements of clinical stakeholders.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
3
Regional Scalability:
Lincus Integrate will be rapidly scaled through the partnership with our at market partner, Worcestershire Telecare.
 
We will build on the success and scale of the Worcestershire Telecare service.  Our previous at market activities have not been with a highly ambitious partner who has a growing service.  Through the partnership we are expecting to rapidly scale both locally and then nationally and internationally with the scaling up accelerating as more features are added.
 
This at scale adoption will be only be achieved through evidence of success.  The evidence will be leveraged both locally and also used to create marketing materials to create further uptake outside the West Midlands and into the European marketplace, where we have strong contacts, especially in Spain.
Measures:
Worcstelecare were first attracted to Lincus due to its comprehensive and configurable capability in measuring outcomes of service provision.  

We intend to realise and measure the following outcomes:
  • Savings release through increasing efficiency of care delivery via new proactive preventative teleservices, and better communication systems.
    • Measurement: will compare costs post intervention with historical data and predicted spend based on profiles (regional social care data available), we will base healthcare outcomes analysis on disease specific models such as the Cardiff Diabetes Model.
  • More social inclusion and improved patient experience through wider reaching communication systems and processes. The proactive telecare model demonstrably improved health and social care outcomes including inclusivity amongst the elderly in Spain (Cabrera-Leon et al 2013).
    • We will measure both platform engagement and patient self-reported and assisted reported outcomes from baseline introduction into the programme.
  • Harm reduction through better communication and proactive care.
    • We will monitor events, interventions and incidents reported and compare to historical data.
  • Improved identification and profiling of frailty with the output of tailored personalised care plans best utilising local resources. 
    • This will be measured through cases profiled, new diagnoses and care plans.
  • Better or stabilised quality of life for service users, and carers and support staff through better systems support.
    • Measured through self and advocate-assisted report.
  • Reduced GP visits, hospital admission and delay in admission to long-term care.
    • Comparison of attendance figures for both emergency and routine admissions.
  • Increased jobs and turnover within the West Midlands.
    • Employment metrics for both Worcstelecare and Rescon.
  • Increased exports locally and internationally resulting in considerable inward investment into the West Midlands.
    • Audit of finances.
Adoption target:
Our primary adoption target is for Worcstelecare to commission Lincus Integrate for the 17,500+ users they support.  The minimum viability levels for Lincus Integrate to be sustainable is 13,700 users at £35 per annum to cover support and development costs of £40,000 per month. 
 
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