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Idea Description
Supplementary Information
Innovation 'Elevator Pitch':
AR providing point of need access to support information, training advice and guidance in multiple areas including mental health
Overview of Innovation:
Our augmented reality (AR) materials offer the first phase of support - Instant, point of need, self-help techniques and early intervention strategies. All resources include signposting to follow on professional support and information on long-term strategies to improve access to NHS digital support strategies and resources. These should be implemented alongside our resources to provide a complete support mechanism for those at risk of suicide and dealing with mental health issues.

Key rings, Posters and other objects can be transformed from passive, physical, real world objects into an engaging augmented digital experience and boosting “mobile-first” engagement.
Simply put, mobile phone users, through the use of an access app are able to scan a poster or symbol on a product and immediately access video, website content and/or directly contact an organisation for support. This technology can be harnessed to help meet the objectives set out in NHS Long Term Plan in regards to the use of digital technology to help people better manage their health and achieve widespread digital access to training, information advice and guidance (IAG) and support. With estimates that around 94% of adults in the UK owning a mobile and that around 86% of 12 to 18 year olds regularly use a mobile(Statista, 2019), there is no need for specialized and/or expensive equipment to be supplied to users to use AR technology.

Augmented Reality (AR) allows content to be easily modified based on identified needs. It provides a scalable and cost effective digital model to connect patients with care. By Incorporating AR into, for example, into a mental health campaign strategy the NHS can overcome social and physical hurdles associated with asking for help, seeking information and accessing the right care promptly. AR could also potentially provide immediate access to professional advice and guidance, assist in preventing and providing early intervention access, providing them with ‘take-away’ information and/or swift access to support.

Along with national NHS strategy Augmented Reality content can provide fast support to people in their own homes with ‘same day care’ and point of need digital support via AR wearables linking to online ‘digital’ GP consultations and act as a further service expansion to regional prevention campaigns like the West Midlands Combined authority Thrive at Work helping to reduce outpatient appointments. (see additional information)
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':
ETL is expert in health and care digital transformation developing, digital strategies, creating robust business cases, design and development of solutions architecture, process redesign, training and implementation support and benefits realisation.
Overview of Innovation:
The constant need for change
 
Underpinning every STP plan is the need for a coherent digital strategy encompassing Record Sharing, Whole System Intelligence, Citizen-Facing Technology, Self-Care Management, Infrastructure Interoperability and Digital Maturity.
 
What can ETL do for you?

We can provide much needed support around  
 
Digital Strategy – based on revised STP, ICS, and NHS 10-year plans
Cost to Change – secure funding backed by robust business cases
Programme and Project Management - credible plans with strong governance
Delivery – capacity and capability to ensure full utilisation for Go Live
Competing Priorities - address BAU, STP, ICS, LDR, GDE, LHCRE
Technical - capable infrastructure, applications which support interoperability
Integration - processes and systems, co-operation and collaboration of inter- and intra-organisation boundaries
Timetable for deployment – solutions delivered and aligned to the process and organisational changes.
Benefits Realisation – establishing reliable processes and data for measuring benefits.
 
How ETL can work in collaboration with you?
 
We would work in collaboration with you to develop coherent digital transformation plans. The aim is to identify initiatives, prioritising those that provide the advanced care and generate the greatest value.
 
We would combine resources that can architect solutions and suggest ways in which you can augment resource/services to enable the internal teams to engage with the STP programme.

What are the benefits of working with ETL?

ETL will work with you in an efficient and effective way, providing expertise, support and resource and help guide you through the digital transformation providing:
  • Independent, expert advice and support
  • Delivery of IT projects using proven methodologies
  • Help with creating and presenting robust business cases
  • Programme and project management expertise
  • Process re-design and change management support
  • Effective stakeholder management and collaboration expertise
  • Technical architecture skills and knowledge of new applications
  • Expertise in systems integration, optimisation and interoperability
  • Methodologies for benefits management and realisation
ETL will ensure maximum engagement from staff throughout the STP and provider organisations, ensuring that solutions are used to their full potential and that money is being spent effectively on priority initiatives. 
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: 
Digital health / Innovation and adoption
Benefit to NHS:
For every solution we deliver, we focus on the outcomes and work through what is required to deliver them and measured by it. For instance, we are involved in an initiative with South East London (SEL) STP, to establish how remote monitoring and assistive technologies can prevent patients with Type 1 Diabetes, COPD or Heart Failure from deteriorating and being re-admitted into hospitals. Unless we can prove this, the solution will not be fully adopted. This is just one example of many on how we focus on patient health outcomes beyond any other measure.

We start with the health and care processes and map out the current state in order to establish any inefficiencies. We take a holistic view, based on the well-recognised inter connected and inter related six domains of change POLDAT (Processes, Organisation, Location, Data, Applications and Technology). Essentially, we are considering who is doing what Processes in the Organisation and in which Location with what supporting Data, Applications and Technology. This gives us very valuable insight into where current systems aren’t being used appropriately, where enhancements can be made to practices and procedures to add real value or where new solutions will have a greater impact.

We have expertise in developing end-to-end patient pathways, so that we can see the big picture both for current and future states.

We are also able to do deep dives-in specific areas so that we are clear about the impact of particular solutions. This helps us to:
  • Engage with key stakeholders
  • Challenge any assumptions and identify clear metrics
  • Build and validate business cases
  • Establish clear ownership and robust mechanisms for benefits realisation
We also work closely with NHS Trusts to optimise the solution post implementation so that the greatest return on investment is achieved.

We employ experts with in-depth knowledge of the NHS and health and care systems and transforming processes through digital solutions. We therefore focus on solutions that deliver real value for money and the health and care organisations can be confident that the advice and support we provide will be grounded-in-reality.

Any solution we deliver is created in collaboration with senior stakeholders and end-user-buy in.  It is only with this level of support and collaboration can we be confident that any solution that we implement will generate a cost-effective service and experience for the staff and patients alike.
Initial Review Rating
4.60 (1 ratings)
Benefit to WM population:
ETL with its expertise in delivering transformations underpinned by digital solutions is very well placed to support some of the key initiatives that are underway to improve the health and wealth benefits of the West Midlands and its population. We offer expertise in:
 
Record Sharing – the ability to make appropriate patient data available to all care settings in the STP.

Whole System Intelligence – the utilisation of health data to provide strategic, operational and real time decision support.

Citizen Facing Technology – the ability for patients to access and interact with their own health data in a secure and seamless way.

Self-Care Management – the utilisation of wearables, apps, telehealth, and telecare.

Infrastructure Interoperability – joining up health care settings e.g. via HSCN (Health and Social Care Network) and providing effective systems access throughout the footprint.

Digital Maturity – providing enhanced systems and functionality for Medicines Management and Optimisation, Transfer of Care, Asset and Resource Optimisation, Orders and Results Management.
 
We can :-
  • provide assistance to refresh digital strategies, secure funding required to deliver new solutions, backed by robust business cases.
  • support the development of credible and detailed project plans with strong governance regarding risk, issues, and change management.
  •  offer much needed capacity and capability to ensure full utilisation of key solutions for go-live.
  • work closely with the STPs to highlight and help address and gaps, overlaps and competing priorities at the provider, BAU, STP, ACS, ICS, LDR, GDE level.
  • advise you on how capable, are your applications and infrastructure, to support the much-needed interoperability between inter and intra organisation systems.
  • facilitate processes and systems, co-operation and collaboration of inter- and intra-organisation.
  • help you to determine with confidence the speed with which solutions can be delivered and aligned to the process and organisational changes as stated in the STP plans.
  • help to resource and establish reliable processes and data for measuring benefits.
Transforming Healthcare Through Cloud Technology article published in Heatlh Business - read here.

Aligning technology and estates strategies article published in Health Estate Journal - read here.

What should CIOs be focusing on in 2019 article published on digitalhealthage.com - read here.

Implementing Disruptive Technology at Scale in the NHS article - attached.

 
Current and planned activity: 
In 2018 ETL worked with SEL STP to refresh their Digital Strategy. This was done in collaboration with provider organisations, GPs, CCGs, Community Trusts, Social Services, Third Sector, London Ambulance and 111 Service.
 
Matt Hancock, the secretary of State, announced £412.5m for Health System Led Investment (HSLI) in Provider Digitisation. This gave the STP the funding to deliver the changes in the digital strategy. ETL facilitated the creation of the HSLI Investment Case for £13.7m funding over 3 years and was hailed as the standard for the whole of London by NHSE.
 
ETL then worked with the STP and provider organisations to develop the PIDs, Business Cases and Value for Money (VfM) analysis for each of the initiatives.
 
The plan is to support the delivery of these projects and agree the priority initiatives for FY19/20 based on the ICS and NHS 10-year plans. This will lead to the creation of PIDs, Business Cases and VfM analysis for each of the projects for submission in Spring 2019.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
2
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Innovation 'Elevator Pitch':
Brain in Hand helps individuals to achieve their goals, build confidence, and overcome problems more independently. Secure cloud-based software allows users to develop personal support plans accessible via mobile and stay connected to supporters.
Overview of Innovation:
Brain in Hand’s professional support system gives people easy access to personalised digital self-management tools and human support. Always available via mobile, it helps with remembering things, making decisions when anxious or confused, and coping with unexpected events. Suitable for people with a range of neurological and mental health difficulties, Brain in Hand improves confidence, enables people to cope with anxiety, and increases independence. It also reduces demand on carers and support services.
Whenever we provide support to an individual, we tailor it to their unique needs – and, just as importantly, their unique strengths and goals. Users receive personal planning sessions guiding them to consider what they want to achieve and how best to use the software to do it: using a person-centred approach, a Brain in Hand specialist helps the individual – and their supporters – to begin populating a secure website with their schedule, prompts and reminders for important tasks, and a bespoke stock of strategies in the user’s own words. This information is accessible via mobile software, providing the user with anytime-anywhere access to their most effective co-produced solutions and enabling them to solve problems independently while building healthy habits.
A typical selection of goals to which BiH users might relate strategies, broken down into simple steps, might include:
  • Emotions and feelings: managing anxiety
  • Travel: using public transport
  • Communication: expressing needs
  • Social: new people and new situations
  • Study or work skills: breaking down assignments
  • Organisation: knowing where to be and when
  • Independent living: managing housework, remembering to eat
  • Relationships: responding to others’ behaviour
The software also allows users to monitor their wellbeing and review successes, plus connect to existing supporters or on-demand remote support.
We can deliver all elements of the system to users or work with organisations to introduce BiH into services in the most appropriate way for them.
Completely configurable to each person’s needs, Brain in Hand is a complete support system linking the individual, their supporters or carers, and support teams together using a digital framework. It is digital self-management and human care. Our philosophy is not to try to cure conditions but to enable our users to manage difficulties and be the person they want to be; this leads to a reduction in required support over time, as seen in case studies.
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Mental Health: recovery, crisis and prevention / Wellness and prevention of illness / Digital health / Person centred care
Benefit to NHS:
Improving outcomes for autistic people is a clinical priority for the NHS and is a major focus in the NHS 10-year plan. It is estimated that there are over 480,000 autistic individuals in the UK: the annual cost of this group to the UK is estimated at £32bn.

Autistic people often experience disproportionately poorer outcomes: higher rates of mental health issues, lower employment rates, and increased risk of withdrawing from education. They are often frequently in and out of NHS service provision throughout their lives: many local NHS teams are prioritising services to better address unmet need, prevent and avoid crises, and help people to self-manage long-term conditions.
BiH has proved highly positive for this population and has delivered considerable financial savings to social care and education. Our system has been used by over 4,500 people and proven to deliver positive results for patients/service users and support organisations against national and local improvement targets.

Users can access support whenever and wherever it’s required; this knowledge makes them feel more confident in their ability to self-manage and more supported between contacts with supporters. This leads to improved independence, a reduction in crises, and over time a stepping-down of support. The system also enables people to monitor their own wellbeing and for supporters to review this information; with real-time insights into how individuals or groups are coping patterns can be identified, and with notifications supporters can proactively intervene when needed or keep a light touch if appropriate. Staff can therefore direct resources and energy where it’s most needed, improving their reach and support more people more effectively.

Users’ quality of life improves: many of our users can start work, engage in education and have a more fulfilling life. Delivering improved outcomes for users means we can evidence a strong return on investment achieved by our health and social care clients. We have attached two case studies, one from our project in Mental Health Services in Kirklees and another from an implementation in Hampshire.
Initial Review Rating
4.60 (1 ratings)
Benefit to WM population:
Brain in Hand promoted independence and resilience and empowers users to take responsibility for their own health and wellbeing.

BiH supports users to develop independence and increase confidence and self-sufficiency. Our system has been successfully used in care discharge settings to allow people to live more independently: accessing coping strategies and professional support lets users take personal support plans with them into life in the community and breaks the cycle of users moving in and out of care.

Our approach is truly person-centred and BiH places the service user in charge of their own care. WMAHSN recognises that this is a key ingredient for achieving a healthier region and excellence in care. Using BiH users can track and manage their own anxiety and control the level of involvement of personal or professional supporters; they can seek additional support when required, which leads to a reduction in crises due to securing help earlier, non-intrusively and discreetly before problems escalate.

It is a priority to encourage users to obtain and maintain employment. BiH has a proven record successfully supporting users in education and to obtain and maintain employment. One of our successful local projects is in Acquired Brain Injury rehabilitation with Birmingham Community NHS, the primary aim of which is to support users back into work; we have also worked with a supported internship programme in Hereward College.
BiH is fully configurable to match intervention/escalation policies for an organisation or user cohort, allowing differentiation in the support provided. There is a range of delivery models by which the service can be adopted by organisations and individuals, allowing the greatest flexibility of availability.

The graphic below is from our implementation in Hampshire and the outcomes stated are typical of what users can achieve. Further examples of the impact we have can be found here - https://www.youtube.com/watch?v=gfKq40VNHJ8&feature=youtu.be

See Documents for Info Graphic - https://meridian.wmahsn.org/files/Brain_in_Hand-Case_Study.jpg

See attached case studies – Kirklees in particular, as it includes a table of direct savings and avoided costs. Kirklees attribute significant savings per user to the implementation of BiH. The graphic below is from our implementation in Hampshire.

See Documents for Info Graphic - https://meridian.wmahsn.org/files/Brain_in_Hand-Service_Savings.jpg
 
Current and planned activity: 
We have several NHS programmes underway including:
  • Birmingham Community NHS Trust: ABI rehabilitation service
  • Barnsley CCG: Adult Autism service transformation support
  • Bolton CCG: Autism, Mental Health
BiH has been awarded a place on the NHS Digital Health Accelerator.  The GMCA via the Manchester AHSN are working with us to evaluate how the adoption of the BiH service model across the Integrated GMHSCP Ecosystem could deliver user benefit to patients and financial savings to organisations.

Requested / Planned Activity
We welcome the prospect of BiH deployment for cohorts of users with a wide range of needs and for co-evaluation of the success of applying BiH’s model to different diagnoses and requirements. We are keen to develop our qualitative & quantitative evidence base and to participate in clinical research to continue proving the effectiveness of our system, as well as to enable us to develop our service more effectively for as many users as possible.
 
What is the intellectual property status of your innovation?:
All BiH software and supporting materials are developed by the company, proprietary and protected under international law. BiH has registered trademark. The BiH system does not infringe or depend on the IP of any other product.

Product / Service Certification
BiH is recognised as a leading professional health care application. ORCHA categorise us as a professional system and gave us the highest rating of any mental health app they have reviewed. ORCHA have awarded us a score of 89%.
The National Autistic Society has selected us as their mobile solution for people who need help to achieve greater independence.
BiH is included in NICE guidelines for the management of autistic patients in General Practice. Under NICE definition we are a tier 2 Digital Health Technology.
Brain in Hand has attained the NHS National Network’s Information Governance Statement of Compliance (IG SoC) (registration number 8HY58).
 
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
4
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Innovation 'Elevator Pitch':
We enable employers to provide a one stop support package for employees in times of need. They phone a single phone line to access support for issues inc. emotional support, managing physical & LTC's and providing signposting to local services 
 
Overview of Innovation:
What is BackPack?
Backpack enables employers to provide a one stop support package for their employees in times of need.
Employees phone a single phone line to access support for a range of issues including emotional support, managing physical and long term conditions and providing signposting support to local services offering support in a range of areas including managing finance, debt and other issues. 
The BACKPACK Online Portal
Clients log in with their membership reference to access;
 
Information on;
  • Long Term condition management
  • Local information to support
  • How to access BACKPACK services
 
Access to;
  • Self-Diagnostic forms
  • Quizzes and exercises
  • Checklists
  • Webinars and video information
  • Useful articles and Blogs
 
What Support Is Provided?
Lifestyle Support around long-term conditions- diabetes, HIV, other
Emotional Support 
 
Stage of Development:
Trial stage - Trial stage to prove that the idea actually works as intended
WMAHSN priorities and themes addressed: 
Mental Health: recovery, crisis and prevention / Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Education, training and future workforce / Wealth creation / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
People with mental and physical health conditions will learn to self manage and are less likely to present to primary or secondary care. This will reduce the pressure on services.
This early intervention model, which follows the Preventative Model will reduce demand on the health and social care ecosystem.
We will evaluate the project outcomes. 
We will share best practice
Proactively identify needs through the 'on-boarding' triage programme
Initial Review Rating
4.60 (1 ratings)
Benefit to WM population:
We seek to improve the physical, social and mental well-being of the WM population
People in the WM will recive fast and easy access to personalised care at the early stages of their needs
People will be able to access information 24 hours a day, 7 days a week- at a time to suit them
People will grow their capacity to self manage their own condition or that of the people they care for.
Easy access to mental health resources will help to prevent conditions escalating, improving the recovery time.
Deliver value to the client form first contact through proactively identifying needs at the 'on-boarding' triage programme
Current and planned activity: 
We plan to pull on all our strengths to deliver this innovative programme;
Health Exchange's current triage system used to deliver a holistic well being service for NHS
Citizen Coaching's online course delivery and impact measurement framework. Citizen is a member of Living Well Consortium- delivering IAPT (Improving Access to Psychological Therapy) inteventions.
Our indepth knowledge of the employee assistance market 
Our multi-channel approach to well-being services, blending online and physical interventions
I-SE's strength in taking social enterprises to the market place and operationalising new concepts

 
What is the intellectual property status of your innovation?:
BACKPACK (TM) This will be a collaboration between Health Exchange, I-SE (Initiative for Social Entrepreneurs) and Citizen Coaching. We seek advice on how to progress this. All three busineses are social enterprises.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
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