Whose Shoes? – An exciting approach, allowing you to ‘walk in other people’s shoes’ and co-produce sustainable improvements. (#1914)

Creation
Draft
Initial
Detailed
Accepted
Adoption
Idea Description
Supplementary Information
Innovation 'Elevator Pitch':
Whose Shoes? uses a range of scenarios and topics to help staff explore the concerns, challenges and opportunities facing different groups. So you can walk in their shoes understand the process and issuses associaed with making (an informed) decision
Overview of Innovation:
Whose Shoes? is a popular approach to co-production within the NHS, endorsed and actively supported by the Patient Experience team at NHS England and the Transformation team within NHS Improving Quality, as well as local authorities, universities and other public services. It is a flexible tool that can be adapted (through bespoke partnerships) to a wide range of topics and challenges. The original board game, launched in 2008, explored issues around the emerging personalisation agenda.
A person-centred and values-based focus remains central to all development.
New material is being developed through strong collaborations with passionate people, fired by a very strong social media presence and networking capability. Whose Shoes looks at issues from different perspectives and triggers crucial conversations, with real ‘light-bulb moments’ as participants come together as ‘people’ rather than roles and work together to find solutions to the issues that matter to them. Getting as wide a range of participants as possible around the table cuts across boundaries and flattens hierarchy.
The relaxed approach creates the conditions for ‘service users’ to contribute as equals in a relaxed environment which is conducive to open, honest exchanges. People are empowered to lead rather than simply contribute. There is a strong focus on action and sharing good practice widely, with participants encouraged to make pledges and to share good practice through stories and case studies and to promote these through social media. Graphic recording of Whose Shoes workshops is very popular with hospitals using the records as action plans.
The maternity version of Whose Shoes? has been developed in partnership with the London Strategic Clinical Network and NHS England. It was piloted in five London hospitals. Workshops are now spreading – including other London hospitals, Guernsey, Leeds, Cumbria and Manchester.
Whose Shoes? material to improve communications between children and young people, their parents and healthcare professionals has been co-produced with Great Ormond Street and HENCEL.
Scenarios to promote dementia-friendly communities and understanding by NHS staff of the challenges of living with dementia have been produced through partnerships with Skills for Health and an Age UK consortium. Integration scenarios are used in the Darzi programme. Bespoke scenarios around other areas of patient experience (e.g operating theatres) is being trialled with Kingston Hospital
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':
Whose Shoes?® more than a ‘board game’. Through a wide range of scenarios and topics, Whose Shoes?® can help staff explore the concerns, challenges, issues and opportunities facing Diabetics and their care to form plans that will 'Make a Difference'.
Overview of Innovation:
Whose Shoes? is a popular approach to co-production within the NHS, endorsed and actively supported by the Patient Experience team at NHS England and the Transformation team within NHS Improving Quality, as well as local authorities, universities and other public services. It is a flexible tool that can be adapted (through bespoke partnerships) to a wide range of topics and challenges. The original board game, launched in 2008, explored issues around the emerging personalisation agenda.
A person-centred and values-based focus remains central to all development.
New material is being developed through strong collaborations with passionate people, fired by a very strong social media presence and networking capability. Whose Shoes looks at issues from different perspectives and triggers crucial conversations, with real ‘light-bulb moments’ as participants come together as ‘people’ rather than roles and work together to find solutions to the issues that matter to them. Getting as wide a range of participants as possible around the table cuts across boundaries and flattens hierarchy.
The relaxed approach creates the conditions for ‘service users’ to contribute as equals in a relaxed environment which is conducive to open, honest exchanges. People are empowered to lead rather than simply contribute. There is a strong focus on action and sharing good practice widely, with participants encouraged to make pledges and to share good practice through stories and case studies and to promote these through social media. Graphic recording of Whose Shoes workshops is very popular with hospitals using the records as action plans.
The maternity version of Whose Shoes? has been developed in partnership with the London Strategic Clinical Network and NHS England. It was piloted in five London hospitals. Workshops are now spreading – including other London hospitals, Guernsey, Leeds, Cumbria and Manchester.
Whose Shoes? material to improve communications between children and young people, their parents and healthcare professionals has been co-produced with Great Ormond Street and HENCEL.
Scenarios to promote dementia-friendly communities and understanding by NHS staff of the challenges of living with dementia have been produced through partnerships with Skills for Health and an Age UK consortium. Integration scenarios are used in the Darzi programme. Bespoke scenarios around other areas of patient experience (e.g operating theatres) is being trialled with Kingston Hospital
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 / Wealth creation / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
“ Whose Shoes brings people together to have conversations that matter, the resources stimulate thoughts whichlead to new insights & importantly to actions through the power of human connection & the use of narrative. ..... The energy generated is tangible .......it’s sustained long after as the creativity of both the public and professionals in unleashed. I’d really recommend the approach as a vehicle for any service committed to ongoing improvement
#Hellomynameis… Kath Evans, Experience of Care Lead (Maternity, Infants, Children and Young People), NHS England
 
“ ‘Whose Shoes’ has been an incredible catalyst in Maternity care. Having set up 5 pilot workshops with the London maternity strategic clinical network there has been a tremendous ripple out to hold further workshops in other Trusts as well as the phenomenal change platform that is #MatExp.
The actions are far to numerous to list here, some examples: a  graffiti board …to give live feedback on services, decorating the maternity theatre ceilings to improve the environment for women undergoing Caesarean section (CS), optimal cord clamping ……. midwifery workshop to explore better collaborative working - the list is endless.
We have also used ‘Whose shoes’ in other areas of the hospital with success #KHFTWhoseshoes, improving  staff attitude & environment and patient experience in our main operating theatres & having a drop in session on administration at our Trust Open Day”.

Florence Wilcock, Consultant Obstetrician Kingston Hospital NHS Foundation Trust, Chair of the London Maternity Strategic Clinical Network maternity experience subgroup.
 
"Whose Shoes is a creative opportunity to engage staff, women and patients in a process of improvement and enlightenmen, The #MatExp social movement for change ... used in our failing maternity service to better understand the experiences of women, their birth partners & our staff.  The creative energy & ideas generated during our session were directly developed into practical actions & we have subsequently used the model of engagement in other clinical areas.  Whose Shoes played an important part in our improvement journey & is having a direct impact on outcomes for women, birth partners and staff"
At the time of engaging with Whose Shoes, Steve Hams ex-Interim Dir. of Clinical Governance & Chief Nurse for the Health and Social Services Department at the States of Guernsey, now Interim Dir. of Clinical Performance & Delivery, NHS Surrey Downs CCG
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
It feels currently as though the West Midlands is largely missing out on what is now a popular, proven improvement methodology being adopted rapidly in other parts of the UK and now reaching out internationally. This tool is very different from the ‘same old’ , traditional ‘top-down’ consultation models. It is about real staff and patient engagement leading to rapid improvements – and people find it fun too!

The NHS benefits would be similar to other parts of the country but it would be easier and cheaper (travel, accommodation) to work in partnership with West Midlands (ie local) NHS Trusts / CCGs.

Also New Possibilities, the recommended graphic facilitators, with whom we work as very close business associates, are based in Birmingham.

Thus greater adoption in addition to helping, patients and helcare providers it would also allow our regionally based company to grow and develop new specialised products as well exporting this delivery process overseas e.g Currently exploring taking 'Whose Shoes Maternity' approach to Uganda.

Currently Adopted / Procured by:
  • NHS England: North region; East Midlands
  • Hospital Trusts include:
    • Kingston, Guy’s and St Thomas’s, Lewisham & Greenwich, King’s College, UCLH, Leeds, Croydon, Maidstone & Tunbridge Wells, Stockport, Manchester, NHS Cumbria, North Cumbria
  • Cheshire & Wirrall Partnership Trust
  • Guernsey HSSD
  • Great Ormond Street (partnership - CYPMeFirst masterclasses)
  • CCGs include: West Leicester, West Kent, Leeds
  • AHSN / Area Team: Wessex, Thames Valley
  • International workshops and talks delivered: Australia, Malta, France; Puerto Rico
See: www.nutshellcomms.co.uk for 'Case Studies' and other information.
Current and planned activity: 
  • Building on 5 pilot workshops (& Train the Facilitator session) carried out with NHS Eng. & the London Strategic Clinical Network supporting the new maternity experience; now spreading to hospital trusts across the UK
  • 12 Whose Shoes #dementiachallengers in March 2016 workshops across Kent, Surrey and Sussex, run by Age UK consortium, commissioned by HEEKSS
  • On-going partnership with Great Ormond Street Hospital to use bespoke scenarios in #CYPMeFirst masterclasses for multi-disciplinary health professionals working in paediatric services from many hospitals; the first 20 ‘Communications Champions, who are taking this into their own organisations; more being recruited (up to 100)  
Required activity
  • Procurement / Adoption of Whose Shoes? -  Across the W Midlands NHS Trusts, via workshops or via purchase of online/board game versions of Whose Shoes?
  • Collaborative work to personalise Whose Shoes? For particular projects or departments
What is the intellectual property status of your innovation?:
Design registered. UK Registration Design No. 4009563; Trade Mark (Whose Shoes): No. 2502651
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
Simple
Read more
Hide details
Innovation 'Elevator Pitch':
Whose Shoes?® is much more than a ‘board game’ or training. Through a range of scenarios and topics, Whose Shoes?® helps you explore the concerns, challenges and opportunities facing different groups affected by health and social care transformation
Overview of Innovation:
Whose Shoes? is a popular approach to co-production within the NHS, endorsed and actively supported by the Patient Experience team at NHS England and the Transformation team within NHS Improving Quality, as well as local authorities, universities and other public services. It is a flexible tool that can be adapted (through bespoke partnerships) to a wide range of topics and challenges. The original board game, launched in 2008, explored issues around the emerging personalisation agenda.
A person-centred and values-based focus remains central to all development.
New material is being developed through strong collaborations with passionate people, fired by a very strong social media presence and networking capability. Whose Shoes looks at issues from different perspectives and triggers crucial conversations, with real ‘light-bulb moments’ as participants come together as ‘people’ rather than roles and work together to find solutions to the issues that matter to them. Getting as wide a range of participants as possible around the table cuts across boundaries and flattens hierarchy.
The relaxed approach creates the conditions for ‘service users’ to contribute as equals in a relaxed environment which is conducive to open, honest exchanges. People are empowered to lead rather than simply contribute. There is a strong focus on action and sharing good practice widely, with participants encouraged to make pledges and to share good practice through stories and case studies and to promote these through social media. Graphic recording of Whose Shoes workshops is very popular with hospitals using the records as action plans.
The maternity version of Whose Shoes? has been developed in partnership with the London Strategic Clinical Network and NHS England. It was piloted in five London hospitals. Workshops are now spreading – including other London hospitals, Guernsey, Leeds, Cumbria and Manchester.
Whose Shoes? material to improve communications between children and young people, their parents and healthcare professionals has been co-produced with Great Ormond Street and HENCEL.
Scenarios to promote dementia-friendly communities and understanding by NHS staff of the challenges of living with dementia have been produced through partnerships with Skills for Health and an Age UK consortium. Integration scenarios are used in the Darzi programme. Bespoke scenarios around other areas of patient experience (e.g operating theatres) is being trialled with Kingston Hospital
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 / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
“ Whose Shoes brings people together to have conversations that matter, the resources stimulate thoughts which lead to new insights & importantly to actions through the power of human connection & the use of narrative. ..... The energy generated is tangible .......it’s sustained long after as the creativity of both the public and professionals in unleashed. I’d really recommend the approach as a vehicle for any service committed to ongoing improvement
#Hellomynameis… Kath Evans, Experience of Care Lead (Maternity, Infants, Children and Young People), NHS England
 
“ ‘Whose Shoes’ has been an incredible catalyst in Maternity care. Having set up 5 pilot workshops with the London maternity strategic clinical network there has been a tremendous ripple out to hold further workshops in other Trusts as well as the phenomenal change platform that is #MatExp.
The actions are far to numerous to list here, some examples: a  graffiti board …to give live feedback on services, decorating the maternity theatre ceilings to improve the environment for women undergoing Caesarean section (CS), optimal cord clamping ……. midwifery workshop to explore better collaborative working - the list is endless.
We have also used ‘Whose shoes’ in other areas of the hospital with success #KHFTWhoseshoes, improving  staff attitude & environment and patient experience in our main operating theatres & having a drop in session on administration at our Trust Open Day”.

Florence Wilcock, Consultant Obstetrician Kingston Hospital NHS Foundation Trust, Chair of the London Maternity Strategic Clinical Network maternity experience subgroup.
 
"Whose Shoes is a creative opportunity to engage staff, women and patients in a process of improvement and enlightenmen, The #MatExp social movement for change ... used in our failing maternity service to better understand the experiences of women, their birth partners & our staff.  The creative energy & ideas generated during our session were directly developed into practical actions & we have subsequently used the model of engagement in other clinical areas.  Whose Shoes played an important part in our improvement journey & is having a direct impact on outcomes for women, birth partners and staff"
At the time of engaging with Whose Shoes, Steve Hams ex-Interim Dir. of Clinical Governance & Chief Nurse for the Health and Social Services Department at the States of Guernsey, now Interim Dir. of Clinical Performance & Delivery, NHS Surrey Downs CCG
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
It feels currently as though the West Midlands is largely missing out on what is now a popular, proven improvement methodology being adopted rapidly in other parts of the UK and now reaching out internationally. This tool is very different from the ‘same old’ , traditional ‘top-down’ consultation models. It is about real staff and patient engagement leading to rapid improvements – and people find it fun too!

The NHS benefits would be similar to other parts of the country but it would be easier and cheaper (travel, accommodation) to work in partnership with West Midlands (ie local) NHS Trusts / CCGs.

Also New Possibilities, the recommended graphic facilitators, with whom we work as very close business associates, are based in Birmingham.

Thus greater adoption in addition to helping, patients and helcare providers it would also allow our regionally based company to grow and develop new specialised products as well exporting this delivery process overseas e.g Currently exploring taking 'Whose Shoes Maternity' approach to Uganda.

Currently Adopted / Procured by:
  • NHS England: North region; East Midlands
  • Hospital Trusts include:
    • Kingston, Guy’s and St Thomas’s, Lewisham & Greenwich, King’s College, UCLH, Leeds, Croydon, Maidstone & Tunbridge Wells, Stockport, Manchester, NHS Cumbria, North Cumbria
  • Cheshire & Wirrall Partnership Trust
  • Guernsey HSSD
  • Great Ormond Street (partnership - CYPMeFirst masterclasses)
  • CCGs include: West Leicester, West Kent, Leeds
  • AHSN / Area Team: Wessex, Thames Valley
  • International workshops and talks delivered: Australia, Malta, France; Puerto Rico

See: www.nutshellcomms.co.uk for 'Case Studies' and other information.
Current and planned activity: 
  • Building on 5 pilot workshops (& Train the Facilitator session) carried out with NHS Eng. & the London Strategic Clinical Network supporting the new maternity experience; now spreading to hospital trusts across the UK
  • 12 Whose Shoes #dementiachallengers in March 2016 workshops across Kent, Surrey and Sussex, run by Age UK consortium, commissioned by HEEKSS
  • On-going partnership with Great Ormond Street Hospital to use bespoke scenarios in #CYPMeFirst masterclasses for multi-disciplinary health professionals working in paediatric services from many hospitals; the first 20 ‘Communications Champions, who are taking this into their own organisations; more being recruited (up to 100)  
Required activity
  • Procurement / Adoption of Whose Shoes? -  Across the W Midlands NHS Trusts, via workshops or via purchase of online/board game versions of Whose Shoes?
  • Collaborative work to personalise Whose Shoes? For particular projects or departments
What is the intellectual property status of your innovation?:
Design registered. UK Registration Design No. 4009563; Trade Mark (Whose Shoes): No. 2502651
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
Simple
Read more
Hide details
Innovation 'Elevator Pitch':
Our online workshop helps women from all backgrounds in all demographic areas to access positive, factual information to support their birth choices using evidence-based information that can be updated as and when new guidance is released.
Overview of Innovation:
The Real Birth Company’s mission statements are ‘to provide relevant, up to date, evidence based antenatal information that is delivered with a positive attitude’ and ‘to impart our knowledge with confidence to empower women and their birth partners at this very special time’.
 
We have achieved this with our RCM accredited antenatal education training programme that has been developed into an online e-learning antenatal resource for women birthing in the UK & is available in several languages. This e-learning resource is a birth physiology workshop full of important information that supports UK practice & enables women to understand the reasons behind their care, whilst supporting them to make informed choices in labour.


Antenatal education is essential to helping women form opinions & make choices in regard to their pregnancy & birth. There are various types of antenatal education. Hospital accessible antenatal education is dependant on resources, demographics & availability of staff to name a few. Lots of these classes use traditional methods of teaching with limited time to discuss at length the physiology.
 
The Real Birth online workshop is easily updated & uses evidence-based information from NICE, WHO, RCM, RCOG & others. It is holistic, culturally sensitive & can be accessed from anywhere by computer, tablet or mobile phone.
 
The innovation of creating a multi-lingual online e-learning workshop came from the positive birth results that were consistent with women & their partners who had attended a specifically designed positive birth workshop.
 
The workshop was created using techniques that help graduate students revise for exams, this learning technique has been integrated into the imparting of positive birth physiology. The use of non-threatening language & positive birth information helps to normalise birth & reduce fear. When fear is reduced in labour the benefits for both mother & baby are both psychological & physiological.
 
Barriers to effective antenatal education can include:
  • time pressures for antenatal classes
  • finding midwives who feel comfortable giving antenatal education
  • update & training costs
  • availability of classes
  • limited spaces for face to face classes
  • cost of interpreting services/availability of interpreters
  • birth terminology used
  • women being unable to attend for social or demographic reasons
Our online workshop works to address these barriers to help women from all backgrounds in all demographic areas to access positive, factual 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)
WMAHSN priorities and themes addressed: 
Digital health / Innovation and adoption
Benefit to NHS:
The Real Birth online workshop is an easily accessible form of evidence-based antenatal education (updated as evidence changes) that is interactive, informative & fun to use.
 
The Better Births Maternity Review says that all women should have access to information to enable them to make an informed, non-bias choice.

Making Normal Birth a Reality states ‘evidence-based information for women about factors that make a normal birth with good outcomes for the mother & baby more or less likely, presented in a format which they understand so that they can plan for the kind of birth they want & make informed decisions’ is an essential part of birth preparation.

WHOs new recommendations on reducing unnecessary births by C-section recommended ‘Health education for women is an essential component of antenatal care’ by using childbirth education workshops that include partners to support women & address fear of birth with methods such as understanding birth physiology, our workshop helps to address unnecessary interventions in labour.

Women with access to antenatal education have a higher chance of normal birth & a more positive birth experience that can help in the postpartum period.
 
The workshop follows a researched learning technique. Written in a style that enables users to learn & retain the information more effectively leading to confidence & understanding of birth.
 
Accessed from 25 weeks of pregnancy via a unique coded card issued by the healthcare provider, users work through 1 module at a time before accessing the next to ensure the workshop is comprehensible. Within the modules are questions, diagrams & carefully designed non-threatening animations.
 
Each language has been translated by first language speakers to ensure the terminology is understandable & animations are culturally respectful whilst explaining a journey of birth. NICE Pregnancy & Complex Social Factors list barriers for women who speak no or little English that include lack of interpreters & knowledge of the maternity service. Our workshop helps address such barriers. NICE also say that with this group of women other methods such as online video clips & audio information should be used.

  
 
Our workshop is factually based giving true & correct information & techniques to practice for labour along with the best positions & why. It addresses subjects like the reasoning behind recommendations for skin to skin & looks at how this can help aid mental health for both parents in the postnatal period.
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
Antenatal education has a role to play in improving knowledge of, and preparation for parenthood and can lead parents to be, to adopt a range of healthy behaviours that affect pregnancy and birth, improving outcomes and the mother’s experience of birth.
 
The Real Birth Company is committed to supporting all women to access up to date and evidence-based information relating to their birth. We believe that all women should have access to this information and have produced the e-learning modules in several languages to help tackle health inequalities.
 
Tackling health inequalities in infant mortality and infant and maternal health, will not just improve health outcomes today, but lay the foundations for sustainable, long-term improvements in health.
 
At 5.5 deaths per 1,000 live births, the West Midlands has the poorest infant mortality rate in England [2014 data].  The infant mortality rate takes into account the total number of live births and so provides a more accurate indication of trends than just analysing the number of deaths in infancy over time. The West Midlands rates are significantly higher than the England average. (source)
 
Poorer mothers-to-be often do not attend antenatal classes. Almost three-quarters of pregnant women on low incomes do not attend antenatal classes according to new figures. Nearly half are not even offered them on the NHS. (source)
 
The Real Birth Workshop was created because we believe that all expectant parents should have access to positive birth information. It is beneficial for pregnant mums and their birth partners to have positive help with their birth preparation. We support all birthing choices because we believe in empowering women with the right information when they need it.
 
A report by the National Childbirth Trust (NCT) Preparing for birth and parenthood report surveyed 928 expectant parents (first-time mothers and fathers) attending antenatal courses. The research found that while only 3% of women said they felt confident about birth before attending an antenatal course, afterwards 98% said they felt confident or fairly confident. Similarly, among fathers-to-be surveyed, just 1% said they felt confident about birth before their course; afterward 97% felt confident or fairly confident.
 
The Real Birth Online Workshop provides parents to be with the education they need to manage and reduce maternal anxiety leading to improved coping strategies, greater partner support and a better birth experience.
Current and planned activity: 
We believe the workshop shows decreased admission in the latent phase, decreased use of analgesia & an increase in women having a positive birth experience.

We need champions who can apply for NIHR funding with us to pilot The Real Birth Online Workshop with women using their NHS maternity services.  
 
A number of languages are currently active, we want to include more to help all women access valuable antenatal education. Being able to access our online workshop provides antenatal education to women who may otherwise be unable to attend classes for various reasons including social, cultural & demographic.
 
Many proactive measures are being taken to address perinatal mental health. We believe a positive birth experience doesn't depend on mode of birth but choice, understanding & involvement in decision making & empowerment in pregnancy & labour.
 
Our programme can have a positive effect on women’s birth experiences & her birth partners & assist with informed choice & understanding of birth.  
What is the intellectual property status of your innovation?:
100% IPO The Real Birth Company Limited
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
N/A
Ease of scalability: 
Simple
Read more
Hide details
Innovation 'Elevator Pitch':
Dip.io, a CE approved product turns the smartphone into a clinical grade device enabling lay-users to test urine in their own home, with clinical accuracy and share results electronically with their clinician. 
Overview of Innovation:
42m urine tests a year are undertaken in the NHS to screen for a wide range of conditions. Currently patients collect a sample at home and bring it to the clinic or provide a sample in the clinic where it is either tested on site or sent to a laboratory. This is inefficient, inconvenient for the patient and presents opportunity for improvement in patient experience, clinical quality and cost efficiency.
 
Healthy.io is the first company to turn the smartphone into a regulatory-approved clinical device. Its first product, Dip.io, uses computer vision and user centric design to turn the smartphone into a urinalysis device. Built around existing semi-quantitative urinalysis dipsticks, Dip.io complements established clinical efforts by empowering patients to test themselves at home with no quality compromise, and securely share results with a clinician.
 
Healthy.io is empowering patients to take urine testing into their own hands, opening up an immense opportunity to improve preventive efforts, enable early interventions and increase optimisation in the outpatient setting. Key pathways in which digital urinalysis has strong potential to improve patients’ lives and reduce cost to the NHS:
  • Antenatal care: women with hypertension or diabetes in pregnancy have a higher risk of developing pre-eclampsia, a leading cause of maternity morbidity. Dip.io has proven through a usability study at Johns Hopkins to improve women’s experience and could reduce outpatient appointments amongst high risk pregnant women. 
  • Chronic Kidney Disease (CKD): Home-based screening of albumin:creatinine (ACR) for people with diabetes or high blood pressure, to increase adherence to NICE CG 182 and diabetes care process beyond the current level of 50%.
  • Urinary tract infections (UTI): opportunity to improve self-management for patients at risk of admission from UTI (e.g. MS), reduce the 5m GP attendances for UTI in primary care and create digital pathways for pre-op assessment  through using digital urine testing, within existing clinical guidelines.
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Long term conditions: a whole system, person-centred approach / Digital health / Person centred care
Benefit to NHS:
Benefits to NHS in line with FYFV:
  • Primary Care (Diabetes and CKD screening): Smartphone enabled self-testing offers a critical complement to existing population health efforts by shifting testing from primary care to the home. Providing alternatives to face-to-face contact frees up GP resources and nursing time. NICE recommends that every person at increased risk of CKD (people with diabetes or hypertension) needs to annually get their urine tested. However only 50% of people with diabetes and 30% of people with hypertension have a regular urine test reported. Over 1 million cases of CKD remain undetected. Diffusing Dip.io to every at risk patient (8.3m) could improve adherence with no additional overhead, reducing CKD cost by up to £1bn.
  •  
  • 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%.
  •  
  • Urgent and Emergency Care (Urinary Tract Infection): Conducting common diagnostic tests at the patient's home supports "improving the ability of patients to self-care for minor illnesses" (UECR).  This includes the need to anticipate recurring conditions such as UTIs. 1-3% of GP visits are UTI related and UTIs accounted for 14% of emergency hospital admissions in MS patients costing the NHS over £43 million. Dip.io offers the opportunity to improve self-management for patients at risk of admission from UTI, reduce the 5m GP attendances for UTI in primary care and create digital pathways for preop assessment within existing clinical guidelines.
  • Harnessing technology and innovation: Our solution leverages existing technology to transform care delivery and supports the drive to digital adoption. We easily integrate into other technologies (integrated with PKB and Allscripts) and make sure interoperability is built in. We are replicating this model for our next product to bring innovation to woundcare management.
Online Discussion Rating
5.50 (2 ratings)
Initial Review Rating
4.20 (1 ratings)
Benefit to WM population:
Our smartphone-enabled digital urinalysis service aims to improve quality and efficiency of existing pathways, driving better patient outcomes and experience.

Main benefits:

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

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

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

International:
  • Usability study in pregnant women at Johns Hopkins with 92% favourability (soon to be published)
  • US National Kidney Federation and Geisinger Health to improve care for people with hypertension- successful increase in adherence (soon to be published)
  • Dutch Kidney Foundation and Dutch Health to test population screening for ACR in at risk population compared to other method
  • Roll out in two HMOs in Israel for at-risk pregnancy model
Return on Investment (£ Value): 
N/A
Return on Investment (Timescale): 
N/A
Ease of scalability: 
Simple
Regional Scalability:
Our plan is to scale regionally and nationally through a B2B2C business model. We offer several commercial packages that differ in terms of scale, level of integration, agreement timeline and distribution/shipment method. This allows us to partner with different players within the NHS to provide them full digital capabilities through customised, white label kits, a localised application and access to our algorithm in an end-to-end service proposition. Our vision is to serve as the backbone for smartphone enabled, image based medical diagnostics and enable partners to bring our innovation to their existing user base.
Measures:
Healthy.io and the Dip.io solution work together with healthcare organizations to improve efficiency, value and outcomes by digitizing existing pathways. Measure include:
  • Save outpatient appointment and reduce consultation time to reduce resource pressures.
  • Increase clinical guideline adherence, improving patient safety
  • Improve patient experience (e.g. minimise absence from work and avoid travel expenses)
Adoption target:
Start with a phased roll out to try, test and scale the innovation in a regional NHS organisation. We anticipate that success from this roll out will lead to spreading the implementation of the technology to other specialties within the organisation, other hospitals/GPs within the group and to other providers and partners within the WM area.
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Innovation 'Elevator Pitch':
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.
Read more
Hide details
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