QDoc: A user friendly mobile application for shared decision making in mental health (#2257)

Creation
Draft
Initial
Detailed
Accepted
Adoption
Idea Description
Supplementary Information
Innovation 'Elevator Pitch':
A shared decision making tool that helps to organise the psychiatric consultation and empowers the service users with right information to make the right choices.
Overview of Innovation:
John impressed me with occasional sparks of intelligence and wit. When I first saw him in outpatients, he had all too familiar decline in his personality resulting from a severe mental illness. As a bright young man he was able to secure a place at Oxford for studying history, his long term passion. He was brilliant in his studies but then unfortunately had a gradual decline in studies and in less than one year he had to leave his course.

John appeared hostile in consultations.His mother who supported him in his struggle against voices, delusions and social isolation sat quietly during the appointments, bewildered and confused about what has happened to her very intelligent son.

Despite my best efforts, I could not persuade John to engage in my consultations. He and his mom appeared to be happy with the care but they appeared to have little to ask. The appointments were stereotyped; checking of symptoms, medications, mostly acrimonious debate against continuing treatments and the next appointment.

Once I asked whether they will be interested in few questions which other patients had asked me about their condition. Slightly puzzled as to why a consultant would give them questions to ask (and not answers!), they agreed. I gave John few questions for each appointment, which either John could explore himself or simply bring them to the next appointment.

Gradually the consultations became more engaging and I could see sparks of brilliance in the questions.John now demanded answers to the questions which became more challenging for me. His mother also asked interesting questions, not merely sitting as spectator. For the first time, I could see the shared decision making in action!

That was the start of QDoc (Questions from doctor). I developed a user friendly mobile application that provides all the questions service users can ask in psychiatric consultation about any aspect of illness. Patients can select appropriate questions for each consultation and also add their own questions or notes. QDoc also has other functions to organise the consultation in most effective way. No more scribbling on pieces of paper and then looking for them in the consultation hurriedly!

I have ideas to develope the utilities and functions in QDoc,making it one of the most powerful tools for shared decision making and self-management. I am keen to collaborate to take this further. QDoc is avialable at Google app store bleow
//play.google.com/store/apps/details?id=com.syml.mhq&hl=en_GB
Stage of Development:
Evaluation stage - Representative model or prototype system developed and can be effectively evaluated
Similar Content3
Innovation 'Elevator Pitch':
Swifti is an app designed to address a gap in the mental health services.  It provides service users with a flexible, quick and convenient method of connecting with mental health practitioners.  
Overview of Innovation:
 
  • Specifically, the app has been designed to target individuals who may have been referred to the service, but struggle to access it due to issues such as  the debilitating nature of mental health or lengthy waiting lists. 
  • Through the app, service-users are able to book appointments in advance and cancel upcoming appointments. They can also be notified about their upcoming appointments.
  • Mental health practitioners are also able to advertise last-minute appointments that they have (e.g. up to two days prior to the appointment), which may have come about via cancellation with short notice. 
  • The aim of this is not only to make more efficient use of the practitioners’ time, but to also create a flexible appointment system for individuals who are unable to access the service initially due to being too psychiatrically unwell to attend (Killaspy, 2000), work schedules and ongoing disengagement.
  • In addition, users of the app will be able to engage in live message and video chats with practitioners if they are unable to physically attend their appointment. 
  • Moreover, if practitioners such as (Clinical Psychologists/Assistant Psychologists/CBT Therapists) have spare time to attribute to this facility, they can also go live outside of set appointment times in order to speak to various service-users who would like a brief chat at the time.  This should enhance the connection that the NHS mental health service has with their service-users and may prevent some individuals from falling through the gap when being referred for psychology. 
  • On the app there will also be the option for a swift feed which informs the app users of upcoming events which they may wish to attend and that latest information which is relevant to their healthcare.
  • Furthermore, self-help tools such as Mindfulness and Cognitive Behavioural Therapy (CBT) will also be accessible on the app.
  • NHS mental health staff members will also be able to access each individual’s case file via the app.
  • This app has not been designed to be abused and relied upon as a way of avoiding face-to-face contact with mental health practitioners.  Instead, it has been developed with a brief intervention in mind, when conventional methods fail.  The hope is that service-users may be able to utilise this facility for up to a few months before working their way up to face-to-face contact.  Long-term exceptional circumstances, such as work schedule related disengagement, may also be considered at the discretion of the practitioners.
Stage of Development:
Ideas stage - Early concept and ideas stage
WMAHSN priorities and themes addressed: 
Mental Health: recovery, crisis and prevention / Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Wealth creation / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
Swifti aims to improve the efficiency of the mental health services by targeting service-users who do not thrive from conventional methods of communication.  The app will also increase savings for the NHS by utilising the time of mental health practitioners more efficiently and reducing the likelihood of missed appointments.  
Initial Review Rating
3.00 (1 ratings)
Benefit to WM population:
This app will create a flexible appointment system and an interactive medium for individuals who are unable to access the service, due to being too psychiatrically unwell to attend (Killaspy, 2000), work schedules and ongoing disengagement.  646,656 outpatient appointments were missed in 2011-2012 across the West Midlands region (BBC, 2012). The issue of missed appointments appears to be a growing problem, whilst disrupting the continuity of care for service-users and costing the NHS millions every year.
Current and planned activity: 
There are no other stakeholders and I have no current communications with the NHS regarding this app. I would appreciate some support and guidance with the development of the app and presenting the final product to NHS commissioners.
What is the intellectual property status of your innovation?:
I have written a business plan for the app which I have now copyrighted.
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
2
Read more
Hide details
Innovation 'Elevator Pitch':
Heart DNA is a genetic testing kit for patients at increased risk of developing atrial fibrillation and other cardiovascular diseases, the results are reviewed and assessed by a consultant who is well informed about the patient’s medical history.
Overview of Innovation:
“Heart DNA” is a genetic testing service for patients at increased risk of developing cardiovascular diseases and for cardiologists and genetic counseling officers/geneticists who would want to work with us in delivering this service to the public.

We are partnering with healthcare professionals who will review (online) the genotyping reports coming from our well established partner lab and will be giving their health assessment based on both: the patient’s health profile/medical record, which our users will be asked to fill in early on our website, and on the genetic predispositions that may be found in the patients DNA. In esssence, our consultants will be able to give an informed screening assessment that covers: the detection of inherited conditions and an assessment to the patients’ response to certain drugs that may well be administered to treat CVDs.

Heart DNA is a simple saliva-based test that is supported by scientifically validated research and an extensive amount of studies. Heart DNA analyses the patient’s unique genetic markers, which influence a broad range of heart-related conditions, our gene panel list consistc of 96 markers that cover: Atrial Fibrillation, Coronary Artery Disease, Myocardial Infraction, Cholesterol levels, and risks for hypertension. It can also help identify a patient’s propensity for increased risk towards certain heart medications, eight classes of drugs that affect the cardiovascular system are examined; anti-platelets, anti-coagulants, statins, stimulants, beta-blockers, ACE inhibitors, calcium channel blockers and hormone therapies.

Our test provides information that allows Doctors to;
1. Monitor a patient’s specific health conditions thoroughly.
2. Prescribe a more optimal medication and dosage for a patient.
3. Suggest early lifestyle and diet interventions to help combat and prevent certain heart conditions.

Overall, the aim is to enable doctors and patients to bridge the gap in genetic information that has proved over an extensive amount of studies and research to be pivotal in the design of better prevention and treatments regimens. Our focus is to cause a change in the architecture of complex care routines that would address the challenges of working at scale, and which can capitalize on the associated opportunities that we will enable by striking business partnerships with medical consultants to create and deliver a distinctive competitive advantage over all competing genetic testing companies. 
Stage of Development:
Trial stage - Trial stage to prove that the idea actually works as intended
WMAHSN priorities and themes addressed: 
Long term conditions: a whole system, person-centred approach / Advanced diagnostics, genomics and precision medicine / Wellness and prevention of illness / Digital health / Patient and medicines safety / Person centred care
Benefit to NHS:
DNA testing is not available at the point of care, regardless of its imperative potential to mitigate treatment regimens and enhance disease prevention pathways. Moreover, once an individual is diagnosed as having a cardiovascular condition, the challenge exist in prescribing the right medication at the right dose in the right time.
Tools promoting optimal direction for healthcare service and moving patients towards the digital space will be hugely disruptive in a market where faster processes and cheaper costs are imperative to its evolution. Products that can enhance the working process inside GPs offices and provide more rapid, reliable and robust diagnosis decisions within primary care, that could enhance workflow for healthcare professionals, assisting earlier triage and potentially redesigning GP care pathways; such products have the potential to save the healthcare and biotech industries over £1bn every year, just in labour time. 

The current pathway to obtain a genetic test for a single cardiac condition through the NHS is lengthy, complex, costy and is not accessible for everyone; with multiple visits and referrals to see healthcare specialsits (Annex; Figure 1). 
Our system workflow has been designed to empower patients within an innovative framework, that ensures having a certified partner cardiologist assessing their health condition before a patient can receive his/her genotyping results. It will also ensure that patients and doctors have an easy access for booking appointments to follow up, when the need is present. Our comprehensive service will cut down the turn around time from several months to 2 weeks with as little steps as the figure shows (Annex; Figure 2). 

Moreover, our database will later provide an electronic medical record through which other healthcare consultants can opt to review when they need to access the patient’s genotype before prescribing a certain drug at any stage of the patient’s life. Thus, cutting down the path of trial and error before the the right medication is prescribed to the patient. 

Early screening for genetic predispositions and having an early risk assessment for patients who may develop Arterial Fibrillation or any other CVD will significantly allow the NHS mitigate prevention regimen for the general public before they become patients. Thus, signinficantly reducing the £15bn bill of CVDs every year (BHF stats 2015).

 
Initial Review Rating
4.20 (1 ratings)
Benefit to WM population:
The major risk factor associated with Atrial Fibrillation and all other CVDs is having a family history with the disease. By family history we are referring to the genes that have passed from the parents to their offspring, which (if found to be mutated as well) can increase the risks of that individual developing the same disease. 
While it is well accepted that such risk factor could not be changed or adjusted (at least for the time being), hence the term "non-modifiable" risk factor, it is also accepted that if such risk is detected then the patient would be better positioned to manage the other "modifiable" risk factors early on, which can significantly change the course of the patient's life and the development course of his/her inherited condition. 

We believe that well informed and educated individuals about their risk factors will allow them take better decisions and have more enlightened judgments when it comes to managing their risk factors and altering their lifestyle and daily habits. Modifiable factor like quite smoking, being fit, eating healthy and managing diabetes, obesity and cholesterol levels, are all found to be imperative in managing AF and other CVDs from an early stage, the earlier the intervention, the better the outcome. 

Moreover, we believe the greatest benefit to the WM population will come at a later stage through our Data Bank which will provide the perfect reference tool to better direct prevention and treatment regimens withihn the WM population, risk factors such as race, age and sex will all be considered in the future direction towards an advanced and precise person-centerd system.



 
Current and planned activity: 
Business partnerships have all been established for the development and delivery of our product/service. Funding is currenly sought to finance our outsourcing agreements:
  • Genotyping analysis will be conducted at a well established genotyping lab in the UK.
  • Our saliva collection kits will be outsourced from a supplier in the UK. 
  • Our service content is all in place and the gene panel list has been put together through an extensive amount of well researched and accredited reference genetic testing studies, the online platform will be developed by website developement agency in Birmingham.
  • Our box and packaging have been designed and the order is to be placed.
  • An initial agreement has been established with a reputable cardiologist consultant to review the patients results and put his recommendations to each genotyping report being assessed.
  • A pilot study is currently being designed by our Medical and Research Officers (both are GPs at the QE hospital). 


 
What is the intellectual property status of your innovation?:
The company will be developing additional patents and intellectual property related to response and side effect prediction for further treatments of hypertension and other Cardiovascular disorders through its DTC kits and the databank that it will generate from its lab based genotyping services. These will be offered to the BHF and all other concerned research groups in the field of Cardiac Health.

In terms of our regulatory path, there are no specific regulations outside consumer protection, data storage, and for storing biological samples “saliva” we will apply control regs that deal directly with this. 
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
Simple
Regional Scalability:
Please refer to our commercial information section (Business Strategy)
Measures:
​We are here to help; we believe that we have a relevant and compelling solution that (if adopted) can save lives and enhance the prevention and treatment regimens for patients with cardiovascular conditions.
We will measure our performance based on the value that we are delivering. Hence, by the end of year one we are looking to exceed the 1000 kits sale and have a strong clinical data that would support our proposition, in regards to giving patients better options to mitigate their risk factors and to healthcare professionals to administer drugs that are better suited for certain subpopulations; based on genetic makeup and the health profile "environmental factors" for each individual patient.
These assessments will be made through our end of year statistical study that we will run on all the patients whom we have tested. 
Adoption target:
The adoption target is to demonstrate a successful, valuable and cost efficient systematic framework that would address the core objectives of the NHS Sustainability and Transformation Plans in drving a genuine chnage to patients experience and health outcomes of the longer term.
Read more
Hide details
Innovation 'Elevator Pitch':

Heart DNA is a genetic testing kit for patients at increased risk of developing atrial fibrillation and other cardiovascular diseases, the results are reviewed and assessed by a consultant who is well informed about the patient’s medical history.
Overview of Innovation:
“Heart DNA” is a genetic testing service for patients at increased risk of developing cardiovascular diseases and for cardiologists and genetic counseling officers/geneticists who would want to work with us in delivering this service to the public.

We are partnering with healthcare professionals who will review (online) the genotyping reports coming from our well established partner lab and will be giving their health assessment based on both: the patient’s health profile/medical record, which our users will be asked to fill in early on our website, and on the genetic predispositions that may be found in the patients DNA. In esssence, our consultants will be able to give an informed screening assessment that covers: the detection of inherited conditions and an assessment to the patients’ response to certain drugs that may well be administered to treat CVDs.

Heart DNA is a simple saliva-based test that is supported by scientifically validated research and an extensive amount of studies. Heart DNA analyses the patient’s unique genetic markers, which influence a broad range of heart-related conditions, our gene panel list consistc of 96 markers that cover: Atrial Fibrillation, Coronary Artery Disease, Myocardial Infraction, Cholesterol levels, and risks for hypertension. It can also help identify a patient’s propensity for increased risk towards certain heart medications, eight classes of drugs that affect the cardiovascular system are examined; anti-platelets, anti-coagulants, statins, stimulants, beta-blockers, ACE inhibitors, calcium channel blockers and hormone therapies.

Our test provides information that allows Doctors to;
1. Monitor a patient’s specific health conditions thoroughly.
2. Prescribe a more optimal medication and dosage for a patient.
3. Suggest early lifestyle and diet interventions to help combat and prevent certain heart conditions.

Overall, the aim is to enable doctors and patients to bridge the gap in genetic information that has proved over an extensive amount of studies and research to be pivotal in the design of better prevention and treatments regimens. Our focus is to cause a change in the architecture of complex care routines that would address the challenges of working at scale, and which can capitalize on the associated opportunities that we will enable by striking business partnerships with medical consultants to create and deliver a distinctive competitive advantage over all competing genetic testing companies.
Stage of Development:
Trial stage - Trial stage to prove that the idea actually works as intended
WMAHSN priorities and themes addressed: 
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 / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
DNA testing is not available at the point of care, regardless of its imperative potential to mitigate treatment regimens and enhance disease prevention pathways. Moreover, once an individual is diagnosed as having a cardiovascular condition, the challenge exist in prescribing the right medication at the right dose in the right time.
Tools promoting optimal direction for healthcare service and moving patients towards the digital space will be hugely disruptive in a market where faster processes and cheaper costs are imperative to its evolution. Products that can enhance the working process inside GPs offices and provide more rapid, reliable and robust diagnosis decisions within primary care, that could enhance workflow for healthcare professionals, assisting earlier triage and potentially redesigning GP care pathways; such products have the potential to save the healthcare and biotech industries over £1bn every year, just in labour time. 

The current pathway to obtain a genetic test for a single cardiac condition through the NHS is lengthy, complex, costy and is not accessible for everyone; with multiple visits and referrals to see healthcare specialsits (Annex; Figure 1). 

Our system workflow has been designed to empower patients within an innovative framework, that ensures having a certified partner cardiologist assessing their health condition before a patient can receive his/her genotyping results. It will also ensure that patients and doctors have an easy access for booking appointments to follow up, when the need is present. Our comprehensive service will cut down the turn around time from several months to 2 weeks with as little steps as the figure shows (Annex; Figure 2). 

Moreover, our database will later provide an electronic medical record through which other healthcare consultants can opt to review when they need to access the patient’s genotype before prescribing a certain drug at any stage of the patient’s life. Thus, cutting down the path of trial and error before the the right medication is prescribed to the patient. 

Early screening for genetic predispositions and having an early risk assessment for patients who may develop Atrial Fibrillation or any other CVD will significantly allow the NHS enhance its' treatment regimen for the general public and prevent high risk individuals from becoming patients. Thus, causing a substantial reduction in the £15bn bill of CVDs every year (BHF stats 2015).
Online Discussion Rating
6.00 (1 ratings)
Initial Review Rating
4.60 (1 ratings)
Benefit to WM population:
The major risk factor associated with Atrial Fibrillation and all other CVDs is having a family history with the disease. By family history we are referring to the genes that have passed from the parents to their offspring, which (if found to be mutated as well) can increase the risks of that individual developing the same disease. 

While it is well accepted that such risk factor could not be changed or adjusted (at least for the time being), hence the term "non-modifiable" risk factor, it is also accepted that if such risk is detected then the patient would be better positioned to manage the other "modifiable" risk factors early on, which can significantly change the course of the patient's life and the development course of his/her inherited condition. 

We believe that well informed and educated individuals about their risk factors will allow them take better decisions and have more enlightened judgments when it comes to managing their risks and altering their lifestyle and daily habits. Modifiable factor like quite smoking, being fit, eating healthy and managing diabetes, obesity and cholesterol levels, are all found to be imperative in managing AF and other CVDs from an early stage; the earlier the intervention, the better the outcome. 

Moreover, we believe the greatest benefit to the WM population will come at a later stage through our Data Bank which will provide the perfect reference tool to better direct prevention and treatment regimens withihn the WM population, risk factors such as race, age and sex will all be considered in the future direction of our research through our advanced and precise person-centerd system.
 
Current and planned activity: 
Business partnerships have all been established for the development and delivery of our product/service. Funding is currenly sought to finance our outsourcing agreements:
  • Genotyping analysis will be conducted at a well established genotyping lab in the UK.
  • Our saliva collection kits will be outsourced from a supplier in the UK. 
  • Our service content is all in place and the gene panel list has been put together through an extensive amount of well researched and accredited reference genetic testing studies, the online platform will be developed by website developement agency in Birmingham.
  • Our box and packaging have been designed and the order is to be placed.
  • An initial agreement has been established with a reputable cardiologist consultant to review the patients results and put his recommendations to each genotyping report being assessed.
  • A pilot study is currently being desinged by our Medical and Research Officers (both are GPs at the QE hospital).
What is the intellectual property status of your innovation?:
The company will be developing additional patents and intellectual property related to response and side effect prediction for further treatments of hypertension and other Cardiovascular disorders through its DTC kits and the databank that it will generate from its lab based genotyping services. These will be offered to the BHF and all other concerned research groups in the field of Cardiac Health.

In terms of our regulatory path, there are no specific regulations outside consumer protection, data storage, and for storing biological samples “saliva” we will apply control regs that deal directly with this. 
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
Simple
Regional Scalability:
Please refer to our commercial information section (Business Strategy)
Measures:
We are here to help; we believe that we have a relevant and compelling solution that (if adopted) can save lives and enhance the prevention and treatment regimens for patients with cardiovascular conditions.
We will measure our performance based on the value that we are delivering. Hence, by the end of year one we are looking to exceed the 1000 kits sale and have a strong clinical data that would support our proposition, in regards to giving patients better options to mitigate their risk factors and to healthcare professionals to administer drugs that are better suited for certain subpopulations; based on genetic makeup and the health profile "environmental factors" for each individual patient.
These assessments will be made through our end of year statistical study that we will run on all patients whom we have tested. 
Adoption target:
The adoption target is to demonstrate a successful, valuable and cost efficient systematic framework that would address the core objectives of the NHS Sustainability and Transformation Plans in drving a genuine chnage to patients experience and health outcomes of the longer term. 
 
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