Enough of being digitally ‘done-to’

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Enough of being digitally ‘done-to’: 2020 is the year of the nurse, let it also be the year of digital nursing

Recently, Health Innovation Network (HIN) hosted a roundtable discussion with senior nurses involved in digital from across south London. The event was chaired by Breid O’Brien, Director: Digital Transformation at Health Innovation Network with special guest speaker Natasha Phillips, Chief Nursing Informatics Officer: University College London Hospitals NHS Foundation Trust (UCLH) and Digital Health’s CNIO of 2019. Breid and Natasha share some of the discussion highlights and why they are evidence that if 2020 is to be the year of the nurse, then nursing needs to be made a central part of the digital discussion in 2020.

We have a combined 62 years of nursing and healthcare experience and have seen an incredible amount of change in our profession during our careers, but the most significant has probably been the transformation of the time nurses spend with patients. Based on our experience and what we observe happening now, and depending on which studies you read, nurses currently spend approximately 20 – 25 per cent of their time on medication administration. In addition, data from Safer Nursing Care Tool (SNCT) observations shows nurses spend 10 per cent of their time acting as the glue in the system by communicating and raising issues. Seven per cent of time is spent on documenting care away from the patient (i.e. excluding documentation that happens by the bedside). At best, this means 37 per cent of nursing time is not spent on direct care.

This calculation started a lively discussion at our recent roundtable for senior nurses involved in digital across south London, prompting some to suggest that, in their personal experience, it is much closer to just one third of their time that is spent with patients. Additionally, data from “Productive Ward: Releasing time to Care” shows another third is lost to looking for things and duplicating work.

For many nurses, time spent on direct patient care is where the joy of work resides, and this is the time our patients’ value most. The group concluded this imbalance between time spent on tasks and time to care needs to change. We need to release time to care.

How technology could help

It’s undoubtedly true that technology is a huge part of the answer, but, as a profession, nursing is not yet reaping the benefits. We are often digitally ‘done-to’. We often have systems that are designed by others, such as patient flow systems, which, although fulfilling an important need, were designed to meet the needs of the organisation with little understanding of the increased workload for nurses. Attendees gave examples of innovative new systems implemented in their practices, which have led to the need for nurses to duplicate their notes. Under these systems, if nurses see 14 patients, they end up writing 28 sets of notes, as they have to create a physical and a digital copy.

Nurses are not routinely involved in the design of new systems, and other countries like the US are much further ahead in recognising nursing informatics as a profession. The group identified a lack of education for nurses in undergraduate and post-graduate environments when it comes to using digital tools in care delivery, though the group recognised HEE is working to change this.

Nurses are in a prime position to lead transformative change, with a depth of experience and a very rounded view of the system. Sometimes, we underestimate the role that nurses can and should be playing right now in system design. Technology can be overwhelming, the volume of data alone. But let’s remember – nurses have been using data for years, and effectively. If someone cannot explain a new technical system clearly to a nurse, then we argue that they need to get better at explaining it.

Imagine a world where digital is at the heart of our practice, the heart of our education and the heart of our leadership. This is happening in patches and where it does, the results show the great potential. It’s happening where change is clinically-led, where nurses sit on advisory committees and where nurses are embracing the opportunity to change their practice, not just digitise what is already happening.

Technology will not always save time, but it will make our practice safer, and it does have the power to improve our approach to tasks.

Year of the nurse

If 2020 is to be the year of the nurse, let’s make 2020 the year that nursing and nurses are put at the heart of digital transformation, and where these examples become the norm. Let’s make 2020 the year that we stop walking back and forth to computers and put the power in our pockets, the year we embrace audio and voice recognition. Let’s create a culture where newly trained nurses come in with bright ideas, and we create the right opportunities for them. Technology will not always save time, but it will make our practice safer, and it does have the power to improve our approach to tasks.

To do this, we need to stop the feast and famine approach to technology spending and projects. Bursts of capital funding won’t do the trick – expensive, capital-funded roll-outs are just the beginning. Successive governments have proclaimed innovation is a panacea and announced new policies, CQINs and mandates, as though they are the answer to a problem rather than the first step in a long journey of change. Privately, most will admit that they understand that change takes time. Let 2020 be the year that this is publicly recognised, and the slow, painstaking work of ongoing training and optimisation of systems is sustainably funded.

Nurses are close to their patients. Let 2020 be the year we use this to drive real change. What could we be asking our patients to do with technology to help us? Entering their own health information, accessing information, monitoring their own health trends? Too often there is still a fear of putting people in charge of their own care – hunger from patients to change the system will help encourage people to take risks, never with patient safety, but with innovative approaches to care delivery.

2020 is the year of the nurse – let it also be the year of change. If that sounds optimistic, that’s because it is. But after spending time in conversation with fellow senior nurses discussing these issues, we were left inspired and hopeful. Rather than battling organisational hierarchy and tradition alone, we vowed to do it together. To share and learn from each other and to create a new community of digital nurses. No more digitally done-to. The opportunity is there for us to work as a community. Let’s let 2020 be the year we take it.

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Meet the innovator: Shaun Azam

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Meet the Innovator

In this series, we’ll get up close and personal with an innovator asking them to share their thoughts and experience from their journey into the world of health and care innovation. In our latest edition, we caught up with Shaun Azam, CEFO at Sweatcoin; an app that incentivises physical activity by converting steps into points that can be exchanged for actual rewards.

Pictured above: Shaun Azam, CEFO at Sweatcoin.

Tell us about your innovation in a sentence

Through our digital app Sweatcoin, we incentivise people to be more active by converting steps into reward points that have real world value.

What was the ‘lightbulb’ moment?

Realising that modern technology makes us lazy, and as humans we need instant rewards for effort (which is why most of us struggle to go to the gym for sustained periods). Hence, our app that converts steps into points with real value.

What three bits of advice would you give budding innovators?

    1. Listen to your users! You are building your product for them, so listen and take on board what they want.
    2. Don’t test ideas, test a hypothesis – ideas are real life applications and sit above a core hypothesis. When you test a hypothesis, you also test a whole host of ideas, saving vast amounts of time.
    3. I coined an acronym for this – ABA – Always Be Adding. Everything you do should be always be adding value to the business – we’re in a digital age, so use as many tools and apps as you can to create efficiency + cost savings, so you can focus on things that will ADD value to the business. Also, delegate whenever possible.

What’s been your toughest obstacle?

Overcoming the complexity of the healthcare system – we are fortunate in that our product has the ability to improves the lives of everyone in the world. Along with this comes difficulties around ensuring our product accurately caters for these vastly different demographics.

What’s been your innovator journey highlight?

Academics at the University of Warwick investigated the impact of incentives on physical activity – they used Sweatcoin to do this. Their academic study was published in the British Journal of Sports Medicine and found that Sweatcoin helped users walk +20% more each day, even after six months.

That was the moment that we realised that we ARE making the world more active, and that all the struggles were worth it.

Best part of your job now?

Genuinely improving the quality of lives of millions of people, every day. We receive countless messages from our users, informing us that Sweatcoin has motivated them to walk more, and how it has contributed to their improved physical + mental health.

Receiving these messages is truly incomparable.

If you were in charge of the NHS and care system, what’s the one thing you’d do to speed up health innovation?

I would include a line item in NHS budgets, that is designated to be spent with SME’s – this would foster the uptake of new digital solutions that have the potential to improve healthcare and patient journeys across the NHS.

A typical day for you would include..

Trying to grow and sell our product – we operate on two week ‘sprints’ – this means we aim to release new features of our product every fortnight. As you can imagine, this means countless user focus groups, product tests, and iterations.

The product is one aspect – selling it is the other! I’m a big believer in ‘people buy from people’ – so most of my remaining day is around meetings, understanding open opportunities, and communicating the value prop of Sweatcoin.

For more information, visit their website at sweat coin.com or follow them on Twitter @Sweatcoin

World Mental Health Day: A story of a burning platform for change

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A burning platform for change

By Breid O’Brien, HIN Director of Digital Transformation

Today is World Mental Health Day; a day observed by over 150 countries globally to raise awareness and reduce stigma around mental health. In the 17 years since the day was first conceived, society has come a long way in its understanding of mental health. However, even today, people with serious mental illness are still likely to die approximately 15-20 years earlier than other people.

So this World Mental Health Day we would like to highlight some of the incredible progress being made by mental health teams around the world, to bring about parity of esteem in this area by reflecting on a recent roundtable event we held to share learning internationally, where Martin Davis, a Clinical Nurse from New South Wales’ Mental Health Emergency Care division (MHEC), presented on the successful implementation of a virtual consultation system in a rural and remote mental health setting in Australia.

This is a story of a small team that led the way. MHEC was kick started by a government cash injection at a time when the team needed to deliver a better, more cost-effective system of care to its rural and remote population in rural Australia. Before the MHEC service was introduced remote and rural ambulances (and often other emergency services) were transporting patients hundreds of miles just for an acute mental health assessment; taking them from the comfort of their home, family and friends when they were in a vulnerable state, and often leaving their hometown without any emergency provision. Imagine living somewhere where if there was a fire, there would be no one to put it out, simply because they are effectively acting as a patient taxi? Their situation provided a clear rationale for change – a burning platform, if you will. By using virtual consultations, they could save time, save money and deliver faster patient care.

Starting with an 1-800 number 12 years ago and progressing to an online video system just under a decade ago, MHEC now prides itself on answering calls within three rings, and being able to assess patients on a video call within an hour during daytime hours. The stats continue. Every year since its inception, they have saved the combined services over $1,000,000 AUD a year; and 80% of the patients they see are discharged back into their community within a day, a direct reversal of the 20% of patients who were able to go home under the previous system.

“All just geography”

Despite the obvious differences between MHEC’s setting (their ‘patch’ is the size of Germany but has only 320,000 residents), and our urban south London area where almost three million people reside in an area a fraction of the size, when Martin shared his story the similarities were immediately apparent. In London we have a diverse population who speak an estimated 250 languages, requiring a need for numerous cultural sensitivities; the MHEC team have a large aboriginal population – almost 40% of their mental health in-patients identify as aboriginal.

Patients in New South Wales were having to travel miles away from their families to receive acute mental health care; we too have examples of this happening in acute mental health care in the UK, and while the distances in Australia may be greater, the impact on the patient and their family will be the same. The Australian health system also faces an increasing demand for acute mental services against a backdrop of challenges with staff recruitment; turns out, Julia Roberts had it right in Pretty Woman; it is “all just geography”.

The question our roundtable guests discussed cut to the heart of the complexities of digital transformation: if we have so much in common, why, over a decade later, are we still not embracing virtual consultations in the same way that they are? Distance and cost were MHEC’s burning platform, pushing them to make changes ten years ago that other services are only just catching up with. We seemingly are yet to find our burning platform, despite the pressures on our services and the progress being made in many areas.

As our roundtable participants moved the discussion on to the inevitable complexities of implementation, many of the usual barriers made an appearance; procurement, interoperability, money, time. But a few more situation-specific ones also livened the debate; what are the implications for information governance? How do you prevent reprisals of misdiagnosis? How do you train people to deliver virtual care? How do you ensure that changing a pathway won’t affect patient safety? How do you empower your teams to step outside their role? How do you get buy-in from all the organisations needed to deliver the change?

The need for systems to talk

For Martin – and MHEC – all the barriers to change raised were not only a stark reminder of how far they have come, but also how much work is still to be done. We delved into the extensive stakeholder engagement the MHEC team undertook (they visited all the GP practises in person because face-to-face meetings achieved better buy in from clinicians – an irony that wasn’t wasted on them), and listened to how the accountability process was redefined, before unveiling a key area of distinction between our two situations; how joined up their IT systems had become. A steely silence answered Martin’s assumption that we’d managed to fix the interoperability of medical records in the 20 years since he’d served at Homerton, Enfield and the Royal Free. Sadly, Martin, we have not but it is high on the agenda of NHSX and others so perhaps this time we will.

And therein lies part of the problem. The collaborative nature required to implement the MHEC system between mental health, emergency departments, General Practitioners, community mental health teams and even the police (they have supplied local police with digital tablets to ensure they can get the virtual consultations to people in their own homes, not just the local emergency department) is a testament to the power of joined-up care systems, but working together was undoubtedly made simpler by the support of a joined up technology system, something the various LHRCEs are still working hard to crack.

From the discussion, it became clear however that no one issue of technology, procurement, change management, organisational boundaries or geography on its own poses enough of a barrier, but the cumulative effect of them all risks putting off too many commissioners, clinicians and managers from implementing digital transformation. The risk made all the more terrifying by the fear that it might go wrong and that safety could be compromised.

Martin was incredibly open and forthcoming about the fact that MHEC is not yet perfect. When they started the technology didn’t work; not everyone was bought in to the system; it was not – and still isn’t – an overnight success, but none of that mattered. They were trying something new that, at its heart, was trying to improve patient care and support emergency services to deliver better support to people in a mental health crisis, whilst also saving the overall system money. It is clear that really innovative organisations are willing to tolerate failure and see it as an opportunity for learning and doing things even better. Whilst we can’t tolerate failure in terms of compromising patient safety, it does feel that perhaps sometimes this fear also stops us from implementing proven innovations. So why does the fact that something won’t work perfectly first-time round make us in the NHS feel so uncomfortable? Perhaps this is our inherent fear of failure?

We heard from some present about the fabulous work they are doing to implement similar technology and different ways of working, however, to really impact care we need to do this at scale. And to achieve anything at scale, risks will have to be taken. Perhaps our burning platform is just not hot enough. Yet.

About the author
Breid O’Brien leads HIN’s digital consultancy function. She has extensive improvement and digital transformation experience supported by a clinical and operational management background in acute care within the UK and Australia. She has supported major system level change and has a strong track record of delivering complex programmes of work whilst supporting collaboration across varied teams and organisations. With a Masters in Nursing, an MSc in Healthcare Informatics and as an IHI improvement Advisor, Breid is especially interested in the people, process and technology interface.

London’s Health Care Industry Booms as Millions are saved for the NHS

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London’s Health Care Industry Booms as Millions are saved for the NHS

DigitalHealth.London have launched their impact report confirming they are speeding up digital innovations across health and care in London, creating jobs and saving millions of pounds for the NHS. This supports the objects of the Government’s Long Term Plan to make digitally-enabled care the mainstream across the NHS.

DigitalHealth.London is a collaborative programme delivered by MedCity, and London’s three Academic Health Science Networks (AHSN) – UCLPartners, Imperial College Health Partners, and the Health Innovation Network (HIN). It is supported by NHS England (London) and the Mayor’s Office.

The DigitalHealth.London Accelerator is a flagship programme delivered by DigitalHealth.London to fast track innovations into the NHS and support innovators navigating the NHS system. Around 20-30 companies are selected onto the Accelerator programme each year and are given bespoke mentoring, training, networking opportunities to develop their business. This collaboration and support also enables the fast spread of cutting edge innovations into the NHS to benefit patients and support NHS staff. The Accelerator companies range in size when they begin the programme, from a single founder working on one product, to companies with in excess of 30 employees.

467 new jobs were created

Eighty-five percent of companies to have been on the Accelerator programme who participated in this report, reported an increase in their staff numbers. Of the additional jobs created by companies on both the 2016-17 and 2017-18 programmes, 30.3 percent (141) are attributed to their involvement in the DigitalHealth.London Accelerator. A total of 467 new jobs were created between August 2016 and November 2018.

“Anything we achieve as a company is in some way down to, or connected to, working with the Accelerator.” Elliott Engers, CEO, Infinity Health, Accelerator cohort 2017-2018

Over £64 million of investment raised by Accelerator companies

As discovered by the recently published report DigitalHealth.London Accelerator companies raised over £64 million of investment between August 2016 – November 2018. One company alone account for £28 million of this. Sixty-six percent said that the DigitalHealth.London Accelerator had helped them raise investment in their company.

“The DigitalHealth.London Accelerator is saving millions of pounds for the NHS while stimulating economic growth in the health care industry.  It supports innovations that will change the lives of patients, support NHS staff and create jobs.” Tara Donnelly, Chief Digital Officer of NHSx 

NHS Savings almost £76 million

The work of Accelerator companies has resulted in almost £76 million in savings for the NHS, with just over a third of this (£24.8 million) credited to the Accelerator’s support, based on information self-reported by companies involved. A conservative view that 50 per cent of the NHS savings attributed to the Accelerator are actually being realised, given that the Accelerator programme is 50 per cent supported by AHSNs (the innovation arm of the NHS) and their partners MedCity and CW+, the Accelerator programme has a return on investment of over 14 times: for every £1 spent by the NHS (via AHSNs) on the DigitalHealth.London Accelerator, £14.60 is returned, in some way, through the implementation of a digital solution. Some of these savings are made in efficiency gains, for example finding more efficient ways of supporting patients to manage their own health conditions, whilst others may help reduce inappropriate urgent care attendances by providing easier access to GP services.

Read the full impact report here.

 

Meet the innovator: James Flint

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Meet the Innovator

In this series we’ll get up close and personal with an innovator asking them to share their thoughts and experience from their journey into the world of health and care innovation. In our latest edition, we caught up with James Flint, CEO and Co-Founder at Hospify; a compliant, trusted healthcare messaging app.

Pictured above R – L: James Flint, Co-founder and CEO with Neville Dastur, Co-founder at Hospify.

Tell us about your innovation in a sentence

Available for free in the Apple and Android app stores, Hospify puts a simple, affordable alternative to non-compliant consumer messaging services like WhatsApp, Viber, Telegram and Messenger directly into the hands of healthcare professionals and patients.

What was the ‘lightbulb’ moment?

Meeting with the Head of Health for the Information Commissioner’s Office in 2015 and discovering that, while a very big chunk of the NHS was using WhatsApp to communicate while at work, once GDPR arrived in 2018 they were going to have to stop doing this.

What three bits of advice would you give budding innovators?

    1. Be prepared for the long haul. And I mean long.
    2. Keep it simple.
    3. Never miss lunch.

What’s been your toughest obstacle?

Getting sufficient funding, without a doubt.

What’s been your innovator journey highlight?

Getting on the NHS digital heath accelerator last year. It felt like we’d finally been given the official stamp of approval.

Best part of your job now?

Meeting nurses and hearing directly from them what a difference Hospify can make to their working lives.

If you were in charge of the NHS and care system, what’s the one thing you’d do to speed up health innovation?

Implement and support proper health data interoperability standards. I know this Is finally happening, but it’s still the most important single thing that needs to be done.

A typical day for you would include..

Answering a lot of email, talking to my development team, meeting or calling potential investors, networking or promoting Hospify at some kind of health event, answering customer support questions about the platform. Usually all on the same day and sometimes all at the same time!

For more information on Hospify visit www.hospify.com, Facebook, LinkedIn or follow them on Twitter @hospifyapp

Meet the innovator: Lydia Yarlott

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Meet the Innovator

In this series we’ll get up close and personal with an innovator asking them to share their thoughts and experience from their journey into the world of health and care innovation. In our latest edition, we caught up with Lydia Yarlott, Co-Founder at Forward Health; a secure messaging and workflow app, connecting care workers around patient pathways.

Pictured above: Lydia Yarlott.

Tell us about your innovation in a sentence

Forward is a mobile communications platform aiming to connect healthcare professionals for the first time.

What was the ‘lightbulb’ moment?

Probably being a first year doctor on my own in an NHS ward at 2am in the morning trying to get help for a deteriorating patient and being unable to contact anyone. Poor communication leads to a real feeling of helplessness, and I want to change that for doctors and nurses everywhere. It’s hard to believe we’re still using pagers and resorting to WhatsApp to get hold of each other in hospitals, so it wasn’t so much a lightbulb moment as an increasing feeling that something had to change!

What three bits of advice would you give budding innovators?

    1. Talk to everyone, and anyone, you can about your idea. You never know what will happen next. My great friend Will worked with me as a junior doctor; he’s now with us on Forward full-time. We never would have had him as part of the team if we hadn’t spent hours on night shifts discussing the problem together!
    2. Find a Co-Founder (or several!) I couldn’t imagine doing this alone. Philip and Barney are both amazing people and amazing leaders, and it’s their drive and optimism that got us to where we are today – 5% of the doctors in the UK and growing. Whenever one of you is losing faith (inevitable at times!) the others can put you back on your feet and help you with that resilience you need in spades to be a successful Founder.
    3. Care about your problem more than your solution. Get as close to it as you can and stay there. Your solution will be wrong first time around, but as long as the problem isn’t solved, you have a chance of something really worthwhile.

What’s been your toughest obstacle?

Personal doubt!

What’s been your innovator journey highlight?

Getting our first real use cases. Watching our product change the way people work, resulting in better, faster care for patients. We have an amazing group of physios and orthopaedic surgeons using Forward to streamline shoulder surgery for patients, and another group who are using it to coordinate the multidisciplinary team in paediatric allergy. I can’t get enough of those stories because I know how tough it can be on the frontline of the NHS.

Best part of your job now?

The great privilege of working as a doctor and as a Co-Founder. I love clinical work, but I get frustrated by outdated systems, and I would hate it if I couldn’t focus on changing that. I care about healthcare at a systemic level and I want the NHS to survive, but I know that for that to be the case things will have to move forward, fast. I want to be a part of that.

If you were in charge of the NHS and care system, what’s the one thing you’d do to speed up health innovation?

Get Trusts talking to one another and sharing what they do. Incentivise knowledge transfer – both successes and failures. Share the ways in which they are working with others, including start-ups and small businesses, to foster innovation at scale.

A typical day for you would include..

A typical day being a paediatrician is just that – looking after sick children! I’m a junior doctor, so I’m still learning a lot, and working closely within a team to achieve the best outcome for the patient. When I’m at Forward, I spend most of my time meeting with the team to discuss progress and strategy, representing the clinical face of the company and the problem we’re trying to solve. The two jobs couldn’t be more different, but ultimately they are focused on the same thing – improving healthcare for everyone. I love what we’re building at Forward and I love the team – even those of us who aren’t from a healthcare background are driven by the mission to improve communication, and you can feel that energy walking into the office.

For more information on Forward Health visit www.forwardhealth.co or follow them on Twitter @ForwardHealth_

Topol Review highlights potential of digital technologies to address the big healthcare challenges

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Topol Review highlights potential of digital technologies to address the big healthcare challenges

Written by Anna King, Commercial Director at Health Innovation Network.

It is not often that an independent review for a UK Secretary of State gets held up for a book launch, but such is the case when you ask a world-eminent, California-based cardiologist to review the changes required in the NHS healthcare workforce to ensure preparation for the technological future.

Dr Eric Topol, probably best known for his book, The Patient will see you now, published his long awaited The Topol Review: Preparing the healthcare workforce to deliver the digital future last month. The report highlights how digital healthcare technologies have the potential to address the big healthcare challenges as well as tackle increasing costs. The report observes that innovation will “increasingly shift the balance of care in the NHS towards more centralised highly specialised care and decentralised less specialist care”. This shift in the pattern of need and services is aligned with much of the HIN’s work and our focus on out-of-hospital care. Flatteringly, Topol also supports the ambition that the UK has the potential to become a world leader in such healthcare innovations. This is particularly exciting to hear given the work the HIN has been doing locally with DigitalHealth.London building upon local strengths in clinical care, research, education and business to boost London as a world leader in digital health.

However, Topol also offers words of caution for those impatient for new digital healthcare technologies to reach their full potential. As he observed, “it can take up to 10 years to realise cost savings, investment in IT systems, hardware, software and connectivity, as well as the training of healthcare staff and the public”.  The potential benefits of genomics moving beyond rare diseases and cancers is a good example of this. Allowing better prevention and management of conditions that could reduce costs and disease burden in the 10 to 20 year timeframe will require the NHS to have completed the “digitisation and integration of health and care records if the full benefits of digital medicine (earlier diagnosis, personalised care and treatment) are going to be realised”.

Whilst much of the report focused on the longer-term revolutionary technologies, there was also an acknowledgement that some data-driven technologies can and are being deployed today. Particularly, those with the aim of improving ease of access or remote monitoring, designed to reduce unplanned hospital admissions and decrease non-attendance rates. This is an area that we see many solutions being developed by the innovators of the NHS Innovation and DigitalHealth.London Accelerator programmes. Companies like Transforming Systems and Dr Doctor use data to improve access and system efficiency, and companies like Lumeon and Health Navigator helping improve individual patient pathways. Topol is also refreshingly realistic about the issues we see many innovators face because of “uneven NHS data quality, gaps in information governance and lack of expertise”. Potential enablers to overcome the barriers to adoption, he suggests, include: an information governance framework, and guidance to support the evaluation, and purchasing of AI products.

In the report, genomics, digital medicine and artificial intelligence were all seen to have a major potential impact on patient care, but it also showed how digital will help improve the lives of the NHS workforce. There was a helpful introduction to a number of emerging technologies, including low-cost sequencing technology, telemedicine, smartphone apps, biosensors for remote diagnosis and monitoring, speech recognition and automated image interpretation, that are seen to be particularly important for the healthcare workers.

Topol also finally puts to rest dated concerns that technology exists to replace people working in healthcare. The report clearly responds to this fear confirming that technology is intended to ‘augment’ healthcare professionals, rather than replace; releasing more time to care for direct patient care. Whilst, some professions will be more affected than others,Topol finds that the ‘impact on patient outcomes should in all cases be positive’.

At the HIN we have been supporting the development of the NHS workforce as a necessary part of the journey to digital transformation. I was pleased that Health Education England’s involvement in the Topol Report means that training and education will be modernised, as it is still very dated both in its methods of delivery and syllabus. However, this education should not focus solely on just educating new NHS staff members – but we should also be digitally upskilling the workforce we have now, and at every level. And herein lies the real complexity of the digital revolution. What Topol finds undeniable is that the roles of healthcare staff will change and new skills will be required, and it is good to see Health Education England responding to this challenge – although, it was shocking to learn that radiologist are still be taught how to develop traditional x-ray films, despite them rarely being used in the NHS!

Learning from previous changes, implementation will require investment in people as well as technology. It bodes well for the exciting wide-ranging programmes of the AHSNs, that support a learning environment, understand the enablers of change and create a culture of innovation. Programmes of ours like the Graduates Into Health Fast Track IM&T programme and the DigitalHealth.London NHS Digital Pioneers programme will play an important role in developing an agile and empowered workforce to facilitate the introduction of the new these new technologies. The report is clear that it is an exciting time for the NHS to benefit and capitalise on technological advances, and the AHSNs are well place to support this. The observation that ‘within 20 years, 90% of all jobs in the NHS will require some element of digital skills, illustrates the need for digital education revolution perfectly, even if it did raise the question what would the 10% be doing!

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About the author
Anna has been Commercial Director at the Health Innovation Network since July 2013. Prior to her current role Anna was the Commercial Programme Director at the London Commercial Support Unit (Commissioning Support for London, NHS London and NHS Trust Development Authority).

New report maps the MedTech landscape for innovators in England

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New report maps the MedTech landscape for innovators in England

The NHS spends approximately £6 billion a year on medical technology, also known as MedTech, such as medical devices, equipment and digital tools. It is an industry that accounts for over 86,000 jobs in the UK, almost a third of which are within small companies, and supports an additional 24,600 service and supply roles.

A new report from the AHSN Network provides an essential guide for companies looking to successfully develop and roll out innovations in this complex and diverse industry, focused around the MedTech innovation pathway. It includes a foreword by Piers Ricketts, Chief Executive of Eastern AHSN and Vice Chair of the AHSN Network.

The MedTech Landscape Review will be launched formally at an event to be held jointly with one of our partners, the Association of British HealthTech Industries (ABHI), on 20 March and introduced by Piers.

In the meantime, the report is available for download here, featuring case studies, statistics and practical advice for navigating each step of the MedTech Innovation pathway.

Meet the innovator: Vivek Patni

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Meet the Innovator

In this series we’ll get up close and personal with an innovator asking them to share their thoughts and experience from their journey into the world of health and care innovation. In our latest edition, we spoke to Vivek Patni, Director and Co-Founder of WeMa Life; an online marketplace that brings customers and their families together with social care and community care service providers.

Pictured above: Vivek Patni.

Tell us about your innovation in a sentence

WeMa Life is an online marketplace that brings customers and their families together with social care and community care service providers; giving choice, accessibility and efficiency in the service procurement and delivery pathway.

What was the ‘lightbulb’ moment?

As an informal carer for my grandfather, I was immediately shocked by the lack of innovation in supporting families to find, coordinate and manage local care services for their loved one, hence WeMa Life was born. I find online marketplaces very convenient and use them for so many aspects of my life – products, clothes, hotels, restaurants – I knew a similar digital environment was needed for care services. Using WeMa Life as a customer I can search, compare, purchase and rate local care services whilst as a provider I can digitise the outdated, manual, paper-based visit records and manage my daily business activity.

What three bits of advice would you give budding innovators?

    1. Stay flexible: it’s tempting to start a business with a clear idea of how things will unfold; but this is rarely the case. Pivot and react to obstacles and have an open approach to finding the best solutions to all your problems.
    2. User experience: test your product constantly and get as much feedback as you can from all your user groups. Simple solutions sit very well in such a diverse industry.
    3. Be creative in your approach to developing tech and running your business. There are so many applications and tools to create efficiency and cost saving in finding resources, marketing and development, so use them!

What’s been your toughest obstacle?

Where I had faced the difficulty from a customer side of social care, I was less aware of the complexity in delivering publicly funded social and community care to different user groups. This meant learning the nuances of each service type/provider and creating a fluid product that would fit all.

What’s been your innovator journey highlight?

Designing the tech architecture from scratch, building an international technology development team and bringing my ideas to life in just eight months is something I am very proud of.

Best part of your job now?

Taking my product into the market! Now that the product is live, I am driving its use through digital marketing and sales. I meet so many interesting people on a daily basis who bring exciting new ideas to what we do – my mental technology roadmap is never ending.

If you were in charge of the NHS and care system, what’s the one thing you’d do to speed up health innovation?

I would give more opportunity and financial incentives to SME’s. There are a huge number of SME’s with great ideas and technology, they tend to be more fluid, interoperable and customisable to the needs of the NHS; they would be able to make a real change to the daily lives of providers and customers.

A typical day for you would include..

Typically, my days are devoted to technology and selling. My morning tends to be engagement with my India tech team to make sure we are always refining and innovating our solution. Afternoons will be selling, calling and meeting as many people as I can. I get energised by talking to people about what we do so I try to do that as much as possible.

For more information on WeMa Life visit www.wemalife.com or follow them on Twitter @wemalife

Time to Talk – mental health and the role of digital

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It’s time to talk about mental health

Mental health problems affect one in four of us, yet people are still afraid to talk about it. Time to Talk day encourages everyone to talk about mental health and at the HIN we’re bringing digital innovators and clinicians together to identify solutions, says Amy Semple.

Time to Talk day is about encouraging everyone to talk about mental health. Last week, the Health Innovation Network started the conversation early with the sometimes contentious topic of digital. In our experience working with both NHS stakeholders and digital companies, there remains some scepticism and reticence amongst both groups on how they can work together to benefit the 1 in 4 of the population who are currently experiencing mental health issues. So what better way to open up the channels of communication than to invite 100 key decision makers and innovators to spend the day discussing the opportunities and challenges of maximising digital opportunities in mental health, together.

The NHS Long Term Plan

The stars (at least on paper) have recently aligned in terms of national strategy, with the NHS Long Term Plan having digital at its core and a strong focus on mental health. I believe that success in both areas will be mutually dependent. To date, most digital companies, in my experience, have targeted primary care and the acute sector as this has often been the easiest way to prove their concept. Digital interventions available in the NHS are associated with benefits such as improved access to services, online self-help and therapies, prevention and organisational efficiencies.
When speaking to some companies prior to the event I felt that mental health was perhaps outside their comfort zone, seemed too large and unwieldly to take on, or wasn’t acknowledged as a viable space for their product. This is understandable. Stigma surrounding mental health means that many people believe that people with a mental health condition are unable to self-manage and will struggle to maintain the consistency needed to use some technologies. These viewpoints only sustain the inequalities we continue to see in terms of people with mental health conditions gaining equal access to services and support with physical health conditions. Mental health services can be equally cautious of digital solutions, often concerned about the ethical implications of removing the human face to face element in mental health care without putting people at risk.

Maximising digital opportunities

With our Maximising Digital in Mental Health event we created a space to encourage a healthy debate to air these concerns. To get the people who could really effect change talking to each other. We invited national and local leaders to set out their digital strategies, we presented real life examples where digital companies are already working successfully within mental health and we showcased digital companies not yet working in mental health whose products have relevance to the sector in terms of patient care or organisational efficiencies. The result; a two-way conversation where both sides could speak openly and honestly about their fears as well as their excitement at the potential to radicalise mental health care with digital technology. Honest dialogue, open conversations and exploration of the solutions were met with a real appetite for adoption and lateral thinking.

Reducing the inequality in mental health

Yes, there were challenges highlighted, barriers questioned and a little bit of scepticism still; but overwhelmingly there was positivity and real desire to work together. We know that people with serious mental illness are likely to die on average 15-20 years earlier than other people and two thirds of these deaths are from avoidable physical illnesses. It’s time to talk; to find a safe and cost-effective way for users of mental health services to benefit from digital solutions and reduce this inequality. As Liz Ashall-Payne from ORCHA eloquently phrased it, “the conversation [in the room] has moved from not if, but when.”

Time to keep talking

From the dialogue on the day, I believe there are three key next steps to the conversation:

1. Get the decision makers on board. Talking to the right people who are influential in ensuring digital is part of mental health strategy and decision making process, such as Innovation Teams, CCGs, Strategy Teams, Board Members, Systems and Information Teams will ensure digital stays on the agenda.
2. Engage with front line staff. Unless you engage the people who will be using digital technologies, they simply won’t get used. Asking them what solutions they need, what their preferences are working in true partnership with staff and users will secure the buy-in needed to test ideas.
3. Consider the system implications. Interoperability is a huge challenge and needs to be overcome with commitment and responsibility from both organisations and digital companies to make this happen. Put simply, we need to ensure that the systems being able to talk to each other is also part of the conversation.

Enjoy this blog? Then we think you’d also like:
Maximising Digital Opportunities in Mental Health: programme and slide pack
Digital is helping us tackle healthcare inequalities, but the real issues are deeper and run system-wide
Digital is a valuable tool for prevention – and so rightly it’s at the heart of the long term plan

For more information on the Health Innovation Network’s Mental Health theme, click here.

Meet the Innovator

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Meet the Innovator

Each issue we’ll get up close and personal with an innovator asking them to share their thoughts and experience from their journey into the world of health and care innovation. In our latest edition, we spoke to Dr Sukhbinder Noorpuri, Founder and CEO of i-GP, an online consultation platform to allow patients faster access to primary care for minor illnesses.

Pictured above L-R: Dr Sukhbinder Noorpuri with Co-Founder, Dr Aleesha Dhillon.

Tell us about your innovation in a sentence

i-GP provides digital consultations for minor illnesses, using interactive pictures and online questions. It is accessible to patients 24/7 from any device, and 90% of users can start their treatment within just one hour.

What was the ‘lightbulb’ moment?

When I was working as a GP, I met Michael, a 70 year old gentleman who waited three hours to see me at a walk in centre back in 2015. I thought that there must be an easier way to access healthcare. So I started looking into alternatives, and when I found none, I decided to go about creating one. I have been fortunate enough to have a great Co-Founder in Aleesha who has been instrumental in developing creative solutions to all the challenges that we have encountered.

What three bits of advice would you give budding innovators?

  • Have a vision and make it a big one – set your goals globally rather than just locally in the spirit of true disruption.
  • Be relentless in the pursuit of this vision and always try and learn from every experience or opportunity which comes your way – know your market, keep reading about it and stay focused.
  • Build a world class team and inspire them to believe in the company mission. Be confident in your leadership and enjoy the process. A successful entrepreneur may build a well respected company, but a successful team will change the world.

What’s been your toughest obstacle?

Healthcare innovation is very challenging because impact takes time to achieve. However, your clinical experience is really the key differentiator in the marketplace. If you genuinely feel you have a clear perspective on the problem and have created the solution then building the evidence for your product, despite being time consuming, is the clearest way to show its potential.

Some regard regulation as being a tough element of service delivery, but embrace the challenge as a well executed process is the reason you will stand out in the industry.

What’s been your innovator journey highlight?

Over the last three years, we have won or been shortlisted for 22 healthcare awards as a result of the innovations we have developed in digital care. This has led us to international recognition and the opportunity to showcase i-GP at Conferences all over the world.

Learning to adapt and raise healthcare standards has been a reflection of the dedicated team approach to the venture. However, this recognition is secondary to the feedback we receive from our patients as this is our main driving force. Impacting the patient journey to care on a daily basis  is the motivation and inspiration to transform traditional routes of service. For example last week, we treated a patient who was due to catch a flight abroad for her sister’s wedding but was suffering with a urinary tract infection. It was late at night, she was in a rush and her chosen pharmacy was closed. We managed to arrange her prescription at the chemist within the airport just before she was due to take off. When she returned she was so thankful that her trip hadn’t been ruined by illness and she had been well enough to enjoy the celebrations.

Best part of your job now?

Without a doubt, my greatest fulfilment comes from leading our team. We are all passionate about seizing this opportunity in time to showcase the good that technology can bring to healthcare and the NHS. Digital health is still very much in its early stage of adoption and even though smartphones have been commonplace for several years, we are still on the cusp of widespread digital use. The service that we implement today, we hope, will continue for many years to come.

If you were in charge of the NHS and care system, what’s the one thing you’d do to speed up health innovation?

There has been a real drive recently with Rt Hon. Matthew Hancock advocating technology to modernise the NHS. Accompanying this, are the additional Government funds being made available to trial new products. This combination offers a paradigm shift from previous regimes and as innovators, we are very much looking forward to this filtering down to provide new opportunities. I also feel it is imperative that decision makers utilise patient feedback to help determine the future course and not just rely on industry advisers.

A typical day for you would include..

Most days are very varied due to the wide scope of avenues we are exploring at i-GP. I usually like to hold key meetings in the morning with either members of the team or board to review processes and define our future strategy.

We have a schedule over the week to assign time to all the key aspects of service from marketing to patient outcomes and from technology developments to the financial structure we have adopted. Reflection is part of this process and the opportunity to network with other innovators is often on the timetable to ascertain the potential for collaboration.

Liasing with the Accelerator team and our navigator Sara is also a key part of our time as we look to integrate further into the NHS.

We would like to take this opportunity to congratulate Dr Sukhbinder Noorpuri who recently won the Chairman’s Entrepreneur Award (pictured above) at the TiE Awards Wednesday 5 December. Find out more about the awards here

For more information on i-GP visit i-gp.co.uk or follow them on Twitter @wellness_igp_uk

It’s time to put digital diabetes tools in the real world, with south London leading the way

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It’s time to put digital diabetes tools in the real world, with south London leading the way

Laura Semple, Programme Director for Diabetes and Stroke Prevention, on person-centred care planning and digital in the real world.

When it comes to diabetes, we all know that the statistics are both enormous and increasing. In south London alone there are an estimated 230,000 people living with diabetes. Nationally, the NHS spends £14 billion a year treating people with diabetes. That’s an astonishing £1.5 million every hour. And, as many of us working in diabetes treatment and Type 2 diabetes prevention in south London know, the vast majority of this is not on preventative care that will reap future benefits. It is spent treating complications, many of which are preventable if people receive the right support during the early stages of the condition.

It’s against this backdrop that we set about working with our partners, led by the South West London Health and Care Partnership, earlier this year to bid to test a new model of support for people living with Type 2 diabetes. The full team includes South London NHS commissioners and clinicians, Healum, Citizen UK, Year of Care partnerships and Oviva. Just this week, we’ve found out that our innovative bid to co-design a new support system with patients, maximising the opportunities from digital to support behaviour change as we do, has been successful and will receive more than £500,000 of public funding over 18 months.

One option would have been to try and find a digital substitute for the current way of working, insert it into local care plans and call it self-management. But too often, substituting with digital tools ticks boxes without radically improving care, because the digital tool doesn’t work seamlessly within the wider system of care.

We believe digital health tools workbest when there is a partnership between the patient, their GP and where necessary a team of specialist clinicians or coaches supervising results, coaching and encouraging. When this mix is in place the results can be powerful – weight loss, healthy blood glucose levels, increased physical activity, improved self-care because people feel more empowered and self-confident. These are just some of our biggest goals. And of course all of these bring savings in the longer term to the NHS thanks to fewer complications.

For that reason, the new south London Test Bed focuses just as much on training and care planning with primary care professionals as it does on new digital solutions. Our intervention starts by working with the wonderful Year of Care Partnerships to train GP practices to use a truly collaborative approach to care and support planning with their patients. New, co-designed care plans will be available to patients via an app and accessible to professionals across all care settings.

At this point, when the training and planning has taken place, digital can shine. Following their appointment patients receive an innovative video that presents their personal health data in an intriguing animation, explaining their individual results and what these mean for them as an individual. Using the app, patients will then access a wide range of support and resources to help them reach their goals, including with the helping hand of a dietitian coach from Oviva.

This fully integrated approach, that works with EMIS, considers the needs of primary care professionals as well as the needs of patients, right from the off. It’s not using digital as a simple substitute but placing digital as part of a wider mix in real world clinical settings.

We hope that by testing this model we’ll break down existing barriers to ‘self-management’ and show the power of brilliantly supported self-management. At its core, our aim is simple – real, lasting improvements to the lives of people living with Type 2 diabetes in South London, so that they can live the lives they want to lead without their condition getting too much in the way.

Read more about the Test Bed programme here

Meet the Innovator

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Meet the Innovator

Each issue we’ll get up close and personal with an innovator asking them to share their thoughts and experience from their journey into the world of health and care innovation. In our latest edition, we spoke to Dr Nicholas Andreou, Co-Founder of Locums Nest, a staff bank management app; connecting healthcare professionals to temporary work.

Pictured above r-l: Dr Nicholas Andreou with fellow Co-Founder of Locums Nest, Ahmed Shahrabanian.

Tell us about your innovation in a sentence

Locums Nest bridges the gap between hospitals and doctors. Making staff vacancies easier and simpler to fill, without the expensive agency middle man.

What was the ‘lightbulb’ moment?

Working as junior doctors in the NHS and experiencing first-hand the frustrations and inefficiencies of filling gaps in the rota.

What three bits of advice would you give budding innovators?

  • Be tenacious- don’t take no for an answer, have thick skin
  • Hire people with purpose who believe in your message
  • Be kind to everyone you meet.

What’s been your toughest obstacle?

Trying to positively change an established institution, with large long-standing incumbents. Challenging the status quo.

What’s been your innovator journey highlight?

With our help, a Trust managed to staff a winter pressures ward without going to an agency. This meant they saved £1.6m in the first 10 months.

Best part of your job now?

Meeting different people in different environments; realising the NHS is enriched with experience and expertise from a vast range of backgrounds.

If you were in charge of the NHS and care system, what’s the one thing you’d do to speed up health innovation?

Open up the barriers to meeting the right people in the system to support innovation.

A typical day for you would include..

There’s no such thing! One day I could be travelling across the country for meetings, in the office for a full day product meeting or spending the day supporting our NHS clients.

Contact us

W: locumsnest.co.uk

T: @locumsnest

From the “Mortality Aware” to the “Baby Boomer Boozers”, we all need help to cut through the app…

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From the “Mortality Aware” to the “Baby Boomer Boozers”, we all need help to cut through the app…

A new report out today from the International Longevity Centre – UK, Cutting through the App: How can mobile health apps meet their true potential?brings together a whole range of statistics and analysis on the current state of play with health apps. It’s a good read and identifies several health apps that have been proven to reduce unhealthy behaviours.  It’s the latest report to emphasise the potential of digital health. From apps that help tackle the devastating impact of insomnia, to those that make it easier for anxious teenagers to discuss mental health as well as apps to tackle diabetes, the reality is that healthcare can be in your pocket.

The report identifies several population groups in the UK that could benefit the most from effective health behavioural change apps. These include:

  • Nearly 1 million ‘baby boomer boozers’ who are over 60, drink frequently and use a smartphone;
  • 760,000 ‘living fast, dying young’ who are under 40 and smoke, drink frequently, have a smartphone and regularly use the internet;
  • 5.7 million people who ‘just need a push’ and who eat healthy and don’t smoke, but drink moderately and rarely exercise;
  • 2 million ‘connected, healthy and young’ who eat well, exercise frequently and regularly use the internet.

While these groups are found to have a huge opportunity to benefit from health apps, the biggest barrier is the sheer volume of apps out there and the difficulty this adds when it comes to sorting the best from the rest. The NHS apps library is applauded for its approach but complexity for consumers remains.

At AHSNs, we see the way that this complexity can be a barrier for busy clinicians too. With so many digital health innovations to choose from, finding the time to assess and assure them can be incredibly tough. That’s why a key part of the role of AHSNs is to work with the NHS up and down the country to cut through this noise, and find and spread the kind of proven digital innovation that makes a difference.

If you’re a clinician and need help “cutting through the app” you can browse examples of the innovations we support, including apps, here:

https://www.england.nhs.uk/ourwork/innovation/nia/

https://digitalhealth.london/accelerator/companies/

If you need advice about an innovation, contact us at hin.southlondon@nhs.net

Meet the Innovator

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Meet the Innovator

In our latest edition, we spoke to Mike Hurley, creator of ESCAPE-pain – a rehabilitation programme for people with chronic joint pain. Mike is currently a Professor of Rehabilitation Sciences at St George’s University of London & Kingston University as well as Clinical Director for the Musculoskeletal theme at Health Innovation Network.

Tell us about your innovation in a sentence

ESCAPE-pain “does exactly what is says on the tin”, it’s a rehabilitation programme for older people with chronic knee or hip pain (often called osteoarthritis) that helps participants understand why they have pain, what they can do to help themselves cope with it, and guides them through an exercise programme that helps them realise the benefits that can be attained from being more physically active.

What was the ‘lightbulb’ moment?

Not sure it was a lightbulb moment, it was more like one of the low energy lights slowly coming on! But there were two turning points that have led to ESCAPE-pain.

The first was realising the impact of pain on people’s everyday physical and psychosocial function was as important to them as the sensation of pain itself, and that addressing these impacts is as important as minimising pain.

The second was realising the importance muscle plays in causing joint pain and joint damage. We used to think joint pain was caused by damage to joints that resulted in pain, this stopped people doing their regular activities, which caused muscle weakness and makes the joint susceptible to further damage. However, we highlighted muscles are very important for protecting our joints from abnormal movement and suggested impaired muscle function that occurs as we get older may initiate joint damage. Thus, muscle is a cause rather than simply a consequence of joint damage. If that’s true then maintaining well-conditioned muscles through exercise-based rehabilitation programmes, we might prevent or reduce joint pain and damage, and improve people’s quality of life.

Coupling the first light bulb moment – addressing the psychosocial impact of pain – with the second light bulb moment – experience and understanding of the value of exercise – gives us ESCAPE-pain.

What three bits of advice would you give budding innovators?

  1. Prove your innovation works – if people aren’t convinced it is useful to them why would they use it?
  2. Surround yourself with a team of clever, hardworking people who believe in you and the innovation.
  3. Keep your eyes on the prize – wide implementation – and be prepared for lots of ups and downs and hard work convincing the multitude of non-believers that your innovation works.

What’s been your toughest obstacle?

Some of the conversations we had with commissioners would have been laughable if they weren’t so depressing. Financial pressures mean people delivering the programme continually want to reduce the number of sessions, but we know doing that reduces its effectiveness. And even though commissioners were often convinced about the need for the programme and wanted to do the right thing, the requirement to focus on short term benefits meant that anything taking more than a year to show benefits, whether health or cost, was of little interest. Many felt unable to invest in services where the benefits are felt by other parts of the health system, for example taking the pressure off primary care. Often commissioners could hear the madness of what they were saying even as they articulated it, but that didn’t change anything. It was tough and these issues really do slow the spread of innovation.

What’s been your innovator journey highlight?

Getting the unwavering backing of the HIN. In late 2012, I was about to give up on getting ESCAPE-pain adopted clinically, because there were no channels for innovative healthcare interventions to spread across the NHS and beyond. Then I answered an email enquiring about local MSK research in south London from its newly founded Academic Health Science Network, met with the Managing Director and frankly my professional life took a new, exciting and very fulfilling turn for the better.

Best part of your job now?

There are two:

Working with the MSK team is terrific and fun. They work so hard to make it everything work. It’s a privilege to work with such a lovely group of people.

The second great thing is the kick the whole team gets from the positive feedback we get from ESCAPE-pain participants. It never ceases to make me feel very humble and honoured to be able to help people.

If you were in charge of the NHS and care system, what’s the one thing you’d do to speed up health innovation?

I’d start “NICE Innovations”, a body that would screen potential (digital, models of care and service) innovations, pick the most promising, work with innovators and the health systems to find out what works (or not), why (not), and then actively promote and incentivise the health and social care systems to adopt or adapt effective innovations. Its kind of happening at the moment but feels fragmented, so it needs to be brought together to make it more effectual and “given teeth”.

A typical day for you would include..

The great thing about my work is that there is no typical day. I usually wake about six, make a cup of tea and listen to the news on the radio before heading into the new day. That could involve writing papers, grants, presenting at conferences, attending meetings at the HIN or St George’s, lecturing, mentoring students or clinicians, figuring out how to get our MSK work seen and adopted.

Find out more about ESCAPE-pain by visiting the website at www.escape-pain.org or following them on twitter @escape-pain

Contact us

W: chc2dst.com and ieg4.com (main company website).

T: @IEG4

Meet the Innovator

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Meet the Innovator

In our latest edition of Meet the Innovator, we caught up with Simon Williams of CHC2DST, a cloud based digital solution for continuing healthcare assessments. Simon is currently the Healthcare Director at IEG4 Limited.

Tell us about your innovation in a sentence

CHC2DST supports the digital transformation of the Continuing Healthcare (CHC) Assessment process by digitising the forms used in the national framework and automating workflow processes to improve patient service, boost productivity and control CHC care package allocation.

What was the ‘lightbulb’ moment?

When we saw that a complex national process relied upon the copying and transmission of reams of paper across multiple stakeholders, it was clear that the process would be impossible to manage effectively and, that, through automation, efficiencies and service quality improvements could be realised.

What three bits of advice would you give budding innovators?

  1. Be sure the challenges you are solving are recognised within the NHS and then be prepared for a long gestation period
  2. Find some NHS body/bodies who become early adopters, with whom you can collaborate to prove the solution within the NHS
  3. Promote your innovation at multiple levels within NHS to gain ‘share of mind’.

What’s been your toughest obstacle?

Despite a direct call to action from Matthew Swindells and Jane Cummings in Summer 2017 to drive up performance against the 28 Day National Standard for decision turnaround, the biggest challenge is engaging with the CCGs who are struggling to run the existing paper-based process. From NHS England Quarterly Situation Reports for CHC, we can see that many London CCGs would benefit from digital transformation of the assessment process. We are keen to talk to the CCGs in South London. An hour invested in watching a webinar would bring the digital transformation benefits to life.

What’s been your innovator journey highlight?

When the alignment of NHS bodies came together effectively under the auspices of the Yorkshire & Humber AHSN to create a focussed, specific event targeted at an audience of CHC practitioners. NHS Strategic Improvement for CHC explained the importance of improving the area to NHS England. Cheshire and Wirral CCGs discussed their CHC transformation journey supported by our technology and through collaborative working with us. The result was a further take up of the innovation and an increased awareness amongst the 20-odd Y&H AHSN CCGs in attendance that an alternative to the status quo was available and proven to work.

Best part of your job now?

When people who are working very hard to manage and execute the existing assessment process see how our solution puts them in control of their workload.  The ‘lightbulbs’ go on during the demo and the feedback we receive is positive . It’s great to know that we are helping to making a contribution to improve ‘our NHS’ in this area.

If you were in charge of the NHS and care system, what’s the one thing you’d do to speed up health innovation?

For all service leads, make exploring and championing innovation part of the job description on which they are evaluated. Create a National Innovation Channel which holds approved content which can be accessed by NHS professionals to make it easier to find solutions in use in the NHS.

A typical day for you would include..

Reaching out to NHS stakeholders in AHSNs, CCGs, and NHS Executive Management to highlight CHC2DST’s capabilities to them and share results visible from NHS Quarterly Situation Reports for CHC. The data shows that CHC2DST helps to improve productivity by reducing unnecessary work activities, improves decision turnaround timeframes and improves CHC care package allocation.

IEG4 runs regular webinars to demonstrate CHC2DST to NHS Professionals working within the CHC area, without obligation. If it works for them, we help build stakeholder support and the case for change.

Contact us

W: chc2dst.com and ieg4.com (main company website).

T: @IEG4

NHS rolls out new tech to prevent 3,650 strokes, save 900 lives and £81 million annually

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NHS rolls out new tech to prevent 3,650 strokes, save 900 lives and £81 million annually

Thousands of patients to benefit from increased diagnosis of irregular heart rhythms

Innovative technology is being rolled out across the country to prevent strokes in a national campaign.

More than 6,000 devices including mobile electrocardiogram (ECG) units are being distributed to GP practices, pharmacies and NHS community clinics across England during National Heart Month this February. The range of tech being rolled out can detect irregular heart rhythm quickly and easily, enabling NHS staff to refer any patients with irregular heart rhythms for follow up as they could be at risk of severe stroke.

Official figures show that more than 420,000 people across England have undiagnosed irregular heart rhythm, which can cause a stroke if not detected and treated appropriately, usually through blood-thinning medication to prevent clots that lead to stroke.

The range of technology includes a smartphone-linked device that works via an app and a new blood pressure cuff that also detects heart rhythms. Small and easy-to-use, NHS staff can also take the devices on home visits and allow more staff in more settings to quickly and easily conduct pulse checks.

The devices pictured, which are being distributed by NHS England and the AHSN Network, can accurately and quickly detect atrial fibrillation. Clockwise from top right: Watch BP blood pressure cuff, imPulse, Kardia Mobile, MyDiagnostic & RhythmPad

The mobile devices provide a far more sensitive and specific pulse check than a manual check and this reduces costly and unnecessary 12 lead ECGs to confirm diagnosis. As a result, the project aims to identify 130,000 new cases of irregular heart rhythms (known as Atrial Fibrillation) over two years, which could prevent at least 3,650 strokes and save £81 million in associated health and costs annually.

The devices are being rolled out by the 15 NHS and care innovation bodies, known as Academic Health Science Networks, in the first six months of this year as part of an NHS England-funded project.

Professor Gary Ford, Stroke Physician and lead on the project for the Academic Health Science Networks, said:

“More than 420,000 people throughout England are unaware they have irregular heart rhythms and of the dangers that this can pose to their health. We have highly effective treatments that can prevent these strokes, but early detection is key. Using cost-effective technology, the NHS will now be able to identify people with irregular heart rhythms quickly and easily. This will save lives.

“As the NHS approaches its 70th birthday this year, this is also a great reminder of the way that healthcare is continually evolving and innovating. Taking advantage of digital health solutions will be even more important for the next 70 years. Today’s new devices are just one example of the way that low-cost tech has the potential to make a huge difference.”

Professor Stephen Powis, Medical Director of NHS England, said:

“Cardiovascular disease kills more people in this country than anything else, but there are steps we can all take to prevent it. These innovations have enormous potential to prevent thousands of strokes each year, which is why NHS England has committed to funding the rollout of 6,000 mobile ECG devices to help identify cases of atrial fibrillation so behaviours can be changed and treatment started before strokes occur.

“We are also encouraging people, during National Heart Month, to learn how to check their own pulse so we can catch even more cases.”

One million people in the UK are known to be affected by AF and an additional 422,600 people are undiagnosed. As the most common type of irregular heart rhythm, it is responsible for approximately 20% of all strokes. Survivors must live with the disabling consequences and treating the condition costs the NHS over £2.2 billion each year.

The rollout is being unveiled during National Heart Month, which raises awareness of heart conditions and encourages everyone to make small changes towards a healthier lifestyle. This year the British Heart Foundation is encouraging everyone to make small changes towards a healthier lifestyle. See more here.

The public are being encouraged to spread the word about irregular heart rhythm and urge friends and family – particularly those aged over 65 – to check their pulse and see a GP if it is irregular. Pulse checks can be done manually (a British Heart Foundation video and guide shows how here) or through new technology, with irregular rhythms investigated further by healthcare professionals.

REAL STORIES

Ian Clark, 62, North West London

I was visiting a client in 2012 and suddenly thought I was having a heart attack. The client called 999 for an ambulance. When the ambulance arrived, they took me to see a registrar in A&E who said that I had atrial fibrillation. I was in complete shock because I didn’t know what it was. She told me it’s an irregular heartbeat, lots of people have it and you will get attacks from time to time.
I felt dreadful. Really, really bad as it felt like I could die at any point. I was living in fear. The ongoing feeling was of complete and utter exhaustion and being totally drained. It’s far worse than the worst jetlag. You do not have the energy to do anything at all.
To know that there is something dreadfully wrong with your heart is awful and all you want to do is collapse into a corner.
Three days after being in A&E I went to my GP. The nurse there gave me a ECG and while doing it she ran out and came back with the doctor and they thought I was having a heart attack! It turned out I wasn’t but they booked me to see a cardiac specialist at the Harefield Hospital in North West London, who was amazing. She put me on anti-coagulants to treat my condition.
During this whole period, I constantly thought I was going to die and that was massively draining and stressful. I had 37 medical appointments in three months.
Six years on after the diagnosis, the reality is that I am living a normal life. Two years ago, I even went white water rafting in Costa Rica!

Above: Chris (4th from left) white-water rafting in Costa Rica six years after an atrial fibrillation diagnosis

Wendy Westoby, 77, Tyldesley in Wigan

After suffering from an AF-related stroke, Wendy Westoby is the first to encourage people to get their pulses tested.
77-year-old Wendy, from Tyldesley in Wigan had been suffering from an irregular heart rate since 2000. She first noticed an atrial flutter after her 60th birthday but put it down to “over indulgence!”
Wendy suffered a stroke in 2009 and but despite many consultations with cardiologists, her symptoms “wouldn’t appear to order” so she wasn’t diagnosed with AF until 2011.
Wendy has received a catheter ablation but her symptoms reappeared in 2017 and Wendy is scheduled for further surgery this weekend at Liverpool Heart and Chest Hospital.
Now Wendy has become an AF Ambassadors – using the latest AliveCor technology to test people’s pulses in her community – she also finds it useful for emailing her own ECGs to her consultant’s secretary.
She said: “The experience has shown me is that it’s even more important to pick cases up early.”
And for those who may be nervous after being tested, she advised: “Go ahead – very simple – initial treatment should be non- traumatic and may avoid long term problems after a stroke.”

Smartphones among digital tech transforming London’s NHS

News

Smartphones among digital tech transforming London’s NHS

Digital technologies – from smartphone apps that help people successfully manage their diabetes, avoid “no shows” at hospitals, to tools that save time for nurses and paramedics – are beginning to transform London’s NHS services.

For the first time, NHS providers in London have revealed the extent to which smartphones, the Internet and Bluetooth are improving patient care and look set to save the capital’s NHS millions each year.

Guy’s and St Thomas’ NHS Foundation Trust expects to save £2.5 million each year by reducing missed appointments through an app called DrDoctor which gives patients much more say in selecting a date and time of their choice, resulting in “no show” rates falling by 40%.

Health chiefs are also using smartphones to tackle a looming health crisis with London boroughs tackling type-2 diabetes.

Programmes run by the North West London Collaboration of Clinical Commissioning Groups, covering eight boroughs, are successfully tackling diabetes through digital technology. OurPath links an app to a fitness wristband and 3G connected weighing scales to provide clients with realtime updates that help tackle type-2 diabetes, and in studies has achieved an average 5.3kg weight loss, while Oviva has seen more than 200 people complete the online programme with an impressive 90 per cent completion rate.

Dr Tom Willis, diabetes clinical lead for the Collaboration, said: “GPS are by nature very busy, naturally sceptical and want evidence.”

The London Ambulance Service, which was praised for its speedy and high quality care to the victims of the recent London Bridge terrorist attacks, is a key adopter having helped adapt the Perfect Ward audit tool specifically for its ambulance stations. The city-wide service has also developed Perfect Kit Prep and cuts out medicines paperwork for faster ambulance care, these are being implemented across over 70 ambulance stations in the capital.

In Chelsea and Westminster another tool links a stoma bag, used to collect faeces and urine for more than 13,000 people who undergo surgery each year nationally, through Bluetooth to users’ smartphones. A discrete device called ostom-i Alert Sensor, developed by a patient innovator, provides alerts when the bag is full so users have more control over their daily life and, importantly, greater dignity.

A new report ‘Digital Leadership in London’s NHS’ reveals that within eight months the 31 start-ups and digital companies backed by an organisation called DigitalHealth.London have achieved strong uptake within the capital.

Download the report here