Here we take a look at all of the entries for the Health Tech Awards 2023 category of ‘Most Promising Pilot’.
Hanley Consulting
Overview: In partnership with Maple PCN, Hanley Consulting completed a pilot programme and created an automated digital solution to support patients and practices to access services digitally and improve digital literacy across the registered population.
Why? Data suggested that low uptake of digital tools, due to lack of awareness and poor digital literacy, is impacting surgeries’ ability to meet demand with the capacity they have.
What happened? EDATT has been launched across 2 of the 3 surgeries at Maple PCN, with the third set to launch in July 2023; and has now been commissioned across five PCNs and one Federation. 12 percent of digital triages have been signposted to self-care, freeing up clinical capacity. EDATT has relieved pressure on reception staff by moving 15 percent of calls onto a digital route, seeing an improvement in their wellbeing with a 25 percent increase in those that would recommend their workplace. Where patients still require assistance via the telephone, EDATT has reduced call wait times by 2 minutes on average. By increasing use of digital triage by 300 percent in six months, GP time saved has gone from 12 hours to 56.7 hours per month by signposting self-care, pharmacy and ARRS physio. By surfacing directly bookable slots within the bot and offering this from the telephone system, cervical smear bookings have increased sixfold, with 86 smears booked digitally in a single practice in May 2023 (up from 14 in January 2023). The pilot has achieved full scoring against quality improvement activities, including sharing across the network and also capacity and access improvement funding by improving access and patient experience.
Looking ahead. Hanley Consulting will be using patient feedback to make continuous improvements to the solution.
Here (Care Unbound Ltd)
Overview: Piloting the innovative use of health equity data to ensure Sussex Musculoskeletal Partnership Service delivers exceptional care for everyone.
Why? COVID 19 shone a light on the inequalities that exist within healthcare, which urgently need addressing if we are to create an equitable system that works for all.
What happened? Sussex Musculoskeletal Partnership Service developed innovative Health Equity Dashboards to better understand who is and who isn’t accessing services. A pre-appointment questionnaire provided self-reported protected characteristics data for the Integrated Care and Assessment Treatment Service. This data was overlaid with MSK appointment data including DNAs and cancellations, as well as patient reported outcome measures, patient reporting experience measures and satisfaction surveys, 2021 census data, and deprivation index data based on patient postcode. A dedicated team of analysts collated and represented this data in filterable dashboards. Findings revealed that patients are four times as likely to DNA if they are Black and twice as likely if they are Asian; and that more women than men access the service (63/37 percent). 38 percent of people using the service see themselves as disabled, and these make up half of all DNAs. Younger patients generally have a worse impression of our service, compared to elderly people. This data informed Community Appointment Days, creating a one-stop, multi-route experience with access to multiple professions, community and voluntary offers, housed in a de-medicalised environment and tailored to both the local population and the individual.
Looking ahead. Here and SMSKP plan to focus on connecting with underrepresented communities to ensure their perspectives are taken on board, and to make dashboards more representative of the local population.
Hurdle Group Limited
Overview: Working with Lancashire and South Cumbria Foundation Trust to improve clinical data quality and productivity of staff by using hurdle to improve EPR and software systems training online.
Why? With a geographically split workforce, traditional classroom-based training sessions required excessive travel, training rooms and resources that are not always feasible.
What happened? Partnering with LSCFT, hurdle was shaped into a virtual classroom solution to promote digital transformation. The pilot was in part supported by Innovate UK, and filled a crucial gap in the training industry. Worked closely with LSCFT, the platform was tailored to the evolving needs of the NHS. The pilot identified critical success factors, implemented changes to the platform, and hurdle worked closely with the LSCFT digital training team to assess and test the effectiveness of these improvements. The result was a valuable and lasting partnership, with LSCFT now utilising hurdle for the majority of their digital training delivery. The impact of hurdle has been transformative; training rooms have been repurposed for clinical purposes, attendance has increased, and productivity and cost savings have been achieved. Learners benefit from a hands-on approach that combines engaging software training with remote accessibility. During the pilot, the use of hurdle resulted in 1548 hours and £40,526 being saved; which is expected to increase as the use of hurdle expands within the trust. Training sessions delivered via hurdle led to improved clinical data quality, system adoption and a better understanding of staff competency by the digital team.
Looking ahead. The team are committed to building a robust hurdle community across the UK, where NHS colleagues can engage, share ideas, and discuss best practices with the opportunity of widening the reach of hurdle to support ongoing digital transformations.
King’s College London, King’s College Hospital and Ensono
Overview: A web app from King’s College London, King’s College Hospital and Ensono brings together groundbreaking tools to help paramedics and doctors effectively triage patients who suffer cardiac arrest outside of a hospital.
Why? In the UK, statistics indicate that the probability of surviving an out-of-hospital cardiac arrest is approximately 10 percent. In comparison, this rate is as high as 20 percent in other countries such as Denmark.
What happened? Dr Pareek conducted a research programme which resulted in the MIRACLE2 algorithm, which gives a neurological risk score to assess the risk of brain damage following an out-of-hospital cardiac arrest. The algorithm needed a platform for delivery, which presented a perfect opportunity for incorporation into an app. The Ensono team worked with academics from King’s College London to turn the initiative into an effective prototype. It enables the early classification of patients admitted to the hospital with a successfully resuscitated cardiac arrest and incorporates seven variables predicting poor neurological outcomes at six months. Two further tools have been added to the application, further bolstering the capacity for clinicians to diagnose and personalise treatment to match patients’ individual needs. Firstly, the SCAI Grade measures the cardiogenic shock severity in patients with out-of-hospital cardiac arrest. It classifies cardiogenic shock into one of five classes based on severity, helping clinicians make crucial decisions on how to proceed with treatment. Secondly, the KOCAR Culprit tool calculates the probability of a culprit coronary lesion after an out-of-hospital cardiac arrest.
Looking ahead. The app is now being advanced in its development to progress towards use in clinical settings, and there are plans to affiliate this with the British Cardiovascular Interventional Society.
Imprivata
Overview: A single sign-on pilot project at Tallaght University Hospital paves the way for implementation of the digital workplace solution across the whole Irish public health and social care system.
Why? Login procedures across up to 17 different systems were creating bottlenecks for clinicians in accessing healthcare systems, stealing valuable time from patient care.
What happened? Tallaght University Hospital (TUH), one of the country’s largest acute teaching hospitals with 3,000 employees and 495 adult beds, was selected for a pilot to measure the success in implementing Imprivata OneSign Single Sign On, to enable clinical staff needing access to electronic patient records, to move between computer systems without the need to log into solutions more than once, by accessing clinical systems instantly with just the tap of their ID badge. To rigorously test the solution, the pilot project covered three departments with a range of needs. With a single user ID and password, initial access time to reach the PC desktop has been reduced from over 31 seconds to less than two. Results include fast and secure access to applications with an improved workflow for clinicians, 10-20 percent increased time for face-to-face patient care per shift; and improved security, auditability and compliance. The Imprivata team built on initial time savings by introducing the “tap and go” technology, improving workflows and procedures to deliver even more benefits. For example, the Oncology department’s initial overall nine-minute time-saving per staff member/shift was further improved through the pilot to deliver a 46-minute saving for each staff member per eight hour shift.
Looking ahead. Imprivata, together with its regional partner, PFH Technology Group, has secured a national framework contract with the Health Service Executive in Ireland to roll the solution out nationally.
Cambridge and Peterborough NHS Foundation Trust
Overview: Cambridge and Peterborough NHS Foundation Trust (CPFT) in partnership with Healthy.io have been on a journey to improve outcomes for patients requiring wound management in community care.
Why? Variation in current care has led to a 71 percent increase in the annual prevalence of wounds at a cost of £8.3bn. 80 percent of wound care is managed within the community and there is a rising demand for services.
What happened? The pilot with Minuteful for Wound (MfW) offers a solution of digital wound registry, providing caseload oversight for patients living with chronic wounds. Using AI and machine learning to support clinicians, MfW calculates consistent wound measurements, simplifies quality documentation with evidence based clinical assessment flows, and provides a remote monitoring caseload review platform. Benefits so far have included increased caseload and treatment gap visibility, with new assessment flows providing detailed clinical data. MfW enables clinicians to show patients the trajectory and status of their wound. Feedback from patients is that this really helps them to see what is happening with the healing progress for their wound. CPFT wished to provide evidence to purchase 12 Wound Express pumps; traditionally this would have required a manual trawl of current records. The MfW web-based portal (visualisation tool to support reviewing a wound caseload) enabled a quick search for a nine-week time period for all of the patients seen by our community nurses with a venous leg ulcer (125 patients). The MfW audit of 125 leg ulcer patients was completed within six minutes. The manual audit took approx 30 minutes per patient for 125 patients totalling 62 hours. And finally, annual savings of £309,448 in targeted treatment optimisation are anticipated.
Looking ahead. CPFT hope to continue to use the solution to provide benefits for patients requiring wound management in community care.
Maldaba Ltd
Overview: A new approach to Annual Health Checks (AHC) focused on overcoming the barriers identified by stakeholder groups across primary care staff, community staff and families/people with learning disabilities.
Why? The pilot aims to support people with a learning disability by identifying risks earlier and preventing ill health, given that people with learning disabilities die on average 20 years earlier than the general population.
What happened? Through co-design, a new approach to Annual Health Checks (AHC) was produced, including a web-based system for primary care staff to manage the 12-month AHC cycle including Health Action Plans (HAPs); a mobile-based solution for people with learning disabilities and their families/carers to respond to questionnaires, see and track activities related to their HAPs throughout the year; technical designs for EMIS interoperability; and a Standard Operating Procedure (SOP) for primary care staff. This work was a partnership between Symphony Healthcare Services Ltd and Maldaba Ltd, who were the technology partner. With this solution, trackable documents will be sent out to patients, completed and returned electronically. HAPs are more likely to be produced, shared and used with their wider support network e.g. day staff. The estimated time saving per AHC is 113 minutes, constituting reduced time for admin, completion and analysis. This totals over £57 just for the completion of the process, without accounting for broader savings from reduced engagement episodes and reduced paper/postage activities. Scaling this £57 to the estimated 250,000 people on the Learning Disability register in England, the procedural saving alone could reach £14.2m.
Looking ahead. Key inputs from PPI recommendations will be developed in the full solution, such as suggesting gamification methods to improve engagement with the software.
Polygeist & Gloucester Hospitals NHS Foundation Trust
Overview: Using AI to provide real-time patient risk and long stay prediction at Gloucester Hospitals NHS Foundation Trust.
Why? Reducing long stays in hospital is a national priority for NHS England, and forms a key plank in the NHS Recovery Plan, reducing the risks associated with longer stays.
What happened? In partnership with Gloucestershire Hospitals NHS Foundation Trust, NHS AI Skunkworks and the government’s Accelerated Capability Environment, a proof of concept risk stratification tool was developed. As the AI could identify those long stayers on their presentation at the emergency department, the technology was widely publicised, and moved into Phase 2 – integration into the hospital electronic patient records system. Every observation captured by nursing staff and prescribing clinicians, along with all diagnostic test results, can be processed in real time, as they are entered into the EPR. This technology has been privately trialled, and can predict over 99 percent of long-stayer patients. The length of stay was highly accurate, with the average error within just 12 hours of the actual patient discharge time, over a 30-day period. Using population data, key risk factors contributing to that patient’s stay can be flagged to clinicians; this enables them to plan for potential blockers. Analytical assessment suggests that clinicians could safely reduce the average stay between one and five days per long-staying patient. Over 7000 lives per year, nationally, can be saved simply by identifying those high risk patients and discharging five days earlier; based on statistical analysis of the GHNHSFT data, and national mortality statistics. Early discharge reduces readmission rates by 50 percent, projecting 3.15 million bed days per year freed nationally.
Looking ahead. The technology is being developed to establish virtual wards of high risk patients, explore real-time risk alerts, and to allow GPs in the area to use the technology, before a patient reaches the hospital.
