HTN Awards 2025: Best use of digital for improving care pathways

Ortus-iHealth: Pharmacy-led rapid up-titration for heart failure using Ortus-iHealth virtual ward

Overview: A pharmacist-led, asynchronous virtual ward for rapid heart failure medication titration, delivered via Ortus-iHealth, achieves 92 percent optimisation across all four drug classes within weeks. The pathway improves outcomes, eliminates 30-day readmissions, reduces clinic burden, and halves echocardiogram usage.

What happened? Ortus-iHealth and Barts Health NHS Trust developed and deployed an asynchronous virtual ward for rapid, pharmacist-led up-titration of heart failure medications in patients with acute heart failure (HF-rEF). The platform features structured Standard Operating Procedures (SOPs) and automation, with patients onboarded via a 30-min consultation with a pharmacist, daily symptom, BP and heart rate monitoring via the Ortus-iHealth app, and twice-weekly digital reviews with dose changes issued via Clio e-prescribing. It also includes automated GP updates via Accurx; documents uploaded to the London Care Record; and scheduled review at three months with an echocardiogram to assess for implantable cardioverter-defibrillator (ICD) eligibility. Clinical impact has seen 92 percent of patients on all four drug classes at discharge (ACE/ARNI, beta-blocker, MRA, SGLT2i), and a 51-patient audit showed mean Ejection Fraction (EF) improved from 30 to 45 percent within 3 months. There were zero 30-day readmissions (vs 25 percent baseline across five hospitals), 659 outpatient appointments were avoided for 111 patients, and outpatient waiting times were cut to six to eight weeks, down from over four months.

Menwell Ltd: The Voy programme – revolutionising obesity care through digital tools

Overview: Voy is a digital weight loss programme designed to complement tirzepatide. It offers personalised AI coaching, AI dietary analysis, and personalised side-effect management via an app. A 60-person pilot showed exceptional clinical outcomes, with improvements to quality of life and a 100 percent prediabetes reversal.

What happened? Voy is a next-generation digital behaviour change weight loss solution, built to create the best possible patient outcomes in obesity care whilst prioritising patient safety when on Mounjaro. The programme takes a proactive, personalised approach, combining remote 1:1 health coaching, AI-powered tools, adaptive habit formation features, a personalised titration pathway and personalised side effects response programme. A pilot study was conducted with 60 adults aged 18-75 years (BMI: 27 kg/m²) recruited via social media over 12 months. Qualitative interviews confirmed high satisfaction with coaching, app features, and the ability to customise dosing and goals. Results included a 10.4 percent average weight loss in 12 weeks, a 3 percent reduction in waist-to-hip ratio, up to 70 percent improvement in quality of life, and a 53 percent increase in weight lost at four months vs medication-only participants. The pilot also saw the reversal of prediabetes in 100 percent of prediabetic patients at 6 months.

Priory: Implementation of a digital path to triage for mental health

Overview: In April 2025 Priory launched a new digital platform in partnership with Psyomics, to capture rich clinical and social history data via a same-day online questionnaire. This new process reduces delays, improves decision-making, and empowers patients – streamlining the journey from first contact to therapy, including outside traditional hours.

What happened? The Psyomics platform captures rich, structured information about mental health symptoms, personal context, and social determinants of health. The journey began with a pilot in March 2024, which showed 66 percent of individuals who completed the assessment moved directly into treatment. The platform was then embedded into Priory’s national care pathway. Key activities included co-designing the digital assessment tool, integrating the platform into digital infrastructure and patient journey, redesigning referral and triage processes, delivering tailored change management, and establishing governance oversight. Patients can complete the questionnaire on the same day they contact Priory, significantly reducing waiting times. Around 25 percent of assessments are submitted between 7pm and 7am, highlighting the platform’s value in offering patients control over when and how they engage. Clinicians now receive a structured report summarising patient symptoms, risks, and needs – before any direct contact – enabling more targeted and informed care from the outset. Feedback from both clinicians and patients has been overwhelmingly positive. Clinicians describe the platform as a “game-changer” that gives them time and context back.

Health and Care Innovations Limited: HCI CONNECTPlus – Improving pathways of care through patient information

Overview: CONNECTPlus enables healthcare teams to deliver efficient, scalable, and patient-centred digital pathways of care. It supports patients with self-service education and remote monitoring, cutting clinician time and phone calls and improving accessibility and engagement. This reduces demand, optimises resources, and frees up capacity.

What happened? CONNECTPlus provides patients with 24/7 access to structured program content, including on-demand videos, educational resources, and structured treatment programs that mirror in-person curricula. Information covers areas such as pulmonary rehabilitation, DMARDs education, ADHD support, and more. Patients actively engage with CONNECTPlus by providing data through various in-app features. This includes daily activity check-ins, symptom trackers, feedback surveys, and completion of forms. This ongoing interaction allows for tailoring support to individual needs. CONNECTPlus provides healthcare professionals with real-time data through dashboards, offering visibility on patient condition and progress. This enables proactive intervention, better allocation of clinical resources, and improved population health planning. Implementation has shown significant positive impacts across various case studies, including in pulmonary rehabilitation, where patient-reported outcomes show improved mobility and reduced reliance on in-person sessions. Service benefits include reduced demand for face-to-face appointments, the ability to support patients during staff shortages, and lower cost of delivery.

Wavenet: Revolutionising patient experience and enhancing operations with Wavenet’s GP Voice at Conisbrough Group Practice

Overview: Wavenet’s game-changing GP Voice transformed NHS practice Conisbrough Group, addressing outdated systems that hampered operational efficiency and adversely impacted care pathways. Now, patient satisfaction and operational performance is stellar – improving the community’s healthcare experience.

What happened? Conisbrough Practice partnered with Wavenet to implement their revolutionary GP Voice solution, a powerful, intuitive, cloud-based telephony solution designed to transform communication and service delivery and unblock the path to immediate care. Key features include interaction history and call recording, an Intelligent Queueing System (Queuesmart) so patients can select convenient time slots for callbacks, and integration with SystmOne to promote immediate access to patient information. It also offers comprehensive reporting tools for analysing performance, auto attendance to manage peak times, SMS reminders automation, and age-restricted emergency-only messages for the ëNo appointments’ feature. Staff are equipped to manage and adapt system configurations independently from anywhere with an easy-to-use admin portal. The solution is secure and scalable with ongoing cost savings, as inbound and outbound calls are unlimited, and no hardware is required. Equipped with GP Voice, Conisbrough Group Practice experienced improvements such as reduced call abandonment, lower average wait times, and consistent targets met for prompt call answers.

Guy’s and St Thomas’ NHS Foundation Trust & Kings College NHS Foundation Trust: Showcasing scalable models for digital transformation in diagnostics through intelligent system design and collaborative clinical engagement

Overview: A co-produced approach to pathology optimisation has delivered measurable patient experience, financial, clinical and environmental benefits. Utilising close collaboration between clinical, technical, and transformation teams has leveraged advanced system configurations, reflecting national guidelines and enabled consistent practice.

What happened? GSTT and KCH launched a collaborative pathology optimisation programme in October 2024 to utilise digital tools within their single, integrated EHR (Epic). Having a fully integrated EHR across both trusts means that we are able to take a shared approach to clinical management, technical development, process changes, and education and training. We have developed a joint improvement methodology to ensure clarity of vision and actions for staff. Our in-house technical build team has the capability to make changes to the system architecture, which enabled dynamic design from inception. Outcomes include configured alerts on 1361 pathology tests based on the minimum interval testing recommendations from the Royal College of Pathology. These alerts have resulted in 96,312 tests cancelled, equating to a 32 percent test cancellation rate. A total of 2,600 units of blood products (Platelets and Red Cells) have been cancelled because of practice advisory alerts, which support decision making for clinicians, equating to £570k in cost avoidance and protecting vital national blood supplies. At month 10 of 2024/25, we have forecasted £777k of savings based on these triggers across GSTT and KCH (full year actual financial data is currently being validated).

Medway Council Public Health and Health Diagnostics: Digitally transforming prevention: Tackling inequality through community-led health checks

Overview: Medway Council Public Health partnered with Health Diagnostics to transform its NHS Health Check programme, addressing health inequalities and fiscal challenges. The collaboration streamlined service delivery, enabled data-driven outreach, and achieved a 10.5 percent reduction in cardiovascular risk.

What happened? MC needed a system capable of accurately identifying the eligible population, managing targeted invitations, and meticulously tracking outcomes. The digital solution provided by Health Diagnostics allowed budget-conscious commissioning to prioritise essential functionalities such as targeted invites and integrated reporting. We implemented automated invitations, which significantly reduced GP workloads and we replaced manual, error-prone processes with a simple five-click system. Integrated offline templates and SIM-enabled laptops meant teams could deliver checks in remote locations. Analysis clearly demonstrates that MC’s community outreach approach delivered a statistically significant improvement in patients’ cardiovascular risk scores (calculated using QRISK) when individuals were followed up within a year of having had an NHSHC (p<0.0001). At follow-up, these individuals saw, on average, their CVD risk score decrease by 10.5 percent relative to their baseline results established during the initial NHSHC consultation. Pharmacy health checks are now “business as usual” in Medway, helping it achieve 146 percent of its target population for 2024-25.

The Dudley Group NHS Foundation Trust: Transforming perioperative care at Russells Hall with digital health coaching

Overview: The Remote Health Coaching project at Dudley Group NHS Foundation Trust empowered 635 elective surgery patients to take control of recovery through digital coaching – cutting readmissions by a relative 32 percent, subsequent relative ED attendance by 50 percent, and avoiding 318 bed days.

What happened? The Dudley Group NHS Foundation Trust introduced a 12-week digital health coaching programme for elective surgery patients, in partnership with Surgery Hero. 635 patients enrolled, with a 32 percent engagement rate. The programme paired each patient with a dedicated coach and delivered personalised support across physical activity, nutrition, sleep, mental health, and recovery planning, all accessible via a digital platform. Patient activation scores rose significantly. Participants reported lasting improvements in their physical activity, diet, sleep quality, mental wellbeing, and weight management. Average length of stay for ordinary admissions dropped from 2.75 to 2.25 days, saving 318 bed days. Readmission rates fell from 11.8 percent to 8.2 percent. Emergency department visits halved, from 8.5 to 4.3 percent. Surgical complication rates also trended downward. A formal research paper is in progress, and a business case for ICS-wide adoption is under development.

East Coast Community Healthcare: musculoskeletal services digital transformation

Overview: ECCH introduced a self-help app, online and app referral and appointment booking, and a new website to help MSK patients access services and self-manage conditions. The result: increased service reach; response and guidance issued within 48 hours; significantly reduced appointment non-attendance.

What happened? We utilised an existing free-to-use app (Airmid) in a new way to allow patients to self-refer, book, cancel and change appointments remotely. Clinical information submitted by patients sits within their NHS EPR. We also developed a self-management app offering rehabilitation tools, exercise videos, and advice. We involved our clinicians throughout and engaged with local primary and secondary care providers to ensure they could input into the process and understand how it would benefit them. We conducted a number of pilots and training sessions. Since launch, patients are triaged within 48 hours and issued with self-help information to help them start their rehabilitation journey. They now have complete choice over where in the region they attend, as well as when. We encourage them to choose between remote or face-to-face appointments, which again gives control to the patient. Our non-attendance rate for appointments has reduced from 13 percent to 7.8 percent. The number of website self-referral interactions increased from 995 in March 2024 to 5,500 a year later. Clinical time has been freed up at the local acute hospital where our self-referral pathway has been rolled out to the Trauma and Orthopaedic, A&E, Pain Management and Fracture Clinics.

Bolton NHS Foundation Trust: Bolton joins up and accelerates district nurse referrals across secondary and community care using Sunrise EPR

Overview: Bolton NHS Foundation Trust is the first in Greater Manchester to implement district nurse referrals via Sunrise EPR. By integrating care, the digital workflow enhances communication across services, speeds up referrals, and supports safer, more timely care.

What happened? The trust decided that to mitigate the issues and optimise the process, the district nurse referrals should be requested within the central Sunrise EPR, provided by Altera Digital Health. The configuration of the referral form included mandatory elements, embedded guidance and pop-up messages, and conditional logic to ensure the forms were accurately completed. This has meant that there are now fewer inappropriate referrals received, and the district nurses receive all crucial data elements that help them assess, prioritise, and schedule ongoing care. With the district nurse referrals built into the EPR, clinicians can access the form as part of their regular workflows. All community triage nurses and district nurse managers have access to the Sunrise EPR system. Within the first full month of being live, more than 230 referrals were processed. It has helped enable a reduction in patient incidents, a joined-up care record across secondary and community care, more reliable and accurate information sharing between teams, and full compliance with medication policies across care settings. Time savings are offered in the ability for acute teams to complete the whole referral process from within the Sunrise EPR, and less time is required in clarifying patient information.

The Queen Elizabeth Hospital: Development of adult and paediatric virtual wards at The Queen Elizabeth Hospital

Overview: The Queen Elizabeth Hospital has developed an adult virtual ward and pioneered the first paediatric virtual ward within Norfolk. Both projects have developed digital technologies to create clinical pathways, allowing for patients to be treated in the care of their own home, optimising patient experience and care.

What happened? Since its implementation, the VW project has achieved several milestones, including over 400 adult patients and 50 paediatric patients successfully treated at home. Specific pathways have been established to provide care at home enabled by technology. The VW leverages remote monitoring and digital tools to provide timely consultant advice and multidisciplinary care. A KPI dashboard has been developed to track service performance and address concerns promptly. QEH has partnered with Norfolk Community Health and Care (NCHC) and Feebris to provide clinical and digital support. NCHC visits VW patients at home, while Feebris offers rapid remote support and real-time data collection. Comprehensive training has been provided to clinicians and staff on virtual ward operations. No clinical incidents related to patient safety have been recorded, and the project has optimised the use of hospital resources, reduced bed occupancy, and supported patient flow. By providing care at home, the VW has effectively reduced the number of hospital admissions. Patients now have the option to receive care in the comfort of their homes.

VIDEOMED GLOBAL: Your partner in accessible, personalised mental health support

Overview: Designed for medical professionals and patients – including NHS practitioners – Videomed Global offers integrated Electronic Health Records, e-prescriptions, and seamless patient communication to enhance accessibility and efficiency in healthcare delivery for mental health.

What happened? Videomed Mind+, the mental health arm of Videomed Global, is a cutting-edge digital solution designed to meet the evolving needs of individuals seeking compassionate, convenient, and clinically-sound mental wellness support in the UK. Built on Videomed’s trusted telehealth ecosystem, Mind+ provides secure, on-demand access to mental health professionals, personalised wellness journeys, and AI-assisted tools – all from the comfort and privacy of a mobile device. In a world where mental health challenges are increasing and waiting lists for NHS psychological services are often long, Videomed Mind+ bridges the critical gap between need and access. It empowers users to take control of their mental well-being through a platform that is simple, discreet, and responsive to the diverse realities of life in modern Britain.

Maidstone and Tunbridge Wells NHS Trust: Automated vital signs integration at Maidstone and Tunbridge Wells NHS Trust

Overview: The Trust implemented a fully automated process for capturing and recording vital signs. Through a collaboration between the device provider (Welch Allyn), the EPR vendor, and the Trust’s internal teams, vital signs are transmitted directly from the Welch Allyn devices, through the Trust Integration Engine, into the EPR in real-time.

What happened? The solution includes seamless device-to-EPR integration, real-time data availability on patient flowsheets and ward tracking boards, and retention of manual workflows as a fall back for resilience during downtime. The rollout followed a carefully phased approach featuring co-development with frontline clinical staff, pilot implementation on a single ward, iterative feedback loops, and collaboration across multiple departments. Since implementation, the Trust has seen substantial improvements, with time-in-motion studies showing a three-minute time saving per observation, equating to approximately 30 minutes saved per observation round on a typical ward. Observations now appear in the EPR within one minute, down from an average of 45 minutes. Earlier identification of deteriorating patients enables faster escalation and improved clinical outcomes, whilst reduced paperwork and transcription allows staff to focus on direct patient care. Availability of structured, real-time data supports capacity planning and patient flow management, and the solution supports national NEWS2 standards and enhances clinical information governance. The model is now being shared with neighbouring trusts as a regional exemplar of best practice.