At the Health Tech Awards 2021, not only do we celebrate some of the best ideas, solutions and innovations from the past year – we also highlight the fantastic teams behind them.
In this feature, we focus on the ‘Health Tech Team of the Year’ category, for which we have seven superb entries to showcase. Take a closer look at all the great work being done in this area…
Medway NHS Foundation Trust
Medway Innovation Institute launched during Covid, by a team who refused to let a crisis defeat them and believed the best ideas came from the grassroots. They built the foundations for innovation and positive impact, launching a movement to empower staff, nurture their self-confidence and provide them with life-skills.
The Medway Innovation Institute team is made up of a cross-section of passionate individuals across the trust, from both clinical and non-clinical areas, with a common purpose of quality improvement both within the trust and across the system.
Within a year, the Institute has successfully implemented innovation projects including:
- Delivery and design of an end-to-end pathway to launch a Covid Vaccine Hub at speed
- Virtual Bed Bureau for remote bed management and ward clerk services, resulting in better deployment of staff isolating or shielding, faster discharges, fewer waiting patients, and better quality data entry
- Covid dashboards for vital business intelligence to manage oxygen, ventilators and patient safety
- A state-of-the-art Incident Command Centre to manage the Covid response and emergency crisis incidents
- “The Patient will see you now” online sessions with the patient community to co-design our digital strategy
- Patient First framework covering improvement workstreams for A&E, Ambulance handovers, Flow and discharge, Workforce and Infection prevention and control
- Big Room events to discuss “Pressure Ulcers” and “Nutrition and Hydration”
- BebeVue – A pilot in the maternity unit to provide motion videos of babies for expecting parents, with the potential for new use cases to tackle population health issues like obesity
- Orthotic Remote Monitoring – Orthotic and therapies service deployed pedometers deployed to patients for remote monitoring and outcome measurement, encouraging patients to exercise and walk more to increase circulation.
- Changing Places Toilets for people with physical and learning disabilities, to provide dignity in a safe and comfortable environment.
- Big Conversations – Public online events on Innovation, Population Health, Autism and Menopause
- MediLead – A bespoke course designed for junior doctors, with workshops, training events and lectures in leadership and quality improvement.
- Using virtual and augmented reality for enhanced healthcare education and simulations
- QI Training and QSIRV programmes – Training modules for our staff in quality and service improvement, with regular follow up café sessions to keep the cohorts in touch and stimulate collaboration.
- ImproveWell – a pilot application deployed to the surgical team and wards to increase staff engagement, morale and collaboration. It helps staffs to tell the group how they are feeling and is an easy way to send in their ideas on improvements.
- Reciprocal Mentoring with the BAME Network. Junior BAME staff mentor senior executives to explore inherent inequalities and bias through their lived experiences and jointly drive positive action.
- Menopause awareness – 52% of the trust’s staff are going through a stage of menopause right now. They have designed a series of menopause cafes, awareness and treatment sessions, manager training and online content. This has also resulted in the trust reviewing our menopause policy.
Hertility Health says that it is “on a mission to transform women’s healthcare” by pioneering tailored diagnostics and next-generation advancements through predictive algorithms. Its area of focus is infertility and helping women from menstruation to menopause. Among its services are testing, results, teleconsultations, counselling and access to experts.
Targeting misinformation in women’s health, the company aims to “revolutionise the world of reproductive health” by educating, empowering and ‘making knowledge the norm’.
By providing an at-home blood test, along with insights, actionable advice and a route to care, Hertility Health helps women understand their risks of infertility. The tailored hormone tests enable women to get personalised answers that are unique to their individual health needs and begins with an online questionnaire which takes into account over 1,500 variables to calculate the risk of certain pathologies.
Once a sample has been collected and sent to their accredited labs, the results are compiled into a digital report, which accounts for over 54,000 variables and explains the hormone levels in an understandable way, taking into consideration all lifestyle factors.
According to Hertility Health, one in three women will suffer from a reproductive health condition in their lifetime and one in seven couples will experience infertility. In addition, it notes that 80 per cent of women suffer hormonal imbalance, while people from ethnic minority backgrounds are over 25 times less likely to access fertility treatment.
Eager to address some of the barriers to accessing support – in both the NHS and private sector – Hertility Health provides women with detailed reproductive health testing and results, the option to speak to a fertility expert, and also. adedicated family building journey for same sex couples. The company says that, on average, one in five Hertility Health users have been found to have a previously undiagnosed reproductive condition which has been revealed as a result of testing with them.
Royal National Orthopaedic Hospital NHS Trust and Interneuron
The Royal National Orthopaedic Hospital NHS Trust (RNOH) and Interneuron have been working on a project to design, develop and implement an open-source modular care record. The iterative co-design methodology is an example of public-private innovation and aims to deliver more value for money.
The ambition is to create an eco-system whereby NHS organisations and development partners create “safe, secure and fit-for purpose clinical systems and apps” by using freely available open source technologies, to make the most of joint digital investments and reduce the investment burden on the NHS as a whole. It’s hoped that this would then reduce barriers to entry, lift digital maturity and democratise access to a flexible modular EPR for those that cannot afford ‘big bang’ EPRs.
To achieve this, the team took a co-design approach. The RNOH team members understood what was required to improve patient care, how to engage its clinicians and roll-out new software in the NHS, while in Interneuron they found a partner that understood how to design and build software in a modular and extensible way.
They adopted a ‘One Team’ philosophy and agreed on four core principles: to co-create and co-design with multidisciplinary clinical staff high quality modular software with UI and UX; create a flexible system architecture to future proof new module development with a modular approach allowing for changes to modules without having to change to core platform; prioritise patient safety through a fully audited Quality Management System to ensure software can be accredited as medical devices, where necessary; the ‘Collect-once-reuse’ principle reduces the burden of data collection on front line staff, maintains data quality and provides access to high quality, codified and structured data for direct care and research.
To achieve the ‘One Team’ vision, there was a need to move quickly, engage clinicians in the design process, comply with clinical safety best practices and work iteratively. For each project a clinical lead and an executive sponsor were appointed, with authority for the design delegated to a nominated group. Partnership was key to success of the project, with the project board making sure the design team were empowered to make decisions and intervening when required.
According to RNOH and Interneuron, the development process increased the digital maturity and confidence of the whole team, making subsequent modules easier to design, develop and implement. So far the open-source platform and the following modules have been deployed: Inpatient management app – IMA; Patient E-Board; Observations (NEWS & PEWS); Assessments; Fluid balance; Laboratory results and reports; Operation notes; Pre-operative assessment.
During the pandemic, the team also developed new functionality to include COVID-19 specific information for each patient, with NEWS/PEWS data used to assess the oxygen usage and oxygen reserves in real-time, and new badges enabled the infection control team to be alerted about missed COVID tests.
The solution has already been deployed to Manchester University NHS Foundation Trust and East Lancashire Hospitals NHS Trust.
HumWell Private Limited
Social health tech enterprise HumWell is described as a “collaborative effort of experienced health professionals and technology experts” that envision a Pakistan where the ‘right to health’ is enjoyed by all.
HumWell’s app offers primary healthcare to any mobile user in the country, 24/7, and acts as a ‘one-stop’ primary healthcare platform. With challenges in the healthcare sector including self-medication; non-existent healthcare establishments in rural areas; a lack of primary and secondary healthcare facilities and a lack of practicing doctors, HumWell aims to provide an all-inclusive platform that can give access to primary healthcare remotely.
HumWell says that it ensures on-demand doctor consultations by having a team working in shifts in its tele-clinic with no need to book an appointment, and can also provide an updated and accessible medical record for patients, a clinical facilitator who generates a medical profile, the ability to upload pictures, a legal and compliance department, the potential for follow-up appointments, a healthcare library and up-to-date directory for nearby healthcare facilities, and in-app support.
The company describes its aims as “to serve every Pakistani, and alleviate the primary healthcare segment with technology,” to be the “first name that comes to mind when the people of Pakistan thinks of seeing a doctor”, and that its purpose is that “every person in Pakistan should have equal access to quality healthcare without discrimination”.
Bolton NHS Foundation Trust and AllScripts
Bolton NHS FT and AllScripts submit their Acute Medicine Referral List – a clinically developed Electronic Patient List that can help save clinical time.
The trust designed an Electronic Patient List which automates referrals to Acute Medicine, from multiple admission streams. In just five months, it says there have already been reductions of 34.4 per cent in waiting times for consultant reviews, 19.4 per cent for length of stay, and an average of 298 minutes saved throughout the patient journey.
Patients are admitted to Acute Medicine through numerous referral routes, both planned and unplanned. At any one time, patients who need care can be in any number of locations across the hospital, with varying degrees of illness. Tracking each admission relied on complex systems and non-integrated tracking boards. Consultants were unsure about who to prioritise and had to frequently move between wards. During COVID, this was exacerbated, and Bolton reports that there was also significant variability in standards of clinical documentation during doctor reviews, with documents often incomplete and missing key information.
To combat this, the Acute Medicine team identified an opportunity within their Allscripts Sunrise Electronic Patient Record (EPR), which was implemented in October 2019. The EPR provided the trust with the flexibility to manipulate data and integrate information into a single, automated list, accessible by all clinical staff. The solution required minimal manual intervention, improving data accuracy, and would make redundant existing processes of using pagers, verbal referrals, handwritten patient lists and inaccurate tracking boards. The proposed Acute Medicine Referral List would identify and track referrals to the Acute Medicine team, providing an overview of which patients had outstanding clinical assessments, and update the live location of these patients as they moved through hospital.
In addition, to help standardise clinical variability in documentation, the list was designed to update only if the correct clinical documents were completed during the reviews, eliminating incomplete or erroneous clinical information. The trust successfully implemented the unified integrated automated list in November 2020, and then compared cohorts of patients from February 2020 (pre-implementation), January 2021 (six weeks post-implementation) and April 2021 (five months post-implementation), to evaluate the impact. It was found that the greatest improvements were around consultant reviews, with a four hours and 58 minutes reduction in waiting time, 51.4 percent more patients seen within 14 hours of medical referral, and a 65.7 per cent increase in same day consultant reviews.
Improvements over the weekends almost nullified the so-called ‘weekend effect’ with a 25.1 per cent or 52-minute reduction in the average waiting time for medical clerking and a 28.2 per cent reduction in the average waiting time for consultant review. This equated to an 81 per cent increase in the proportion of patients reviewed within 14 hours.
Among other positive impacts, there has also been a 15 per cent increase in patients discharged within 72 hours and inpatient and 30-day mortality has reduced by 13.5 per cent and 57 per cent, respectively. While, by comparing length of stay, the annualised reduction in total occupied bed days and associated financial impact has been calculated. For 12,000 admissions, this equates to a reduction of 15,600 total occupied bed days and potential financial saving of £3.12 million.
Medichecks and the NHS Blood Transplant Service
Next up, healthcare testing provider Medichecks submits its pilot with the NHS Blood Transplant Service (NHSBT), and work around measuring COVID antibodies in potential plasma donors.
Medichecks was selected by the NHS Blood and Transplant Service, supplying over 37,000 blood tests within three months. For the major research project assessing COVID antibodies among potential plasma donors, the company applied ecommerce conversion techniques, creating a bespoke communications strategy in a matter of weeks.
The company was selected to deliver a pilot supplying finger prick blood test kits for COVID antibody tests to thousands of volunteers who registered through the NHSBT service. Medichecks was among a number of blood testing providers awarded the project, but the very first to roll-out testing.
The Medichecks activity delivered approximately 251,000 emails over the three-month pilot, including communications about the end of the trial to ensure donors were well informed at every stage, as well as a landing page for volunteers to sign up to receive their at-home sample collection kit, and a result of 66 per cent of people returning their blood sample. Throughout the trial, NHSBT also wanted to test different types of potential donor data and the most successful set of data saw an 83 per cent sample return rate, while on average, it took donors seven days to return their blood sample from the date their kit was dispatched.
Crucial to the success of the project was tailored communications, with each donor provided with informative materials and updates throughout the testing process. This effective strategy was devised within weeks, to meet the NHS’ fast turnaround requirements.
Medichecks’ touchpoints with volunteers on the testing journey was extensive and included sample updates, reviews, reminders, error alerts, and a feedback survey in which 98 per cent of respondents said signing up to receive their kit was very easy or easy and 82 per cent said they would be happy to participate in remote blood testing again using an at-home finger-prick test.
Medichecks was commended by NHSBT for its prompt communications and low complaint rate. Thanks to the pilot, the NHS also discovered that men produce higher antibody levels in response to COVID-19, which prompted an NHS plea for more male COVID survivors to donate plasma to its national trial.
The team successfully delivered the pilot and Medichecks also established several initiatives that ran alongside the NHSBT pilot, including: helping its UKAS-accredited laboratories to validate finger-prick testing for a COVID antibody test; introducing a range of remote GP monitoring tests in response to public demand; launching a new collection of fertility checks to help those whose IVF plans may have been stalled; launching a ‘Right to Diagnosis’ campaign – an initiative supporting those with health conditions such as thyroid disorders, coeliac disease and PCOS, who struggle to get the correct diagnosis and treatment.
In March 2020, Rethink Partners, the tech company Alcove and Essex, Suffolk and Kent Councils launched an ambitious tech roll-out. Over 16 weeks, they equipped over 5,000 vulnerable adults with Video Carephones, so they could talk to friends, family, carers and other professionals via video, when unable to meet. The strategy was to identify key groups of people with the most need, to help them stay connected with their friends, family and care services.
By working with social workers, care professionals, therapists, commissioners, care providers, community and NHS partners, they aimed to get as close to the frontline as possible. Before the Video Carephones were ready to go, they also worked closely with commissioners to support and unlock internal processes, including governance, business case development, communications and briefings to senior leaders, navigating sensitive information sharing, procurement and legal checks and balances.
Acting as a conduit between councils, providers, partners and Alcove, and using the information available, Rethink Partners identified the groups of people who would get the most benefit from the devices including those who were shielding, in receipt of care services and those at most risk of social isolation and loneliness. The company also got social workers, nurses and other staff involved and spent time and energy upfront getting their support and buy-in.
Rethink Partners, the councils and Alcove jointly delivered briefings, training and communications, across multiple organisations and channels to engage, inform and stimulate uptake – finding that face-to-face and small, direct conversations worked best to hook people in. As well as caputirng good news stories and user experience, they listened to the frontline staff using the devices and brought peers together to encourage spread.
Outcomes included reacting to the COVID landscape and shifting the focus onto care homes and people in supported accommodation, as well as supporting internal teams to ensure the roll-out continued, capturing learnings for future care technology programmes, and building strong relationships with partners as part of a legacy for more joint work in the future.
By the end of July 2020, in just 16 weeks, they delivered more than 5,000 Video Carephones – 2,000 in Essex, 1,700 in Kent and 1,400 in Suffolk – allowing more than 1 million video calls to be made in the last 12 months, to keep the most vulnerable people in society in touch with care providers, loved ones and professionals. The team also managed to train more than 750 health and care professionals, including those working in care homes and in the community.
NHS Shared Business Services and Medway NHS Foundation Trust
NHS Shared Business Services (NHS SBS) and Medway NHS Foundation Trust have worked together to develop a new workforce analytics solution, which uses data science techniques to improve NHS staff retention by predicting – with 95 per cent accuracy – which individual employees are at increased risk of leaving.
At the height of the COVID-19 pandemic, the NHS in England – according to figures from The Health Foundation – faced a workforce shortfall of over 115,000 full-time equivalent (FTE) staff, with projections this will double by 2025/26 and exceed 475,000 by 2033/34.
High levels of attrition amongst nursing staff is a particular concern and can impact on both patient care and hospital finances, with the total financial impact of replacing a fully-trained nurse estimated to be anything up to £12,ooo – meaning that potentially even a modest reduction in nursing turnover could save millions of pounds for an individual NHS trust.
Medway NHS Foundation Trust sought to both address its nurse retention challenge and develop a model that could also be rolled out to help NHS colleagues across the country. By working alongside data scientists and workforce experts from NHS SBS, the team analysed historic data from staff and leavers over a five year period to prove that statistical modelling could be used to accurately predict an employee departure.
The subsequent Workforce Analytics solution was developed to analyse employee information – predominately from the NHS Electronic Staff Record (ESR) – and produce a forecast of expected leavers. The model identifies and assigns a weighted numerical risk score to a range of primary and secondary factors, which when combined can determine the probability of an individual leaving.
A large number of factors are analysed – including an employee’s salary, the length of time they have been in their current role, the distance they travel to work, the area they work in, and personal circumstances such as recorded stress or special leave taken. As part of the solution, analytical reports are also provided to the trust to identify those at increased risk of leaving and provide actionable insights. The intelligence also provides the organisation with the ability to identify and focus interventions on those individuals who are in posts that are very difficult to fill and flags wards, teams or departments with the highest average ‘flight risk’ scores.
At Medway, the model was refined until it was capable – when tested against real data – of predicting leavers with 95 per cent accuracy over a given period, and it also revealed that the three most common primary factors linked to an individual’s risk of leaving at the trust were salary, the length of time an employee had worked there, and age.