One of the words that tends to stir up excitement in the health tech sector is ‘pilot’ – and there have been some fantastic pilot schemes of new tech, innovations and ways of working taking place across the last 12 months.
Here – from the work of our nine finalists in the Health Tech Awards 2021 ‘Most Promising Pilot’ category – we take a look at just a selection of the great work going on across the world of health and tech.
Find out more about the potential of these pilots…
Careology
LloydsPharmacy Clinical Homecare (LPCH) and Careology’s promising pilot for this section focuses on how cancer care is delivered. The Careology healthtech platform, which is recommended by Macmillan Cancer Support, helps people living and dealing with cancer to feel supported and connected during their treatment. The platform partnered with LPCH to empower patients receiving treatment at home via a mobile app and remote monitoring dashboard.
During the COVID-19 pandemic there have been a number of concerns around keeping cancer patients safe and trying to ease the backlog of treatment and care. The need to reduce hospital exposure and keep patients safe whilst establishing continuity of care resulted in a rise in treatment being administered in a homecare setting. Within the last 12 months, LloydsPharmacy Clinical Homecare has seen a 200 per cent increase in demand for cancer homecare services, with both NHS and private healthcare referrals.
In February 2021, LPCH, which supports over 100,000 patients across the UK, commenced a three month Proof Of Concept (POC) with Careology. During this time it introduced Careology Professional to the entire LPCH nursing team and the Careology mobile app to a selection of patients. The two companies partnered with a vision of delivering accessible and personalised support to patients by using digital technology to connect people with cancer to their family, friends and to their nurses and clinicians.
Through various collaborative workshops the project was co-designed, which included defining where in the current service design and patient pathway Careology would be best introduced, while key milestones and KPIs were also identified.
The Careology Professional dashboard allows clinical teams to remotely monitor their patients’ health and wellbeing information, symptoms and side effects for the first time. The dashboard charts data from wearable devices which continually monitor temperature, heart rate and activity levels. Clinicians and nurses can identify potential red flags, including anomalies in vital signs and medication adherence, allowing early intervention, which can improve health outcomes.
Proactive support and day-to-day management of the initiative was provided by LPCH’s Lead Cancer Nurse, the regional nurse managers and the ‘Careology Champions’, and regular online training and feedback sessions were held for the nurses. Guidance on which patients to invite and supporting documentation was also shared, while supporting marketing materials were created and distributed.
Ahead of launching the initiative, LPCH surveyed a cohort of patients and nurses to understand their appetite for adopting digital health care. 67 per cent of patients used the mobile app after an LPCH nurse introduced it to them, which was greater than the survey results indicated (58 per cent). Adoption has also been high within nursing staff, with 97 per cent of nurses using Careology Professional throughout the POC.
Intelligent Lilli
Intelligent Lilli smart remote care technology pilot with Dorset County Council is centred around how an AI-driven platform can transform care for the elderly and those with chronic conditions. The solution employs behavioural analytics to detect subtle signs of an emerging problem, allowing carers to intervene earlier and patients to remain independent for longer, while reducing care costs.
The aim of the pilot with Dorset CC is to utilise Lilli’s AI-driven platform in a social care setting to provide an opportunity for them to co-create, learn, experience and test how digital technology solutions can better support needs and improve outcomes. The focus is on proactive patient care and the optimisation of resource management in care provision, and the pilot will determine a range of outcomes and measures by deploying the Lilli solution to 100 homes across Dorset.
Other aims include demonstrating the value of remote monitoring in social care and supporting safe discharge, show how it can improve safeguarding, deliver evidence insight, help with efficiencies in resource management and provide a pathway to predictive care solutions.
The pilots are split into two key phases: Phase 1 – Definition and Discovery – three months and Phase 2 – Deployment – three months
Work began in March 2021 on Phase 1 and the parameters of the pilot have been workshopped and defined, with the desired outcomes agreed. The data and reporting have also been defined and are being designed within the platform.
100 service users have been identified with suitable conditions, as well as 10-20 Occupational Therapists to trial the software through the pilot phase. Once deployed the Lilli software uses the masses of data from wearable lifestyle monitoring devices and discreet sensors in people’s homes to quickly establish what is their normal behaviour. Against this benchmark it spots signs and trends indicating they might be developing a problem – anything from a change in heart rate, failure to move around, increased toilet use or fewer hot drinks.
The technology will notice the difference in real time and alert carers or clinicians who can investigate and, if necessary, intervene to resolve a problem before it becomes serious. This reduces the likelihood of more complex and costly treatment or admission to hospital.
Dorset CC can then tailor provision to the individual, creating a “flightpath” with thresholds appropriate to their condition. The accuracy of the data and the insights reduces unnecessary call-outs and visits while providing reliable information for resource allocation. Whereas patients may be unable or unwilling to discuss symptoms of a new problem, the insights from the data provide care-givers, clinicians and managers with firm evidence they might never obtain otherwise. The pilot is also set to save in the region of £4,000 per person annually through reduced visiting
Imprivata
Imprivata’s Virtual SmartCard pilot took place at Salisbury NHS Foundation Trust to address the challenges of rapid staff onboarding, remote working and multi-location care, while meeting data security requirements
Enrolling new users with smartcards can create logistical challenges, from procuring the physical cards, to the new increased risk of in-person enrolment and collection of the smartcard from an on-site department.
Imprivata recognised the requirements for access to applications with the new challenges of remote working, the influx of additional staff, lack of cards and readers, and the rapid set up of new temporary locations, while still managing identity authentication and access to patient data.
The technology provides fast, secure No Click Access to NHS Spine-enabled applications, eliminates smartcard hassles and risky workarounds and makes it easy for on-site and remote users to securely access the NHS Spine.
The NHS IT department and Registration Authorities (RAs) use smartcards to authenticate users and control access to Spine-enabled healthcare applications and systems. Just like with a bank card, a user must insert an NHS smartcard into a reader and enter a PIN or passcode to gain access to a healthcare application. Additional benefits include improving user experience and the ability to move around sites, and being easy to deploy at scale.
Imprivata worked with staff at Salisbury District Hospital to develop the solution prior to running the pilot. The hospital provided resources, access and input into the design and build process of the solution. Following the use of the solution by the test groups of staff, the outcomes recorded were significantly better than initially expected – and hoped for. Feedback from the practitioners was that the solution was working as intended and it was well received by the backend teams, the IT department and Registration Authority (RA) as well as the frontline clinical staff.
Sonin App Development and OpenAir Med
According to this respiratory-focused entrant, 10,000 new people are diagnosed with a respiratory illness every single week. With respiratory illnesses responsible for more than 700,000 UK hospital admissions and six million inpatient bed-days each year, the annual economic burden of all lung conditions combined is estimated to be more than £13.5 billion in the UK.
With respiratory illnesses a key focus of the NHS’ Long Term Plan, a key aim is to provide patients with personalised care to manage their conditions themselves.
OpenAir Med was founded with this aim in mind and the app, in combination with the IoT-connected spirometer and big-data analytics behind it, hopes to hand patients back control of their illness. OpenAir Med helps patients to live their lives uninhibited through features, including: fast registration and multiple family member profiles; clear instructions on how to pair IoT-connected device; instant results through a universally-accessible traffic light system that shows users their peak flow and lung capacity ratings; personalised analytics, such as capturing the time and geo-location of readings and third-party services collection of information like weather conditions and pollution levels; the ability to log respiratory attacks manually and add custom comments; and personalised healthcare advice.
From the trials so far, OpenAir Med says it has observed several correlations between environmental factors like air quality, lung performance (FEV1), location, and sex. In a time when the capacity of the NHS is so critical, OpenAir Med says it hopes to help patients live ‘safe, independent, and uninhibited lives’, without having to worry about when their next attack may be.
Skills For Health
Our next finalist, Skills for Health, has developed an in-house, enhanced, integrated and customisable eRostering solution, with NHS staff in mind. The pilot, to be released later in 2021, will provide improvements to help NHS Workforce Managers deliver time-saving rotas across the sector.
As a not-for-profit organisation, governed by a Board of healthcare specialist Trustees, Skills for Health – which was also behind the Doctors Rostering System (DRS) – made the new Custom Rostering System (CRS) fully bespoke, providing the flexibility needed to manage hundreds of specialist services.
CRS is built with variations of NHS roles in mind. Every staff member on the system has a contract associated with them, and it is through these contracts that the workforce can then be deployed. By meeting the evolving and changing contractual needs for all staff rostering, which were proven to be critical as the COVID-19 pandemic began. CRS will enable trusts, departments and teams to deliver efficient and effective rosters and workforce management, allowing staff to have more time to focus on patient care.
Developed as a tool for culture change, and designed to transform workforce planning roles from data entry to data intelligence, the interface allows more people to be involved in making informed decisions and directly reduces computer-based planning and administrative work. In addition, Rostering Managers and Workforce Directors can review staffing at a trust-wide level, identifying early signs of burnout, departments “running hot” or with high staff absence, and address this.
Skills for Health is also working as a partner with NHS Improvement to develop and implement shared interoperability standards across digital workforce platforms, such as bank staff and job plan integrations. These standards will allow any compliant providers to link their systems together, reducing the need to re-enter data in multiple platforms, saving time and reducing human error, whilst improving data quality and consistency, and allowing for greater reporting opportunities and operational efficiencies.
Expected to launch later in 2021, the early adoption pilot scheme will gain feedback from users and managers who have lived through a year of complex crisis management with regards to rota planning during COVID-19.
Northampton General Hospital NHS Trust
Northampton General Hospital NHS Trust (NGH) also submitted its pilot, which it says improves throughput in Radiology by 8.6 per cent in 21 days.
NGH had previously used a paper-based tea card system in Radiology, which it says is prone to inefficiencies and human error and required a solution to overcome those challenges.
To provide this, a new digital task allocation system called MyPorter was installed as a pilot in the Radiology Department and created an immediate impact on throughput with an extra 141 transfers completed over the first 21 days.
Northampton General Hospital’s Radiology Department consists of CT, MRI, Ultrasound and X-Ray. The department needed a product that would improve patient flow and reduce lost time for each job in all our four departments and that solution came in the form of a new digital task management system. The system also allows porters to report any delays or cancellation to their allocated tasks.
After implementation on 10 of May 2021, the system has reduced time spent on unnecessary travel. Within a three-week period of using MyPorter, the department completed extra patient transfers and even if that number – 141 – stayed at a similar level, the trust says that over the period of a full year, it would equate to an approximate figure of 2,444 extra transfers being completed in the Radiology Department alone.
Other improvements include resolving the challenges faced in downtime, inefficiencies and porter visibility, and the ability for accepting or declining tasks from devices without having to walk back to the porter’s lodge.
Cambridge University Hospitals NHS Foundation Trust
The MyChart patient portal is Cambridge University Hospitals NHS Foundation Trust’s (CUH) pilot example in this award. As the trust’s electronic patient portal, it is directly integrated to its electronic patient record (EPR). With over 76,000 users, Cambridge says it has “proved pivotal during COVID-19” by supporting the self-booking of 13,507 vaccination appointments electronically, securely releasing 4,800 swab test results per week to patients and staff personal devices, and also saved thousands in associated time, printing and postage costs.
Prior to implementation of the solution, all letters and clinical correspondence were generated in CUH’s EPR system and then sent primarily to patients via post. With MyChart, which Cambridge says is the first patient portal in the UK to be directly integrated with an EPR, patients receive their hospital information – appointment information, clinical correspondence, test results, conditions, medications, allergies, vitals – in a ‘more timely way’, enabling them to be more involved and informed about their care and conditions.
Over the past two years, the trust has developed additional functionality in collaboration with its MyChart patient group, including the introduction of automatic results release. On average, the trust says that approximately 120,000 test results are automatically sent to patients each month via MyChart, instead of being manually released or posted. In January 2020, proxy access was also enabled to allow parents and guardians to access their child’s hospital health records in a more convenient way.
These developments have been enabled by the trust’s eHospital digital team – a team of staff with combined clinical, operational, technical, analytical, administrative, managerial and training expertise.
Over the past year or so, the benefits of MyChart have included clinicians using the portal to share information about COVID-19 and changes to care, the ability for patients to upload photographs of their wounds and conditions, allowing the workforce to receive the results of a large-scale staff asymptomatic COVID-19 PCR swab testing programme direct to their personal devices, and the self-scheduling of appointments.
New COVID-19 workflows were also designed and built in-house within the trust’s EPR and MyChart to enable the self-scheduling of vaccination appointments by staff, enabling the direct booking of 13,507 COVID-19 vaccination appointments. In addition, the teams also built a COVID-19 vaccination workflow for both CUH outpatients and inpatients to inform, book, document, and track their COVID-19 vaccination status electronically through MyChart. In total, 46,138 COVID-19 vaccination doses were administered at CUH (first and second doses), while in January 2020 almost 25,000 CUH patients were using MyChart to better engage with their care and almost 45,000 patients/staff have registered with MyChart since the start of the pandemic, with the current total number of MyChart users now over 76,000.
East Kent Hospitals NHS Foundation Trust
Next in line is East Kent Hospitals NHS Foundation Trust’s Real-Time Location System (RTLS) for Operating Theatres pilot at Kent and Canterbury Hospital. The system, from MYSPHERA, is expected to increase operational efficiency and improve patient outcomes. Already well established in Spain, it is being delivered for the first time in the NHS through a partnership with Beautiful Information.
The trust says that it’s estimated that 291,000 more routine operations could take place in the NHS each year and the NHS Institute for Innovation and Improvement calculates that the average trust has an opportunity to save £7 million a year in efficiency savings by running a ‘productive theatre’ (2017).
With this, and the routine operations backlog in mind, East Kent Hospitals University Foundation Trust (EKHUFT) turned it attention to improving the efficiency of theatres and is part of the national Getting it Right First Time (GIRFT) programme. As part of this commitment, EKHUFT have embarked on a new pilot project with MYSPHERA’s Surgical Theatre Optimisation Tool. This pilot aligns to the principles of GIRFT with its data-rich and data-driven evidence to support change.
The innovation comprises of small wearable patient ID tags that fit onto an existing hospital ID band. Beacons that are fitted into the hospital ceilings use Bluetooth low-energy technology to track a patient as they move through their surgical journey. A change in a patient’s location automatically triggers a change to the information shared about where that patient is in the hospital, notifying staff via dashboards on their devices. In addition, staff can press a button on the patient tag or on a touchscreen computer to trigger specific tasks related to that patient’s journey.
The pilot will investigate and measure all the changes in the identified metrics for theatre efficiency, and predict the scale of the benefits across all theatres within East Kent. For comparison, Hospital General de Valencia had a reported theatre utilisation of 79 per cent prior to MYSPHERA, but after installation, MYSPHERA calculated real surgical performance was 48 per cent, and then helped improve it to reach 69 per cent.
A future phase of this work will include real-time information for friends and family via an app, enabling them to track their loved ones’ progress. The pilot has so far been well-received by clinical staff and training has begun.
Trigger Stuff
Responding to curtailed hospital visitations during the pandemic, arts charity Trigger has created WithYou – a platform to help relatives connect to critically ill and isolated hospital patients. Features include friends and family members being able to collaborate on a playlist which combines voice notes and music tracks, and are then delivered digitally to the patient’s bedside.
Piloting WithYou in Intensive Care Units in London, Leeds and Bristol, Trigger aims to give those in care easy access to the voices and memories of their loved ones, at the time when they need it most. While messaging systems allow people to send text messages or voicemails to patient’s mobile phones, WithYou can reach those patients who are in critical care and are too unwell to use their own devices.
Described as “a gift, a mixtape, an audio memoir both for the patient and their loved ones”, Trigger hopes WithYou will support recovery and soothe patients in a state of distress. It also aims to strengthen patients’ mental health, as well as that of their family and friends, by reducing feelings of helplessness and isolation.
Charlie David, Patient Experience Manager, Whittington Health NHS Trust, said: “The patient was intubated and unconscious, but occasionally tries to move or has erratic heart beats. When I played the messages she was visibly calm and settled.”
WithYou is also intended to relieve pressure from NHS staff, who often have to coordinate relatives’ video calls – including challenges such as technical hitches during live video, and unexpected demands during shift work interrupting scheduled calls. WithYou allows careworkers to deliver messages during quieter moments, and avoids the potential risks of relatives experiencing distress during a videocall with unconscious patients.
Since December 2020, WithYou has delivered over 500 messages to critically ill patients being cared for in 15 wards across three NHS trusts. And from summer 2021, the service will be offered by three further NHS trusts. Its flagship partner is Whittington Health NHS Trust in London, and developers are currently in discussion with NHS ICU and stroke wards around the country, as well as supported living residences for wider rollout.
