Here we take a look at the ‘Innovation in Digital Pathways’ category with 10 examples of health tech innovations and providers making an impact.
This category features Definition Health, Intouch with Health, vCreate, Lumeon, eConsult Health, Bolton NHS Foundation Trust/AllScripts, Diaceutics, DrDoctor, East Kent Hospitals University NHS Foundation Trust and University College London Hospitals NHS Trust.
Explore the programmes here…
First up in this category is Definition Health, a company behind multiple web-based apps including LifeBox e-POA, Secure Virtual Clinic and Recovery. The solutions focus on efficiency, reducing paper-based administration and reducing patient attendances whilst increasing patient safety.
Its virtual clinic module offers a video consultation function and a two-way file transfer (video, image, document) facility between patient and hospital.
The LifeBox e-POA module provides a healthcare questionnaire for a patient to complete at home. The company said: “By collecting this information prior to an initial outpatient appointment, LifeBox prevents unnecessary hospital visits at the pre-assessment stage whilst ensuring valuable clinical capacity is reserved for those who need greater clinical support and intervention. The patient’s questionnaire is remotely reviewed by a nurse who can triage the patient as fit for surgery, requiring further assessment by phone / virtual appointment, or as needing to be seen face-to-face.”
The company also provides a ‘recovery module’ providing digital tools to support a patient’s wellbeing to continually update caregivers on the patient’s recovery status. During this period, files can continue to be shared for the delivery of materials to support the patient’s recovery, such as physiotherapy instructions or dietary advice. Wound healing can be tracked by patient image uploading.
Intouch with Health
Intouch with Health has developed a platform to support outpatient teams tackle the patient backlog of appointments efficiently.
Through its ‘Mobile Appointment Manager’, ‘Activity Manager and ‘Room & Resource Manager’ healthcare teams are using the tools to improve efficiency and redesign processes.
Michele Roberts, Outpatients Department General Manager at Poole Hospital, commented on the appointment manager tool: “Mobile check-in helps us safely manage the flow of patients in the department at any one time, for example by giving them the ability to check-in in on arrival in the hospital vicinity, and then wait there comfortably and safely before being notified via the app when it is time to move to their clinic area for their scheduled appointment.”
Suzanne Rodgers, Programme Manager, ABMU (Abertawe Bro Morgannwg University) Health Board, commented on the Activity Manager tool: “As a result (of using Activity Manager), we are able to gain a detailed understanding of the whole patient journey from a multidisciplinary perspective. Since going live, we have received positive feedback from our clinical, administrative and senior management teams. Our patient surveys have also collated fantastic feedback across the board.”
For its Room & Resource Manager tool, the company cites a medium-sized NHS Trust, where clinic room utilisation has increased from 55 per cent to 92 per cent.
vCreate Neuro’s secure video service provides a new digital pathway to streamline neurology diagnoses.
The tool is currently being piloted across the UK, and has supported 2,500 families in sharing 6,000 videos with clinical specialists for review.
It helps to streamline the diagnostic process within neurology, creating a new digital pathway to allow clinical teams to accurately diagnose conditions such as epilepsy throughout the coronavirus pandemic and beyond.
The company said: “vCreate Neuro was designed to improve clinical access to these diagnostic requirements. When concerned about an unknown movement or event, patients, carers and parents can upload smartphone-recorded videos of potential seizures to the platform. From this footage and the corresponding specialist metadata, neurology professionals can make a diagnosis, recommend further investigations, or provide reassurance of normal behaviours.”
Developed in 2020 to help support services with secure video sharing and remote care for those with neurological conditions, the service is being piloted across the UK, including in Evelina London Children’s Hospital, Great Ormond Street Hospital and The Royal Hospital for Children in Glasgow with support from charity Epilepsy Research UK.
Lumeon and Nuffield Health
Lumeon created the digital patient experience powering Nuffield Health’s COVID-19 Rehabilitation Programme, to support patients recovering from the effects of long COVID.
The platform integrates with Nuffield Health’s Salesforce platform and automatically delivers an initial Patient Assessment Questionnaire to patients placed on the programme. Based on their response, a patient triage session is triggered, leading to creating a personalised recovery plan of care for the patient, consisting of three rehabilitation sessions per week for 12 weeks. Using Lumeon’s automation engine, Nuffield can scale and streamline crucial parts of the care delivery process, like initial patient assessment questionnaires, triage to a personalised recovery plan, and progress reports for Nuffield Health’s staff.
Nuffield Health’s programme blends physical therapy and emotional support to help participants recover from lingering symptoms of COVID-19. Over the course of 12 weeks, participants work with a rehabilitation specialist to design a recovery plan consisting of at-home and in-person exercise sessions, emotional support calls, and access to a community of participants where they can share their experiences. Programme experts also share advice on coping with fatigue, managing breathlessness, anxiety, improving sleep, and eating for recovery.
This entry focuses on the company’s eTriage digital check-in and automated triage tool to improve patient and clinical pathways.
In the emergency department, patients use a bank of tablets to check themselves in, with the information automatically triaged into priority categories 1-5, with 1 being the most critical, and 5 the least. Nurses then monitor potential risk and patient numbers in their waiting room.
The company said: “In places where we have successfully implemented this new system, improvements in patient experience, maintenance of social distancing, identifying sick patients early, and redirecting patients away from A&E have all been key outcomes from changing the existing pathways.”
Bolton NHS Foundation Trust and AllScripts
Bolton NHS Foundation Trust developed its ‘Acute Medicine Referral List’, a digital patient list to help improve patient flow and patient safety.
The patient list automates referrals from multiple admission streams to Acute Medicine and identifies and tracks a patient on their journey, helping to decrease waiting times for clinical review.
The trust introduced the Allscripts Sunrise Electronic Patient Record (EPR) in October 2019 providing an opportunity to develop the system further, by extracting data and automating processes. Using the Acute Medicine Referral List, clinicians would be able to identify and track a patient from all referral routes into Acute Medicine.
Clinical teams mapped the referral pathways and worked with configuration analysts, to create the new digital tool, implemented in November 2020, which allowed the Trust to improve the visibility and traceability of patients, allowing clinical teams to identify them during their hospital journey. The list collates acute medical referrals, from all sources, without having the need for a clinician to go find them.
The list now presents useful clinical information including patient name, date of birth, ID, NEWS2 score, clinical review status and clinician comments.
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 solution delivered a number of benefits in areas such as consultant review, waiting times, patient experience and clinical handovers.
Diaceutics’ application of machine learning and AI helps to identify the best possible testing journey for patients.
The diagnostic commercialisation platform for precision medicine, integrates multiple pipelines of diagnostic testing data from a global network of laboratories. Through the application of machine learning and standardisation of millions of aggregated de-identified patient testing events, Diaceutics identify the best possible testing journey or “Deductive Diagnostic Pathway (DDP®)” for patients at disease level, providing the industry with a guide to getting the right medicines to the right patients, faster.
In late 2020 the company launched a digital, scalable solution for precision medicine diagnostics in line with therapy launches by integrating multiple pipelines of real-world diagnostic testing data with a vibrant diagnostics marketplace.
The company combines data from multiple sources including laboratory result data, diagnostic profiling meta data and CMS and commercial claims data into its DXRX platform providing access to 365m+ de-identified patient records globally in 53 countries.
The company said: “With 476 potential precision medicine therapies now in late phase of development and over 30 per cent of all FDA approvals between 2018-2020 being for Precision Medicines, the pipeline of therapies requiring a companion diagnostic solution is rapidly growing.
“To date the company has leveraged deep disease level data analytics and implementation solutions to improve the diagnostic testing infrastructure for over 600 projects with 39 of the world’s leading pharmaceutical companies.”
DrDoctor has worked with Chelsea and Westminster Hospital NHS Foundation Trust to digitise its endoscopy pathway.
The new digital pathway has reduced the time spent collecting pre-op information by over 20 per cent and released clinical and admin staff capacity.
The aim of the programme was to ensure patients are seen as swiftly as possible, improve the patient experience, and release staff time. It introduced a range of digital tools that enabled patients to receive clinical letters, receive reminders and complete pre-assessments remotely.
Its digital pre-op assessments tool has been used on average by 63 per cent of patients, leading to time savings for teams at the trust.
Since go-live, a total of 2,309 digital notifications have been sent to patients on the digital pathway, and almost 4,000 broadcast messages.
The Endoscopy Business and Governance Lead praised the project: “From a pre-assessment point of view the biggest difference is the reduction of telephone pre-assessment calls. With standard pre-assessment data gathered via the DrDoctor link, nursing staff have more time to focus on individual care plans and patient-centred care. From a service point of view, it’s great to see patients more engaged in the pre-procedure process. We have noted patients are more aware of sedation options and have organised their escort in advance. This has improved list utilisation and patient flow.
“The DrDoctor team were brilliant, we were given time to reflect and feedback on changes. We believe our patients are now better informed, more organised and hopefully a bit more relaxed!”
East Kent Hospitals University NHS Foundation Trust
East Kent Hospitals project enables the standardisation and automation of workflows by an innovative, real-time-location, patient-flow solution that orchestrates digitalised clinical pathways and boosts staff coordination.
A project that supports its standardisation of clinical pathways initiative, aimed to address the main challenge to improve any elective care pathway and streamline the surgical process.
The trust notes some of the challenges such as the distances between surgical areas, and the need for good coordination between teams. The trust said: “To optimise this experience, we have relied on a technological innovation provided by MYSPHERA that uses a light, patient-tracking system to record patient journeys in real time. This generates a live stream of data that is digested by a platform, where the digital pathway is coded. This platform subsequently and automatically orchestrates the varying stages of the process, involving the right teams, with live patient-flow data and notifications.”
“At Canterbury, we have overseen the process of digitalising the whole patient pathway. To do it, we installed a series of Bluetooth gateways across the physical patient flows we wanted to digitalise. We then used Bluetooth tags to capture the patient pathway, in real time.
“In addition, we coded the range of statuses that can occur across the process, which include the following journey: “tag assigned”, “patient at preparation at bays”, “patient prepared for surgery”, “call for surgery”, “in transit to pre-op”, “in anaesthesia room”, “anaesthesia start”, “in theatre”, “in surgery”, “surgery end”, “ready to exit surgery”, “recovery”, “adaptation” and “end of process”. The main benefit of digitalising this pathway is to provide proactive information to other teams in different areas. For instance, notifying that the patient is already in preparation at bays, notifying the pre-op area that the patient is ready for surgery, or theatre staff notifying the ward area that they are ready.”
University College London Hospitals NHS Trust
University College London Hospitals has introduced a video-based pre-hospital assessment tool to improve the accuracy of pre-hospital stroke assessment in order to improve treatment for hyperacute stroke, provide better care for non-stroke “mimic” presentations and to support the ambulance service during times of peak strain.
The trust formed apartnership between the University College Hospital Stroke Service and the London Ambulance Service and developed a pathway for an immediate video-enabled shared ambulance crew and remote stroke specialist evaluation to be performed at the time of the crew arrival at the place of symptom onset for residents in NCL.
The trust commented on the benefits: ” the implementation of a video-linked stroke team and on-site ambulance crew assessment resulted in a 50% improvement in assessment accuracy, reduced non-stroke transfers and improved stroke treatment times.”
Findings included approximately half of patients “selected” by the ambulance crews as stroke to be safely diverted to a more local Emergency Department (ED) with a non-stroke diagnosis. They identified that patients with high risk rapidly resolving events could receive definitive treatment in less than 15 hours since onset compared to a standard pathway treatment time of greater than 24 hours and often far longer if initial presentation was via a General Practitioner. This reduced the non-stroke presentations to the hub hospital from 43% of all presentations to 13% and reduced the length of stay of this group.