HTN Now Awards 2023/24: Excellence in Digital Pathways

Here are the finalists for the category of Excellence in Digital Pathways.

Health Innovation Manchester

Overview: The redevelopment of the SMASH Dashboard (Salford MedicAtion DaSHboard, now called the Safety Medication DASHboard) using the Microsoft PowerBI analytics platform, integrated seamlessly within Greater Manchester’s integrated digital shared care record.

Why? The primary challenge addressed was the need for a more streamlined, cost-effective, and scalable solution for managing medication safety across Greater Manchester. The existing SMASH dashboard, although successful, relied on on-premises data servers, posing limitations on scalability and accessibility.

What happened? The collaborative effort resulted in the development of the SMASH Dashboard 2.0. The impact of the Dashboard has been profound, resulting in almost 4,000 accesses in 2023, with more than 50 percent of users reporting that it had supported quality improvement initiatives in their practice, and fully live data which provides instant access to medication safety information for the clinician’s patients. With back-end row level security protocols and a trusted authority process for gaining access to patient level data, the dashboard features an extensive security model to ensure the user only has access to patient information for the practice(s) that they actively work in. The dashboard allows the summary data to be viewed and visualised across all of GM, including at sub-ICB, PCN and practice level for all users, enabling the user to benchmark their practice, PCN or sub-ICB to others in the region. Challenges included rebuilding the functionality within the closed operating system of PowerBI presented coding restrictions and required innovative problem-solving, and managing the parallel run of the old dashboard (SMASH 1.0) during development and for a crossover period, to ensure seamless onboarding without downtime.

Looking ahead. The Dashboard offers the potential for scalability, and learnings from the project can be shared to help others looking to complete similar transformations elsewhere.

Liverpool Women’s NHS Foundation Trust

Overview: Utilising digital technology to improve triage waiting times, enhancing Birmingham Symptom Specific Obstetric Triage System (BSOTS) compliance and patient experience in Maternity Assessment Unit (MAU) at Liverpool Women’s.

Why? Through the Trusts Power BI operational reporting it was highlighted that BSOTS targets were not being achieved, and the data suggested that the delays that some women were experiencing were a significant cause for concern, specifically in relation to patient safety and experience

What happened? Following an in-depth review of the data and patient records, an MAU improvement group was mobilised with key stakeholders. The digital midwives developed and delivered a comprehensive training package comprised of face-to-face training, videos and guides. The informatics lead and digital midwives worked together to develop a real-time Power BI dashboard that was hosted on an interactive digital whiteboard, collating a host of key pieces of information from the EPR that aimed to provide live visual oversight of clinical activity and compliance with BSOTS. The report identifies all women who are in the clinical area, their time of admission and time since admission, reason for attendance, time waiting for triage, and BSOTS priority rating. The staffing structure was reviewed and increased to ensure there was a dedicated midwife for triaging patients telephone calls to minimise the number of “walk-ins”, a ward clerk, a midwife specifically for triaging the women who were invited in for assessment, a minimum of two midwives available for reviewing women after initial triage, and the introduction of a supernumery shift leader on every shift. Since the implementation of these controls, we have seen a marked improvement in BSOTS compliance, from 34.2 percent triaged within 15 minutes in December 2022 to 97.3 percent in November 2023.

Looking ahead. We have been able to share our innovative MAU improvement project with other Trusts to support their compliance with BSOTS.

iOWNA wHealth

Overview: Inefficient care pathways in IBD clinics at Milton Keynes University Hospital were transformed through the adoption of the iOWNA digital platform, with a significant impact on nursing time spent on patient education and their confidence to place patients on self-management pathways.

Why? Educational appointments for all IBD patients were conducted in-person in clinics, to the cost of both patients and clinicians, and educational information about patient’s conditions and treatment was often lost or forgotten by patients, resulting in high volumes of calls to the clinic’s IBD helplines.
What happened? iOWNA is a secure cloud-based platform, accessible through a downloadable app or via a web browser, which enables two-way trusted information exchange between clinicians and patients. Since the start of this year, 31.7 percent of the active patients using IBD clinics at the hospital have been on-boarded onto the iOWNA platform, with the introduction of digitally-enabled care pathways having a significant impact on the efficiency of the IBD services in the hospital. The platform has enabled the IBD clinicians to engage patients by sending personalised content, to send educational content remotely, and to send digital forms for capture of patient reported outcomes (PROMs) or patient feedback. Between January 22nd and July 1st, 2023, a total of 123 in-person appointments were saved through use of the iOWNA platform. This represents nearly £9,000 in savings. Improving the ability of patients to self-manage their condition has reduced the volume of calls to IBD helplines. From 22 Jan -1 July, IBD nurses in the hospital estimated that a total of 4,200 nursing minutes were saved through the newly-streamlined care process. iOWNA as a digital patient self-management tool has also strengthened the confidence of IBD nurses to place patients on patient-initiated follow-up care pathways.

Looking ahead. The success of the project will continue to be monitored, and opportunities will be sought to share learnings.

Cornwall and the Isles of Scilly ICS & Strata Health UK

Overview: The unified electronic referral platform has streamlined processes across diverse sectors, handling 52,875+ referrals since July. With 2,000+ users and notable time efficiency gains, it signifies a leap toward accessible, high-quality care and improved system-wide patient flow.

Why? The previous system, while functional, had its limitations prompting the need for a more adaptable and streamlined solution. While it served its purpose, it became evident that to meet the evolving demands of our healthcare system and provide an even better user experience, a transformative change was necessary.

What happened? The journey began with an agile development using existing infrastructure—Microsoft SharePoint and Microsoft Forms. The collaborative effort between system partners across the Cornwall and the Isles of Scilly ICS and Strata Health resulted in a unified electronic referral platform spanning primary, secondary, community, social services, and the third sector. It provides comprehensive visibility, enabling stakeholders to track referrals and monitor the patient journey efficiently. Recognising that innovation is an ongoing journey, this project is structured into multi-phased approaches with phase one involving replacement and enhancements, with a continuous focus on refining workflows and functionality based on user feedback. The successful deployment of the unified eReferral solution across 250+ referring locations and three Integrated Transfer of Care Hubs is described as “remarkable” – on its first operational day, the system received 462 referrals, showcasing its immediate uptake and relevance. From July – November, 52,875 referrals have been processed, with 1,0575 referrals on average per month. A decrease of 38.95 percent in response time was seen in the first four months.

Looking ahead. As the platform implements more integrated workflows, its influence and impact are expected to grow significantly, enhancing its reach across various sectors and organisations. Future phases are aimed at leveraging AI-powered reporting for critical performance metrics, expanding functionalities to transform service delivery, automating complex referral streams, and integrating with various service systems for seamless data flow.

Healthcare Communications, part of Webex by Cisco

Overview: King’s College Hospital NHS Foundation Trust reduced colonoscopy cancellations by 28 percent with Healthcare Communications’ SMS solution, providing education on upcoming appointments. Over six months, the digital solution improved patient preparation, leading to £130,000 annual savings.

Why? It’s estimated that 5 percent of colonoscopies are not completed due to patients failing to follow pre-procedure instructions. Patient anxiety and inadequate bowel preparation not only affect procedure quality and experience but also lead to financial losses for trusts.

What happened? KCH joined together with Healthcare Communications and Barking, Havering and Redbridge University Hospitals NHS Trust (BHR) to apply for two years of NHS funding to develop an innovative digital solution to tackle the effect of poor bowel prep on growing waiting lists, by reducing wasted slots and repeat procedures. The project uses digital technology to deliver educational materials via automated SMS messages, providing patients with guidance and links to instructional videos for each stage of bowel preparation. Regular meetings ensured a holistic approach, focusing on patient safety, with appointment reminders and pre-procedure instructions sent directly to patients by automated and timed SMS. Patients receive a standard reminder 14 days in advance of their appointment, followed by reminders seven days, three days, and 48 hours prior to the procedure. Additional reminders to begin bowel prep, scheduled in accordance with the patient’s scan time, are sent 24 or 22 hours before the appointment to reinforce the importance of following the instructions. The trust has seen a 28 percent drop in failed colonoscopies due to poor bowel prep as reported by performing clinicians. A reduction in wasted slots of two percent equates to roughly a £130,000 a year saving.

Looking ahead. KCH plans to share their learnings with colleagues, the British Society of Gastroenterology, and NHS England. 

Inhealthcare and Locala 

Overview: Locala has partnered with Inhealthcare to deliver a digital vaccination programme across Kirklees in West Yorkshire. The digital service has increased vaccination uptake, reduced admin for clinical teams, saved costs and made the process easier for parents and guardians.

Why? Locala needed a solution to increase vaccination uptake across its region of West Yorkshire. The process of distributing paper forms to parents and getting signed copies back was time consuming and manual for clinical teams.

What happened? Locala Health and Wellbeing, an NHS community healthcare provider, partnered with Inhealthcare to roll out a digital solution to support their vaccination programmes across Kirklees in West Yorkshire. The digital service removes the need for paper forms by automating the process of capturing parental consent and adding patient details to NHS records. It also provides real-time visibility of uptake across schools to help manage public health. Now, nurses can simply refresh their tablets and see at a glance how many children are on the day’s list and prepare accordingly. The service means consent can be gathered at speed, avoiding the need for letters to be sent home. It sends parents an online questionnaire to gather consent and medical information and any contraindications trigger notifications for clinicians to review. The service creates a list of eligible children and integrates the results of the programme into patient records and also provides a dashboard with real-time data reporting for take-up across the population demographic. The service has saved approximately 23.5 hours per week in admin time within its five-strong child health team. It also made it easier for parents to book appointments, particularly at weekend clinics, where attendance has increased.

Looking ahead. Outcomes will continue to be monitored and opportunities for further development and knowledge sharing will be identified.

The Northern Care Alliance NHS Foundation Trust and Open Medical

Overview: The Northern Care Alliance (NCA) collaborated with Open Medical to streamline their skin cancer teledermatology pathway using PathpointⓇ eDerma. This partnership improved efficiency, reduced diagnosis time, increased accessibility, addressed health inequalities, and proved cost-effective.

Why? The NCA skin cancer pathway is overwhelmed with increasing demand and is the most challenged clinical pathway in Greater Manchester, with backlogs peaking at over 500 patients waiting over 62 days. Urgent transformative solutions were required to rapidly mobilise a new out-of-hospital diagnostic pathway.

What happened? The NCA and Open Medical partnered to redesign and optimise their service delivery with eDerma, facilitated by Greater Manchester Cancer Investment through national SBRI technology funding. This led to the development of a project targeted at increasing community-based diagnostics, diagnostic efficiency, and service accessibility by leveraging Open Medical’s cloud-based platform, PathpointⓇ eDerma. This model made use of remote teledermatology, where a specialist examines patients’ skin lesions following image capture in a community setting. Before eDerma’s implementation, the NCA was struggling to meet the Two-Week-Wait target; less than one percent of patients were seen within 14 days of referral, an issue largely due to the resource-intensive nature of traditional F2F consultations. However, just three months after the launch of the optimised pathway via eDerma, dermatologists were able to evaluate 99 percent of referrals within 14 days. Patients received their diagnoses an average of 6.4 days faster, and 50 percent of patients received their diagnosis 14 days sooner. 79 percent of patients assessed via eDerma received a clinical diagnosis or treatment plan within 28 days, compared to 16 percent before its implementation. Even after accounting for the cost of implementing eDerma, each consultation is £32 cheaper than traditional F2F consultations, with an independent evaluation estimating it could save over £18,261 in just six months compared to the previous pathway.

Looking ahead. It is hoped that this pathway will set a new standard for healthcare initiatives.


Overview: IQVIA’s unique integrated services and technology solutions for drug safety and regulatory compliance are revolutionising drug development. The platform’s combination of advanced technology and industry expertise paves the way forward for pharmaceutical organisations today.

Why? When it comes to PV, drug safety professionals are increasingly challenged to do more with less, and a lack of synergy between separate vendors can result in failure to efficiently operate.

What happened? IQVIA Safety & Regulatory Compliance is an integrated platform that serves as a technology and a service vendor, providing comprehensive safety, regulatory and MI support throughout the product lifecycle. Through automation, IQVIA streamlines processes and operations, reducing cost and complexity while boosting speed, accuracy and efficiency. The integrated model significantly frees up project management capacity for sponsors, as they no longer need to moderate between vendors. By leveraging artificial intelligence and machine learning, the platform can perform automated adverse event intake, auto-translation, auto- redaction, auto-coding standardised fields, pre-population and auto-generation of case narratives, designation of duplicate or invalid cases and automated regulatory report scheduling. These capabilities not only provide additional scalability but reduce staff burden as well. Automation is a key asset within the platform; the solution can automate processes such as smart searches, summarisation of documents, light data analysis, automated submission content processing and bookmarking and the automatic classification of documents. The solution effectively increases the speed and accuracy of regulatory operations and activities.

Looking ahead. IQVIA plans to continue to innovate, utilising technologies such as AI and ML to solve challenges within the pharmaceutical industry.