HTN Now Awards 2023/24: Health Tech Case Study of the Year

Next up, the finalists for the category of Health Tech Case Study of the Year.

Nottingham University Hospitals NHS Trust

Overview: Establishment of a Technology Living Lab to co-design an evidence-based digital ecosystem for the future National Rehabilitation Centre using the triple helix model of innovation

Why? To ensure the new National Rehabilitation Centre (NRC) is an exemplar of digitally enabled care, and to support the development of an evidence-based digital ecosystem that is end-user focused and fit for purpose.

What happened? Nottingham University Hospitals note that there is no comprehensive technology blueprint guiding the NRC digital strategy. To address this challenge, NUH Digital Strategy Lead Jamie Clegg has worked with staff to transform Linden Lodge, a 25-bed facility, into a technology living lab. The goal being to facilitate the co-development of an evidence-based digital ecosystem for the NRC with staff and patients. The Living Lab is underpinned by the triple helix model of innovation, bringing together government, industry, and academia to accelerate digital transformation of the NHS through a series of technology trials. The Linden Lodge Trials include real time location tracking systems, AI CCTV, environmental monitoring, and patient control units, IoT, silent hospital alarm diversion, wayfinding, and digital twins. Three factors are deemed to have been critical in the success of this digital strategy: comprehensive engagement of clinical staff with the digital team and industry and academic partners; engagement of supportive and agile industrial partners such as CISCO and the Lister Alliance; and the involvement of academic expertise from the University of Plymouth Centre for Health Technology, who embedded an evidence-based methodology to ensure that the Linden Lodge trials are rigorous and transparent.

Looking ahead. It is hoped that this case study will serve as an exemplar, shedding light on the complexities of a smart hospital’s digital ecosystem and the meticulous methodology involved in cultivating an evidence-based environment that supports cultural change through the establishment of a Technology Living Lab within the NHS.

Leeds Health and Care Partnership

Overview: Partnering with Access HSC, the Leeds Health and Care Partnership (LHCP) developed a pioneering Digital Continuing Healthcare solution, significantly improving invoicing and payment processes.

Why? The legacy system at LHCP faced significant challenges due to its heavy reliance on the expertise of a single operator. Additionally, the absence of an effective brokerage management system hindered the ability to match patient needs with appropriate care providers, resulting in delays and increased costs.

What happened? LHCP partnered with Access to introduce the Digital CHC solution to modernise its administrative operations. The new process has revolutionised LHCP’s Invoicing and Payments workflow. Service agreements are now directly added into the system, complete with cost codes and subjectives. The task of manually processing over 10,000 invoices a year has been streamlined to 52. Moreover, the staff required for invoice processing has decreased from 3.4 full-time equivalents to just one. Brokerage processes have been streamlined and simplified; providers can view and respond to care needs directly through the system; and a dashboard allows the LHCP team to monitor each care request’s progress efficiently. The system ranks providers using specific quality-focused criteria, ensuring the selection of the best possible care. All communications regarding the outcomes of offers are handled within Access Adam, which also facilitates the creation of service agreements. This approach has led to a reduction in  time required to arrange home care support, with a 35 percent decrease in sourcing time. Detailed monthly reports that are instrumental in making informed commissioning decisions, offering valuable insights for strategic planning in healthcare services and fulfilling Freedom of Information requests. The Patient Portal significantly streamlines administrative processes and costs by automating previously manual and time-consuming tasks like sending letters and arranging appointments.

Looking ahead. The partnership hopes to serve as a good practice exemplar for other providers looking to make similar improvements.

Lifeness

Overview: Mobile health solution Lifeness is designed to enhance obesity treatment. With a significant increase in weight loss outcomes and user engagement, Lifeness proves to be a promising solution, transforming lives and redefining the fight against obesity.

Why? Obesity, a multifactorial chronic disease, demands regular follow-ups for successful long-term weight loss. However, the healthcare sector often grapples with limited resources and a lack of user-friendly technology tools. As little as 10 percent of patients are successful in long-term weight loss.

What happened? Lifeness used a design-thinking approach with inputs and testing, in a clinical setting, from patients and healthcare professionals. It offers a smartphone app for patients and a cloud-based web-app for health professionals which enables patients to communicate and log parameters like body weight and mood. Lifeness was made to support autonomy, increase motivation in treatment and improve treatment results. In order to test the effect of the m-health tool compared to other e-health solutions, a six-month trial was conducted in collaboration with UiT The Arctic University of Tromsø, with 27 adults suffering from obesity. The m-health group used Lifeness, while the control group used standard follow-up tools such as telephone, email, or SMS. The m-health group lost an average of 12 kg (-10 percent of body weight), whereas the control group lost just 2.5 kg (-2 percent of body weight) over six months. The m-health group demonstrated significantly higher weight loss and total percent weight loss after six months compared to the control group. The m-health group unanimously agreed that Lifeness had a positive impact on their overall treatment, weight-loss, and motivation.

Looking ahead. While Lifeness has already demonstrated notable improvements, more research is needed to explore its full potential. This case study stands as a testament to the potential of m-health solutions in tackling global health issues.

Card Medic Limited

Overview: University Hospitals of Leicester NHS Trust (UHL) ran an evaluation of the CardMedic app to help communicate vital maternity information to women and birthing people who speak English as an additional language.

Why? Overall, 59.7 percent of births in Leicester are to non-British parents. Where effective communication wasn’t possible, parts of the trust’s services became inaccessible. Adopting traditional support services such as interpreters to help was found to sometimes delay acute care.

What happened? The trust decided to run a short evaluation of CardMedic, whose app offers a library of scripts covering common clinical interactions, which can be delivered in over 45 languages, as well as other formats such as British Sign Language (BSL). Scripts are translated and peer reviewed by clinicians and speed and language therapists, to ensure they represent current clinical practice. UHL chose to evaluate CardMedic by rolling the app out across the trust’s maternity unit. They nominated user champions to aid adoption and support maternity staff with downloading, registering, and navigating the app. Overall, during the short evaluation, CardMedic was adopted by 150 staff members. Users of the app reported that the app helped them to explain procedures, such as inserting a urinary catheter during labour. However, the trust also found wider benefits of CardMedic adoption, beyond the initial intended use cases. Midwives at UHL began to use CardMedic to perform infant and newborn physical examination checks, as well as request scripts to include giving pregnant women and birthing parents advice about their baby’s movements and breastfeeding. In addition, maternity staff have found the app helpful for communication with service users with other needs, such as visual impairments, cognitive impairments, and literary issues, through the Easy Read and Read Aloud formats.

Looking ahead. The trust is now keen to foster an even more equitable service by suggesting new topics for scripts to help CardMedic expand the app’s library further.

Surgery Hero

Overview: Since March 2022, Barking, Havering and Redbridge Hospitals NHS Trust (BHR) has been working in partnership with Surgery Hero to support patients awaiting elective surgery. The aim of the project was to evaluate the effectiveness of the Surgery Hero intervention in enhancing patients’ physical and mental preparedness for surgery.

Why? Preparing patients preoperatively (prehabilitation) is an effective way of improving perioperative outcomes by supporting patients to become more active, optimise their nutrition, and build mental resilience for surgery, reducing perioperative morbidity by up to 50 percent.

What happened? Surgery Hero is a supported self-management intervention that helps patients prepare for and recover from surgery at home. The product consists of a digital learning platform that guides patients along the surgical journey, while patients are supported by a team of qualified health coaches who work with patients on a one-to-one basis. Procedure types categorised as major-grade surgery tended to have a larger average reduction in LoS for the intervention group. Of note, substantial reductions were seen in LoS for total knee replacement (35 patients) and total hip replacement (22 patients) with an observed reduction of 1.32 and 4.27 days respectively. Of the 569 patients referred who had previously been deemed “unfit” for surgery, 57.47 percent (327 patients) were able to proceed to surgery following intervention after completing the Surgery Hero programme. This is in contrast to 33.16 percent (650 patients out of 1960) in the comparator group. A substantial shift from levels of low activation (levels 1 & 2) to high activation (levels 3 & 4) was observed in the intervention cohort, with 29.9 percent in a high activation group at entry compared to 40.7 percent at exit. The mean increase in PAM score from entry to exit was 5.4.

Looking ahead. This collaboration between BHR and Surgery Hero is encouraging evidence that the Surgery Hero programme can be effective in optimising the health of eligible patients pre-operatively and in reducing hospital length of stay.

Riverbed Technology

Overview: Riverbed’s Alluvio Aternity is said to be revolutionising healthcare at Princess Alexandra Hospital NHS Trust. Through seamless integration, Aternity improves patient care, empowers clinicians, and increases digital efficiency.

Why? The partnership aims to alleviate clinician burden and equip them with efficient tools, enabling a stronger focus on patient care.

What happened? To achieve targets, a phased approach was implemented. This involved comprehensive staff training, seamless integration of Aternity, and regular performance monitoring. Data analysis and feedback mechanisms were put in place to evaluate progress and make necessary adjustments to ensure the set targets were met effectively. The implementation of Aternity’s Self Remediation capability has reduced Blue Screen of Death (BSOD) incidents by a remarkable 83 percent. PAHT had a number of specific requirements for dashboards and automations to improve their service, and working with our professional services team PAHT were not only able to deliver on these requirements but also share them with other NHS users at no additional cost. Aternity’s data-driven insights have allowed the trust to identify and address issues proactively, significantly minimising unresponsive blue screens. This reduction has saved approximately 700 hours per month, which is equivalent to 28 days, effectively returned to clinicians. Rather than investing in new equipment, the trust’s IT spend has been optimised through performance-based hardware replacement. Over a five-year period, anticipated savings are between £2.5 million and £3 million in total IT costs. With up to 10,000 automations per month, the trust states that it has achieved an exceptional level of operational efficiency and improved clinician experiences.

Looking ahead. To ensure best practices, regular meetings, workshops, and training sessions have been organised. Riverbed is actively engaged with NHS professionals, conducting knowledge-sharing sessions where innovative approaches, successful strategies, and industry advancements are discussed and demonstrated.

Sweatco Ltd

Overview: SweatCo is a NHS diabetes prevention partner working alongside SW London ICS to tackle Type 2 Diabetes by creating a specialised programme ‘Prevention Decathlon’ prescribed to at-risk individuals.

Why? Living with obesity or being overweight has a significant impact on both a person’s health and quality of life. More than 2.1 billion people—nearly 30 percent of the global population—are overweight or obese. It is the second-largest preventable cause of cancer, costing the NHS approximately £6.5 billion annually.

What happened? Sweatcoin partnered with South West London ICS to build a programme prescribed to those at risk of Type 2 Diabetes – a disease costing the NHS around £10bn each year. 70 patients with an average age of 56 years old were recruited through health checks run at a range of faith centres. The 10-week Diabetes Prevention Decathlon Programme trial included a structured education programme, group activities and encouraged team sports. Competing in assigned teams, patients were encouraged to increase their activity levels in between sessions to win ‘Sweatcoins’ which they could redeem in exchange for prizes such as a Kindle, headphones, weighing scales or a healthy eating recipe book. In addition, a CVD Prevention Decathlon Programme was developed and deployed in South West London ICS and in South East London ICS for 2024, with an additional 22-week primary care check in, to further demonstrate the behavioural change results achieved by users. Results of the trial demonstrated an average weight loss of 3kg, with one in 10 of those likely to lose 10 percent of their body weight. In terms of movement, patients increased their daily step count by 45 percent between the start and end of the programme, with one patient reporting movement of 336 percent more than before the trial.

Looking ahead. This ongoing collaboration with the NHS aims to expand beyond addressing diabetes and cardiovascular disease, supporting other chronic long term lifestyle diseases,  as well as other regions across the UK.

Urgent Health UK (UHUK)

Overview: UHUK, faced with increased demands on urgent health services, created one-of-a-kind Innovation Programme with the University of Warwick. Focused on optimising workforce efficiency, they worked in collaboration to develop 6 solutions, one of which demonstrates potential to improve call productivity by 25 percent.

Why?In response to a 30 percent increase in patients using NHS 111 services over the last 12 months without a corresponding increase in funding, UHUK and its members embarked on a “first of its kind” innovation programme.

What happened? The programme brought together nine UHUK members, collectively covering approximately 40 percent of the UK patient population and handling millions of patient calls every year. The team notes that the market response was “incredible”, and 74 potential solutions were identified, from which four innovators were selected: Medwise AI, Isla, Inicio, and Ummanu. Once the innovators were selected, the programme moved into a phase of guided product development workshops facilitated by the WMHWIN over a period of 10 weeks. Two of the collaborative solutions that emerged from the UHUK Innovation Programme were the Ummanu/Inicio/Medwise AI Solution, a comprehensive end-to-end service leveraging AI to reduce clinician workload, screen time and enhance the in-person patient experience. This solution has anticipated benefits including nine to 14 minutes of time saving per consultation, improved transcription efficiency, and streamlined referral processes resulting in a 25 percent increase in call productivity. The second solution was developed by Isla and Medwise using AI,  enabling clinicians to quickly find and send guidance to patients through various delivery methods of the patient’s choice, including legacy systems such as SMS, ensuring inclusivity.

Looking ahead. As the UHUK Innovation Programme concludes its first phase, a second programme, commenced in December 2023, is already in motion. New challenges and innovators will further contribute to the evolution of digital healthcare solutions.

Catalyst BI

Overview: Catalyst BI has implemented its revolutionary ‘Athena Command Centre’ solution to enable NHS Tayside to use evidence-based data to understand, support and predict their patient flow. They are now the best performing Health Board in Scotland for A&E waiting times and patient discharge, freeing up bed space using predictive analytics.

Why? NHS Tayside lacked visibility of patient flow, emerging bottlenecks across the system were not visible until they had happened, and there was no visibility of real-time ambulance information or of the hospital’s current state for staff on call.

What happened? The initial release of the Athena Command Centre was within Ninewells Hospital, displayed across four large screens, covering 760 beds and an annual take of 70,000 patient admissions. The Command Centre provides real time decision-ready data for multi-disciplinary hospital flow teams. The Command Centre uses advanced analytic predictions for the full day and week ahead to enable the planning of patient pathways, staffing and service capacity, and predicted potential pressure points in the system. Further developments have included predictive modelling with an 86 percent accuracy to identify risk of patients requiring admission and a downstream general inpatient bed on initial triage within the Emergency Department. The Command Centre has provided a reduction in emergency department waiting times, bed boarding and delayed discharges, plus an increase in morning discharges for NHS Tayside. These improvements have resulted in £70,000 savings, and have transformed NHS Tayside into a data-driven organisation that uses evidence-based data to understand and support patient flow, delivering average ambulance handovers of 11 mins verses the national target of 15 mins. The reporting, analysis and predictive data within the Command Centre saves approximately £70k per annum.

Looking ahead. The team is currently working on  improvements including making the Command Centre secure to access via mobile phone: making it even more accessible to multiple parties involved in patient flow and care, and developing a Planned Care dashboard.

South Warwickshire University NHS Foundation Trust and Consultant Connect

Overview: South Warwickshire University NHS Foundation Trust is transforming Frailty and Elderly Care delivery. Using Consultant Connect technology, clinicians connect to specialists in under a minute, meaning many patients avoid visiting hospital unnecessarily.

Why? The SWFT Acute Frailty team were finding that referral calls were often unanswered/ not connected making the service unreliable. Staff felt that if it was more reliable, the number of referrals or transfers to hospital would be reduced.

What happened? The implementation began with the launch of the care of the elderly line early 2017, giving GPs direct access to the local frailty consultants for advice. A communications plan for primary care was deployed by CC, to ensure effective uptake of the service. The service was set up using a rota of available consultants to answer calls placed by GPs through the CC app or a dial-in number. All data, call recordings and activity reports are tracked and documented on the IG-secure CC platform, allowing instant access to measure usage and outcomes of the project. The technology has since been adapted beyond the initial requirements. In partnership, SWFT and CC now work with the West Midlands Ambulance Service (WMAS) , the advanced clinical practitioner (ACP) community team and the care of the elderly team to establish quick two-way communication between teams. Access to the service allows callers to deliver patient-centred care; paramedics making calls whilst with a patient can involve them in the conversation. To date, 66 percent of calls from primary care to the care of the elderly result in hospital attendance being avoided and patients directed to more suitable treatment locations. 78 percent of calls from WMAS to the frailty unit result in an ED attendance being avoided. The frailty team has also launched a new Patient Initiated Follow-Up (PIFU) line for two of their wards, allowing recently discharged long-term patients to call into the wards 24/7 and with the ability to be called back through Patient Connect (virtual consultation).

Looking ahead. SWFT’s Frailty Team are actively evolving the use of technology by setting up frailty nurses in the community to connect with acute frailty, getting SWFT consultants to use CC for internal referrals, using written advice & guidance referrals through CC’s messaging feature, and expanding the technology within SWFT to incorporate other care specialists.

The Dudley Group NHS Foundation Trust

Overview: Dudley Group NHS Foundation Trust has developed a bespoke maternity patient record, building on the trust’s existing Sunrise electronic patient record (EPR). As a result of the implementation, Dudley’s labour and inpatient maternity units are now entirely digital, supporting the trust’s aim to become a digital first organisation.

Why? Prior to implementation, clinical teams spent a considerable amount of time completing unnecessarily admin-heavy processes.

What happened? Recognising the limitations of paper records, the trust decided to extend Altera Digital Health’s Sunrise EPR to the maternity department. A robust staff engagement and training programme was developed to make sure the go live went smoothly, and so staff felt empowered to make suggestions for how the system could improve as they grew comfortable using it. Using Sunrise, staff can identify people at risk of deterioration by completing and recording observations electronically, automatically calculating the MEOWS score. This has enabled staff to recognise warning signs more quickly with embedded guidance a decision support prompts, making it possible to intervene and escalate appropriately, improving patient outcomes. Sunrise has been designed so that multiple people can review records simultaneously. This has meant that doctors and midwives have been able to document clinical records at the same time and in the same room as the mother, reducing the time taken to complete the task. As a result of these efficiencies women are having their c-sections at the scheduled time, avoiding long waits and improving patient flow. The time taken to complete postnatal documentation has decreased by 78 percent, from three hours to 40 minutes. The process, which was previously carried out in the handover office, and is now completed in real time at the bedside, and notes are immediately available in Sunrise.

Looking ahead. The trust is looking forward to continuing its digital journey and increasing the functionality of its EPR. Having already gone live with emergency department (ED) and nursing documentation, Dudley is now looking to go live in the paediatrics and outpatient departments, continuing to develop as an advanced digital trust.