HTN Now Awards Finalists 2022: Excellence in Digital Pathways

The HTN Awards is one of our favourite events of the year – it means we get to share some of the most impactful work and projects from the world of health tech, which have helped shaped the last 12 months.

Before the final reveal of the winners at 7pm on 20 January 2022, we first release an overview of each award category, to showcase the fantastic achievements of all of our finalists.

HTN would like to say a huge thank you to all of our entrants and also to our expert judging panel, comprised of health tech experts from a range of organisations across the NHS and industry.

But before all of the pomp and fanfare of the upcoming awards evening, find out more about the submissions to the Excellence in Digital Pathways award…

Credentially

Credentially’s healthcare software presents a solution that can reduce hiring time from months to around 10 days, by enabling onboarding and compliance checks, in line with the CQC in the UK.

In 2020, NHS England needed to mobilise a team of thousands of ex-doctors and nurses, as well as volunteers, to help with the COVID response and were onboarding 50/week but, according to Credentially, with their help it increased to 1,000/week.

The software allows healthcare workers to have a customised journey through the onboarding process and is helping the healthcare sector to stop wasting time on paperwork. By helping to ensure compliance checks it is also transforming patient safety.

The ultimate mission is to save time and money in the recruitment, onboarding and compliance processes instead of using traditional methods which may not be GDPR compliant, while also ensuring fit and proper persons are employed in line with Regulation 19 of the CQC. Credentially also helps human resources departments working with tight budgets for hiring to reduce their costs and the burden of stress and paperwork.

Its services are accessible on a PC, a tablet or mobile phone and the digital platform allows users to upload CVs and documents including DBS, NMC, GMC records, which are then scanned using AI technology and can be used to electronically sign documents and do video training. Since its launch, Credentially says it has helped clients globally to: reduce hiring time by 40 per cent; reduce manual work by 90 per cent; save 67 per cent of hiring costs.

EIDO Healthcare

EIDO’s Inform Consent Suite helps improve shared decision making and digital informed consent.

A clinical team in a pilot NHS trust wanted to transform the pre-op patient experience in General Surgery through better communication of risk and managed expectations of surgery outcomes. They used digital innovation from EIDO which, working with clinicians, improved patient engagement in the consent process, reduced variation in the consenting pathway and reduced the amount of poorly completed consent documents.

EIDO’s Inform patient education module provides an engaging and interactive environment for patients to learn about their upcoming procedure. Patients are sent an invitation (via SMS or email) to view an up-to-date information article, which is triggered after the patient and clinician have met to diagnose the problem and a recommendation about proposed treatment has been made.

Patients who are not digitally enabled can be identified and will be given the same information in paper format. EIDO’s Inform library is available in accessible formats to support patients with visual impairment, special education needs or foreign language requirements. The system dashboard will keep end-user clinicians up to date with the status of each patient in the consent journey. If a patient does not engage with the system, staff can resend invitations or contact the patient directly to see if they need the information in a different format.

The benefits of delivering the content digitally include up-to-date information, animations for patients to watch, the ability for them to make notes of questions and concerns, the ability to authenticate patient identity and record how long patients have spent engaging with each section of the content and in totality, and provides good evidence of a patient’s full engagement in the process.

After reading through the procedure-specific content at home, patients are invited to affirm a number of informed consent statements, and then create and adopt a digital signature. This outputs a draft consent form (Home Consent) that is both procedure- and patient-specific, including any patient-originated notes or questions. All the relevant EIDO content is pre-populated on the draft consent form, which can save clinician time, and when the patient presents in hospital for their procedure, the draft consent form is accessed digitally in order to provide final consent.

Intouch with Health

This entry explores how the Intouch Platform is currently supporting outpatient teams to tackle the backlog of NHS appointments efficiently and effectively and with integration and interoperability at its core. The platform is deployed in 42 per cent of NHS Acute Trusts and processes over 52 million NHS outpatient appointments annually.

While outpatient teams across the country are working tirelessly to ensure patients can access treatment as soon as possible, Intouch with Health has fast-tracked new solutions and updated existing solutions to support new care pathways.

In response to COVID, kiosks now display social distancing messaging and prompts to use hand sanitisers. Kiosks also ask COVID-related questions which may alter the patient’s journey. If a patient answers yes to a question, they could be re-directed to another area of the hospital, before they enter the main building, thus helping to minimise contact with other patients/staff. A trio of PAS / EPR integrated digital solutions from the Intouch with Health Platform are also supporting outpatient teams to create and manage new digital care pathways, as they tackle the backlog in an efficient and safe manner.

Meanwhile, the integrated Virtual Clinic Management Suite (iVCMS) solution enables clinicians to run blended clinics from one cohesive dashboard. As a result, clinicians can plan and conduct face-to-face, video and telephone appointments from the dashboard, enjoying all the features they are accustomed to for face-to-face appointments. This solution is ensuring virtual appointments do not operate in silo and iVCMS acts as the integrated gateway between the hospital’s PAS / EPR system and the video or phone software it already has procured. Using Intouch’s integration technology, the information is pulled together into the single dashboard, which contains the live data all staff can view and access securely.

Intouch has already integrated with Attend Anywhere and Modality Systems with live deployments across the NHS, with several other integrations for both phone and video in the pipeline and being actively progressed with NHS customers. The Mobile Appointment Manager allows patients to register their arrrival and benefit from improved social distancing and infection prevention measures by staying outside of waiting rooms / the hospital until they are needed. Some of the NHS Trusts using Mobile Check-in include The Rotherham NHS Foundation Trust and University Hospitals Dorset NHS Foundation Trust.

While, when a patient has arrived for their appointment, Activity Manager allows outpatient staff to plan, monitor and manage any activities and tests they require during the appointment, via a central digital dashboard accessible across the hospital’s network. Planning and coordinating tests and activities in advance using Activity Manager is saving each patient an average of 35 minutes during their appointment time, giving the patient a better experience and improving operational efficiency across outpatients.

Solve.Care

Solve.Care’s Care.Wallet allows users to manage their healthcare while retaining control of their data.

The Care.Wallet is a gateway to a diverse range of digital healthcare networks – such as diabetes care management, mental and physical well-being-  that users can choose to participate in. It uses blockchain technology and puts people in control of who has access to their data.

The personal digital life-long health management application gives consumers choice and control over their healthcare options, data, and decisions. Selected example of services offered by various healthcare networks accessible through the Care.Wallet include: the ability to find doctors anywhere in the world, from GPs to specialists, and book an immediate appointment; booking non-emergency medical transportation to your appointment; creating an appointment checklist to share with your family and loved ones; tracking and sharing vitals such as blood pressure, body mass index and A1C levels; managing medicines; symptom and side effect tracking; Share How Are You Feeling Today (HAYFT) Care.Cards with loved ones and care providers; providing feedback to your employers as to how you are coping with work and your health status.

Care.Wallet can be set up to include medical records, list of the doctors’ appointments, allergy information, and prescription history, all in one place. to help clinicians. The innovative use of blockchain also allows for configuration of patient centric care administration networks that allow participation based on disease conditions, economic and social needs, employment, and other eligibility criteria. Users of Solve.Care Care Administration Networks can track and manage everything by using Care.Wallet, and records are immutable, which reduces fraud and abuse.

Solve.Care also uses blockchain to issue intelligent payment through  native utility digital tokens, SOLVE, which accelerate the healthcare payment cycle, saving time and reducing costs.

Solve.Care has already launched solutions for  Arizona Care Network (ACN), a leading Accountable Care Organisation in the US. Arizona Care Network’s goal was to reduce the significant administrative burden on providers and improve the healthcare experience for patients. Through the Care.Wallet for Physicians, ACN delivered to their physicians real-time information about the opportunities to improve care for every patient they saw and, based on these improvements, rewarded the physicians in real-time.

“The Care.Wallet brings focus to the most important care metrics…it removes their pain points and lets them get back to doing more of what they are trained to do – deliver great healthcare,” said Dr. David Hanekom, former CEO of ACN.

Bolton NHS Foundation Trust

Bolton NHS Foundation Trust designed an Electronic Medical eHandover List which allowed clinicians to add, track and action outstanding clinical tasks and highlight acutely unwell patients throughout the hospital. This resulted in a significant increase in documentation of clinical tasks which were actioned in a timely manner, improving patient safety.

The trust saw an opportunity to exploit the flexibility within its EPR, following the implementation of the Acute Medicine Referral List, to design and implement a Medical eHandover clinical task list.

Configuration analysts worked with the Allscripts team to identify the best way to pull the data from the system and collated clinical tasks for patients. The clinical handover processes were mapped, with the electronic list automating the majority of the steps and minimising the risk of human error.

The list collates clinical tasks and information on acutely unwell patients from 24 medical wards, releasing time previously spent conducting and transcribing verbal handover to clinical work. The list includes useful clinical information such as patient demographics, clinical location, details regarding the outstanding clinical tasks, when they need to be actioned by and the grade of clinician needed to action them. The list can be updated in real-time and viewed by multiple clinicians simultaneously, improving continuity of care.

The list was implemented in September 2021 and three months post implementation, there had been 1,630 entries, equating to 1,755 clinical tasks for 934 patients, almost one-third of all the medical admissions during this time period. Compared with pre-implementation data from 2020 and 2021, there has been a 65 per cent increase in the number of recorded clinical tasks, and a ten-fold increase in the number of outstanding investigations. The team now intend to share the list more widely so it can be deployed across all specialties.

Dr Areej Islam, an on-call clinician said: “Trying to keep track of clinical tasks on paper left you wide open to error. The implementation of eHandover all but nullifies human error and has gifted me more time to complete my clinical tasks.”

Isla Care

Isla is a digital platform for the secure sharing of enriched data between patients and clinicians, including high-resolution images, videos and digital forms. Isla’s entry in this category revolves around the acne pathway redesign at Chelsea and Westminster NHS Foundation Trust.

The Isla platform empowered clinicians to bring transformational efficiencies to acne treatment by enabling patients to submit photos and forms prior to their appointment. This reduced in-clinic admin time and allows patients to receive their prescriptions and achieve their outcome measures faster.

Patients with severe acne are often prescribed a very powerful medication, which can present several risks due to its strength. One of these risks is an adverse effect on pregnancy and, therefore, female patients who receive a prescription have to either agree to contraception or provide a negative pregnancy test, a process that can take up a significant amount of clinical time during the appointment.

Isla allows female patients to submit a pregnancy test directly to the pharmacy, where relevant, and empowers them to administer isotretinoin when patients come in. The platform tracks patients’ decisions regarding the opt in/out policy of submitting monthly pregnancy tests, as outlined by the British Association of Dermatologists. It is also used to distribute leaflets and information to patients regarding the risks of the medication. This delivers clinical time savings, patient time savings, and also streamlines the treatment process whilst maintaining patient safety.

Through the platform, patients are also sent their outcome measures forms the day before their appointment, via an SMS with an encrypted link. This allows for speedy analysis of the progress of individual patients, as well as entire clinics. With the use of Isla, clinicians can have a record of the patient’s acne from the initial consultation, and they can share with other clinicians for another opinion or referral. Patients were also reminded of the appointment and were active partners in their treatment, reducing the amount of Did Not Attends.

Using Isla means that face-to-face clinics are now only booked in where necessary, with other patients being tracked and cared for by remote monitoring pathways, with patients instead sending in photos of their acne through schedules which automatically request photos from a patient on a predefined timeline.

Dr Eirini Merika, Consultant Dermatologist and lead for the acne service, estimates Isla has saved at least five minutes per patient for a follow-up appointment. Dr Merika said: “Isla has revolutionised the pathway as we have been able to run a remote clinic which is more effective and much safer. The passive monitoring allows for collaborative treatment in a team, as you have access to sequential photography and all of the data points act as a fail-proof safety net.”

Royal Berkshire NHS Foundation Trust and Wellbeing Software

Determined to transform the patient experience digitally, Royal Berkshire NHS Foundation Trust partnered with Wellbeing Software to implement eConsent, a clinician-led, paperless solution to radically streamline consent.

Setting out to digitally transformation the paper consent processes and determined to become more digitally mature, Royal Berkshire sought the help of connected healthcare specialist Wellbeing Software to implement eConsent, a digital solution that enhances patient consent consultations.

In addition to this being a part of a wider national scheme, Royal Berkshire wanted to use eConsent to improve the patient experience, optimise consultant time, as well as improve access to standardised and up to date information throughout their consent to the treatment process.

The solution enables digital consent forms to be created dynamically, pre-populated with individual patient demographics and shared with the patient in the context of the proposed procedure, along with information leaflets during the consultation.

By introducing eConsent, the Trust has also been able to report on, analyse and further optimise the consent process, which would not be available via a paper process. For example: consent form usage across a specific date range showing the number of procedures by department, which can then be further filtered down to show both procedure type and numbers by consenting clinicians; remote form access shows which forms have been accessed, downloaded and/or signed; access to ‘raw’ consent data that is provided weekly for the trust, for analysis, by their own Business Intelligence team.

Steve Avery, General Manager at UK Operations at Wellbeing Software, said: “Royal Berkshire was able to quickly digitise their consent process because they did not need to change their existing workflows. This allowed them to significantly accelerate their digital transformation despite the obstacles of this challenging year.”

FollowApp Care

FollowApp aims to bring digital pathways to dentistry and has built custom digital pathways that are treatment specific and follow up with patients after they’ve been to the dentist. The journey is bespoke to their treatment and any issues are flagged back to the dentists to resolve. This means dentists can spot issues before they become problems and give patients solutions when they are needed.

The technology acts as a web-app for dentists to help them follow up with every single patient that passes through the practice automatically, with no extra time required. Patients receive follow-ups over SMS with web-links to interactive surveys, meaning no app download is necessary for patients.

The system integrates with the dentist’s practice management software and any concerns raised by patients are presented back to the dentist as prioritised alerts. Dentists have the opportunity to respond to these concerns straight in the app through two way SMS communication. Dentists also get a collated view of all patient feedback, giving them the opportunity to improve their practice based on what patients think through a dashboard view. They can track how they are doing through live Net Promoter Scores and drill down into feedback for each dentist in the practice. FollowApp also uses AI to analyse and categorise comments, making it even easier to focus on the improvements that matter most to patients.

FollowApp has been working with dental chains for the last five years to help them connect with their patients outside of the practice and is now also available for small clinics, expanding its reach, with more than 5,000 dentists having used the platform worldwide.

“Patients are being brutally honest and some of the feedback we wouldn’t have had unless they left a google review,” said one practice manager.

Cardiff and Vale University Health Board

Cardiff and Vale University Health Board (UHB) set about building a sustainable ‘Shared Care’ Eye Care Service without Boundaries, for the residents of Cardiff and the Vale of Glamorgan.

Throughout COVID-19 they moved more than 5,000 patients into primary-care, provided essential social distancing space for more complex patients to be seen in the University Hospital of Wales Outpatient Suite, and saw an improvement in performance due to the delivery of an effective training plan for qualified optometrists in primary care.

The Welsh Government monitors the performance of its eye care appointments by classification R1 – and patients unless seen timely, could suffer irreversible harm. In April 2020, the NHS Wales average for R1 performance was 58.8 per cent, while was at Cardiff and Vale UHB 59.7 per cent. By September 2021 the NHS Wales average was down to 48.4 per cent, while Cardiff and Vale UHB rose to 66.7 per cent.

Over the last three years the UHB has made substantial changes in how they deliver Ophthalmic services to the citizens of Cardiff and the Vale of Glamorgan. The next stage in the journey is to provide a sustainable eye care service to not only the citizens of Cardiff and the Vale of Glamorgan, but the wider nation.

In 2021/22, the UHB employed nine optometrists for one day a week to support their attainment of the Higher Certificate in Glaucoma and/or Medical Retina. These nine optometrists now all have clinic lists and are seeing over 70 patients per-week. The team also set a 100 day challenge to implement a Teach and Learn Centre to support the attainment of the Higher Certificate in Glaucoma and Medical Retina to the Optometrists of Wales.

They approached the School of Optometry and Vision Sciences Cardiff University and Health Education Improvement Wales (HEIW) to address: the provision of training placements for the Higher Certificate in Glaucoma and Medical Retina, providing 2,700 patients to the novel proposal of an NHS University Eye Care Centre; supporting the delivery of “shared ophthalmic care” with qualified optometrists in primary care; monitoring “low risk” Glaucoma and Medical Retina patients to an agreed treatment plan, releasing capacity for complex patients; and about MSc Undergraduates observing optometrists in training.

The UHB is now also in discussion with Welsh Government, Health Education Innovation Wales (HEIW) and Cardiff University to implement a Laser Simulation Unit, the transfer of the Ophthalmic Neuro-physiology service into the NHS Wales University Eye Care Centre, and two more National Teach and Learn Centres in North and West Wales. While, in April 2022, they be advertising across the seven Health Boards Wales for nine optometrists to undertake the Higher Certificate in Glaucoma and twelve optometrists to undertake the Higher Certificate in Medical Retina.

It is projected that by April 2023, they will have achieved a sustainable and timely ophthalmic service for the residents of Cardiff and the Vale of Glamorgan.