Deliverables
The Test Beds programme tests combinations of digital technologies with pathway redesign in a clinical setting with real patients and harnesses the potential of innovations to help transform the way in which healthcare is delivered; empowering staff to deliver care that improves the quality of life for patients and carers.
To achieve this, Care City are working in partnership with eight innovations comprising of diagnostics, smartphone applications and management tools which are already making dramatic contributions to people with long-term conditions.
Why is this so important?
Who’s involved? The key stakeholders
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Administrators will be supported to use digital pathway tools TickerFit and DrDoctor to support patients to change their lives
Cluster 1
TickerFit
Cardiac Rehabilitation (CR) is offered to patients who have suffered a cardiac event or undergone heart surgery, and is proven to reduce five-year mortality by 27% and hospital readmissions by 40%. However, only 14-44% of eligible patients receive this life saving treatment in the UK. Innerstrength Health’s first product, TickerFit, enables healthcare providers to deliver cardiac rehabilitation programmes to patients remotely, allowing them to scale their programmes to many more patients. TickerFit is personalised for patients, supporting behaviour change and focusing support on those likely to benefit from it.
We will train domiciliary care staff to use digital innovations to become the eyes and ears of the health system
Cluster 2
Starting with and building on the work by Health1000 locally in care homes – which reduced hospital admissions by 36% – the Test Bed will support domiciliary carers to learn from this work, working in partnership with general practice. Working in partnership with Health1000, testing will begin in care homes for feasibility, before bridging into domiciliary care, using discharge from hospital as a point of intervention.
Whzan Digital Health
Whzan Digital Health provide digital equipment to record vital signs and photos, and deliver assessments and questionnaires, reporting to a cloud triage system. The tools are used by community nurses, care home staff, and some chronically ill and post-operative patients. Whzan enables staff to assess temperature, blood pressure and pulse, and other devices can be added. Case studies from the ~10,000 patients being monitored show NHS resource savings of up to 71% alongside significant improvements in patient lives.
Healthy.io
Heathy.io is the first company to be CE accredited for using the smart phone camera as a clinical grade diagnostic device. Their first product is digital urine testing, which has multiple uses. The most significant for Care City is ACR (albumin to creatinine ratio) screening in people with hypertension and diabetes to identify chronic kidney disease (CKD). People with diabetes and hypertension should have their urine tested for protein (albumin) annually. Nationally, adherence is poor (66% for type-2 diabetes) and we believe that locally perhaps 10% of over-65s with diabetes have undiagnosed CKD, which Healthy.io can help to identify quickly and inexpensively.
Echo
Echo is a simple, free digital service that delivers medicine to patients’ doors. Many Echo users are young, but they are focusing on a new segment – older patients with more complex needs for whom getting to a pharmacy is more difficult and comprehensive support important. Echo recently introduced a service for patients’ representatives, which can be used by paid carers and which is being used by 250 patients today. Almost half of all adults take a repeat prescription, but 40% of medication isn’t taken as directed, costing the NHS billions. Echo removes the barriers to adherence, providing nudges through their app to take and re-order medication. Echo’s data suggests that its users’ adherence is much higher than the average.
We will support healthcare assistants and other non-clinical staff within primary care in Barking & Dagenham to become digital prescribers
Cluster 3
, building the service, training and standard operating procedures to embed this work as an integral part of service pathways. Testing will take place through Barking & Dagenham primary care, in partnership with Barking & Dagenham CCG.
Sleepio
Sleepio is a self-guided, six-week digital CBT package for insomnia developed by Big Health. The application includes sleep hygiene, a sleep diary, sleep scheduling, and a variety of cognitive behavioural sleep interventions. Sleepio has been evaluated in seven randomised controlled trials, and endorsed by NICE in a Health Application Briefing. Evidence suggests that Sleepio not only improves sleep but can help to relieve depression, anxiety and risk factors for psychosis. Sleepio is currently free of charge to Londoners via a partnership with Good Thinking, a pan-London digital mental wellbeing service, aimed at population-wide prevention of poor mental health.
LIVA Life
LIVA Healthcare’s platform facilitates ongoing personalised lifestyle support through an intuitive app, building on a strong bond between coach, patient and healthcare professionals. Its focus is to improve outcomes for those with or at risk of chronic illnesses by driving lifestyle behaviour change. Liva is proven to be effective across all socio-economic backgrounds, with over 9,000 registered users to date, and is capable of engaging older patients. It is based upon nine to 18 months of continuous patient engagement to make new habits and behaviours stick.
