Digital change in health and social care

This Kings Fund report aims to support  local organisations looking to undertake large-scale digital change. The document states that the future is bright for technology in health and social care, with local care providers digitising under their own steam and initiative.

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The report shares the lessons from five varied case study sites that have made significant progress towards their digital aims. It sets out the lessons learnt and tips for other organisations that are looking to progress their own digital change.

Overview

  • The use of digital technology in health and social care can improve quality, efficiency and patient experience as well as supporting more integrated care and improving the health of a population.
  • Large-scale change involving digital technology, such as adopting electronic patient records (EPRs) and shared care records, is complex and necessitates attention to particular aspects of the change.
  • This report shares practical learning from a series of case studies where significant largescale digital change is happening.
  • Key barriers to successful digital change include the constraints care organisations face in their workforce, tight budgets, organisations’ attitudes towards risk and the relationships that exist between care providers and key stakeholders.
  • Most of the barriers can be mitigated through time and effort and by treating digital projects as change projects, not IT projects. Effective and consistent staff engagement and resource allocation to the project are key factors in success.

The Kings Fund have also produced an interactive map which brings together case studies from across England, highlighting some of the places that are experimenting with and implementing new technologies to achieve better health outcomes or more efficient care.

Full report: Digital change in health and social care

A summary of the report is available here

Banning phones in schools could give children ‘space to focus’, says RCGP

Royal College of General Practitioners | June 2018 | Banning phones in schools could give children ‘space to focus’, says RCGP

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Writing in The Telegraph earlier this week,  the Culture Secretary Matt Hancock argued mobile phones should be confiscated at the beginning of the school day. Now the Chair of the Royal College of GPs, Helena Stokes- Lampard has responded to this in a statement.

“Children are under so much pressure to conform to social norms around how to look and what to do in order to be popular, and this can certainly impact on their mental, and physical, health and wellbeing. Whilst pressure to conform might always have existed, these days it is relentless through social media and other such channels and smartphones are often the gateway to this. Considering taking measures to ban the use of mobile phones in schools during lessons – either physically or by blocking 4G signals – would be a welcome move, and one that we hope will give children more space to focus on their studies, and have some respite from the pressures they face online (via RCGP).”

In the news:

The Telegraph Exclusive: Teachers should ban mobile phones in classrooms, says minister

 

BBC News To ban or not to ban: Should phones be allowed in schools?

US study uses phone app to screen for autism

Science Daily | June 2018 | Mobile app for autism screening yields useful data

A new US study that uses a smartphone app to screen young children for signs of autism has found the application produces reliable data. It was also accessible for children and praised by caregivers (via Science Daily). 
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During the year-long  there were over 10000 downloads of the app; parents completed more than 5000 surveys and uploaded 4441 videos. These data were collected, 88 per cent of the videos yielding useful data.  The app uses video footage of the adolescents filmed while watching films and designed to identify patterns of emotion and attention, autism risk factors, on the device.  The videos are then analysed by behavioural coding software which tracks the child’s response and quantifies their emotions and attention.

A member of the research team Geraldine Dawson, Director of the Duke Center for Autism and Brain Development, remarked “This demonstrates the feasibility of this approach.

“Many caregivers were willing to participate, the data were high quality and the video analysis algorithms produced results consistent with the scoring we produce in our autism program here at Duke.”

The full news article is available from Science Daily 
The study has now been published in the open access journal npj Digital Medicine. It can be accessed through Nature 

Full reference:

Egger, H. L. et al .| 2018| Automatic emotion and attention analysis of young children at home: a ResearchKit autism feasibility study |npj Digital Medicine| Vol. 1 |DOI: 10.1038/s41746-018-0024-6

Video game used as part of physiotherapy

NIHR | June 2018 |Manchester hospital first in world to introduce video game shoulder rehab

Doctors at Manchester University NHS Foundation Trust have trialled an innovative approach to physiotherapy.  As part of the trial Patients recovering from shoulder surgery were either assigned to a traditional course of treatment or played ‘Exergames’ as well as physiotherapy.  Volunteers were given a Microsoft Kinect game sensor to take home for 12 weeks, they also were asked to complete an exercise diary.

The team behind the ViP therapy, anticipated that the video games would increase patients’ engagement with their recovery, and that the games’ levels would motivate them to complete their exercises. A combination of patient feedback and data generated by the game provided the patient wtih a ‘score’.

Principal Investigator, Mr Bibhas Roy,  a consultant orthopaedic surgeon at Trafford Hospital,  said: “Supervised physiotherapy is a major resource provided by the NHS, but it is estimated that up to two thirds of patients fail to stick to their exercise programme outside of sessions with their physiotherapist.

“ViP aims to increase the number who do, and help them to achieve better rehabilitation outcomes. We expect to replace about 50 per cent of the standard physiotherapy sessions with these new virtual tools.

“Crucially, our study shows the games give patients extra motivation for physiotherapy and I believe we are approaching a stage, in the not too distant future, where this approach will become the norm.”

Source: NIHR

The full news item is available from NIHR 

Have your say on GP online consultations

NHS England |May 2018 | Have your say on GP online consultations

NHS England is seeking thoughts and opinions from both GPs and members of the public on online consultations.  They want to know what people think about the idea of online consultations so we can improve the service and increase the availability and use.

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Online consultations are a way for patients to contact their GP practice without having to wait on the phone or take time out to come into the practice. Using a smartphone, tablet or computer, they can contact their practice about a new problem or an ongoing issue (Source: NHS England).

There if further information for members of the public here

There is further information for GP and practice team engagement here 

The two surveys will close on Friday 15 June 2018.

New brain scan progamme may predict memory and thinking problems following stroke

Stroke Association | April 2018 | New’ brain health index’ could predict memory and thinking problems after stroke

 The Stroke Association have released a press release highlighting recent research published in the International Journal of Stroke. The researchers recruited 288 participants in Edinburgh, including stroke and lupus patients and healthy working age volunteers. Brain scans currently enable doctors to see when a stroke has occurred; but a new computer programme, the Brain Health Index (BHI)  is more sophisticated in terms of predicting the level of memory and thinking (cognitive) problems patients will experience after stroke, than more time consuming current methods (via Stroke Association).

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The programme was created and developed by scientists Universities of Edinburgh and Glasgow and co- funded by the Stroke association. It is up to ten times more effective in assessing whole brain deterioration and helping to predict cognitive function than current tools. The programme   is able to translate many pieces of information from brain scans into a single measure, the  brain health index.

Dr David Alexander Dickie, from the University of Glasgow’s Institute of  Cardiovascular and Medical Sciences, said: “We recognised a need for a more inclusive approach to assessing common brain disorders of ageing. Our new method allows us to use every piece of information from a brain scan, rather than just individual features of the brain that can only tell us so much about a person’s risk for cognitive problems.  (University of Glasgow)

The BHI method will now be tested in newly-developed brain scanners, and in larger groups of patients.

Full details of the BHI can be found at the University of Glasgow New ‘Brain Health Index’ can predict how well patients will do after stroke 

New study finds online ads may encourage pregnant smokers to quit

NIHR | April 2018 | Online ads effective at helping pregnant women stop smoking 

An NIHR funded study has found that an online advertising campaign may be more effective in encouraging expectant mothers to quit smoking, than a clinic based intervention. The study was part of a collaboration between the University of Cambridge, University of East Anglia (UEA), and the University of Nottingham (via UEA).

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One of the researchers, Dr Felix Naughton, developed MiQuit, which is a text-messaging intervention specifically for pregnant smokers. As it is automated, the women could use it without health professional’s involvement. In tandem with this the research team also  advertised links to a website providing MiQuit information on Google and Facebook, which incurred a cost. Adverts were also placed on the National Childbirth Trust and NHS Choices websites free of charge.

The team found that the Facebook advert generated initiations throughout pregnancy, around 50 per cent of those who initiated MiQuit via Google were within their first five weeks’ gestation. Adverts attached to online search engines may therefore be a useful way to reach women when they are first pregnant and looking for support or information about smoking during pregnancy. Currently, the earliest cessation interventions tend to target pregnant smokers at their antenatal booking appointment, at around 8-12 weeks’ gestation.

Lead author of the study, Dr Joanne Emery, Research Associate at the University of Cambridge, said: “This study shows that online advertising appears to be a valuable means of promoting health interventions to hard-to-reach groups.

“We found that a significant minority of pregnant smokers were willing to initiate an automated text messaging intervention when offered this online. Given the high reach of the internet this could translate into substantial numbers of pregnant smokers supported to quit.” As a result of this study’s findings, a more definitive trial is now underway.

An article based on this study has been published in the Journal of Medical Internet Research

ABSTRACT

Background: Smoking in pregnancy is a major public health concern. Pregnant smokers are particularly difficult to reach, with low uptake of support options and few effective interventions. Text message–based self-help is a promising, low-cost intervention for this population, but its real-world uptake is largely unknown.

Objective: The objective of this study was to explore the uptake and cost-effectiveness of a tailored, theory-guided, text message intervention for pregnant smokers (“MiQuit”) when advertised on the internet.

Methods: Links to a website providing MiQuit initiation information (texting a short code) were advertised on a cost-per-click basis on 2 websites (Google Search and Facebook; £1000 budget each) and free of charge within smoking-in-pregnancy webpages on 2 noncommercial websites (National Childbirth Trust and NHS Choices). Daily budgets were capped to allow the Google and Facebook adverts to run for 1 and 3 months, respectively. We recorded the number of times adverts were shown and clicked on, the number of MiQuitinitiations, the characteristics of those initiating MiQuit, and whether support was discontinued prematurely. For the commercial adverts, we calculated the cost per initiation and, using quit rates obtained from an earlier clinical trial, estimated the cost per additional quitter.

Results: With equal capped budgets, there were 812 and 1889 advert clicks to the MiQuitwebsite from Google (search-based) and Facebook (banner) adverts, respectively. MiQuitwas initiated by 5.2% (42/812) of those clicking via Google (95% CI 3.9%-6.9%) and 2.22% (42/1889) of those clicking via Facebook (95% CI 1.65%-2.99%). Adverts on noncommercial webpages generated 53 clicks over 6 months, with 9 initiations (9/53, 17%; 95% CI 9%-30%). For the commercial websites combined, mean cost per initiation was £24.73; estimated cost per additional quitter, including text delivery costs, was £735.86 (95% CI £227.66-£5223.93). Those initiating MiQuit via Google were typically very early in pregnancy (median gestation 5 weeks, interquartile range 10 weeks); those initiating via Facebook were distributed more evenly across pregnancy (median gestation 16 weeks, interquartile range 14 weeks).

Conclusions: Commercial online adverts are a feasible, likely cost-effective method for engaging pregnant smokers in digital cessation support and may generate uptake at a faster rate than noncommercial websites. As a strategy for implementing MiQuit, online advertising has large reach potential and can offer support to a hard-to-reach population of smokers.
Full reference: Emery, J.L, Coleman, T., Sutton, S., Cooper, S., Leonardi-Bee, J., Jones, M., & Naughton F. | Uptake of Tailored Text Message Smoking Cessation Support in Pregnancy When Advertised on the Internet (MiQuit): Observational Study | J Med Internet Res |2018| Vol. 20 |4| e146| DOI: 10.2196/jmir.8525|PMID: 29674308
Related: University of East Anglia Online ads help pregnant smokers quit