Manchester study: Smartphones could transform patient care

University of Manchester | August 2019 |Smartphones could transform patient care, finds study 

A smartphone app used remotely to provide information on parents with arthritis could have the potential to transform the care of patients with long-term conditions reports a study now published in the journal Rheumatology.

Remote Monitoring of Rheumatoid Arthritis (REMORA) study designed and tested a system to support clinical care and research, enabling people living with RA to report daily symptoms using a smartphone app with data integrated into the electronic health record (EHR). The study  evaluated the system’s acceptability and feasibility including exploration of participants’ views and experiences of remote monitoring, with specific focus on how integration of smartphone data into the EHR in graphical format influenced consultation

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A sample of 20 patients’ data from the app was uniquely integrated into their EHR at their hospital, with the data summarised as a graph visible at their outpatient visit.

The app, jointly designed by patients, clinicians and researchers, allowed patients to input what symptoms they were experiencing each day and the impact it had on their lives.

Their doctors used the data generated by the app when carrying out face to face consultations.

The system provided a “bigger picture” than doctors would otherwise get, capturing “symptoms that would otherwise have been missed”.

And the graphs generated by the app made it easier for patients to participate in consultations and treatment, enabling a shared discussion between the patient and their doctor (Source: University of Manchester).

The authors’ report that:

  • Daily remote monitoring using a smartphone app was viewed positively by patients and completed regularly.
  • Graphs of patients’ daily data identified changes in disease that would otherwise have been missed.
  • Patients valued consultations being focused around their own data, supporting person-centred care.

Read the full news story from University of Manchester

Abstract

Objectives

To establish the acceptability and feasibility of collecting daily patient-generated health data (PGHD) using smartphones and integrating PGHD into the electronic health record, using the example of RA.

Methods

The Remote Monitoring of RA smartphone app was co-designed with patients, clinicians and researchers using qualitative semi-structured interviews and focus groups, including selection of question sets for symptoms and disease impact. PGHD were integrated into the electronic health record of one hospital and available in graphical form during consultations. Acceptability and feasibility were assessed with 20 RA patients and two clinicians over 3 months. A qualitative evaluation included semi-structured interviews with patients and clinicians before and after using the app, and audio-recordings of consultations to explore impact on the consultation. PGHD completeness was summarized descriptively, and qualitative data were analysed thematically.

Results

Patients submitted data on a median of 91% days over 3 months. Qualitative analysis generated three themes: RA as an invisible disease; providing the bigger picture of RA; and enabling person-centred consultations. The themes demonstrated that the system helped render patients’ RA more visible by providing the ‘bigger picture’, identifying real-time changes in disease activity and capturing symptoms that would otherwise have been missed. Graphical summaries during consultations enabled a more person-centred approach whereby patients felt better able to participate in consultations and treatment plans.

Conclusion

Remote Monitoring of RA has uniquely integrated daily PGHD from smartphones into the electronic health record. It has delivered proof-of-concept that such integrated remote monitoring systems are feasible and can transform consultations for clinician and patient benefit.

The full article can be read at Rheumatology

Alternatively, download a copy here 

 

Sparking change in public systems: The 100 Day Challenge

Nesta | July 2019 | Sparking change in public systems: The 100 Day Challenge

Front-line practitioners and people who rely on health and care services have unrivalled expertise in how the system operates, but often have little influence or ownership over change. The 100 Day Challenge allows front-line staff and citizens to collaborate and experiment with new ways of working, testing them for 100 days to see if they make a difference. The 100 day challenge is a structured and rapid innovation process that incorporates coaching support and other methods that enable people to take on new ways of working. 

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Image source: media.nesta.org.uk

Nesta -an innovation foundation- have produced Sparking change in public systems: The 100 Day Challenge a booklet that identifies five key ingredients to achieving success using real-life challenges

Local – taking a place-based approach to change
Participation – working with front-line staff and citizens
Pace – rapidly testing and learning
Action – testing a range of ideas in the real world
Results – seeing improvements in people’s lives (Source: Nesta)

Read the full press release from Nesta 

Innovating with NHS data

Public attitudes to organisations innovating with NHS data | National Data Guardian

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The National Data Guardian (NDG) has released findings from a poll on public attitudes to NHS organisations working with partners to use data to develop new medicines and technologies to improve health.

The poll tested what the public thought would be fair when partnerships with universities or private companies result in valuable new discoveries that could be traded commercially.  It found strong support for the idea that NHS and patients should benefit from such partnerships although significant proportions of respondents said they neither agreed nor disagreed with whether the range of benefits was fair.

The NDG is now calling for a debate about the relationships between the NHS and those innovating with NHS data.

Full detail: NDG poll findings

NHS England Innovation and Technology Payment 2019 to 2020 Technical Notes

NHS England | June 2019 | NHS England Innovation and Technology Payment 2019 to 2020 Technical Notes

NHS England has produced  guidance- 2019/20 National Tariff Payment System-  which sets out the national approach to supporting the adoption of innovation using the Innovation and Technology Payment. It contains the innovations, specifications, reimbursement and reporting requirements for the 2019/20 Innovation and Technology Payment, and for the innovations from 2018/19 and the 2017/19 Innovation and Technology Tariff, whose funding is continuing.

Full details from NHS England

Achieving a digital NHS

Creating a digital NHS is a national policy priority. The NHS Long Term Plan emphasised  commitment to the digital agenda and promised fully digitised secondary care services by 2024. This report looks at digitisation from the perspective of acute trusts, and examines what lessons can be learnt for national policy | Nuffield Trust

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As a new body, NHSX, has been established to lead national policy for technology, digital and data, and with the Secretary of State firmly behind plans to create a fully digital NHS, this report seeks to understand how national policy for digitisation is working from the perspective of acute trusts.

The authors spoke to 72 senior digital leaders in national organisations and NHS trusts as well as frontline health care professionals in an attempt to understand how national policy for digitisation is working from the perspective of acute trusts. The researchers wanted to know:

  • How national policy impacted on a trust’s approach to digitisation
  • How national policy was helping and hindering digital progress
  • What national policy could do differently to better support digitisation on the ground

This report sets out a number of areas that would benefit from national attention. A clear theme across all of the areas is the need for better communication and engagement between national policy makers and NHS providers.

Full report: Castle-Clarke S and Hutchings R  (2019) | Achieving a digital NHS: Lessons for national policy from the acute sector | Nuffield Trust

National survey of local innovation and research needs of the NHS

The AHSN Network has published the document National Survey of local innovation and research needs of the NHS,  the report outlines the national findings from the survey with local health and social care stakeholders. It includes a detailed analysis of the innovation and research needs at local level across all AHSNs.

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Interviews were used to question 61 people and a survey which received more than 250 responses in total.

Commons themes were identified from these responses. They include:

  • a need for innovation and research addressing workforce challenges
  • integrating services to provide effective care for patients with complex needs – including multimorbidity and frailty
  • delivery of mental health services and providing care for patients with mental health needs, particularly in children and young people
  • use of digital and artificial intelligence technology

National Survey of local innovation and research needs of the NHS

NHS patients to get faster access to pioneering treatments

Department of Health and Social Care |May 2019 | NHS patients to get faster access to pioneering treatments

New improvements to the Accelerated Access Collaborative  (AAC)will put the most promising medicines, diagnostic tools and digital services through the clinical development and regulatory approval process faster. The AAC functions as the  front door’ for innovators looking to get their products funded by the NHS and will provide support to overcome barriers that can prevent the best medical innovations from reaching patients.

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To do this, a new unit in NHS England and NHS Improvement will be established, led by Dr Sam Roberts as chief executive.

The new AAC will:

  • implement a system to identify the best new innovations and make sure the NHS is ready to make use of them
  • set up a single point of call for innovators working inside or outside the NHS, so they can understand the system and where to go for support
  • signal the needs of clinicians and patients, so innovators know which problems they need to solve
  • establish a globally leading testing infrastructure, so innovators can generate the evidence they need to get their products into the NHS
  • oversee a health innovation funding strategy that ensures public money is focused on the areas of greatest impact for the NHS and patients
  • support the NHS to more quickly adopt clinically and cost-effective innovations, to ensure patients get access to the best new treatments and technologies faster than ever before

The AAC has already selected and supported 12 ‘rapid uptake products’ to increase their use within the NHS. This includes a blood test for pre-eclampsia, which can diagnose the condition earlier in pregnancy and significantly reduce life-threatening complications.

Together the products have the potential to improve the lives of around 500,000 patients and save the NHS up to £30 million.

Further details available from the Department of Health and Social Care