Health Tech Digital Magazine | April 2019

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MAGAZINE COVER STORY:

Matt Hancock Delivers ‘Power of Technology’ Speech At Spectator Health Summit - p5 NHS Long Term Plan To Reduce Sepsis - p6 App empowering people to monitor themselves for early signs of skin cancer Software goes live - p20 Zytronic touch screens speed check-in at doctors’ surgeries - p21

The UK’s essential Digital Health resource

www.HealthTechDigital.com April 2019

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HEALTH TECH DIGITAL Health Tech Digital brings healthcare professionals, thought leaders and healthcare technology companies together by providing a comprehensive online and print magazine, e-newsletter and Health Tech TV covering every aspect of the healthcare technology sector in the UK. We make it easy for healthcare professionals to find solutions, read case studies and connect with companies who are pioneering the digital transformation of healthcare in the UK.

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Health Tech Digital covers the entire digital transformation journey, from learning about a solution, hearing about new funding and health-tech news, reading case studies, learning about integration, interoperability, security, infrastructure, hardware, equipment, commissioning and procurement. Join over 30,000 healthcare professionals by signing up to our newsletter today.

WELCOME

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n this issue of Health Tech Digital Magazine we cover industry news and hot topics from the month of March providing you with a full month view of the sector in the UK as a whole.

Health Secretary, Matt Hancock, delivered a speech about how technology can make lives better. Since his placement in the role, Matt Hancock has tried to remove out of date technology, such as pagers and fax machines, from the NHS. In his speech, he discussed why he was so determined to continue updating technology in the NHS. New rules implemented in the Long Term Plan means that hospital staff must alert senior doctors if patients who may have sepsis do not respond to treatment within the first hour. This new strategy hopes to save thousands of lives from a potentially fatal sepsis diagnosis.

Health Minister Nicola Blackwood delivered a speech to celebrate the role of National Data Guardian. In her speech, Nicola Blackwood highlighted the scientific, ethical and regulatory issues surrounding patient data.

However, she also shone the spotlight on the UK and how the use of patient data has led to many ground-breaking medical discoveries.

We write about the Air Pollution Evidence Review which was released and the ethical challenges surrounding DNA analysis on pages 11 and 12. Swanage Hospital and The Robert Jones and Agnes Hunt Orthopaedic Hospital (RJAH) have exciting news regarding their new technology implementation.

We cover six intuitive healthcare technologies in our “Technology in the spotlight section”. SKIN VISION’s Skin Cancer App which empowers people to monitor themselves for early signs of skin cancer, Zytronic touch screens speeding up check-in at doctors’ surgeries, NHS SBS with MySBSPay, Pilloxa with a new Smart Pillbox, WiFi SPARK and The SPARK® Platform and lastly Kaia Health with the world’s first virtual personal trainer.

All in all it has been another lightening fast month for healthcare technology in the UK and prepare for it to get even faster as hospitals and healthcare establishments assess and continue to digitalise our healthcare system.

Tracy Williams, Editor and Marketing Director

Would you like to get involved?

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here are many ways for you to get involved with Health Tech Digital. Health Tech TV, our new YouTube channel is where we will be sharing healthcare technology information on key topics relevant to the digital transformation of the UK healthcare sector. If you are a healthcare professional and you would like us to film your talk about the digital transformation of your trust or if you are a professional who has knowledge on a particular aspect of digital health, we would like to hear from you.

If you are a healthcare technology company, we are always interested to hear any news you may have or a solution overview and case study. Contact us today if you would like to get involved.

Email: info@healthtechdigital.com Website: www.HealthTechDigital.com

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CONTENTS INDUSTRY NEWS

5.

Matt Hancock Delivers ‘Power of Technology’ Speech At Spectator Health Summit

11.

DNA Analysis: What Are The Ethical Challenges?

6.

NHS Long Term Plan To Reduce Sepsis

12.

Air Pollution Evidence Review Released

7.

How To Build Trust When Using Patient Data

13.

Understanding Population Health Management

8.

Health Visitors go digital for millennial parents

14.

League of Friends purchases stateof-the-art spinal surgery kit for RJAH

9.

New Campaign Hopes To Lure Family Doctors Back To GP Surgeries

15.

Radiology revamp underway at Swanage Hospital

10.

Patient online consultation requests ‘mirror’ busiest surgery times

16.

Another digital advance for Alder Hey Children’s Hospital as eConsent from Wellbeing Software goes live

TECHNOLOGY IN THE SPOTLIGHT

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SKIN VISION Skin Cancer App

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PILLOXA Smart Pillbox

EVENTS

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Digital Health Events

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ZYTRONIC PLC Zytronic PCT™

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NHS SBS MySBSPay

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WIFI SPARK The SPARK® Platform

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KAIA HEALTH Virtual Personal Trainer

Matt Hancock Delivers ‘Power of Technology’ Speech At Spectator Health Summit

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ealth Secretary, Matt Hancock, delivers a speech about how technology can make lives better.

During a speech at the Spectator Health Summit, well-known technology enthusiast, Matt Hancock, discussed how technology can improve lives. Since his placement in the role, Matt Hancock has tried to remove out of date technology, such as pagers and fax machines, from the NHS. In his speech, he discussed why he was so determined to continue updating technology in the NHS.

Matt Hancock says; “I believe in the innate and instinctive desire in all of us to care for those we love. And all this new health technology has the same simple quest to do just that: to help care for each other.”

The future of healthcare technology Matt Hancock discusses the fact that there is gamechanging potential through AI and genomics as well as with robotic surgery which is faster, lower error-rate and less invasive. However, Matt Hancock believes that technology can help to get the basics right such as booking a GP appointment online.

Matt Hancock believes that people are behind every technological advancement. For example, vaccination, IVF and immunisation were all once pioneering technology advancements that have helped to improve and save lives.

The existing technology can help with wearable technology, video consultations and remote monitoring of vulnerable people. As a result, many patients and NHS staff want to embrace technology and now expect it to be present in their treatment.

Many of these advancements are now taken for granted such as IVF. IVF when first introduced many believed it shouldn’t or couldn’t be done. However, now 8 million children are born every year because of help from IVF. It is advancements like these that bring technology changes that can help to make lives better. As a result, these healthcare advancements come about because someone cares enough to do something that brings change for the better.

So, how can the NHS implement technology to improve patients’ lives?

1. Use of predictive prevention This covers how technology can be used to identify those most at risk of developing a disease.

Technology and ethics

2. Driving innovation The implementation of NHSX will bridge healthcare and technology to enable safe and proven technology to spread throughout the NHS.

In the speech, Matt Hancock addresses the ethical questions that come through the use of technology such as robotics, personalised medicines and genomic sequencing. However, just because it raises questions does not mean it should be rejected because of its controversy. Instead, people’s concerns should be listened to. Technology can be humane and compassionate too.

3. People Matt Hancock believes that technology matters because people matter and that the best technology can help NHS staff to deliver the best treatment that will make a difference in people’s lives. No robot will provide the empathy that patients needs, but with staff embracing technology, they’ll have more time to deliver a caring service.

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NHS Long Term Plan To Reduce Sepsis

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atients with suspected sepsis to receive better care under the new NHS plan

New rules implemented in the Long Term Plan means that hospital staff must alert senior doctors if patients who may have sepsis do not respond to treatment within the first hour. This new strategy hopes to save thousands of lives from a potentially fatal sepsis diagnosis.

Currently, sepsis claims 37,000 lives a year in England.

The NHS Long Term Plan means that every trust must take action to detect and treat sepsis as quickly as possible to prevent deaths. The new guidance requires staff to look for sepsis at the very early stages of admission for patients arriving at A&E. As well as this, staff should be on the lookout for sepsis with patients already on wards.

As well as escalating treatment after an hour, staff must also take note of any non-specific symptoms as well as any changes or concerns that relatives may raise. This new standard will come into force in April 2019, and every NHS hospital will be contractually obliged to ensure full compliance with the new measures.

The new sepsis measures come as part of a focus for faster sepsis treatment in emergency departments.

Furthermore, the NHS hopes to pilot new clinical standards for swifter sepsis diagnosis.

CURRENTLY, SEPSIS CLAIMS 37,000 LIVES A YEAR IN ENGLAND. EVERY TRUST MUST NOW TAKE ACTION. 6

The Medical Director for Clinical Effectiveness at NHS England, Celia Ingham Clark spoke at the announcement; “The NHS Long Term Plan is a blueprint for transforming NHS care, and after the success we’ve had ramping up earlier sepsis diagnosis in many parts of the country, all hospitals will now be required to deliver the best possible practices for identifying and treating sepsis.”

Dr Time Nutbeam from UK Sepsis Trust agreed; “We have been working with NHS England for the past three years to improve the recognition and management of sepsis in hospitals. This next step will ensure that every patient receives the attention they require within existing resource.”

What is sepsis?

Sepsis occurs when the body responds to a bacterial infection. The body responds by attacking its own tissues and organs which can lead to organ failure. Sepsis is hard to spot as there is no obvious symptom or test to take. Often treatment begins too late.

The NHS has increased its awareness of sepsis by improving screening in emergency departments. From 2015 to 2018 screening rates improved from 78% to 91%. Furthermore, 80% of patients are given sepsis medication at the right time. The new measures hope to improve early detection and reduce the number of fatal sepsis diagnoses.

How To Build Trust When Using Patient Data

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ealth Minister Nicola Blackwood delivered a speech to celebrate the role of National Data Guardian.

For all medical staff and patients, the storage, use and distribution of patient data can raise significant concerns.

Since the establishment of the NHS in 1948, people have been working hard to determine the best ways to record, maintain and share data safely and securely.

In her recent speech, Nicola Blackwood highlighted the scientific, ethical and regulatory issues surrounding patient data. However, she also shone the spotlight on the UK and how the use of patient data has led to many ground-breaking medical discoveries.

Patient data in the Long Term Plan The Long Term Plan which set outs the future of the NHS for the next ten years and beyond covers to use of patient data. One of the main goals of the Long Term Plan is to deliver better prevention, targeted treatment and earlier diagnosis. Nicola Blackwood explained that patient data is crucial to the Long Term Plan. She discussed the fact that data can provide safer, more responsive services as well as the reduction in admin time which means patients will receive longer treatment times.

One of the most significant advancements in patient data comes from the 100,000 Genomes Project. As a result of its success, the UK Biobank is now planning to sequence 5 million genomes in just five years. However, alongside the advancements in patient data, medical staff must also balance patient trust.

Statutory footing for National Data Guardian During her speech, Nicola Blackwood announced that the National Data Guardian is now on a statutory footing which helps to give patients a strong, independent and authoritative voice. With a National Data Guardian, patients will have a chance to have representation on how their data is used across the NHS. The National Data Guardian will serve as a champion for the voice of the people but also advise patients to challenge the system if they feel there is an inappropriate use of their data. It is a chance for patients to make sure their information is safeguarded and properly used.

Dame Fiona Caldicott is the first National Data Guardian and wants to build public trust for the use of their data.

This will be an ongoing discussion as perceptions are likely to evolve through experience that patients have and the advancements of technology which can further build trust that data is appropriately protected.

Cybersecurity for the NHS Understandably, many patients are concerned about their data after the 2017 WannaCry attack. However, since the cyber attack, the NHS has strengthened its cyber resilience by investing ÂŁ60 million into data and IT infrastructure. Furthermore, the NHS has imposed hefty fines for any organisation that allows a data breach to occur.

As well as cybersecurity, Dame Fiona believes building trust will come from the NHS staff. Many patients are frustrated with having to explain their medical history at every appointment. As a result, the health system and staff could do more to show the benefits of sharing data.

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Health Visitors go digital for millennial parents

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n 11% rise in the number of health visiting teams setting-up text messaging helplines for new parents means that the mums and dads of nearly 80,000 new-borns are getting more convenient access to healthcare support and advice.

The innovations seen over the last two years are in line with the new NHS Long Term Plan which encourages teams to make better use of digital technology and provide more convenient access to services for the millennial generation who have grown-up in the digital age. The text messaging service for parents and carers is offered by health visiting teams alongside traditional face-to-face care.

It follows a trailblazing year-long pilot by pioneering health visitors in Leicestershire, Leicester and Rutland, which has been highlighted in a peerreviewed, evidence-based article published online

by Royal College of Nursing journal, Primary Health Care. This led to very positive feedback from service users, with 97% stating that they were satisfied or very satisfied with the care provided. Health visitors at Leicestershire Partnership NHS Trust embraced the new way of working, with one staff member commenting; “I was initially anxious about using the messaging service. I have been a health visitor for over 10 years and always delivered care in predominantly a face-to-face way. However, I now love the messaging service and really enjoy being one of the duty nurses and cannot recommend the service enough.”

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Similar services have since been launched in other areas including Warwickshire, Norfolk, Devon, Nottinghamshire, Hampshire, Croydon, Telford, Shropshire and more recently in Stoke and Staffordshire. Further services are expected to launch in the coming months in Bedfordshire and

Kirklees, West Yorkshire. An evaluation of public health messaging services under the new NICE evidence for effectiveness framework suggests they help provide timely and convenient advice to people who need it and can help improve the allocation of healthcare resources.

At Southern Health NHS Foundation Trust, new parents and carers have responded remarkably to the new “ChatHealth” text messaging service. Following the launch on 1st October 2018, in just the first three months they received over 5000 messages from over 1000 parent/carer contacts in the Hampshire area. This is roughly four times the amount of house call contacts a single health visitor could make in a month.

The new digital services supplement face-to-face appointments between health visitors and new parents, which continue to be available. In Hampshire, 64% of the queries received by text were dealt with entirely as messaging conversations, 11% led to face-to-face health visitor appointment and other outcomes have included GP referrals. So far, the main types of contact have been regarding minor illness and feeding.

Barbara Hollis, Area Manager for South East Hampshire Health Visiting Teams said; “Becoming a parent can be incredibly rewarding, it can also be really daunting and all parents have questions. ChatHealth has enabled our Health Visitors to provide that advice in a really responsive way, to a much greater number of people than we would normally be able to, without impacting on other areas of our work.”

Feedback for the service has been overwhelmingly positive, with parents regularly scoring the service five out of five, praising the speed of response along with the simple and effective advice. A service user recently gave a rating of 5 and commented; “I feel much more reassured that I’m doing the right things for my little one, and am much calmer about the problems I asked for advice about. The advice was specifically suggested based on the information I gave about my baby, not just generic suggestions that work for the majority of babies – if was specifically to help our situation. I now know who to contact to seek further help and feel confident to ask for help in the future should I need it.”

New Campaign Hopes To Lure Family Doctors Back To GP Surgeries

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campaign hopes to see hundreds of doctors coming back to general practice

Following the 800 GPs who have come back to GP surgeries after coming out of retirement or returning from overseas, a new campaign hopes to increase that number. The campaign comes as part of the NHS Long Term Plan. Health Education England and NHS England have produced a brochure to help GPs who are considering a return to general practice.

The Long Term Plan aims to recruit 22,000 health professionals. It is hoped this recruitment will not only improve services for patients but will also help to ease GP workloads which may help general practice to seem more inviting to those who have left GP surgeries.

Furthermore, the NHS is also launching an Induction and Refresher Scheme that will run as a print and social media advertising campaign. The Induction and Refresher Scheme began in 2016 as a way to make it easier for doctors to return to the profession.

It hopes the advertising campaign will help the NHS to hit its target of recruiting 500 GPS by 2020.

So far, the scheme has been successful as 785 GP applied to the scheme by the end of 2018 and 279 have now fully completed the programme. However, NHS England and Health Education England are hoping to recruit hundreds more.

Speaking of the scheme, Dr Nikita Kanani said; “We’re delighted to see how many GPs have returned via the scheme, with more than 50% of the recruitment target already achieved.”

The Health Minister, Steve Brine, added; “We want to make it quicker and easier for former GPs to return to the profession, confident they will have the support and funding they need so that patients can benefit from their wealth of experience.”

Speaking of the Induction and Refresher Scheme, Professor Helen Stokes-Lampard said; “The Induction and Refresher scheme has demonstrated positive results so far – and it’s great that so many appropriately-trained doctors want to work in UK general practice – we now need to build on this success and expand it.”

The brochures will show family doctors that there is an extra £1 billion a year for funding general practice while primary care networks are expanding to create growing multi-disciplinary teams that support GPs and lessen their workload.

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Patient online consultation requests ‘mirror’ busiest surgery times

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atients are using online consultations in the

same times and for the same sort of problems than they did

same way they would arrange a consultation via

using traditional routes. This suggests that patients’ consulting

traditional means, a new independent evaluation by

behaviour will not be easily changed by introducing online

the University of Warwick reveals.

platforms. Therefore practices should be clear as to exactly why they are introducing these online platforms, and what they want

• • • •

Patients still make enquiries at busiest hours, despite 24/7

to achieve for themselves and their patients in doing so – the

online access.

expectation may well not meet reality.”

University of Warwick publishes first independent evaluation of one of the main providers of online consultation platforms

The NHS Long term plan sets out that over the next five years

Targeting services at younger patients and those with

all patients will have the right to online ‘digital’ GP consultations.

general administrative enquiries could be most effective

The main way these are being delivered is via online consultation

“In reality, patients were seeking access to health care at the

platforms. The online platforms claim to offer patients greater

same times and for the same sort of problems than they did

convenience and better access and to save time and workload

using traditional routes.” Says supervising author.

for GPs, however there is currently a lack of independent evidence about their impact on patient care and care delivery. Patient

Despite this, the study identifies several opportunities to tailor

feedback analysed as part of the study showed that many found

online platforms to specific patient requirements and improve

the askmyGP system convenient and said that it gave them the

their experience. Primary care researchers from Warwick Medical

opportunity to describe their symptoms fully, whilst others were

School have today (26 March) published the first independent

less satisfied, with their views often depending on how easily

evaluation of one of the main providers of online consultation

they can normally get access to their practice, and on the specific

platforms in NHS general practice. Published in the British

problem they are reporting.

Journal of General Practice, it provides independently analysed information on the types of patients that are using online triage

The study found that two thirds of users were female and almost

systems, how and when patients are using this platform, and

a quarter were aged between 25 and 34, corroborating existing

what they think of it.

evidence. The commonest reason for using the service was to enquire about medication, followed by administrative requests

Online triage is a system in which patients describe their

and reporting specific symptoms, with skin conditions, ear nose

problems via an online form and subsequently are telephoned

and throat queries and musculoskeletal problems leading the

by a GP to conduct a telephone consultation or arrange a face-

list.The researchers argue that practices should avoid a ‘one

to-face consultation. Practices aim to respond within one hour

size fits all’ approach to implementing online consultations and

of receiving the request. The researchers examined routine

should tailor them to suit their practice populations and model of

information from 5140 patients at nine general practices using

access, considering whether it is likely to add value for their patient

the askmyGP platform over a 10 week period. Highest levels of

population.

use were between 8 am and 10 am on weekdays (at their highest on Mondays and Tuesdays) and 8 pm and 10 pm at weekends,

Dr Atherton adds: “Individual online consultation platforms are

mirroring the busiest time for patients contacting their practice

uniform in their approach, patients are not. We found that patient

via telephone.

satisfaction is context specific – online consultation is not going to be suitable for all patients and with all conditions and that one

Supervising author Dr Helen Atherton, from Warwick Medical

approach is unlikely to work for everyone.

School, said: “With online platforms there is an assumption that

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having a 24/7 ability to make contact with a general practice will

“Practices could focus on encouraging people to deal with

cater to those who wish to deal with their health problem at a

administrative issues using the platform to free up phone lines

convenient time, often when the practice is shut, and that being

for other patients. It could be promoted specifically to younger

online means they will perhaps share different problems than

patients, or those who prefer to write about their problems and not

they would over the telephone or face-to-face.

to use the telephone. Clear information for patients and a better understanding of their needs is required to capture the potential

“In reality, patients were seeking access to health care at the

benefits of this technology.”

DNA Analysis: What Are The Ethical Challenges?

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att Hancock delivered a speech at the Royal Society discussing the ethical challenges surrounding DNA analysis.

In a speech delivered to the Royal Society, Matt Hancock celebrated the achievements of the 100,000 Genomes Project that can help families to get closer to a treatment option or cure. Furthermore, families can feel part of a community as their genetic data is helping others.

Matt Hancock then discussed taking part in a predictive polygenic risk test where he would be able to find out how likely he is to get 16 serious diseases and if he was at high risk for any. While the results showed he was in 3% of the population with the lowest genetic risk for heart disease, his results showed he was in the worst 20% for prostate cancer.

Consequently, after finding out this information, Matt Hancock booked a blood test and is now on full alert for any screening checks and any symptoms that are associated with prostate cancer. However, the important aspect of this genomic testing is that it is focused on risk factors. A clinician can help individuals to make sense of the data and help to make screening more targeting and effective.

Genomics can also help with rare diseases too as it can also be a diagnostic test with certainty. As a result, genomics can have an immediate impact for a patient which can be life-changing. However, with the benefits of genomics, it can also pose some ethical questions. During his speech, Matt Hancock addresses three areas concerning the ethical challenges.

Roll out Despite the huge amount of work sequencing genomes, there is still a data blockage. For example, not all cancers can be tested for, because data is locked away. In order to help more people, data must be accessible.

Ethics Rules need to be in place surrounding both diagnostic and predictive genomics.

Furthermore, there needs to be established rules surrounding privacy and consent.

There must be a policy for how and with whom data is shared.

Operation While sequencing is taking place, it is crucial to train doctors and nurses so that they can make sense of genetic data and the predictive tests available. They must also be able to explain it to patients in a way that makes sense.

As a result, it can help the NHS to save time and money. However, perhaps more importantly is that it can help people to have control over their physical and mental health by preparing them for news that could be life-changing.

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Air Pollution Evidence Review Released

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ublic Health England aims to create a ‘clean air generation’ as a result of the review.

Public Health England has just published a review on how to improve air quality in the UK. The report includes a number of local and national actions, all of which aim to improve outdoor air quality as well as health.

Currently, between 28,000 and 36,000 deaths are year are attributed to long-term exposure to air pollution.

Furthermore, it is considered one of the biggest environmental threats to health. Evidence suggests that air pollution can increase the risk of heart disease, stroke, lung cancer and respiratory disease.

Actions for local authorities Some of the advice published in the review that local authorities can action include; •

Promoting the use of low-emission vehicles

•

Installing electric car charging points

•

Encouraging the adoption of low emission fuels

•

Improving foot and cycle paths

•

Redesigning housing to make sure people aren’t close to high pollution roads

•

Creating low emission and clean air zones.

•

Increasing the use of hedges to screen pollutants

•

Widening road networks.

The director of Health Protection and Medical Director at Public Health England, Professor Paul Cosford says; “Transport and urban planners will need to work together, with others involved in air pollution to ensure that new initiatives have a positive impact. Decision makers should carefully design policies, to make sure that the poorest in society are protected against the financial implications of new schemes.”

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In order to support the local authorities in their quest to improve air pollution, the national government will

implement incentives that help. Some incentives will include policies that promote low emission vehicles and implementing policies regarding industrial emissions in populated areas.

CURRENTLY, BETWEEN 28,000 AND 36,000 DEATHS ARE YEAR ARE ATTRIBUTED TO LONG-TERM EXPOSURE TO AIR POLLUTION. Understanding Population Health Management

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n interview with Tony Ramwell, Servita

What is Population Health Management?

I guess firstly we should understand what Population Health is. The widely accepted definition of population health is: “the health outcomes of a group of individuals, including the distribution of such outcomes within the group”. In simpler terms it is the clinical or health outcomes of a defined section of society, as well as the distribution of health outcomes within the group.

Population Health Management [PHM] is an analytical use of data collected from multiple sources. This data is focused on defined segments of the population in order to manage specific diseases in that group. The idea being that this approach will improve clinical outcomes, standardise physician approach and help to reduce the cost of the disease management, amongst other benefits.

Is this new, new or a new definition for a previous theme / idea?

This is really an evolution of the public health approach. With the increased amount of data available via the modernisation of healthcare systems such as Electronic Health Records (EHR), this has made it easier collate data, often in huge amounts. PHM has

taken the public health approach one step further by using advanced analytics of the data collected from EHR’s, disease registries and other data sources.

What’s the main benefit to the provider and patients?

The benefits are vast. From a patient perspective PHM would aim to deliver improved patient outcomes, disease prevention, improved management of chronic diseases and standardised coordinated care. For providers such as physicians the information available to them enables for far greater understanding of the disease and impact to the patient groups. Healthcare institutions will expect to see the cost of care reduced with more targeted, standardised evidence based treatment being provided to the patients.

Lastly, both patients and providers will benefit from the preventative medicine aspect that aims to reduce the need for health interactions once the patient is already advanced to the point of poor health.

How can his help with issues like an ageing population?

Generally, we are seeing a global trend for aging populations with less births and a longer life expectancy. With this expanding older adult population there is also an increase in chronic diseases such as hypertension, coronary heart disease, stroke, diabetes, and cancer. The management of these chronic diseases in this defined population group can benefit from the data that is being collated both at hospital, national and international levels. Using this data to understand how best to treat these chronic diseases will help the outcomes and also reduce the cost of care. Further, with more understanding better preventative measures can be applied to help reduce the onset of these chronic diseases.

What stops more providers using it?

There are a few challenges with providers utilising PHM. Firstly, there is a huge reliance on data; where this data is stored and how it is shared to enable a large enough data set to have meaningful levels of insight. Typically, healthcare institutions have kept their data to themselves and the sharing of data on regional or national levels has been sparse.

Increasingly, the need for this data sharing has become a hot topic and is now beginning to gain traction. Next, the quality of the data is of paramount importance. Often EHR data is incomplete through poorly entered patient information or poorly structured data capture where the use of free text fields allowed for the important data to be buried in with other information.

There is also the question of funding, most healthcare providers globally are funded on a fee for service model aimed at treating sickness and not at preventing illness.

Therefore, there is little incentive to focus on preventative care models. However, this is changing. Countries where there is an insurance based healthcare system have started to see insurance companies realising the benefit of preventative medicine and more focus is being placed upon this. In countries such as the U.K. there is obvious synergy in preventative medicine which is cheaper to implement and reduces the cost of the management of chronic disease over the longer term. There is a shift in thinking but it has taken time to be realised.

Another challenge with PHM is the patient themselves. The patient is the key factor in the implementation of PHM and the ability to engage the patient in their own care management.

Changing the populations/patients’ behaviours are key, health is not something an individual should become concerned with only when they are ill, but should be throughout all stages of their life. Increased access to cheap, high calorific food is driving obesity globally, more so in emerging nations such as Mexico (which has the fourth highest rate of obesity in the world), India and China (who project rapid increase in diabetes by 2035). A clear strategy to engage the patient at all states of their life is critical to create a successful PHM model, this has to be done not just through primary care but all the healthcare system. There may also be an issue if patients are not willing for their personal data to be shared in a PHM system.

How would you recommend approaching a PHM deployment?

This has to be a well thought out and carefully managed transformation that has the stakeholder buy in across the healthcare system. This can be at a trust level for the NHS or at a national level where they have achieved a single patient record or are planning to implement a new regional or nationwide EHR. From a technical aspect the key point is understanding the current data and where the challenges lie. How can a system be optimised to better capture this data to allow for secondary use? There are many aspects of the system design that allow for this. I would recommend a Data Enterprise Architect team complete a review of the data structure and quality as an initial step to understand the challenges that may need to be resolved to enable the data capture required for PHM.

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League of Friends purchases state-of-the-art spinal surgery kit for RJAH

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tate-of-the-art surgical equipment to benefit patients undergoing back surgery has been purchased by the League of Friends to The Robert Jones and Agnes Hunt Orthopaedic Hospital (RJAH).

RJAH was the first NHS hospital to practice fully endoscopic spinal surgery.

The League of Friends have purchased endoscopic surgical equipment for the Oswestry-based hospital, which will enable the Trust to carry out fully endoscopic spinal surgery.

Mr Balain said: “So far we’ve done 45 cases at RJAH and I’m pleased to say that all have been successfully discharged. We’re using new equipment to enable this keyhole procedure thanks to a donation from the League of Friends, and we’re extremely grateful.”

This kind of surgery allows for the same operation and technique to be used as in open surgery, but done through a single and small keyhole incision, whereas in open surgery the incision can vary from 4-8cm in length. This can result in much quicker recovery times for patients.

Victoria Sugden, League of Friends Charity Director, said: “This is such an exciting piece of equipment for the League of Friends to fund. Having had the privilege of seeing Mr Balain operate, and the positive outcome for his patients, I’m delighted the League has given such wholehearted support.”

The purchase of the equipment cost £110,000.

Mark Brandreth, Chief Executive at RJAH, said: “Thank you to our wonderful League of Friends for generously funding this state-of-the-art equipment. This new kit will enable us to carry out this keyhole procedure.

Mr Birender Balain, Consultant Orthopaedic Surgeon at RJAH, said: “I’ve been involved in minimally invasive complex spinal surgery since 2010. As decompression and discectomies are the most commonly performed spine procedures, I thought we should look at offering those procedures through keyhole techniques.

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techniques as there are huge benefits to patients.

“I think fully endoscopic spine surgery is the future of all common spine surgeries, and in five to 10 years’ time, new surgeons will all be trained in these

“This will make a real difference for our patients, as this kind of surgery can result in a much faster recovery.”

Picture caption: From left, Victoria Sugden, League of Friends Charity Director, in one of our Theatres, with Mr Birender Balain, Consultant Orthopaedic Surgeon. protected, and the systems we use are some of the safest in the world.”

Radiology revamp underway at Swanage Hospital

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atients at Swanage Hospital will soon have access to some of the most advanced digital X-ray technology in the world.

Work has begun to refurbish the site’s Radiology Department to not only upgrade its outdated imaging equipment, but also make the facility a lot more spacious and modern.

The Dorset HealthCare-run hospital has a long history of providing high quality care to its local community, with a continual focus on innovation and promoting clinical excellence.

However, it’s Radiology Department – which sees around 50-60 patients each week – is badly in need of a refresh.

More than £275,000 is being spent on the facility which, when finished, will boast a state-of-the-art digital X-ray room that will provide high resolution images in a shorter time.

This will result in reduced waiting times and enable staff to make more accurate diagnoses.

Matron Donna Kiss said: “This is fantastic news for the people of Swanage who rely on our services, and this project shows we are committed to providing the highest standards of care we possibly can.

“We are delighted to be installing some of the best X-ray imaging equipment available, which will enable us to run a more efficient service in more attractive surroundings.”

The refurbishment does mean the X-ray service will be temporarily closed until work is completed on Thursday, 13 June, with patients being redirected to either Poole Hospital or the Victoria Hospital in Wimborne during this period.

Service opening times will remain the same, and staff will ensure patients are signposted to the most convenient site for treatment.

Ultrasound examinations won’t be affected, but will take place in the hospital’s Outpatient Department.

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Another digital advance for Alder Hey Children’s Hospital as eConsent from Wellbeing Software goes live

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eeds becomes the first fully-connected GP Connect City through NHS Digital.

Clinicians across the whole of Leeds now have access to GP records for patients in the city. NHS Digital has developed GP Connect, a service which allows authorised clinical staff and GP to share digital records. This fast access to records will enable clinicians to make quicker and better decisions about patient care.

GP Connect is particularly beneficial for hospitals across Leeds. It allows hospital staff to access information about patients’ care and previous encounters with GPs. Through NHS Digital, there is a stronger link between primary and secondary care thanks to data.

GP Connect is now available to all GP practices in Leeds after the GP system supplier, TPP, joined EMIS Health to help implement and roll out GP Connect.

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In the future, GP Connect will be able to provide allergy information and structured medications for more efficient appointment management and to improve patient care across the whole city.

The Chief Digital and Information Officer at Leeds Teaching Hospital Trust said of GP Connect; “In Leeds we can now plan to have a fully integrated primary care, social care, hospital care and mental health care record in place throughout the city in 2019, a giant leap and a unique proposition for the NHS.” The Chief Medical Officer at EMIS Group, Dr Shaun O’Hanlon said; “We are delighted that connectivity via GP Connect is available right across Leeds. This important partnership with NHS Digital is part of our company’s wider commitment to providing the tools for system interoperability using open NHS standards across the UK, and helping clinicians drive up standards of joined up patient care.”

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DIGITAL DIGITAL DIGITAL DIGITAL DIGITAL HEALTHCARE HEALTHCARE HEALTHCARE HEALTHCARE HEALTHCARE SHOW SHOW SHOW SHOW SHOW Dr Simon Eccles Chief Clinical Information Officer for Health and Care NHS England

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TECHNOLOGY IN THE SPOTLIGHT DIGITAL HEALTHCARE Each month we cover healthcare technology that is revolutionising the healthcare sector. This month we cover six intuitive healthcare technologies: SKIN VISION’s Skin Cancer App which empowers people to monitor themselves for early signs of skin cancer, Zytronic touch screens speeding up check-in at doctors’ surgeries, NHS SBS with MySBSPay, Pilloxa with a new Smart Pillbox, WiFi SPARK and The SPARK® Platform and lastly Kaia Health with the world’s first virtual personal trainer.

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SKIN VISION Skin Cancer App

PILLOXA Smart Pillbox

ZYTRONIC PLC Zytronic PCT™

WIFI SPARK

NHS SBS MySBSPay

KAIA HEALTH

The SPARK® Platform

Virtual Personal Trainer

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App empowering people to monitor themselves for early signs of skin cancer

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kinVision, An app which empowers people to monitor themselves for early signs of skin cancer is one of four new technologies supporting earlier diagnosis and prevention of cancer, selected to join the NHS Innovation Accelerator.

Through the award-winning NHS Innovation Accelerator (NIA) – an NHS England initiative delivered in partnership with England’s 15 Academic Health Science Networks – SkinVision will be supported to spread across the NHS over the next three years, ensuring that people at risk of skin cancer are diagnosed and treated earlier.

Developed in the Netherlands, SkinVision enables the user to take a photo of their skin spots via a smartphone camera. Within 30 seconds they will receive a risk indication on skin cancer risk level ranging low, medium or high. In the case of a high-risk rating, the user will receive advice within 48 hours from SkinVision advising them on next steps to take. Clinical studies demonstrate that the overall accuracy of the app in recognising skin cancer (melanoma, BCC, SCC and pre-malignant stages) is in line with experienced dermatologists. It is available to download on both iOS and Android.

Incidence of skin cancer is increasing rapidly, with an estimated 159.000 people diagnosed with some form of the disease in 2015, with over 3.600 related deaths in the UK. It is predicted that 1 in 5 UK citizens will get some form of the disease in their lifetime.

Early detection is key for a more favourable prognosis, but most people don’t know what to look for.

The sooner skin cancer is detected, the higher the possibility of successful treatment and survival.

SkinVision has over 1.2 million users globally and has contributed to the finding of 27,000 cases of skin cancer.

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In the future, it is hoped local NHS groups might buy a licence for the app, enabling GPs to encourage their patients to download the App, particularly those who have had problems in the past, so they can use it free of charge.

Professor Stephen Powis, NHS Medical Director, said: “The NHS Long Term Plan puts the latest technology and innovation at the heart of people’s care and the future of our health service.

“Right across the NHS patients are benefitting from worldbeating innovations, spread as part of this programme, and now even more patients will be supported by new tools like the app which uses AI to help identify skin cancer, puts people in control of their care and enables them to get treatment as quickly as possible.”

Erik de Heus, CEO of SkinVision, said of the announcement: “We are very proud that SkinVision is able to provide support to the NHS in saving many people’s life whilst making the health system more effective and reducing costs.”

“The hard work Insurance Provider CZ and SkinVision have done in the past year, proving the technology can be integrated with the Dutch health system, is now recognized as best practice in deploying machine learning technology. It is ready for rollout in large population health systems.”

“We know from studies conducted here in the Netherlands that 70% of visits to GP related to suspicious skin spots are unnecessary, by the use of the app it is hoped that this number can be drastically reduced, freeing up GPs to run their practice more efficiently and to see more patients.

By bringing down the cost of diagnosing sufferers and by ensuring that they enter the health system earlier, we bring down costs and help ensure that money can be diverted to fund new treatment such as immunotherapie and free up clinicians to work more effectively.”

Since launching in 2015, the NIA has supported the uptake and spread of 37 high impact, evidence-based innovations across more than 1,700 NHS sites and £79.3M in external funding has been raised. SkinVision is the only non-UK company chosen to take part in the Accelerator this year.

Zytronic touch screens speed check-in at doctors’ surgeries

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ver 47 million patients have checked in to see their GP through a Zytronic PCT™ touch sensor. This is because the sensors, supplied by distributor Display Technology, have been the top choice for Engage Health Systems Ltd (formerly known as Wiggly-Amps Ltd), one of the UK’s leading suppliers of patient-facing services for the healthcare sector.

Jon Witte, Managing Director of Engage Health Systems, explains, “Our expertise lies in developing user-friendly and secure systems which make patients and clinicians lives easier and ensure a safe working environment for all staff. We are passionate about developing and implementing products which simplify, digitise and safeguard the workplace. Our clients tell us how our products have helped empower their staff and patients whilst streamlining administrative tasks to achieve a cost-effective, efficient working environment.”

He continued, “When we first created Engage Touch, it was clear that a well-designed touch interface was essential to create a screen that was easy and intuitive to use by the full and diverse spectrum of patients visiting surgeries – including the elderly, the disabled, those with a limited command of English and those with other special needs. Features include a multi-lingual interface, which can essentially only be implemented using a touch interface.”

The vision for Engage Touch was to allow patients to quickly and conveniently check-in for their appointment and to assist the practice with capturing patient data.

With a patient check-in kiosk, practices avoid lengthy queues at reception and improve operating efficiency.

A number of key considerations surrounded the choice of touch sensor. Clearly the sensor itself had to offer exceptional performance – a clear, crisp response even

if the touch was hesitant. Engage Touch is built to order whether it’s a single order placed by a surgery or a large CCG procurement. The touch screen supplier needed to offer complete flexibility of supply, to suit Engage Health Systems’ requirements.

Engage Health Systems created its own enclosure for Engage Touch, which fitted into the surgery environment and in particular is easy to clean and disinfect with suitable detergents. In partnership with Display Technology, Zytronic designed and delivered a touch sensor to meet their exact requirements. The solution selected was a 3mm thick Anti-Glare 19” ZYBRIDX sensor paired with a Zytronic ZXY100 controller.

Jon Witte commented, “Zytronic’s flexibility and responsiveness and Display Technology’s support throughout the design process was exceptional. We believe in dealing with UK suppliers wherever possible, and Zytronic fully demonstrated the value of this approach.”

He continued, “We now have over 1500 terminals live in doctor’s surgeries around the country. All our terminals come with a lifetime guarantee and we’ve never had a unit back because of a touch issue. They see a surprising level of abuse. They’ve been ripped off the wall and we regularly see them with scratches and gouges but the touch screen just keeps going.”

Ian Crosby, Sales and Marketing Director at Zytronic, concluded, “Our partnership with Engage Health Systems Ltd has gone from strength to strength for over ten years. They have continuously developed and improved the software at the heart of their product.

Zytronic touch sensors have provided a reliable, rugged and flexible interface for patients and surgery staff to access the capabilities of this outstanding terminal.”

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Over 330 NHS workforce hours saved every month after launch of new payroll App

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olume of payroll queries from staff at NHS hospitals falls significantly following introduction of MySBSPay.

A new App that enables NHS staff to view and interrogate their payslips on any mobile device is helping to save the NHS around 333 hours every month, by reducing the number of telephone payroll queries from NHS employees.

MySBSPay was launched by NHS Shared Business Services (NHS SBS) towards the end of 2018 to give NHS employees their pay information in a more convenient and understandable format, including the facility to ask common pay-related questions using modern Chatbot technology.

With almost 400,000 NHS staff paid via the NHS SBS payroll service, which is used by around 90 NHS organisations around the country, the App has been downloaded over 40,000 times and has already led to hundreds of NHS workforce hours being saved for more valuable activity, such as frontline patient care.

Figures for the three months August to October 2018 – shortly after the App was introduced – show that the NHS SBS payroll service desk dealt with an average of 12,808 queries a month from NHS employees, ranging from payslip clarifications to tax enquiries, pay day information requests to maternity pay questions.

Between November 2018 and January 2019, however, the total number of cases was down significantly to an average of 9,474 per month – a 26 per cent decrease.

With an average case taking approximately six minutes to resolve, this equates to a saving of around 333 staff hours every month – the equivalent of 48 working days across the NHS. At Chelsea and Westminster Hospital NHS Foundation Trust, where staff worked closely with NHS SBS last year to design and test MySBSPay, more than one in four employees (26%) are now using the App. The average number of monthly queries to the payroll service desk from those working at the Trust has reduced by 19 per cent – saving around nine hours of staff time every month.

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Deirdre

Richardson,

Associate

Chief

Pharmacist

(Operations) at Chelsea and Westminster Hospital NHS Foundation Trust, said: “I’m a huge advocate of the NHS SBS App. It is very helpful to see at a glance my salary over the last few months and also when the next pay day is – as both can vary from month to month. Rather than having to be at work and logged into ESR (Electronic Staff Record), which can be time-consuming, MySBSPay gives Trust employees the flexibility of viewing their payslips very easily at home or on the go from their mobile phone.”

The Trust’s Assistant Director of Nursing, Cathy Hill, agreed: “Using MySBSPay is much easier than having to log on to ESR to view your payslip. The ability to ask questions on the App will also mean NHS staff spend less time on phone calls and emails to Payroll. One of the most useful things about the App for me and others in my team is being able to easily see and track the payment of any arrears or travel expenses.”

Elsewhere, at Oxleas NHS Foundation Trust, around a fifth (21%) of employees have downloaded MySBSPay. This has helped reduce the number of cases raised with the payroll service desk by around a third (32%), the equivalent of 11.5 hours of staff time per month.

David Morris, NHS SBS Managing Director, said: “The MySBSPay App is a perfect example of how innovative technology can be used to give the NHS workforce the tools to be more effective. The NHS Long Term Plan talks about removing wasted time and irritating tasks so that staff are able to focus on patient care. And this is exactly what we are doing in the back office. Listening to what NHS hospitals need and developing digital ways of working that lessen the admin burden on their employees.

With NHS trusts across the country struggling to recruit and retain enough staff to meet demand, it has never been more important to ensure that the current NHS workforce is working efficiently and on high value tasks.

To see that our App has had such a huge impact in a relatively short period of time shows how important it can become for the NHS in future.”

“As more NHS employees continue to download and use MySBSPay to manage their pay information, the expectation is that many more hundreds of hours can be saved every month – freeing up NHS staff to concentrate more of their time where it really matters and on what makes the biggest difference to patients.”

Pilloxa initiates a strategic partnership with Bayer AB for innovative smart pillbox to tackle growing problem of patient compliance

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illoxa initiates a strategic partnership with Bayer AB for innovative smart pillbox to tackle growing problem of patient compliance.

Swedish digital health start-up Pilloxa has entered a strategic collaboration with Bayer AB. Pilloxa helps patients take their medicine in time by using an app that is connected to a smart pillbox. Non-compliance, with patients either forgetting or failing to complete complete courses of medication leads to thousands of deaths and billions of Euros in costs for society, every year.

Pilloxa has it roots in the Karolinska Institute in Stockholm, Region Stockholm and the Royal Institute of Technology (KTH). The user gets a reminder if they are about to forget their dose. In the app there is also an up-to-date medicines list, a dashboard visualizing the patient’s medication history and a motivational tool.

Poor adherence to medication leads to both medical risks for the patients as well as increased strain on the healthcare system, both in terms of time and costs. By gaining access to both Bayer’s Scandinavian and global

network through this new collaboration, Pilloxa will get the opportunity to expand the market and introduce more people to their smart pillbox.

“We see great potential in this innovation. For someone not too familiar with the subject it might seem like a trivial task to take one’s medicine. The reality shows that poor adherence to medication is one of the biggest medicinerelated issues that affects healthcare; many, especially chronically ill patients, could get better treatment. We also see that the product can improve the quality of outcomes when following up with the patients”, says Ingalill Hyltander, Commercial Operations Director, Bayer Scandinavia.

“Pilloxa aims to be a leader in patient centric healthcare where innovation and modern technology combine to lay the foundation. We are delighted to collaborate with Bayer to meet one of the biggest problems in healthcare: poor adherence to medication. By joining forces in this way to we are able to lead the development of digital treatment aids that empower the patient and improve the result “beyond the pill”, adds Francesco Mazzotta, CEO at Pilloxa.

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WiFi SPARK allows staff, patients and visitors to stay connected, and Trusts to learn useful insights

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iFi SPARK is enabling patients to access live TV streaming, digital magazines, service requests, meal ordering and a host of other capabilities such as the ability to engage and inform your patients through the use of a fast, secure WiFi capability and a TV, tablet, bedside unit or mobile media table.

WiFi SPARK is the leading specialist in providing commercial WiFi solutions to large venues, from hospitals to shopping centres and are the owner and developer of the innovative and unique SPARK® Platform which delivers the most flexible, feature-rich and scalable solution for guest-access WiFi on the market today. The SPARK® Platform has successfully been deployed across a multitude of sectors, ranging from shopping centres and stadiums to hospitals and enterprises.

Their branded and bespoke user experience, tailored specifically for healthcare, provides an enhanced reporting platform so you can track data in real-time to help you boost loyalty and increase ROI. The 75+ age

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group are the biggest areas of growth for the smart phone market at present, which shows that mobile devices are being used by a wide range of ages. People already have an ability to use mobile technology and it has become an expectation that these technologies will be available across multiple public health sectors.

Entertained patients are happier and the distraction and entertainment provided can aid in the recovery process.

SPARK® MEDIA provides access to many entertainment portals and can be tailored to your particular healthcare needs and goals.

WiFi SPARK’s managed wireless solutions provide 24 hour support and monitoring and full legal compliance so you can be sure you’re receiving the best fully managed service available.

Offer your visitors excellent WiFi and learn about their behaviour. Use the knowledge and data to your advantage, whilst being given full support.

World’s first virtual personal trainer counts reps and provides feedback using just a smartphone

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orld’s first virtual personal trainer will count your reps and provide real-time audio feedback, using just a smartphone AI is disrupting the fitness industry and democratising access to professional training worldwide New York, March 2019 – Leveraging years of building health and fitness applications, including the world’s leading back pain app, digital therapeutics pioneer Kaia Health is now launching Kaia Personal Trainer, the world’s first full-body virtual personal trainer which tracks exercises, creates personalised fitness plans, counts reps and provides real-time audio feedback.

The app is powered by patent pending AI-powered motion tracking technology and uses just a smartphone (no additional hardware is required). It is like having a personal trainer at home – without having to go to the gym – and is democratising access to professional physical training and wellness feedback worldwide.

The Kaia Personal Trainer app has been developed with physiotherapists and fitness experts. It combines AIpowered motion tracking technology and personalised training to offer a customised full-body workout featuring a variety of exercises, including the side plank, bridge and reverse crunch.

To activate Kaia Personal Trainer, users stand seven feet away from their smartphone camera and begin exercising with video instructions. The app tracks physical activity with a 16-point system that compares the metrics of actual movement against ideal movement, including the relative positions of limbs and joints, and the angles between them. Kaia Personal Trainer counts the number of reps and provides users with instant, personalised real-time audio feedback, advice and encouragement to

improve fitness and performance.

Kaia Personal Trainer covers all relevant body parts and muscle groups, including the lower back, core, glutes and hamstrings. The AI-powered motion tracking technology adjusts the difficulty level and exercise based on the user’s feedback – and is particularly suited to those with little experience or training who want to integrate exercise into their lives in a mindful way.

Maximilian Strobel, Head of AI Lab at Kaia Health says: “Kaia Personal Trainer is a full-body workout in your pocket. It uses tech to offer you the experience of a personal trainer anywhere, with real-time performance metrics – without the expensive personal trainer fees. The app puts users in control of their exercise performance with a virtual personal trainer which accompanies their every step. This fosters more intimate connections, establishing a relationship by becoming a part of their everyday routine and integrating with their fitness goals. We’re incredibly excited by our patent pending AI-powered motion tracking technology and virtual personal trainer as it has the potential to democratise access to a sustainable wellness feedback and fitness training worldwide.”

Commenting on the unique technology behind the Kaia Personal Trainer, Achilleas Georgiadis, Principle Deep Learning Engineer at Kaia Health, says: “Up until now, specialised hardware like a Microsoft Kinect was required to track the human body. We remove the need for costly hardware using advanced Deep Learning and Machine Learning algorithms and optimised them for mobile. This enables us to track the human body in real time using only the hardware of the smartphone – hence democratising access at no additional cost.”

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What to look forward to in the next issue In the May issue we will cover the news highlights for the month of April and more ground-breaking healthcare technology in our spotlight section.

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