New report suggests supported self-care may improve patient outcomes

Patients may benefit from using a package of technology, education and support from clinicians (called ‘supported self-care’) to empower them to manage their health needs more effectively at home, a new report suggests.

The report highlights the outcomes of an eight month Champion Project where supported self-care was implemented with a small cohort of patients in one GP surgery in Bristol. The project was run by the social enterprise Bristol Community Health, in partnership with Philips Healthcare, The Lennard Surgery and funded by the West of England AHSN.

93 patients were enrolled at three different levels of service, depending on their disease acuity and personal preferences. Different technologies were offered to patients, to enable them to learn more about their condition and/or submit vital readings in their own home. All three levels of service were connected to a clinical hub, enabling staff to monitor readings and provide further support as required.

At the end of the year, a range of outcomes were reported:

  • GP practice contacts (visits, phone calls) reduced by a third for all acuity levels.
  • Patient activation levels increased by 38% to 56%.
  • 98% of patients would recommend the service to family and friends

Due to the small sample size, no statistical claims are made of this data, but the results are consistent with statistically significant results obtained elsewhere.

A range of positive benefits was also reported through interviews with patients.

“It’s made me more aware of my own condition; I’ve learnt to read the signs. I’m able to judge when I need to contact someone,” said one patient.

“I’ve found it reassuring – this scheme gives you confidence,” said heart failure patient Gordon Hennessy. “If there’s anything wrong my nurse will pick it up or my doctor will pick it up.”

The partnership is now exploring whether an extended model for supported self-care, involving patients with differing health conditions, might be feasible across the whole city. To aid this, two new videos have also been released to explain the concept of Supported Self-Care to GPs and local commissioners.

Watch the video for commissioners here:

Watch the video for GPs here:

Liz Dymond, Deputy Director of Enterprise said: “The West of England Academic Health Science Network was delighted to co- fund the Champion Project. We are always keen to support innovative projects, especially those encouraging people to be more informed and involved in in managing their long term health conditions.”

Lennard Surgery Practice GP Dr Gareth Ronson said: “I know from directly talking to patients how much they appreciated the monitoring and how much confidence it gave them to manage their condition at home. Just this week, I visited a gentleman who was sad to see the project finish but had continued to record his data despite the end of the project, and he directly commented on his increased confidence. I’m sure there will be more of this type of Supported Self-Care in the future and it will help motivate and support patients to improve their medical conditions.”

Julia Clarke, Chief Executive of Bristol Community Health said: “We’re really excited by the outcomes of our supported self-care partnership project. There’s a growing and important role for technology and education in empowering patients to take control of their own health, and these initial outcomes support this. Our vision for the future is one where patients are able to self-care as much as possible, in the comfort of their own home, and with support from community healthcare staff, and contacts with GPs and hospitals is minimised. This work will help us achieve that.”

Malcolm Hart, Senior Director of Hospital to Home at Philips said: “This collaborative project has demonstrated valuable new insights on how people living with long term conditions can be supported to self-care more effectively. This is a win-win for patients and the health system– better quality of life, and improved health outcomes, at lower cost.”

To access a full copy of the report Supported Self-care through technology: a population approach to long term condition proactive management in the community, please email gemma.hargreaves@briscomhealth.nhs.uk.

People with diabetes welcome opportunity to be part of pioneering NHS technology Test Bed

People with diabetes in the Westcountry have welcomed the news that they will have an opportunity to shape future innovative developments aimed at self-managing their condition.

The West of England has been selected as an innovation Test Bed to help people with diabetes in the region self-manage their condition in the future. It is one of seven test beds announced by the NHS around the country as part of a major new drive to modernise how the NHS delivers care.

The Diabetes Digital Coach Test Bed, funded by the Department of Health and led by the West of England Academic Health Science Network, will involve a collaboration between the regional health community, national charities and technology businesses.

Recruiting up to 12,000 people with diabetes

Over the next two years, the project will be looking for up to 12,000 people with diabetes across the West to come forward and participate in the Test Bed. ‘Diabetes Digital Coach’ will involve using and evaluating a range of technologies that can support self-management of the condition, from wearable sensors to online apps. It aims to deliver a range of benefits for those with diabetes, including providing a real time view of their own data which will enable them to take prompt actions to prevent their condition deteriorating and the opportunity to share their information with healthcare professionals to help shape their advice and support.

Sandra Tweddell, from Bristol, has lived with Type 1 diabetes since 1961. She is coordinator of the Bristol Diabetes Support Network and has been involved in the design of the Diabetes Digital Coach programme.

Like many others, she has seen significant advances to the monitoring and treatment of the condition over the past five decades. When she was diagnosed in 1961, insulin was injected with metal and glass syringes that had to be boiled to sterilize them.

She says: “You managed your diabetes almost by guesswork as home tests for blood glucose were non-existent and you relied on the rare visits to the consultant who told you what to do.

“Not a one size fits all”

“Everyone with diabetes needs a good understanding of their condition and how they personally react to different medications. Managing diabetes is not a one size fits all. We make life saving decisions 24/7 and self-management technologies have a key role to play in supporting these decisions. You are walking a tightrope trying to keep your blood glucose within a normal range to avoid complications and it is easy to fall off. Technology gives you the means to know when you are about to fall off and to take the steps to correct it.

“Today’s technology can also be used to enable true partnership between the GP, consultant or practice nurse and the person with diabetes. In the absence of a cure for diabetes, the innovation Test bed will enable more people to better manage their diabetes, hopefully reducing the awful complications that go with the condition.”

“I want to die with my feet on!”

Mary Perkins, also from Bristol, developed gestational diabetes with her second child in 2002 and went on to be diagnosed with type 2 diabetes in 2009. She underwent bariatric surgery in 2011 and now maintains her blood sugars within normal limits.

Mary says: “I’m very excited about The Diabetes Digital Coach Test Bed. I have Type 2 diabetes and for me the major benefit of all of this will be the real time feedback. At the moment my diabetes is ‘managed’ by annual screening, which tells us the average control I have had of my blood sugars in the previous three months. It does not provide any feedback on how what I do now (such as eating those three biscuits in a staff meeting) impacts my blood sugar today, and therefore the problems I could be storing for myself further down the line. So, while my overall control can be good, daily insults could be taking their toll.

“Using these digital self-management devices to get early feedback and identify trends is exactly what us needed. I’m really keen to take part in this – I want to die with my feet on!”

Lars Sundstrom, Director of Enterprise at the West of England AHSN, comments: “I am really delighted that we have been chosen as a Test Bed site to pioneer the next generation of connected self-management tools for people to better manage long-term conditions and encourage more timely and appropriate interventions from peers, healthcare professionals, carers and social networks. This is great example of how the NHS and the Department of Health with Innovate UK are leading the way in co-developing the future with patients and leading technology providers for the benefit of all.”

Claire Gordon, South West Regional Manager for the charity Diabetes UK, adds: “This is a great project because it will provide patients with joined-up information, allowing them to take control of their diabetes and manage it more appropriately to live well with their diabetes.”

The test-bed is one of just seven which together will receive £17m from NHS England and the Department of Health. Successful innovations will be available for other parts of the country to adopt and adapt to the particular needs of their local populations.

NHS Chief Executive Simon Stevens said: “Our new NHS Test Beds programme aims to cut through the hype and test the practical benefits for patients when we bring together some of these most promising technologies in receptive environments inside the world’s largest public, integrated health service.”

Find out more

Anyone with diabetes living in the West of England (Bristol, Bath & North East Somerset, Gloucestershire, Wiltshire, Swindon and South Gloucestershire) who would like to find out more or get involved in the Diabetes Digital Coach programme in the coming months can get in touch with the team at enterprise@weahsn.net.

New Test Bed trial of self-management digital technology set to improve patient care in the West

Patients in the West of England will be among the first to benefit from a major new drive to modernise how the NHS delivers care, as announced today (Friday 22 January) by NHS Chief Executive Simon Stevens at the World Economic Forum in Davos.

The West of England AHSN will be leading the way in NHS innovation as part of a pioneering ‘Test Bed’ with partners including the regional healthcare community, Corsham Institute, Diabetes UK, Hewlett Packard Enterprise, Ki Performance, LeLan and SocialDiabetes, R-Outcomes, and HEOR.

As part of the ‘Diabetes Digital Coach’ Test Bed, people with diabetes and frontline health and care workers across the West (with a population size of 2.4 million) will pioneer and evaluate opportunities to work with the ‘Internet of Things’ through using remote monitoring and coaching technology for better self-management.

The programme, along with six others from around the country, will be unveiled by NHS Chief Executive Simon Stevens on Friday as part of the first wave of NHS Innovation Test Beds; collaborations between the NHS and innovators that aim to harness technology to address some of the most complex issues facing our population and the health service.

Successful innovations will then be available for other parts of the country to adopt and adapt to the particular needs of their local populations.

The Diabetes Digital Coach programme will bring together mobile health self-management tools (such as wearable sensors and supporting software) with the Internet of Things (IoT). The Test Bed will enable people with Type 1 or Type 2 diabetes to ‘do the right thing at the right time’ to self-manage their condition, and will encourage more timely and appropriate interventions from peers, healthcare professionals, carers and social networks.

This IoT Test Bed is part of an integrated £40 million, three-year Government programme in collaboration with Innovate UK that seeks to advance the UK’s global leadership in IoT and increase adoption of high quality IoT technologies and services throughout businesses and the public sector.

Co-developing the future with patients and leading technology providers

Lars Sundstrom, Director of Enterprise at the West of England AHSN, said: “I am really delighted that we have been chosen as an Internet of Things Test Bed site to pioneer the next generation of connected self-management tools for people to better manage long-term conditions. This is a great example of how the NHS and the Department for Health with Innovate UK are leading the way in co-developing the future with patients and leading technology providers for the benefit of all.”

Sandra Tweddell from Bristol has lived with Type 1 diabetes since 1961. She is coordinator of the Bristol Diabetes Support Network and has been involved in the design of the Diabetes Digital Coach programme.

Sandra says: “I am so excited by the news about Diabetes Digital Coach being announced as an NHS Test Bed. In the absence of a cure for diabetes, technology offers a way of giving immediate information about your diabetes control so you can manage it better and prevent or delay the complications that can go with the condition.

“Technology can be used to enable true partnership between the GP, consultant or practice nurse and the person with diabetes. Diabetes Digital Coach is a really exciting initiative as, if successful, it will enable more people to better manage their diabetes, hopefully reducing the awful complications that go with the condition.”

Providing patients with joined-up information

Claire Gordon, South West Regional Manager for the charity Diabetes UK, said: “This is a great project because it will provide patients with joined-up information, allowing them to take control of their diabetes and manage it more appropriately to live well with their diabetes.”

Jacqui Ferguson, Senior Vice President & General Manager for Enterprise Services UK & Ireland at Hewlett Packard Enterprise, said: “Digital innovation and collaboration are at the heart of how HPE brings value and as such we look forward to working with the West of England AHSN on the application of this Test Bed to achieve effective diabetes self-management.”

Expanding our range of options

Kizzy Harris, Diabetes and Nutrition Services Manager for Bristol Community Health, said: “I’m delighted with this announcement. Whilst our service currently offers a range of courses and videos for people living with diabetes, we need to expand our options to ensure that people in the community have improved support to self-manage at any point that they need it. The Test bed will assist us with this. It  will also further support the Diabetes Transformation Programme – a five-year programme of change by Bristol Clinical Commissioning Group (CCG), partner organisations and patients which aims to improve the outcomes for people with diabetes in Bristol.”

Inform and empower patients

Mary Hutton, Executive Sponsor of the Diabetes Digital Coach Test Bed and Accountable Officer at NHS Gloucestershire Clinical Commissioning Group (CCG) said: “This exciting technology offers the NHS an opportunity to test out innovative and new ways of working that will inform and empower patients to take control of their diabetes. NHS Gloucestershire CCG is pleased to be an active partner in this programme over the next few years.”

Consent driven applications

Richard Male at Corsham Institute, added: “The potential of digital technologies to transform the provision of healthcare, in particular, patient led care for chronic illness is significant. The Corsham Institute is delighted to be part of a talented consortium in testing and developing the Diabetes Digital Coach programme. By providing the NHS and our fellow partners with a trusted, secure and agnostic environment to house data and develop consent driven applications, we are delighted to be helping to create solutions and analytics that add significant value to patients, clinicians and researchers alike.”

Cutting through the hype

NHS Chief Executive Simon Stevens said: “Over the next decade major health gains won’t just come from a few ‘miracle cures’, but also from combining diverse breakthroughs in fields such as biosensors, medtech and drug discovery, mobile communications, and AI computing.

“Our new NHS Test Beds programme aims to cut through the hype and test the practical benefits for patients when we bring together some of these most promising technologies in receptive environments inside the world’s largest public, integrated health service.”

The Diabetes Digital Coach programme in the West of England will work with a number of SME partners, who have responded warmly to today’s Test Bed announcement:

Tommy Parker from Ki Performance said: “We’re delighted to be collaborating with such a fantastic team on this innovative project and very excited to demonstrate how the use of personalised physical activity in a free-living environment can improve diabetes management. KiActiv® will enable individuals to self-manage their condition more effectively and empower sustainable behaviour change through improved access, engagement, motivation and understanding.”

Dr Matthew Goodman from Mapmyhealth said: “We are deeply committed to improving diabetes care in the UK through the use of patient-facing technologies, in particular increasing the uptake of education to improve self-management. With the launch of the NHS Test Bed initiative, together we have an opportunity to make a significant and lasting impact on the care of patients with diabetes, leading to improved outcomes and lowered costs.”

Lucy Jones, a well-known TV dietitian and Head of Dietetics at Oviva, said: “Achieving the lifestyle changes needed to improve your diabetes or obesity can be really challenging for people and difficult to sustain. Using Oviva’s technology with my own patients I find it greatly improves the communication and support that can be given as and when they need it in their journey, whilst still managing to empower self-management as they track and capture their own dietary choices. Our goal is to improve patient’s outcomes and provide significant cost savings to the NHS, and this Test Bed is a fantastic opportunity to demonstrate this.”

Tom Dawson from Rescon said: “We are excited to be part of the extraordinary collaboration that the West of England AHSN has put together to deliver the Diabetes Digital Coach Test Bed.  Rescon leverages technologies developed for elite performance athletes, particle physics and cutting edge of social and healthcare research to deliver software and services to improve the physical, mental, emotional and social wellbeing of individuals.  Our Lincus platform will be a key component of the Diabetes Digital Coach offering.”

Adam Lester-George, Director at LeLan Solutions, commented: “We are delighted to be collaborating in this consortium of exceptional organisations with a view to developing new systems to tackle the diabetes epidemic. We are especially excited to demonstrate the fantastic technology provided by our partner, SocialDiabetes – this multiplatform self-management system has already been shown to radically improve the day-to-day lives of individuals with Type 1 and Type 2 diabetes. Winner of the 2012 UNESCO WSA award and with more than 100,000 downloads worldwide, SocialDiabetes is the number one app for diabetics in Spain and Latin America, and we believe that it will significantly contribute to creating a truly patient-centred platform in this NHS Test Bed.”

The Diabetes Digital Coach partnership

There are a number of partners involved in the Diabetes Digital Coach Internet of Things Test Bed, with the West of England ASHN as lead organisation.

The partnership also includes two charities, 10 companies, seven Clinical Commissioning Groups (CCGs), two acute providers, and three community providers.

NHS England Test Beds

A joint programme between NHS England, the Office for Life Science, the Department of Health and the Department for Culture, Media and Sport, NHS Test Beds bring together local health and social care bodies including CCGs, hospital trusts, primary and community care providers with a wide range of innovators from home and abroad.

Each Test Bed will use a different combination of innovations, from both large and small organisations, to address a locally-identified clinical challenge.  The changes made will be rigorously evaluated, with the aim to provide evidence which will give more areas the confidence to adopt the innovations over the coming years.

Test beds are a key strand of the NHS Five Year Forward View, and will help realise the ambition of reforming the NHS so that it is fit to face the challenges of the 21st Century – particularly an ageing population and an increase in patients with long-term health conditions – while remaining financially sustainable.

The NHS has a track record of being open to new ideas and technology – they’re being implemented all the time. Where progress has been slower is in combining innovations, in a whole-system way, so that their impact is bigger than the sum of their parts – the ‘test beds’ programme will change that.

Find out about all seven Test Beds.

Folium Optics wins £1 million funding to develop ‘My Health Tag’ technology

Bristol-based Folium Optics has been awarded £1 million funding in the latest SBRI Healthcare competition to develop ‘My Health Tags’, an innovative new product designed to improve medicines adherence.

A plastics display technology business set up by two former employees of Hewlett Packard Labs, Folium Optics has created the prototype in partnership with Pumpco and Designability. This significant funding award will enable the company to further develop their technology and carry out the first clinical evaluation.

The West of England AHSN has provided Folium Optics with valuable advice, particularly on how to work effectively with the healthcare sector and who they needed to be talking to. The collaboration with Pumpco and Designability, for example, was a direct result of them meeting at one of our networking events. We also supported them through the SBRI application process.

The problem

Up to half of prescribed medicines are not used as the prescriber intended. Non-adherence – or under-use – represents not only a missed opportunity for health improvement but also a danger to patient health and significant waste of resources. One recent study estimates medicines non-adherence costs the NHS more than £500 million per year.

The solution

To tackle this problem of non-adherence, Folium Optics has developed a ‘smart’ electronic tag which is attached to medical packaging, wirelessly linked to a remote cloud service and a separate portable reminder unit. The reusable, lightweight tags feature an ‘always-on’ display, showing clearly what medicine needs to be taken and when.

The tags still work if the medication is taken outside the home and can be easily configured by pharmacists, carers and users. The technology integrates well with people’s lifestyles, making it easier for them to manage their medication, and acts as a bridge to higher intervention solutions such as medicine compliance aids.

Folium Optics has initially targeted the 65 to 75 year old age group and is now developing the system for wider use.

“This is a great example of how companies in the high tech sector can bring in new skills and apply them to delivering effective solutions to health care problems.”

Steve Kitson, CEO of Folium Optics, said: “We are delighted to win the SBRI funding. It allows us to take the next step in developing our technology and ultimately to help more patients.

“We are grateful to the West of England AHSN for the support they have given us to date, particularly in helping us bring together such a strong team to deliver the project. Pumpco and Designability will help us deliver the technology, while the Bristol Heart Institute will lead the clinical evaluation. We’re really looking forward to working together to develop a solution that will help so many patients.”

Lars Sundstrom, Director of Enterprise at the West of England AHSN, added: “This is a great example of how companies in the high tech sector can bring in new skills and apply them to delivering effective solutions to health care problems.”

Current SBRI competition

The latest SBRI Healthcare competition is focusing on ‘Reducing Pressure on Urgent and Emergency Care’, and is being run in partnership with the South West and Greater Manchester AHSNs. Find out more here.

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