2012 Software and Telehealth
Winner and Finalists
The winner of the Software and Telehealth category supported by Medilink was Dr Philip Holland, a Paediatric Diabetes Consultant at Leeds Teaching Hospitals NHS Trust who together with colleagues from the University of Leeds, My Knowledge Map Ltd and children with Type 1 diabetes and their parents has developed ‘Upbete’ - an Online support tool for children with diabetes and their families.
Features of the system include:
- Self-management: The Blood Glucose Tracker engenders effective management from an early age with a motivating game-like aspect.
- Community knowledge-sharing: The online service encourages effective community support.
- Learning: Providing information and educational resources on diabetes care.
- Public outreach: Dispelling fears and misconceptions about diabetes.
Over 1,000 visitors have been received in six months, with 200 people registering for accounts. Feedback is extremely positive with enquiries received from patients and clinicians outside Leeds.
The impact of Upbete has been that:
- An online community has been formed, supporting and advising families.
- The understanding of diabetes has increased, as has the confidence and well-being of the families: “This has helped to normalise diabetes. This now feels like a family, I’ve got a support network.”In six months the percentage of children with good HbA1c has increased from 16% to 24% with poor control dropping from 30% to 12%. Whilst this cannot be linked directly to Upbete, it is likely that the website has contributed to this improvement.
To find out more, please visit www.upbete.co.uk.
Other finalists in the Software and Telehealth Category were Claire Rowland of Leeds Community Healthcare NHS Trust, Dianne Tetley of Lincolnshire Partnership NHS Foundation Trust, Dr. Christopher Hammond of Leeds Teaching Hospitals NHS Trust and Dr. Martin Wildman of Sheffield Teaching Hosptials NHS Foundation Trust.
Claire Rowland is a highly Specialist Speech and Language Therapist at Leeds Community Healthcare NHS Trust who has developed a computer-based clinical tool for people who stammer.
Adults who stammer develop frequently report anxiety. The tool was developed to enable exploration of speech-associated anxiety and encourage increased therapeutic autonomy. We collaborated with a patient to understand why he experienced increased anxiety and stammering in different speaking situations and how therapy targets would address this.
The client identifies and rates the variables which come together to construct a speaking situation, such as audience size, familiarity of surroundings, formality etc. An Excel spreadsheet converts the data into a radar chart - a visual representation of the client’s experience.
Using the chart, the client and therapist see and understand how the different situations compare, assumptions are prevented and the therapy process develops from the client’s perspective.
The impact of the tool has been:
- Supporting clients in understanding their anxiety can help them to take control.
- Patients understand therapy targets and become increasingly independent in setting these, decreasing reliance on NHS resources.
- The tool has been presented at an international level with specialists interested in using the tool clinically or for research purposes.
- An on-line recording system to increase accessibility for clients is under discussion. The tool could also be developed for client groups in relation to anxiety.
Dianne Tetley is the Assistant Director Research and Effectiveness at Lincolnshire Partnership NHS Foundation Trust and has developed the OO-Tracker, an innovative, secure, web-based automatic feedback and data management system that supports the practical application of an Outcomes-Orientated Approach to the delivery of Mental Health Services (OO-AMHS).
This approach incorporates a whole-service model built upon a sound evidence base, using two scales - the Outcome (ORS) and Session (SRS) Rating Scales - to chart therapeutic outcome and the relationship between clinician and service user.
OO-Tracker will interpret ORS and SRS scores automatically and chart progress graphically. Clinicians can then provide ‘real-time’ feedback to service users. Data will be aggregated into reports, enabling therapeutic outcomes to be monitored in different ways. An app will be developed to allow data entry via mobile devices, reducing inputting time.
The impact of using the OO-Tracker is:
- Increased recovery rates
- Identification of those with no signs of improvement
- Reduction in long-term use of services
- Avoidance of early drop-out from treatment
- Improved therapeutic efficiency
OO-Tracker will accelerate wider take-up of an outcomes-oriented approach to delivery of mental health services and an OO-CAMHS toolkit has been published to support implementation locally and nationally. NICE has recognised our approach as an example of Quality and Productivity in Health and Social Care (QIPP) and the NSPCC is rolling out our approach nationally.
Dr Christopher Hammond is a Consultant Vascular Radiologist at Leeds Teaching Hospitals NHS Trust who is developing an Electronic decision support tool for patients undergoing vascular radiological procedures.
Patient preparation for invasive procedures is informed by multiple guidelines. If patients arrive for treatment inadequately prepared, this leads to risk, cancellations, inconvenience and inefficiency.
As pre-assessment is performed by junior staff, this is not surprising. The diversity of referral sources and turnover of junior staff presents a major obstacle to the resolution of these issues.
Audits in our unit have identified same-day cancellation rates of 50 patients per year, with inconvenience for the patient and wasted resources for the Trust. Arrangements made to avoid cancellation are inefficient and can also result in patient harm from inappropriate treatment.
This project will develop a web-based decision support tool founded on evidenced-based best practice to construct individualised workup and care plans. The plan will also be electronically available to aid remote decision-making. The tool will minimise poor patient preparation, resulting in increased safety and efficiency.
The predicted impact of the decision support tool will be:
- Junior staff have clear, patient-specific instructions that will increase patient safety.
- Reduction in cancellation rates will result in cost savings to the Trust and make more time available for procedures.
- The tool could be adapted for any invasive surgical or non-surgical procedure.
Dr Martin Wildman is a Consultant in Respiratory Medicine and Cystic Fibrosis at Sheffield Teaching Hospitals NHS Foundation Trust who has developed a software system to aid treatment of Cystic Fibrosis patients.