Medipex Innovation Awards and Showcase 2018

Medipex was delighted to receive a large number of high quality entries into this year’s Innovation Awards and Showcase. The finalists in each of the five categories are:

Medical Devices & Diagnostics

Emego - Barnsley Hospital NHS Foundation Trust

The Emego is a small, battery powered, user worn device that uses novel sensor technology to detect muscle activity. For those who have severe disabilities this provides a control method for communication aids, computers and environmental control.

By accurately detecting even the smallest signal from a user’s muscle movements using electromyography technology, the user is able to interact with their environment. Attaching the small and light body-worn patient unit to any muscle enables the user to control accessibility software simply by twitching their working muscle group. The Emego provides independence and participation that would otherwise be lost to these individuals.

  • Intended for people with severe neurological disorders such as those who have motor neurone disease (MND) or acute brain injuries
  • Class I medical device
  • User centred design ensures reliability and ease of use

Launched in 2018, now available via www.emego.co.uk

Non-invasive diagnostic test for adrenal insufficiency - Sheffield Children’s NHS Foundation

Adrenal insufficiency describes inadequate production of the stress hormone, cortisol, which is associated with significant mortality and morbidity. Adrenal insufficiency is usually permanent but may be transient, especially in babies and children, requiring periodic diagnostic testing.

The Short Synacthen Test (SST) is the first line diagnostic test worldwide but requires intravenous cannulation and blood sampling, making it invasive, resource-intensive and unpleasant for the patient.

We have developed a non-invasive version of this test. A novel formulation of Synacthen mixed with a nasal drug enhancer is administered nasally, via a spray, and the resultant cortisol response is measured using saliva samples.

  • Novel test validated in five pharmacokinetic studies in adults and children
  • Improves patient care and reduces resource & cost required to perform the test
  • Further regulatory pivotal trials planned
  • Commercialisation plans in place

Bladder Shape Test (BlaST) - Sheffield Teaching Hospitals NHS Foundation Trust

Overactive bladder syndrome is associated with involuntary bladder contractions, is characterised by urgency incontinence and affects approximately 20% of adults worldwide.

BlaST is a new diagnostic which enables the detection and quantification of bladder contractions by measuring shape changes via abdominal ultrasound.

  • Proof of concept studies completed on 20 asymptomatic volunteers & 52 patients. Bladder shape was characterised during filling using ultrasound, leading to refined techniques, protocols and algorithms
  • BlaST avoids the need for urodynamics (the current standard tests) which use invasive pressure measurements, recorded through bladder and rectal catheters
  • BlaST opens up options for the use of a simple portable ultrasound scan probe, providing less-invasive, more widely available, acceptable and affordable investigation of incontinence

Self-Management

National Paediatric Diabetes Quality Improvement Initiative - Sheffield Children’s NHS Foundation Trust

Children with diabetes in the UK have suboptimal outcomes compared to other developed countries such as Germany and Sweden. Through analysis of mean HBA1c data, we recognised a particular problem with poor control in the first year after diagnosis and identified the need to drive change.

We have devised and implemented a number of initiatives to improve self-management of children and young people’s insulin dependent diabetes. The aim is to improve both short and long term glycaemic control and hence positively influence their quality of life, morbidity and mortality.

Interventions include:

  • Introduction of carbohydrate counting from diagnosis
  • Bespoke education packages
  • Introduction of Expert Meters to allow home testing and remote data management with clinical team members able to offer advice on blood glucose readings remotely

Initial data suggests a reduction of HBA1c at 6 months post diagnosis of diabetes by 0.5-0.6%. An improvement of this magnitude would reduce later diabetic retinopathy and nephropathy by 40% with huge cost savings to the NHS

A Structured Health Intervention for Truckers - University Hospitals of Leicester NHS Trust

SHIFT is a group-based, theory-driven self-management programme, developed in conjunction with a transport company, designed to promote healthy lifestyle behaviours surrounding physical activity and diet.

Lorry drivers comprise a large, ageing workforce with a high prevalence of risk factors for chronic disease. Observational data showed 84% of lorry drivers were overweight/obese, 87% were physically inactive, 35% were hypertensive and 31% had borderline/abnormal scores for anxiety. Overweight and obesity-related illness cost the NHS £6.1billion in 2014-5.

A pilot study demonstrated a reduction in cholesterol, waist measurement, risk of cardiovascular disease and blood glucose levels and an increase physical activity amongst participants in SHIFT.

  • Grounded within the Social Cognitive Theory for behaviour change, SHIFT consists of a group-based 6-hour tailored education session
  • The programme includes activities, behaviour change techniques, physical activity monitoring, workplace challenges and a ‘cab workout’
  • SHIFT is now under further evaluation in a large randomised controlled trial with the aim of generating evidence to support its inclusion in the compulsory Continued Professional Competence training undertaken by lorry drivers

Service Improvement – Primary Care

BBV_TestPrompt - South Tees Hospitals NHS Foundation Trust

A significant proportion of individuals with HIV and other blood-borne virus (BBV) infections in the UK are undiagnosed. These patients usually present late with AIDS or cirrhosis/liver failure leading to higher morbidity, mortality and healthcare costs.

50% of the UK population has a blood test every year for some reason. Medical data on electronic patient records can potentially identify individuals at higher risk of undiagnosed BBV infections. Intelligent algorithms which can identify and prompt BBV testing of patients at higher risk could reduce late diagnosis.

  •  “BBV_TestPrompt” is a comprehensive electronic patient record clinical decision support system
  • The software links to SystmOne and is able to risk-stratify patients in real-time
  • In patients where a higher risk of infection is identified, and no recent BBV tests done, a prompt is activated suggesting the clinician orders BBV tests alongside the routine blood test
  • A pilot evaluation to demonstrate impact is underway

Innovative software to support the complete management of prevention programmes - Health Diagnostics Ltd

Health Diagnostics create digital tools for assessing risk of heart disease, stroke, CKD and dementia. Our digital tools have facilitated the delivery of around 200,000 health checks, each of which has enabled patients to understand their risk of heart disease and how they can improve their quality/quantity of life.

Health Diagnostics have worked alongside numerous local authority public health departments and CCGs across the country to support the delivery and administration of the NHS Health Check Programme. Through collaborations with universities, the generation of a robust evidence base for cardiovascular prevention programmes has been spear-headed. The solution is used by GPs, community outreach teams and NHS Trusts. It is at an advanced stage of development and is already helping to generate many positive outcomes for those using it.

  • Use of tool helped increase the uptake of NHS Health Checks from 41.3% (below the national average of 48%), to an uptake of 64.9% (above that national average) in an early trial

Quadrant model - Sloan Medical Centre

Primary care aims to support people living with long term conditions, such as diabetes, to achieve better health outcomes and experiences at a reduced cost.

Current evidence suggests that the most effective way to achieve this is when the wider determinants of health (such as loneliness, inactivity, or poor diet) are addressed alongside traditional health care targets.

This service redesign introduces a simple, easily implemented model that assesses a person’s capability to look after themselves as well as traditional markers of disease. It creates a framework for efficient resource distribution, tailored to individual need, making the most of approaches and providers that focus on wider determinants of health.

  • Results after 18 months using the model show an encouraging shift towards more activated patients with better disease control
  • Staff and patient experience and satisfaction is enhanced
  • Resource is targeted to the patients who need it most 50% reduction in practice nurse appointments

Service Improvement – Secondary Care

NHS Natural Health School - Harrogate and District NHS Foundation Trust

Complementary therapies provide an important part of the multi professional support offered to cancer patients and their families at the Sir Robert Ogden Macmillan Centre. We identified a national shortage of complementary therapists skilled, experienced and competent in the delivery of safe high quality evidence based care and able to meet the needs of these complex patients.

NHS Natural Health School is a unique competency based programme, combining mandatory training components and 100 hours of clinically supervised practice in healthcare settings.

  • NHS Certificate in Complementary Therapies enables practitioners to be competent, safe and confident to practice within NHS healthcare settings in accordance with recognised Care Quality Commission and professional standards
  • Generating income for reinvestment into sustaining & expanding the existing service Implementation data demonstrates an average improvement of over 50% in physical and emotional symptoms. It has also proven direct cost savings in medication prescriptions, interventions and sick time off work

LMSU! (LetMeShowYou) - Leeds Community Healthcare NHS Trust

Transitions from children’s services into the adult care system is very challenging and high risk for the young people and their families. For those with complex, significant needs, the risks can translate into poorer outcomes and quality of life. Parents describe this as the point at which they ‘fall off a cliff’.

The advent of Education Health and Care Plans (EHCP) and increasing use of smart technology to support young people presents an opportunity to bridge the gap with a person centred, co-designed digital solution for the young people, their families, Personal Assistants and practitioners across health, care and education.

  • LMSU is an app where the young person can invite practitioners to join their network and contribute effectively to delivery of the EHCP goals
  • Personal Assistants & family can access training materials
  • Cost savings (£2.5k per person per year) based on fewer transition team meetings and more efficient communications, reduced length of planned admissions

AMOS – Artificial Member of Staff - Calderdale and Huddersfield NHS Foundation Trust

AMOS is an ‘artificial member of staff’ within the pharmacy department.  It is software based and its role is to perform the complex task of processing High Cost Drug (HCD) data each month (accurately and consistently) to meet the needs of commissioners.

AMOS is virtually autonomous and can be operated by members of staff without specialist pharmacy training or financial knowledge. This manual automated software process is in the advanced stages of deployment to release the workplace pressures which can occur when clinical staff need to spend time on non-clinical activities.

  • Releases two members of staff from needing to assist the pharmacist
  • Greatly reduced the time to process HCD data from an average of 20 days to within 1 day
  • Improved data quality

Mental Health & Wellbeing

Criteria Led Discharge Tracker for Acute Mental Health Wards - Bradford District Care NHS Foundation Trust

A new approach was developed, designed and implemented to facilitate focussed multi-disciplinary discussions to address known barriers to discharge at the point of admission. This promotes a safe, effective, appropriate discharge with improved efficiency.

The Criteria Led Discharge (CLD) system is on a SharePoint platform and tracks live progress to support any escalation of issues that contribute to a longer length of stay in hospital than is required.  The tracker records specialist observation requirements and the care clusters of patients including a live view of available beds.

The CLD enables a qualitative approach and consistency of method to support non-medical barriers to discharge such as specialist housing, benefits or physical health concerns.

  • CLD tracker has contributed to 60% reduction in length of stay on acute mental health wards over 9 months
  • Includes patient-specific and ward-specific views
  • Live bed tracker

Clinician’s Dashboard - NAViGO Health and Social Care CIC

The Clinician’s Dashboard is an innovative, very low cost tool to assist community mental health clinicians with caseloads. It improves patient safety by preventing the most vulnerable service users ‘falling through the gaps’; improves efficiency and can save lives.

The project combines national data on suicide/premature mortality risk factors (from the National Confidential Inquiry into Suicide and Homicide) with locally collected data on service users’ circumstances. The Clinicians Dashboard displays patient information in order of those at highest risk, flagging up wherever a contact is overdue and making it easier for clinical staff to identify patients at risk of self-harm or suicide. By including physical health information, the project encourages collaboration between providers.

  • Physical health checks increased from 39% to 79%
  • Follow-up of ‘Did Not Attend’ events was reduced from 49 days to 4
  • Increased monthly time to care from 6500 hours to 8000 hours
  • 24 days between each attended contact reduced to 12
  • Serious incidents action plan profile changed to exclude people being seen regularly

StepUp! - Leeds Community Healthcare NHS Trust

StepUp! is a digital service which allows young people to engage proactively with CAMHS to assess needs, set goals and develop strategies for self-help.

Currently at the trial stage, StepUp! has the potential to transform services, improving access and outcomes for young people and giving clinicians additional support options to utilise.

As demand for CAMHS services continues to outstrip resources, it is vital to find new ways of supporting traditional delivery methods. StepUp! presents a significant opportunity to improve organisational efficiency and can be utilised by young people beyond the end of their treatment pathway.

  • When the StepUp! app is installed, an introduction, preliminary resources, strategies and self-help material can be pushed by the clinician or selected by the user prior to the first appointment
  • Focuses on early intervention/prevention, integration of services and promotes smoother transitions
  • Testing is showing the potential to increase access and deliver evidence-based interventions at scale, which can help address resource constraints

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