s131 - day 1 - 1545 - co-creating health apps in an ehealth eco system
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Health and Care Innovation Expo 2014, Pop-up University S131 - Day 1 - 1545 - Co-creating health apps in an Ehealth eco system Dr Helen Rostill Sarah Armani Alicia Ridout #Expo14NHSTRANSCRIPT
Co-Creating Health
Sarah Amani – Chief Clinical Information Officer (@S_Amani)
Aims • Why co-create?
• What is your vision and strategy for co-creating health?
• How will you get there?
• What are the challenges?
• Some resources
• Co-Creation in Action - Examples from SABP
Why?
Source: NHS England
Achieving Parity of Esteem: Transformative Ideas for Commissioners
Source: Know Your Own Health http://kyoh.org
Co-Creation • Emphasises that people are not passive recipients
• People as assets with expertise which can help improve services.
• Transformative way of thinking about power, resources, partnerships & risks and outcomes
• Not an off-the-shelf model of service provision or a single magic solution.
• ‘To act as partners, both users and providers must be empowered’.
• Involving citizens in collaborative relationships with more empowered frontline staff who are
able and confident to share power and accept user expertise.
Source: Co-production: an emerging evidence base for adult social care transformation,
SCIE 2013
Trends
1M Units 10M Units 100M Units 10Billion Units ? Units
What is your strategy?
Target: sweet spot where
person who uses services,
clinicians &
organisational processes
seamlessly align.
How do you get there?
• What is your experience?
Organisational Processes
Growing Need & Demand
Information &
Structured Education
Co-Creation of
Health &
Wellbeing
Emotional and
Psychological Support
HC
P C
omm
itted to
Partnership W
orking
Eng
aged
and
Act
ive
Per
son
Who
Use
s S
ervi
ces
Identify Need and
Map Resources
Positive Risk Taking
Skill and Attitude
Integrated and
Multi Disciplinary Team
Senior Buy-in and
Local Champions
Quality Assure and
Monitor
Personalised
Care
Benefits and Challenges
• What will your co-creation strategy enable you to do?
• What are your challenges?
• What has worked/what could work to overcome the
above challenges?
Source: NESTA: People Powered Health www.nesta.org.uk
• Reductions in unplanned admissions and the requirements for expensive,
acute care.
• Potential savings of at least £4.4 billion a year
• These savings are based on the most reliable evidence and represent a 7 per
cent reduction in terms of reduced A&E attendance, planned and unplanned
admissions, and outpatient admissions.
Resources:
Source: NHS Employers: NHS Social Media Toolkit
Engaging People Where They Are.
Want Innovation? Embrace Change.
Source: Powered by Coffee www.poweredbycoffee.co.uk
Source: Powered by Coffee www.poweredbycoffee.co.uk
25
Self-help & peer support
Self-management and remote triage
Remote care support
Face-to-face care
VCS Statutory Care
Against a traditional clinical perspective
Level 0 Level 1 Level 2 Level 3 Level 4
General access to information Sign-posting to offline services
Health administration – reminders, appointments, prescriptions
Remote service support to assess and diagnose symptoms and conditions
Advanced remote service support to provide care support and treatment
Multichannel care services leveraging a digital core for optimal access and data sharing
Thriving Coping Managing Difficulties Struggling Complex needs
Along a trajectory of evolving digital capability
Along a care trajectory marking the transition between statutory
and VCS and the shift from self-service to highly skilled face-
to-face support
Crisis
Problems Ideas
Quaterley ThinkTech! Events
There is an app for that!
NodOff Surrey and Borders Partnership NHS Foundation
Trust Metka Shawe-Taylor
Charlie Beeson, James Pearson and George Wooding
NodOff is aimed at NHS patients with both depression and insomnia.
It has two purposes:
- recording answers to a sleep diary questionnaire and sending a
summary of the results to clinicians via a secure website
- playing a choice of relaxing sleep tones to aid with falling asleep.
USP: Motivational, inspirational and attention grabbing design due
to our very specific target audience.
1. Infrastructure Overview The project will be divided into four parts:
- Questions
- Graphing
- Server and Website
- MP3 Tone Player
The questions program will ask the user a series of 12 questions, with the answers being
sorted in a comma separated .txt file for the graphing program to read. On completion of
the questionnaire the user will be rewarded with a ‘congratulations’ page with a funny or
motivational cartoon, image or quote.
The graphing program will analyse the .txt file after the first 2 weeks and then every 4
weeks after that, each time outputting 3 .png graph files. The .txt file will store the answers
of each question (with a time stamp) indefinitely, accumulating data over time. The graphs
will always present as much data as possible. After two weeks, and then every four, (on
the occasions when the graphs are updated) the user will also be presented with three
personally selected tips to help them improve their sleep habits.
The most recent three graphs and personalised tips will be presented to our users’
clinicians on a secured website via a UCL server. It must also be noted that the information
will only be stored on the UCL server whilst we are trialling the app. When the app is used
by real-world patients the information can then only be accessed by those with
authorisation.
Three recorded tones; ‘walking on sand’, ‘wind chimes’ and ‘waves crashing onto the
beach’ will be made available to users via an MP3 player to aid with falling asleep. Our
users will be able to choose for how long they want their choice of tone to repeat.
3. Project Expansion
Operating System -Initially we will release for Android phones, but after we plan to release it for Windows
phones.
Movement Measurement - The App will be developed further to gather data from a wristband worn by the patient (or
directly from the phone’s accelerometer) to record the patient’s movement and therefore
depth of sleep throughout the night. This data can be directly compared with questionnaire
answers to better identify sleep problems that can be addressed.
Statistical Analysis of Questionnaire Data - There is huge scope to increase the detail and depth of analysis on the current
questionnaire’s data, for either the patient or the clinician’s use.
New Markets - e.g. any user wishing to improve their sleep quality, or patients taking part in trials for sleep
medication.
Use of Analytics - The app will be able to record analytics that will be of use to the developers of the app.
E.g. how often the sleep tones are used, how long the reward screens are kept open, how
long it takes different questions to be answered, and how long the whole questionnaire
takes to complete will help us improve the usability of the app.
2. Scientific Background The three personalised tips are formulated from questions answered on Sleep Hygiene. The
three graphs are produced from questions answered on Sleep Quality:
Sleep Quality: A term used to describe a combination of factors that suggest successful
sleeping habits. For example; a patients tiredness/alertness on waking and throughout the
day, ease of waking up, number of awakenings experienced through the night, and how
easy it was to fall asleep.
Sleep Hygiene: Practices we have direct control over that are conducive to sleeping well. Of
most importance is the consistency and regularity of our sleep routine. Other factors include
caffeine intake, exercise, consumption of nicotine or alcohol, maintaining a calming bedtime
environment and reducing stress.
.txt file
sends .png graphs
to web server
saves to reads from
Our Logo:
Health Passport: Proof of Concept
Exploring the potential of wearables
UCL & SABP Health Apps Collaborative
Denise Souter (Community Learning Disabilities Nurse)
& UCL Computer Science Students
Surrey Telehealth Pilot
Reaching Out to Under Represented Groups
Reach Out Project: www.itsgoodtochat.com