S131 - Day 1 - 1545 - Co-creating health apps in an Ehealth eco system

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

Thank You

Q & A

Web: www.sabp.nhs.uk

Twitter: @SABPNHS