From Challenge to Opportunity through Digital Innovation Presentation 1 Andy Shakeshaft, Associate Director, Innovation Agency @ShakeshaftAndy

The Innovation Agency 15 Academic Health Science Networks across England Licensed and funded by NHS England Promoting innovation in healthcare Networked structure to improve outcomes regionally and nationally Creating wealth 4.1m inhabitants, total health and social care funding in the North West Coast of England is £7 billion (8.8 billion EUR). Our Aims and Objectives To spread innovation at pace and scale across NHS To promote and integrate the strengths of higher education, the NHS, industry, third sector To improve health of individuals and communities Bring investment to North West Coast Create jobs for local people

Using portable technology to detect and prevent strokes Nationally, it is estimated that nearly 1.4 million people in the UK are affected by arterial fibrillation (AF), and a quarter of these people are unaware that they have AF. AHSN Network AF community has been formed, which aims to prevent an additional 4,500 strokes over the next five years. 1.4 million affected by atrial fibrillation (AF), quarter of these people are unaware that they have AF. AF causes an irregular or abnormally fast heart rate- increases risk of stroke by up to five times, with about 12,500 strokes per year directly attributed to AF. Recognising and receiving proper treatment is important because these strokes more severe, with survival rate of 50% per cent and a risk of increased disability among survivors. AHSN Network AF community formed, aims to prevent 4,500 strokes over the next five years. The charity sector is a key partner in this, as they work closely with residents who suffer from AF. Programmes of work- GP collaboration- 50 practices- Don’t wait to anti-coagulate programme. Public Campaigns/events- with charities, providers, health watch, SCN-raising awareness/ clinical buy in NWC commissioning toolkit & Pathway- toolkit for treatment of AF & clinical pathway for high risk AF patients NWC dashboard- a range of data sources that supports CCGs to have an overview of AF outcomes in their region New medical tech- introduction of genotype guided dosing to establish the right does of whafarin- 1st in UK Mobile technology- more than 35 different digital technologies to support the identification of AF

Results (12 Months) Nationally: 365 undiagnosed patients detected across 11 AHSNs Equates to £8.5m savings to the NHS and social care North West Coast Region MyDiagnostick and Kardia 2000 pulses tested 60 abnormal pulses detected, reducing the likelihood of stroke Saving £24,000 per person (potential saving £1 million pa) Results- read national and local Devices MyDiagnostick -stick-shaped, hand-held ECG recorder -detects AF using a clincal algorithm metallic handles at both ends -held for one minute as indicators flash at the rhythm of the heartbeat. green indicator -no AF was detected, red warning the detection of an episode of AF. stores 100 high-quality ECG's retrieved through an USB connection by healthcare professionals Kardia Mobile ECG same prinvipoels to detect AF fits to the back of most moble devices, it communicates wirelessly meaning health professionals and consumers can track heart health instantly.

Managing Dysphagia: Teleswallowing Swallowing difficulties (dysphagia) precipitates a range of conditions Effects include Poor rehabilitation Hospital admittance Longer hospital stays Reduced quality of life Teleswallowing allows immediate, remote video assessment and treatment Used by Speech and Language Therapists Efficient clinical tool adopted in Blackpool Teaching Hospitals NHS FT Swallowing difficulties (dysphagia) may precipitate aspiration pneumonia, malnutrition, poor rehabilitation, hospital admittance, increased hospital stay and reduced quality of life. Dysphagia, prevalent among the elderly, particularly following a stroke and in end stage dementia, is common among care home residents. Teleswallowing is an innovative use of telemedicine. Speech and Language Therapists can rapidly and accurately assess a care home resident’s ability to swallow remotely, via video, and has proved a highly efficient clinical tool in Blackpool Teaching Hospitals NHS FT

Teleswallowing Results 100% diagnostic accuracy for diet and fluid modification compared to bedside assessment Annual cost efficiency 79.5% reduction in cost per patient compared to home visits 66% reduction in time taken assessing each patient compared to home visits 50% reduction in time taken assessing each patient compared to hospital bedside assessment Improved response time to referrals Quality service for patients and care homes

Sources of Further Information AHSN Atlas of Solutions in healthcare. Using portable technology to detect and prevent strokes. Available at: http://atlas.ahsnnetwork.com/using-portable-technology-to-detect- and-prevent-strokes-2/ Bert Vaes, Silke Stalpaert, K aren Tavernier, Britt Thaels, Daphne Lapeire, Wilfried Mullens and Jan Degryse. The diagnostic accuracy of the MyDiagnostick to detect atrial fibrillation in primary care. Available at: http://www.biomedcentral.com/1471-2296/15/11 Dr Elizabeth Boaden. Service Evaluation Report. prepared for Blackpool Teaching Hospitals NHS Foundation Trust Speech and Language Therapy Department. Available at: http://www.innovationagencyexchange.org.uk/projects/teleswallowing-managing-dysphagia