1. Smartphone enabled albumin screening
Service proposal

2. January 2019
We will be able to routinely identify missed elements of pathways of care for individuals and ensure that those gaps are filled ”
NHS Long Term Plan

3. Shift to community setting
Healthy.io enables people to self-test in the comfort of their own home
Patient safety
Prevention
Long term conditions
Outpatient redesign
With 42m urine tests undertaken by the NHS, urinalysis is the second most common diagnostic test.
A&E demand reduction
Shift to community setting

4. Smartphone enabled screening
Healthy.io makes home albumin testing a clinical reality.
Early intervention
>1m people with undiagnosed Chronic Kidney Disease (CKD)
Reduce health inequalities
ACR testing is most often missed in at-risk populations
Digital self-management
Enable more people to take responsibility of own care
Significant population health savings
Cost savings of up to £461 per patient in previously untested patients

5. 50% Clear guidance, but low compliance 30% 10%
ACR tests reported in at-risk populations
50%
Clear guidance,
but low compliance
of people with diabetes
30%
NICE CG 182 and NICE QS05 define testing Albumin:Creatinine Ratio (ACR) in at-risk populations as critical from a clinical and cost point of view.
of people with hypertension
11 million people in UK are at risk of CKD
10%
of people with other risk factors
Source: 2017 CKD Audit

7. ‘Adherence as a service’: shifting testing from the clinic to the home
Fully integrated digital ACR testing pathway
GP practice just needs to provide a list of patients
Includes app sent by SMS message and testing kit
Interoperability and integration with EHR and clinical systems supporting HL7 & FHIR message types
Already integrated to SystmOne and emis
Onboarding, fulfilment and delivery services available

9. 72% 11% 89% Improved adherence to testing
Of consented patients completed the test
11%
Of patients with new albuminuria detected
Trialed across 10 Modality GP practices in Hull CCG and Airedale, Wharfedale & Craven CCG.
Patients who had no previous ACR measurement reported in the last 12 months were given an option to receive a home albumin test.
Test results were directly sent through SystmOne and reviewed by a clinician.
89%
Of patients avoided a visit or lab testing

10. “
We have been able to identify cases of early stage CKD which may otherwise have gone undetected. Patients find the kits easy to use and welcome the convenience of home testing.”
Dr. Ros Davies, Executive Partner, Hull Division

11. Reaching 30% of untested patients can yield £209m in cost savings over 5 years
Results over 5 years for UK population
(assuming 30% consent rate)
Using Healthy.io's ACR home testing
(previously untested population)
Savings per patient
£461
New CKD diagnosed
22,946
ESRD cases avoided
3,463
Deaths avoided
523
Total Costs Saved
£209,445,072
Yorkshire and Humber AHSN commissioned York Health Economics Consortium (YHEC) to develop an economic evaluation cost-effectiveness model comparing Healthy.io’s albumin-to-creatinine ratio (ACR) self-screening test against standard care (SC) for the detection of albuminuria in people with diabetes or hypertension in the English National Health Service (NHS). The model uses data from the Modality Evaluation undertaken in GP practices in Hull and Airedale, Wharfedale and Craven CCGs.

12. Total Net Savings Cost and Savings of albumin service per CCG COST
Avg. registered patients with DM (2018 National Diabetes Audit)
16,193
Avg. % uncompliant
34%
Avg. # people eligible for home testing
5,506
% receiving enrolled in service (based on Modality evaluation)
32%
# of people receiving home test
1,762
Cost per service delivery (incl. test, shipment and patient engagement)
£12
Total cost per CCG
£21,141
NET SAVINGS
Year 1
Total Net Savings
£26,427
Per Patient
£15
ROI
125%
Year 5
£812,179
£461
3,842%

13. Home based ACR testing solution for people with diabetes
Enables self-testing to support self-care
Improves access to preventative services 
Promotes compliance with NICE guidelines
Improves convenience and satisfaction for patients