Challenge

A partnership of health and social care organisations working together, Our Dorset holds the ambition for its 750,000 residents to lead healthier, fulfilling lives supported by sustainable health and care services. But the organisation faces real challenges. Dorset’s population is ageing, bringing more long-term conditions, which places a growing demand on services. Its funding cannot keep pace with this growth in demand and without changing its services, in five years it would face an annual shortage of £229 million a year(1).

To address its ambitions and challenges, the Integrated Care System has identified a clear plan, in which digital plays an enabling role.  It established a ‘digitally-enabled Dorset programme’ to increase the use of technology in the health and care system, to support new approaches to service delivery.

Solution

The programme first researched and established the building blocks needed to establish public facing digital health.  Alongside videos and the NHS choices website, apps were identified as a key building block to enable patients to better manage their own health.

To understand more about if and how health professionals could recommend the use health apps and what would be needed to support them, a pilot was run with 20 nurses.  This revealed the team didn’t know where to find good health apps, how to know if they could trust them, if they met policy or who to ask for advice.

Without the expertise to establish a closed-loop quality assured programme, or capacity to be able to test health apps, let alone test them again when they are updated, the team recommended partnering with ORCHA.  They selected ORCHA as they had seen how it had delivered testing at a national level and for other regional providers.  With ORCHA, Our Dorset could build a programme to mitigate risk and assure clinical teams they are recommending safe apps.

ORCHA tested apps against 350 standards and measures and worked with Our Dorset to identify the best health apps across each priority health area. A dedicated app library was built to house the apps and enable patients and staff to search.  It was also agreed that if an app doesn’t appear in the library it will not be recommended by any member of staff.  If an app is ever nominated that isn’t in the library it will first be reviewed by ORCHA before being used by Our Dorset.

Our Dorset also opted to include a feature to enable staff to recommend apps via email or text message from the app library directly to residents and patients. This eliminated human error and enabled recommendations to be monitored.

Once ready, the team ran a series of 30 onboarding sessions across all ICS providers and governance leads, including all non-clinical teams, including link workers, health coaching and social prescribers.  Over one or two sessions, teams were briefed on the value proposition of health apps, walked through the system and key apps were demonstrated.  The health app programme also saw the emergence of a local Community of Practice which became a regular fixture on team meetings, prompting people to share learnings, tips and good practice including hearing about cohorts that are responding well to health apps.

Alongside training staff, the app library was launched to the public, forming part of its #HereForYou campaign which reassures Dorset residents that their health services are still available should they need them and that they should seek help and advice despite the Covid-19 pandemic.  This included PR, social and paid digital activities.

Results

Since introduction, the teams have actively embedded the app library and the practice of recommending health apps into their service offer. The teams drive home the concept of self-management and pick out effective tools that are available.

There have been almost 25,000 pages viewed on the site (up to the end of November 2020), and in one month alone, the app library achieved nearly 5,500 page views.  Social prescribers are actively recommending apps to service users and vitally, this advice is being acted upon, with almost 1,500 apps recommended to date and 56% of recommended apps downloaded, which is a very good engagement rate, especially compared with other services.

The most popular search terms include Mental Health MSK, Dementia, Diabetes and Cancer. Some of the most popular apps to be viewed are Wysa: Stress, Depression & Anxiety Therapy, Sleepio, NHS Weight Loss Plan and Musculoskeletal (MSK) Self Care, providing a range of health interventions and show that apps are being selected to improve the physical and mental health of the population.

One of the most active recommenders of health apps is George Mitchell, Social Prescriber, Live Well Dorset. One app from the library he finds useful is Quit Now, as he shares that “it gives people support 24×7.” He regularly shares app tips with other prescribers, as he says “Don’t assume that just because you know about an app, everyone else does.”

Commenting on the programme Crystal Dennis, Interim Lead for Public Facing Digital Health Services, Our Dorset Digital said:

“ORCHA power our health app library. They help us to break down the barriers and mitigate issues around digital health. Previously our clinical leads didn’t recommend digital health technologies as they had no idea where to look, were concerned about implied liability and couldn’t tell if a technology was of a good standard.  Thanks to ORCHA we are building the trust with clinical teams and have put in place the tools and governance they need.”

Source: (1) https://ourdorset.nhs.uk/wp-content/uploads/2018/07/Our_Dorset_STP.pdf

TSA will host the annual ITEC conference this month (March 22nd-25th), which is taking place virtually this year. Each day of the conference has a theme: strategic vision, social care, housing, health and care integration, with over 25 exhibitors having a virtual booth that allows them to host breakout rooms, deliver demo sessions, share content and 32 hours of conference content, which can be accessed for 90 days after the conference.

The conference will discuss proactive & preventative service models enabled by technology, showcasing learning from COVID around the role played by telecare services and solution suppliers, remote technologies, proactive intervention driven by risk profiling of users/patients or through real time data and trend analysis to provide early warning of changes in circumstances (monitoring frequency of bathrooms visits, use of appliances for hydration/eating, inactivity etc) and also a commission within Adult Social Care in England around the role of technology within a reformed social care model.

COVID has opened the eyes of many to the multiple applications of telehealth solutions to be able to deliver remote monitoring (and self-monitoring) of long term conditions, connectivity through video for families, GP consultation, outpatients visits and to also link to everyday solutions in the home to identify risk escalation ahead of crisis point and certainly a strong case for this to continue post-COVID.

ORCHA CEO, Liz Ashall-Payne, is joining the conference on the morning of Thursday 25th March. Liz will deliver a presentation on Supporting the Digital Patient before joining the main panel discussion to discuss the personalisation of health and care through proactive and preventative service delivery.

There are free passes available: bookings can be made via https://itecconf.org.uk/registration/ and using the code VITEC/ORCHA21 for a free pass. The aim is for people to come and go as they please and going back to content after the event, with good opportunities to network and learn more about what organisations are looking for from technology.