Situation
Since 2022, our work within Rochdale place has been primarily focused on direct to population activities supporting long term conditions, and mental health support across the primary care health system. The direct to population approaches have been delivered through a combination of E-comms via text batching from GP surgeries, and use of carefully curated ‘landing pages’ to target specific cohorts within Rochdale place.
Within the long-term condition focus, diabetes and diabetes prevention have been a specific target group for Rochdale place, given the prevalence of 8.8% within the local adult population against a national average of 7.3% (based on NHS Quality Outcome Framework 2021/22).
Solution
To cater to the needs of the population, we curated a collection of digital health apps designed to address various health and wellness requirements associated with diabetes. The apps underwent a thorough selection process with guidance from our clinical team, who pinpointed those most beneficial for empowering individuals to self-manage aspects of their condition.
After finalising the app selection, we generated text content with direct links to the chosen apps. Collaborating with Primary Care Networks throughout Rochdale, we subsequently distributed these texts directly to individuals identified as having diabetes.
Results
Over the period May 2023 to October 2023, utilising the text-batch campaign, we saw over 2,400 downloads achieved, equivalent to 400 apps per month. This equates to 11% of the targeted population. If this was extrapolated across a full-year effect (circa.4,800 Downloads), we would reach 23% of those adults identified in the prevalence data (circa 21,000 adults) who either have been diagnosed with diabetes or are at a pre-diabetic stage.
Of note, is the evidence-based impact and benefit of use of the range of Apps deployed during these campaigns for diabetic and pre-diabetic patients. Over a period of five months, the three most downloaded diabetes apps were identified. Among them, the Low Carb Programme, which has been proven to improve diabetes management. Studies have shown that the app helps reduce HBA1c levels to less than 6.5% across the research group. After using the Low Carb Programme for a year, the number of participants reporting an HBA1c level of less than 6.5% increased from 25.7% to 50.3%.
Links to Research
In research that ORCHA has previously conducted it was found that blood glucose levels amongst those with Type 2 Diabetes can be reduced by up to 1.1% when patients use digital health tools alongside their standard medication.
Patients with Type 1 Diabetes can reduce their blood sugar (HbA1c), on average, by 0.5%. In 21 out of the 25 trials, patients using digital health tools to supplement their care achieved better HbA1c results. In 20 out of the 25 trials, there were additional reported reductions in cholesterol levels, blood pressure and Body Mass Index. Amongst those with Type 2 Diabetes, the improvements in blood sugar levels were similar to the benefits patients receive when using Metformin, a commonly used medicine to lower blood sugar levels which is often the first line of treatment for the condition.
Although researchers expect a drop-out rate of 40% when patients trial digital tools, there were lower drop-out rates when the people with diabetes used them, at 20%. In the trials, the average duration of diabetes for those using digital health was 12.49 years and the average age was 52.
If you would like to read more information about this study, click the link: www.frontiersin.org/articles/10.3389/fcdhc.2022.936752/full
If you would like to visit the campaign page or browse our library of health apps please visit: ourrochdale.orchahealth.com/en-GB
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.
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.
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
A high proportion of people in the UK are living with overweight or obesity, increasing their risk of severe illness and death from COVID-19. Meanwhile, social distancing and self-isolation impact face-to-face weight management services.
The use of technology is a good answer to providing services, but how can we provide evidence-based care, combat misinformation and ensure a rapid roll out of technology that is safe, effective and does not put the public at risk of harm?
Our report, developed with The Association of UK Dietitians (BDA), outlines the situation and shares advice and best practice on how to embed digital health in weight management services.
Click on the PDF icon below to download the Digital in Weight Management Services Report. Discover:
If you are experiencing any issues with downloading the report, or want to know more, please get in touch with us at hello@orcha.co.uk or on +44 (0) 1925 606542
Dr Tom Micklewright discusses his views on three apps for managing diabetes that have scored well in ORCHA’s Review.
As there are 4.7 million people in the UK with diabetes, management of this condition now makes up 10% of the NHS budget.1 Health apps give patients tools to self-manage, reducing pressure on the NHS.
But how do you find the right ones? ORCHA has reviewed 229 diabetes apps, and 82% score below our quality threshold, indicating a market of low quality apps.
Today, Dr Tom Micklewright discusses his views on three apps for managing diabetes that have scored well in ORCHA’s Review.
In these videos, Dr Tom Micklewright looks at three top-scoring diabetes apps, giving his opinion on their features, benefits, and areas for improvement.
Dr Micklewright demonstrates the Intellin app, shares his views, and explores how the app simplifies the management of diabetes and identifies the risk of developing complications. Intellin gives personalised predictions on users’ highest risk areas and provides tips on how to prevent these complications.
Click below to watch the video:
Dr Micklewright next looks at the way in which the Diabetes Forum app provides a moderated peer-to-peer support network to people with diabetes (considered vulnerable under COVID-19). This includes elderly people, friends and caregivers. The app can be distributed through a mobile and web app:
For his insight into another top-scoring diabetes app, Dr Micklewright demonstrates how Liva UK provides personalised health coaching programmes to patients at risk of developing, or currently living with, chronic diseases such as Pre and Type 2 Diabetes:
