WannaCry’s anniversary: have we learned our malware and cybersecurity lessons?

Hard to believe that WannaCry, and the damage this malware wreaked worldwide, was but a year ago. Two months later, there was Petya/NotPetya. We’ve had hacking and ransomware eruptions regularly, the latest being the slo-mo malware devised by the Orangeworm hackers. What WannaCry and Petya/NotPetya had in common, besides cyberdamage, was they were developed by state actors or hackers with state support (North Korea and–suspected–Russia and/or Ukraine).

The NHS managed to evade Petya, which was fortunate as they were still repairing damage from WannaCry, which initially was reported to affect 20 percent of NHS England trusts. The final count was 34 percent of trusts–at least 80 out of 236 hospital trusts in England, as well as 603 primary care practices and affiliates. 

Has the NHS learned its lesson, or is it still vulnerable? A National Audit Office report concluded in late October that the Department of Health and the NHS were warned at least a year in advance of the risk.  “It was a relatively unsophisticated attack and could have been prevented by the NHS following basic IT security best practice.” There was no mechanism in place for ensuring migration of Windows XP systems and old software, requested by April 2015, actually happened. Another basic–firewalls facing the internet–weren’t actively managed. Worse, there was no test or rehearsal for a cyberdisruption. “As the NHS had not rehearsed for a national cyber attack it was not immediately clear who should lead the response and there were problems with communications.” NHS Digital was especially sluggish in response, receiving first reports around noon but not issuing an alert till 5pm. It was fortunate that WannaCry had a kill switch, and it was found as quickly as it was by a British security specialist with the handle Malware Tech. 

Tests run since WannaCry have proven uneven at best. While there has been reported improvement, even head of IT audit and security services at West Midlands Ambulance Service NHS Trust and a penetration tester for NHS trusts, said that they were “still finding some real shockers out there still.” NHS Digital deputy CEO Rob Shaw told a Public Accounts Committee (PAC) in February that 200 NHS trusts tested against cyber security standards had failed. MPs criticized the NHS and the Department of Health for not implementing 22 recommendations laid out by NHS England’s CIO, Will Smart. Digital Health News

Think ‘cyber-resilience’. It’s not a matter of ‘if’, but ‘when’. Healthcare organizations are never going to fix all the legacy systems that run their world. Medical devices and IoT add-ons will continue to run on outdated or never-updated platforms. Passwords are shared, initial passwords not changed in EHRs. Add to firewalls, prevention measures, emphasizing compliance and best practices, security cyber-resilience–more than a recovery plan, planning to keep operations running with warm backups ready to go, contingency plans, a way to make quick decisions on the main functions that keep the business going. Are healthcare organizations–and the NHS–capable of thinking and acting this way? WannaBet? CSO, Healthcare IT News. Hat tip to Joseph Tomaino of Grassi Healthcare Advisors via LinkedIn.

Health tech for stroke prevention and rehab from Kardia Mobile, Watch BP, Northwestern U (UK/US)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2018/02/Northwestern-stroke-patch.jpg” thumb_width=”150″ /]Is stroke avoidable? We know it is an expensive medical event at $20-23,000 for hospitalization alone (NIH), which does not count rehabilitation or the devastation to individuals and their families, including loss of ability and work. NHS England is testing two devices, the Kardia Mobile and Watch BP, with an eye to preventing stroke in those vulnerable to it. 6,000 devices are being distributed to GP practices in England in a program through 15 NHS and care innovation bodies known as Academic Health Science Networks (AHSNs). The Alivecor‘s Kardia Mobile is a smartphone add-on clip that captures a medical-grade ECG in 30 seconds, stores, and sends readings to physicians. The application to stroke is primarily in atrial fibrillation (AF) and irregular heart rhythms, which according to statistics, more than 420,000 people across England have. Watch BP is a blood pressure cuff device which is also equipped with an AF detection system. The goal of the project is to identify 130,000 new cases of AF over two years, to prevent at least 3,650 strokes and potentially save 900 lives. Savings to NHS are being estimated at £81 million annually. Digital Health News

Post-stroke rehabilitation treatment is also being boosted by a new device developed at Northwestern University and being tested at the Shirley Ryan AbilityLab, a Chicago research hospital. It is a Band-Aid® like device which can be applied to key areas such as the throat (left above, credit AbilityLab), chest, or limbs to send back information to doctors on how a patient in treatment post-discharge, especially at home, progresses. The sensors and platform measure heart activity, muscle movement, sleep quality, swallowing ability, and patterns of speech. Especially revolutionary is the monitoring of speech communication and swallowing, which are often impaired in stroke patients but hard to track once the patient is out of a facility. The team’s research was presented last week at the American Association for the Advancement of Science (AAAS) annual meeting. New Atlas. Hat tip to Toni Bunting.

Telehealth alternatives to in-person consultation found lacking in effectiveness: Alt-Con Study (UK)

It needs work and can’t be top down. That’s the conclusion of the Alt-Con Project and its researchers from several UK universities: Warwick, Bristol, Oxford (Nuffield) and Edinburgh. After examining the use of technological alternatives to GP consultations in eight general practices, they found that there were significant barriers to implementation, including insufficient training of non-clinical staff on these approaches’ benefits. The study includes recommendations to guide a more effective implementation.

Practices have been slow to adopt tech alternatives to F2F consults using telephone, email, e-consultation systems, and online video, despite NHS encouragement and programs such as the GP Access Fund. The paradox is that time devoted to non-F2F consults cuts into GPs time seeing live patients in the office.

  • They were adopted without a clear rationale or clearly thinking through cost-benefit for patients and practice staff.
  • Professor Sue Ziebland from Nuffield found that “…practices introduced alternative consultation methods for very different reasons and to solve problems that the practice had identified. These included a failure to be modern, to work more efficiently, to better serve commuters or dispersed populations, and to ensure appointments were available to those who needed them most.”
  • Other reasons: “the acknowledgment that the previous system was broken and unethical in providing a first-come, first-served system that left patients without appointments that they needed, and “the recognition that reception staff and phone lines were overwhelmed.”
  • Noted by other researchers were that ‘one-size-fits-all’, policy and financial incentive driven approaches were “not the best way forward”.

The study looked at GP practices of different sizes (1,938 to 18,353) covering over 85,000 patients, located in different geographic areas of England (6) and Scotland (2) including urban and rural areas, and with a mixture of patients’ socioeconomic status. 45 staff members and 39 patients were interviewed over eight months.

The University of Bristol Centre for Academic Primary Care has published a web page based on the Alt-Con research, offering guidance for GP practices. 

NHS England’s rejoinder: ‘This is a tiny study based on data that is almost two years old. Online consultations offer a convenient alternative to face-to-face appointments and patients are already seeing the benefits.’ Nuffield Department of Primary Care release, British Journal of General Practice, Daily Mail  Hat tip to former TTA Ireland editor Toni Bunting

Get happier, lose weight, be fitter–the efficacy of apps debated in studies present and future pilots

Do they really work to change behavior? Studies for the past seven or so years have debated efficacy; a quick search online will show you a wealth of articles with findings on both sides. We know healthcare-related (consumer behavior and professional apps) are growing like weeds after rain– over 320,000 mobile, wearable, and IoT health apps were available for use in 2017, with 200 added daily (Research2Guidance, IQVIA estimates). But qualitatively, the jury is out.

Three studies published in the last two months come somewhere in the middle.

Obesity and weight loss: A telemedicine-based 12 week study from California State University found that the combination of a secure mobile phone-based platform for data tracking and video conferencing with the research team, plus meeting with the medical doctor once per month, and weekly with a registered dietitian worked to clinical standards, ≥5% of initial body weight loss over six months, for 69 percent of the telemedicine participants (n=13) versus 8 percent in the control group (n=12). Note the substantial hands-on human support each of the 13 participants received. Journal of Telemedicine and Telecare, Clinical Innovation & Technology

Activity monitoring not effective unless users set goals: A 400-person study performed by researchers from the Oregon Health & Science University (OHSU) School of Medicine and their Knight Cardiovascular Institute found that when people used such monitors and apps without a specific goal in mind, their physical activity declined and their heart health did not improve, even if 57 percent thought it did. The subjects, primarily office workers at one site, wore a Basis Peak band for about five months. To gauge heart health, the researchers also tracked multiple indicators of cardiac risk: body mass index, cholesterol, blood pressure and HbA1C. Cardiac risk factors did not change. However, the corresponding author, Luke Burchill MD PhD, told EurekAlert (AAAS) that when paired with specific goals, the trackers could be powerful tools for increasing physical activity. The original study published in the British Journal of Sports Medicine doesn’t go quite that far. 

But it’s great for your morale, especially if you pay for it: A Brigham Young University study published in JMIR MHealth and UHealth (August) confirmed that physical activity app usage in the past 6 months resulted in a change in respondents attitudes, beliefs, perceptions, and motivation. This study’s purpose was to track engagement factors such as likeability, ease of engagement, push prompts, and surprisingly, price–that higher-priced apps had greater potential for behavior change. Possible reasons were that the apps provide additional features or have higher quality programming and functionality. (And user investment?)

One growing area for apps is mental health, where the metrics are solidly behavioral and the condition is chronic. The UK’s National Institute for Health and Care Excellence (NICE) has moved forward in favor of piloting them with NHS England. The latest is one from Germany, Deprexis, that uses texts, emails, questionnaires, and cognitive behavioral therapy to give feedback to users. It also has tools to relax users through audio and visual programs. NICE recommends therapist guidance for the trial. According to Digital Health News, NICE is recommending it should be trialed for up to two years in at least two of the specialist services that were set up to improve access to psychological therapies. Again, cost is a factor in rolling out but others are access to care and freeing up therapist time. The organization also plans to review up to 14 digital programs to treat anxiety and depression over the next three years.

Hat tip to Toni Bunting for much of the above

For further reference: The 2017 R2G mHealth App Developer Economics 2017 study has been released and is available for free download here. The 2017 study surveyed 2,400 mHealth developers and practitioners. (Disclosure: TTA was a media sponsor for the study.)

Robots, robots, everywhere…even when they’re NHS 111 online algorithms

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/01/Overrun-by-Robots1-183×108.jpg” thumb_width=”150″ /]The NHS continues to grope its way towards technology adoption, gets slammed–but is it justified? The Daily Telegraph (paywalled–see The Sun) revealed a draft December NHS report that recommended that the NHS 111 urgent non-emergency care line’s “enquiries will be handled by robots within two years.” Moreover, “The evaluation by NHS England says smartphones could become “the primary method of accessing health services,” with almost 16 million inquiries dealt with by algorithms, rather than over the telephone, by 2020.” (That is one-third of demand, with one-quarter by 2019.)

Let’s unpack these reported statements.

  • An algorithm is not a ‘robot’. This is a robot.[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/06/robottoy-1.jpg” thumb_width=”100″ /]
  • What is so surprising about using algorithmically based questions for quick screening? Zipnosis in the US has been using this method for years as a pre-screener in major health systems. They call it an ‘online adaptive interview’ guiding the patient through branching logic of relevant questions; a provider can review the provided clinical note and make a diagnosis and treatment recommendation in 2 minutes. It also captures significant data before moving to an in-person or telemedicine visit if needed. Babylon Health uses a similar methodology in its chatbot-AI assisted service [TTA 26 Apr 17].
  • Smartphones as a primary means of accessing health services? How is this surprising when the Office of National Statistics says that 73 percent of adults use the internet from their mobiles? 51 percent go online for health information.
  • Based on the above, 66 percent would still be using telephonic 111 services.

It seems like when the NHS tries to move forward technologically, it’s criticized heavily, which is hardly an incentive. Over New Year’s, NHS 111 had a 20 percent unanswered call rate on its busiest day when the flu epidemic raged (Sun). Would an online 111 be more effective? Based on the four-location six-month test, for those under 35, absolutely. Yes, older people are far less likely to use it, as undoubtedly (but unreported) the disabled, sight-impaired, the internet-less, and those who don’t communicate in English well–but the NHS estimates that the majority of 111 users would still use the phone. This also assumes that the online site doesn’t crash with demand, and that the algorithms are constructed well.

Not that the present service has been long-term satisfactory. David Doherty at mHealth Insight/3G Doctor takes a 4G scalpel to its performance and offers up some alternatives, starting with scrapping 111.

Babylon Health’s ‘GP at hand’ not at hand for NHS England–yet. When will technology be? Is Carillion’s collapse a spanner in the works?

NHS England won’t be rolling out the Babylon Health ‘GP at hand’ service anytime soon, despite some success in their London test with five GP practices [TTA 12 Jan]. Digital Health cites an October study by Hammersmith and Fulham CCG (Fulham being one of the test practices) that to this Editor expresses both excitement at an innovative approach but with the same easy-to-see drawback:

The GP at Hand service model represents an innovative approach to general practice that poses a number of challenges to existing NHS policy and legislation. The approach to patient registration – where a potentially large volume of patients are encouraged to register at a physical site that could be a significant distance from both their home and work address, arguably represents a distortion of the original intentions of the Choice of GP policy. (Page 12)

There are also concerns about complex needs plus other special needs patients (inequality of service), controlled drug policy, and the capacity of Babylon Health to expand the service. Since the October report, a Babylon spokesperson told Digital Health that “Commissioners have comprehensively signed off our roll-out plan and we look forward to working with them to expand GP at Hand across the country.” 

Re capitation, why ‘GP at hand’ use is tied into a mandatory change of GP practices has left this Editor puzzled. In the US, telemedicine visits, especially the ‘I’ve got the flu and can’t move’ type or to specialists (dermatology) are often (not always) separate from whomever your primary care physician is. Yes, centralizing the records winds up being mostly in the hands of US patients unless the PCP is copied or it is part of a payer/corporate health program, but this may be the only way that virtual visits can be rolled out in any volume. In the UK, is there a workaround where the patient’s electronic record can be accessed by a separate telemedicine doctor?

Another tech head-shaker: 45 percent of GPs want technology-enabled remote working. 48 percent expressed that flexible working and working from home would enable doctors to provide more personalized care. Allowing remote working to support out-of-hours care could not only free up time for thousands of patient appointments but also level out doctor capacity disparities between regions. The survey here of 100 GPs was conducted by a cloud-communications provider, Sesui. Digital Health. This is a special need that isn’t present in the US except in closed systems like the VA, which is finally addressing the problem. The wide use of clinical connectivity apps enables US doctors to split time from hospital to multiple practices–so much so on multiple devices, that app security is a concern. 

Another head-shaker. 48 percent of missed NHS hospital appointments are due to letter-related problems, such as the letter arriving too late (17 percent), not being received (17 percent) or being lost (8 percent). 68 percent prefer to manage their appointments online or via smartphone. This preference has real financial impact as the NHS estimates that 8 million appointments were missed in 2016-2017, at a cost of £1bn. Now this survey of 2,000 adults was sponsored by Healthcare Communications, a provider to 100 NHS trusts with patient communications technology, so there’s a dog in the hunt. However, they developed for Barnsley Hospital NHS Foundation Trust a digital letter technology that is claimed to reduce outpatient postal letters by 40 percent. Considering my dentist sends me three emails plus separate text messages before my twice-yearly exam…. Release (PDF).

Roy Lilley’s daily newsletter today also engages the Tech Question and the “IT desert” present in much of the daily life of the NHS. Trusts are addressing it, junior doctors are WhatsApping, and generally, clinicians are hot-wiring the system in order to get anything done. It is much like the US about five to seven years ago where US HHS had huge HIPAA concerns (more…)

Babylon Health: correcting our NW London CCG report; objects to concerns raised by CQC report (latest updates)

Correcting and commenting on our earlier report. This Editor had earlier published on 11 Dec, as follow up to the extensive coverage on Babylon Health’s ‘GP at hand’ pilot activity in London, summarizing a report in Digital Health stating that the North West London Collaboration of Clinical Commissioning Groups (CCG) ended plans for expanding a test of the Babylon video consult/symptom checker app for GP practices in that area and that the app could be ‘manipulated’ to secure GP appointments faster and would not reduce demands on GPs. The original article was first corrected at an NHS England‘s representative’s request to reinforce that this was a local CCG project and that NHS England was not involved. The second request we received last Friday was from Babylon Health’s PR representative, Giles Kenningham, principal at Trafalgar Strategy. It was certainly strong and quoted here, edited as indicated to remove the link to the original article and Mr. Kenningham’s signature:

Your recent article on Babylon is factually wrong and misleading (link removed):
You claim the babylon app was dropped after being manipulated by patients. The term ‘manipualtion’ has been removed from the board papers and is wrong. Similarly the planned pilot had never begun so there so nothing to roll out.
This story is based on incorrect board papers which have now been corrected.

Please find a spokesman quote below. (closing signature removed)

A spokesperson for Babylon said:

“No pilot was ever carried out, nor any agreement signed with Babylon for such a pilot.

“Discussions were held after Babylon was selected in a competitive procurement exercise as the best technology to trial in GP practices across North West London. Subsequently, a decision was taken not to fund the pilot.”

This Editor then checked on the Digital Health article and found it had been removed without any follow-up or correction. Thus on Friday 8 Dec, this Editor removed the article, thanked Mr. Kenningham for bringing it to attention, and added that our report cited Digital Health as the source. I also requested a reference or third-party confirmation of his corrections. (This last request was not received as of the time of this writing.)

Wanting to get to the bottom of this for our Readers–and as a marketer who’s corrected more than a few inaccurate reports, your Editor has located the CCG’s report which is here published 22 November. It corresponds with Mr. Kenningham’s full note. The CCG report appears to have been revised (the URL indicates a v3), there never was a Babylon pilot, this version does not use the word ‘manipulation’, and the end result was that the CCG decided not to proceed to the pilot stage. In short, it appears to this Editor that the Digital Health report was based on an earlier and incorrect version of the report (perhaps as early as 25 Oct) and we are of course happy to correct. My fault and apology to our Readers and to Babylon in that I should have located the 22 Nov revised report prior to publishing the article and essentially provided a correction to Digital Health‘s report.

However, the CCG’s report on their Babylon evaluation contains two findings that were included in Digital Health‘s now-deleted article and give some pause. The CCG used focus groups of potential users, which surfaced that, in the CCG’s words, “The focus groups had also commented that there is a risk of some people gaming the symptom checker to achieve a GP appointment. The insights gathered therefore revealed that the symptom checker in particular was unlikely to reduce demand for GP services.”

Our Editor Chrys has pointed out the Pulse article which also comments on this and was corrected for the CCG’s revised report. The comments here by practicing GPs are worth reading. Scroll down and you’ll see that  ‘gaming the system’ has happened using direct triage in practices using personal phone consults–no app required. Can this even work?

Focus groups are highly subjective, but they are great ways of surfacing the flaws that developers and companies have gone blind to.

We hope that Babylon Health does take this feedback seriously. This Editor makes no secret of her advocacy of technology that can speed the obtaining of care, but based on her experience with early-stage companies, every critique, every hole that can be kicked in a service, delivery, and logistics, exposing a weakness should be appreciated–and ruthlessly scrutinized for flaws that need solutions. This becomes harder to do when you’ve achieved Big Funding. Babylon is typically burning a hole through it (The Times, 1 Oct–hat tip to Chrys). The pressure on now to find The Road to Breakeven must be stunning.

Important updates: Speaking of finding solutions, Babylon differs strongly with the findings of the Care Quality Commission (CQC)(not to be confused with the CCG), in the CQC report on their service published on Friday 8 December. 

(more…)

NHS, Public Health England testing multiple digital health devices for obesity, diabetes

NHS England, Public Health England, and Diabetes UK launched a pilot, announced on World Diabetes Day on 14 November, to test various digital health approaches to controlling obesity and Type 2 diabetes. Approximately 5,000 patients will be recruited for a test period of up to one year. Multiple apps, gadgets, wristbands, and other digital devices to measure their results against goals will be tested,  combined with health coaching and online support groups. NHS is also offering to some wearable devices which record activity levels and receive motivational messages and prompts. 

The test will use products and services from five companies and the patients will be recruited from eight areas of the country. The companies, programs, and tools are:

  • Hitachi – Smart Digital Diabetes Prevention program combines an online portal + coaching
  • Buddi Nujjer – a wristband which monitors the user’s activity, sleep patterns and eating frequency, paired with a smartphone application
  • Liva Healthcare – 12 months of a dedicated coach starting with a personal face-to-face meeting. The Liva platform and patient app supports the patient with smart goal setting and plans, lifestyle tracking, video communication, and online peer to peer support.
  • Oviva – An eight-week intensive lifestyle intervention with an experienced dietitian providing personalized advice and support.
  • OurPath – A six-week mobile and desktop digital program with structured education on healthy eating, sleep, exercise and stress management.

The pilot builds on Healthier You: The NHS Diabetes Prevention Programme, launched last year to support people who are at high risk of developing Type 2 diabetes. This adds digital tools to a coaching-intensive, educational, and activity-oriented program. Public Health England also has the Active 10 app, which encourages at least 10 minutes of daily brisk walking. NHS press release, Digital Health

How *does* the NHS get funded and work? The King’s Fund pulls it together for you.

Confused on how a CCG (clinical commissioning group) is funded? Mystified about the relationship between local authorities and the NHS? Updated last month, The King’s Fund’s handy organograms (US=org chart) explain the formal organization of the NHS, how it is funded by Parliament, and the relationships between entities. The slides are downloadable. There are also two six-minute videos that tackle how NHS and NHS England work. See this page also for links to content on local service design, governance, and regulation, plus NHS finances. How is the NHS structured?

Tender Alert: advance notice for NHS England ACS-STP Innovation Framework

Susanne Woodman, our Eye on Tenders, has located another NHS England prior information notice for healthcare technology services. This is for Sustainability and Transformation Partnerships (STPs) and Accountable Care Systems (ACS) for building services around population needs, improving outcomes and quality of care. NHS is seeking “a ‘one stop shop’ framework and contracting vehicle to allow STP and ACS partners to more easily source a range of transformation support.” A description is under VI.3) Additional information. Interested suppliers must register via the NHS Bravo portal at https://nhsengland.bravosolution.co.uk/web/login.html–Bravo will be used to issue further information to interested suppliers. Estimated date of publication of contract notice is 8 December. Tenders Electronic Daily-TED.

Tender Alert: advance notice for NHS England/Leeds online consultation system

Susanne Woodman, our Eye on Tenders, has offered Readers a ‘heads up’ on a future tender for NHS England in Leeds. This is for the establishment of a national dynamic purchasing system (DPS) for the procurement of online consultation systems. According to the listing on Tenders Electronic Daily–TED, the DPS will allow NHS contracting bodies (e.g. CCGs and GPs) to procure online consultation systems in a robust and compliant way on a regional/local basis. “Online consultation is also increasingly a key part of patient pathways in urgent care, and the 111 Online programme seeks to connect patients to urgent care settings following a digital triage….to bring together a seamless experience for patients bridging primary and urgent care needs.”

This initial expression of interest is to gather information on the opportunity and to give interested parties the opportunity to ask clarification questions about the process. Deadline is 19 November for this information gathering exercise. Download any associated documentation via the In-Tend e-procurement system via the following link: https://in-tendhost.co.uk/scwcsu/aspx/Home. This may be part of an eventual investment of £45 million towards the purchase of online consultation systems.

The King’s Fund: ‘Sharing health and care records’ Leeds 13 Dec

Wed 13 December, 9.00am-4.30pm
Horizon Leeds, Kendall Street, Leeds 

The King’s Fund is hosting a December conference in Leeds on the digital sharing of health and care records. Delivering the key benefits of coordinated care requires three things: the appropriate technology, the right governance structure and a culture of adoption. Attendees will learn more at this full-day event about:

  • The direction of national programmes on interoperability and data sharing across and between local areas
  • Case studies from around England where teams have developed ways to share health and care records locally
  • The challenges involved in implementing data sharing across and between local areas and learn how others have overcome them

Keynote speakers include Will Smart (CIO, NHS England), Prof. Maureen Baker (Chair, Professional Record Standards Body), Andy Kinnear (Director of Digital Transformation, NHS South, Central and West Commissioning Support Unit and Chair, BCS Health), Nicola Quinn (Project Manager, Health Informatics Unit, Royal College of Physicians), and Jan Hoogewerf (Programme Manager, Health Informatics Unit, Royal College of Physicians).

For complete information, agenda, and to register, click on the sidebar advert or here. TTA is pleased to be a long-time supporter of The King’s Fund and a supporter of this event. Hat tip to Claire Taylor of The King’s Fund–if you are interested in supporting this conference, contact her here.

Tender Alert: NHS England–IAPT, Arden & GEM, Yorkshire and The Humber

Susanne Woodman, our Eye on Tenders, has three that cover a major initiative of NHS England, plus two regional telecare projects.

  • NHS England–IAPT (Improving Access to Psychological Therapies). NHS Shared Business Services is procuring ‘Digital Therapies for IAPT Assessment: Project Management Organisation’. The aim of the programme is to find good quality, evidence-based digital therapy packages for use in IAPT services. Up to 14 digital therapy products will be assessed for IAPT by 2020. This will help expand provision of psychological therapies, as well as improving access to digital services, both goals set out in the Five Year Forward View for Mental Health. Clarification questions are due by Wednesday 13 September at 10am. Bid deadline is Monday 18 September at noon. More information and contact here on Gov.UK Contracts Finder. Additional programme information on NICE and IAPT here.
  • Arden & Greater East Midlands: Bravo reference Project 851 is an Innovation and Technology Tariff. There are three parts (2-4): the closest related to health tech is #4, web-based applications for the self-management of COPD. Deadline is 2 October 2017 at 5pm. More information and application links on the Arden-GEM website here.
  • Yorkshire and The Humber: Kirklees Council is seeking a provider of assistive technology and telecare solutions aimed at supporting vulnerable people to live safely and independently in their own home. This also includes support for existing and future social care applications, lone workers, and building security. Value of the contract is £210,000. Deadline is 2 October 2017. There’s not a lot of information on the Gov.UK page and it directs questions to the Kirklees coordinator.

The King’s Fund Digital Health & Care Congress coming up next week (London)

11-12 July, The King’s Fund, London W1G 0AN

Make your plans, if you have not already, to attend The King’s Fund’s annual Digital Health meeting in London. NHS England’s “Next steps on the five year forward view” outlines the plan to harness technology and innovation over the next two years. But what’s really happening on the ground? Tuesday features seven breakout sessions, a drinks reception, and speakers ranging from Rob Shaw, Interim Chief Executive, NHS Digital to Sarah Thew, Innovation and User Experience Manager, Greater Manchester Academic Health Science Network. Day 2 on Wednesday features an interactive panel discussion on NHS Test Beds, which are evaluating the real-world impact of new technologies, a breakfast workshop on integrating technology with care in Greater Bristol and eight more breakouts that cover everything from interoperability to self-care and patient engagement. The content is wide-ranging, fresh, and different. There’s also plenty of opportunities to network and also to see new technologies in the exhibition area. For more information and to register, click on the sidebar advert at right or here. #kfdigital17, @TheKingsFund  TTA is pleased to be for another year a marketing supporter of the Digital Health conference.

CHANGED DEADLINE Calling all diabetes prevention apps: may be your chance for greatness!

Our Mobile Health is seeking to identify the best digital behaviour change interventions aimed at helping people diagnosed as pre-diabetic to reduce their risk of onset of Type 2 Diabetes. They are working with NHS England and the Diabetes Prevention Programme to identify the best 4-5 of these that are suitable for deployment to around a total of 5000 people across England. The aim is to build up an evidence base for digital behaviour change interventions for people diagnosed as pre-diabetic.

Organisations with suitable digital behaviour change interventions are invited to submit their solutions for inclusion. These should be either actually deployed or will be ready to be deployed within three months. They should be suitable to be, or have been, localised for the UK market, and they should not be dependent on any further integration with the UK health system for deployment.  Shortlisted digital behaviour change interventions will be invited to participate in Our Mobile Health’s assessment process; the final selection will be made based on the results of that assessment.

The deadline for submissions, which can be made directly online is midday on Wednesday 15th March.  NOTE THIS IS A CHANGE FROM THAT PREVIOUSLY ADVISED. There is more about the programme on the NHS website.

(Disclosure: this editor has been asked to assist with the assessment process referred to above)

What is the future of digital technology in NHS England for the haves and have-nots?

This thoughtful essay published on The King’s Fund blog by David Maguire discusses the uncertain way forward for digitizing health within NHS England as part of the sustainability and transformation plan (STP). There’s a certain lack of vision and support from the top; there is £4.2 billion in funding over the next five years from the Department of Health, but priorities including ‘Paperless by 2020’ are unclear. There needs to be a ‘clear and definitive plan’, but at the same time, local innovation shouldn’t be stifled. Local areas vary widely in capability and resources. As Mr Maguire points out, some are still using Windows XP and others are well advanced in data analytics; some are more willing to take risks and have a “collective vision”. In a funding-constrained environment, local areas may find themselves scraping up, pooling resources to create the systems they need, and sharing that knowledge. Seizing opportunities for digital development in the NHS Hat tip to Susanne Woodman.

A reminder that the Digital Health and Care Congress is on 11-12 July. Preview video and the event page; the Digital Health Congress fact sheet includes information on sponsoring or exhibiting. To make the event more accessible, there are new reduced rates for groups and students, plus bursary spots available for patients and carers. TTA is again a media partner of the Digital Health Congress 2017. Updates on Twitter @kfdigital17