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. 

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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

What are the impacts of NHS CCGs forcing disabled and LTC patients into care homes? (UK)

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/04/Thomas.jpg” thumb_width=”150″ /]Care for elderly and disabled goes off the tracks again. A report in the Health Service Journal (subscription required), covered in an opinion piece in the Guardian, indicates that thousands of patients who are disabled and also those who require long-term care may be forcibly put into care homes (US=nursing homes) rather than being treated and maintained in home care. According to the HSJ, “Freedom of Information (FOI) requests from campaign group Disability United found that 37 NHS clinical commissioning groups (CCGs) in England were introducing rules about ongoing care that could force up to 13,000 people with health conditions into care homes.” CCGs due to NHS cuts have been setting limits on financing home care, between 10 and 40 percent above the care home option. In other words, where a care home is cheaper, the CCG will withdraw payment for home care, and unless the individual can self-pay or has an advocate who can organize a care plan, that person may be involuntarily moved.

The word ‘institutionalization’ deservedly strikes fear on both sides of the Atlantic as a recipe for patient decline, physical and verbal abuse, theft and generally bad care. It’s a blunderbuss solution to ‘bed-blocking’ which we discussed here [TTA 7 Sep 16]–the care plan becomes ‘move ’em out’. By going this way in policy, NHS England is going counter-trend, against more personalized care delivered in home settings, and setting an unfortunate trend for other countries like the US.

Outside the scope of the article, but in this Editor’s thoughts, is the knock-on effect it will have on the UK’s developers and providers of telehealth and telecare services/TECS designed to support home care. Many of these technologies are in a transition period to the greater capabilities (and freedom from land line) of digital from analogue care, which was discussed in TTA here. Cutting domestic demand may not only be critical not only to companies’ survival, but also to their expansion in the (now far more open to the UK) US market. Readers’ thoughts?

Events dear boy, events…

Here is a selection of events you may wish to engage with that have crossed this editor’s PC recently:

Nominate someone for a Digital Pioneer Award – nominations close on 2 December.

DigitalHealth.London in collaboration with NHS England is hosting the Digital Pioneer Awards. They are seeking out within the NHS individuals at any rank and in any role, who are deserving of an award for any of:

  • Digital leadership
  • Digital Innovation, or
  • Sustainability through digital (which means that they have been instrumental in making sure a digital implementation has been sustained enough to a point of delivering benefit).

Med-e-Tel, the Luxembourg event,  has a call out for abstracts with a deadline of 4 December.

The NHS England Clinical Entrepreneur Programme have launched recruitment for their second year cohort. Applications for all doctors will close on 9 December 2016. This intake apparently “will have limited places” (don’t they all?). Interviews will be held in March 2017 and the programme will commence in autumn 2017.

The West Midlands Health Informatics Network (WIN) will be holding its third (free) annual digital healthcare conference on 24 January 2017 at the University of Warwick. The keynote and guest speakers are:

  • Professor Theodoros N. Arvanitis, Chair in eHealth Innovation and Head of Research at The Institute of Digital Healthcare
  • John Crawford, Healthcare Industry Leader, Europe, at IBM
  • Noel Gordon, Chairman of NHS Digital
  • Harpreet Sood, Senior Fellow to the CEO at NHS England
  • Jenny Wood, Director of Adult Social Care at Solihull Metropolitan Borough Council

The aims of the conference are to:

  • showcase innovation and research in digital health, care and wellbeing;
  • enable the sharing of good practice and experience from those working in this area; and
  • promote collaboration across various settings.

The day will consist of exhibitions, poster presentations, talks/panels delivered by stakeholders, and networking sessions. With the keynote/guest speakers they have lined up, this is set to be their highest profile event to date, therefore, they ask that people should register as soon as possible here.

The Royal Society of Medicine is holding its highly popular Recent developments in digital health conference on 28 February. Speakers this year include Ali Parsa, Dame Fiona Caldicott, Shafi Ahmed,  and Sir Mark Walport – it’s going to be another great event. Last year there were disappointed late bookers because it sold out, so worth getting in early by booking here, now!

Hat tip to Prof Mike Short for some of the events.

 

Three of the best – digital health events at the Royal Society of Medicine for 2016

The Royal Society of Medicine has two unbeatable benefits to offer conference attendees: virtually every world expert is keen to present there and, because it is a medical education charity, charges are heavily subsidised. As a result you get the most bang for your buck of any independent digital health event, anywhere!

And just now the offer is even more attractive as if you book for all three in the next 14 days (ie by 12th February) the RSM will give you a 10% discount on all three!

On February 25th, the RSM is holding their first 2016 conference: Recent developments in digital health. This is the fourth time they have run this popular event which aims to update attendees about particularly important new digital heath advances. For me the highlight will be Chris Elliott of Leman Micro who plans to demonstrate working smartphones that can measure all the key vital signs apart from weight without any peripheral – that includes systolic & diastolic blood pressure, as well as one-lead ECG, pulse, respiration rate and temperature. When these devices are widely available, they will dramatically affect health care delivery worldwide – particularly self-care – dramatically. See it first at the RSM!

I’d also highlight speakers such as Beverley Bryant, Director of Digital Technology NHS England, Mustafa Suleyman, Head of Applied Artificial Intelligence at Google DeepMind (who’ll hopefully tell us a bit about introducing deep learning in to Babylon), Prof Tony Young, National Clinical Director for Innovation, NHS England and Dr Ameet Bakhai, Royal Free London NHS Foundation Trust. It’s going to be a brilliant day!

Book here.

On April 7th the RSM is holding Medical apps: mainstreaming innovation, also in its fourth year. Last year the election caused last minute cancellations by both NICE & the MHRA, who are making up for that with two high-level presentations. Among a panoply of other excellent speakers, I’m personally looking forward especially to (more…)

Health Datapalooza 2015: more data, better health

Guest columnist and data analytics whiz Sarianne Gruber (@subtleimpact) sat in on the Health Data Consortium’s 2015 edition of Health Datapalooza last week in Washington, DC. It was all about the data that Medicare has been diligently harvesting. Also see the US-UK connection on obesity.

Health Datapalooza 2015, now in its sixth year, welcomed more than 2,000 innovators, healthcare industry executives, policymakers, venture capitalists, startups, developers, researchers, providers, consumers and patient advocates. Health Datapalooza brings together stakeholders to discuss how best to work the advance health and healthcare,” said Susan Dentzer, senior policy adviser to the Robert Wood Johnson Foundation and a member of the Health Data Consortium. The Consortium promotes health data best practices and information sharing; and works with businesses, entrepreneurs, and academia to help them understand how to use data to develop new products, services, apps and research insights. This year’s conference was held on May 31 through June 3 in Washington, DC. And how best to celebrate is with the gift of more data!

New Medicare Data Means More Transparency
The Centers of Medicare and Medicaid Services (CMS) released its third annual update to the Medicare hospital inpatient and outpatient charge data on June 1, 2013. (more…)

Healthcare Apps 2014 – a few impressions

This event was held on April 28th-30th in Victoria in London. It was organised by Pharma IQ and clearly had a strong pharma focus (including the charge which at £1995 for industry attendees clearly discriminated in favour of those with big-pharma sized budgets). It was also held just a few days after the significantly lower-priced Royal Society of Medicine event, and in the middle of a London Tube strike, all of which doubtless contributed to the relatively modest attendance (26 paid). I am most grateful to the organisers for kindly inviting me as one of speaker Alex Wyke’s guests.

As mentioned in an earlier post, there was a similarity with the RSM agenda, so I won’t repeat comments made by the same speaker before. The first up was the 3G Doctor, David Doherty, who gave another of his excellent presentations, although the sound engineer sadly made some of it inaudible. After a review of how we had got to where we are, he suggested that the Internet is about to become a device-dominated network. He drew a parallel between (more…)

NHS futures – more encouraging signs of change (UK)

Monitor has now released the output from the NHS Futures summit held on 21 November 2013, hosted by NHS England, Monitor and the NHS Trust Development Authority. The summit was designed to spark debate about how the landscape of health and care providers could evolve over the next decade to better meet the challenges outlined in the Call to Action. Over 100 senior health leaders took part including commissioners, providers (including GPs), health policy experts, and patient and charity representatives.

The summary Call to Action document makes encouraging reading for those who believe technology can help the NHS to improve patient outcomes at lower cost.  Contrary to the consultation exercise held by NHS England last August when we pointed out that remote consultation was not even mentioned, this features prominently in the Monitor summary (see especially Appendix 3, on pages 19-21), together with many other uses of technology such as smart homes, encouraging self-care, telemedicine, single patient record, interoperability, etc.

There are also some great videos – in particular (more…)