ISCF HDRUK DIH Sprint Exemplar: Using a digital transformation approach to drive improved clinical outcomes for patient with heart failure

Lead Research Organisation: Cent Manchester Uni Hospital NHS FdTrust

Abstract

Devolution allows us to use the delegated control of our health and social care budget to improve outcomes for our 2.8 million citizens. This, combined with a large cluster of life sciences and digital organisations, strong universities, increasing digital maturity and established city-region leadership makes GM an important place to collaborate with industry to develop and evaluate new products and services.
Cardiovascular disease is a major health priority in GM, with higher mortality and morbidity rates than the UK average. 25,000 people have diagnosed heart failure - just under 1% of our population. During 2015/16 there were 4330 admissions in GM with a primary diagnosis of heart failure, costing over £17,000,000. There is emerging evidence that many of these admissions may be avoided or modified to deliver benefits to patients and to the economy.
Our exemplar sprint will generate better insights about patients’ health by using data from implantable devices already used to treat patients, to feed a new digitally-enabled platform which will detect earlier signs of deterioration. We will use these insights through a new service to prevent hospital admissions, and conduct analyses to detect other patients who are at risk and will potentially benefit from this approach.

Technical Summary

Around 2,500 patients in GM with heart failure have implantable devices (pacemakers or defibrillators) which already transmit data onto a cloud platform (including thoracic impedance, arrhythmia burden, percentage of pacing, diurnal heart rate variability and patient activity).
Our industry, academic and NHS partners will use an existing algorithm to detect early deterioration in these patients from the data flows. These insights will drive in near real time into a new operating model for treating heart failure at home. The sprint aims to demonstrate improved outcomes for patients and the health economy, by preventing hospital admissions. We will use the data to demonstrate the efficacy of the intervention, and run machine learning algorithms to improve prediction.
We will use real world evidence and artificial intelligence (AI) to look for missed opportunities for implantable devices (for both therapeutic and diagnostic purposes) and accelerate the deployment of devices to a wider population suitable for these treatments.
Our sprint will deliver a reproducible model for digital transformation to support the life sciences (LS) product lifecycle management processes. City region commissioning in GM (which acts under delegated financial control) is a key partner in our consortium, giving opportunities for rapid scale-up of detected benefits to population and industry benefit.
 
Description Exemplar for digital transformation
Geographic Reach National 
Policy Influence Type Influenced training of practitioners or researchers
 
Description Ongoing discussion with AHSN network on scaling up innovation
Geographic Reach National 
Policy Influence Type Participation in a national consultation
Impact The approach is under consideration for support from the AHSN network for national scaling
 
Title Development of new data set on heart failure 
Description IoT heart failure data plus routinely collected healthcare data 
Type Of Material Database/Collection of data 
Year Produced 2020 
Provided To Others? No  
Impact The dataset will be made available through the HDRUK gateway 
 
Description Industry partner for digital transformation in heart failure 
Organisation Medtronic
Country United States 
Sector Private 
PI Contribution Through Health Innovation Manchester we have driven the GM-Medtronic partnership through methods, both digital transformation and business model innovation
Collaborator Contribution Medtronic is a global healthcare solutions company committed to improving the lives of people through medical technologies, services, and solutions with 84,000 employees across 160 countries. Medtronic works with new partners in new ways, and there is strong strategic alignment in delivering patient-focussed integrated technology solutions that improve patient experience and decrease healthcare utilisation whilst still improving outcomes. Medtronic has existing relationships with all the acute trusts in GM, and especially with Manchester Foundation Trust, and is leading on the engagement with the Trusts to manage the roll-out of the pathway.
Impact We have worked with Medtronic to refine the digital transformation model, including people process culture tools and technology. We have fed this approach to numerous meetings regionally, nationally and globally, both academic and trade missions on behalf on GM
Start Year 2018
 
Title Digitally transformed heart failure pathway 
Description We are awaiting generation of real world evidence on the efficacy of the transformed pathway. We will take this to GM integrated commissioning for scale up depending on the results, We have already started the engagement process with commoners on the promise of a positive result. 
Type Health and Social Care Services
Current Stage Of Development Small-scale adoption
Year Development Stage Completed 2019
Development Status Under active development/distribution
Impact Early evidence suggests great patient experience and more efficient and effective heart failure care in the community 
 
Description Multiple presentations on methods and emerging findings to regional national and international meetings 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Industry/Business
Results and Impact We have spoken at multiple meetings including

HDRUK conferences
HSJ conferences
DIT trade missions to China
Local academic meetings
AHSN meetings
Year(s) Of Engagement Activity 2019,2020