Transforming deteriorating patient care with a digital and sustainable rapid response system developed in the open

This project seeks to research and implement a new proof-of-concept open standard digitally-enabled electronic observation (eObs) solution for deteriorating patient care. It will address a major unmet need in the NHS where a significant proportion of patients still experience suboptimal care leading to adverse clinical outcomes such as unplanned ICU admissions, emergency surgery, cardiac arrest and death. An estimated 7% of in-hospital deaths are preventable. (_NCEPOD Emergency Admissions_).

Core reasons behind poor care of deteriorating patients can be linked to current ineffective paper-based (and digital) systems of observation and management of patients leading to lack of recognition of deteriorating conditions. Incumbent, proprietary digital systems lack interoperability and deliver very low value with unsustainable high costs, plus barriers-to-iteration and evolution required for utility needed to deliver improved outcomes and to advance clinical progress.

Our vision is to transform the care process digitally and also to overcome the barriers the NHS faces over proprietary IT systems that cannot be easily or cost-effectively iterated to meet clinician requirements and best practice operating procedures.

We will deliver this by innovating the care process informatics design using an approach commonly used in translational medicine. With Coventry University's help, we will analyse current practice at two NHS Trusts (South London and Maudsley, Cheshire and Wirral Partnership), design an optimal approach and trial it with healthcare practitioners in a simulated NHS hospital environment at Coventry University (the first major project for CU at the most advanced simulation lab in UK); and once proven, trial it for real with our two NHS Trust partners. Governance, safety and standards will be assured through working with Apperta and Open UK.

Success with our project will bring measurable improved patient outcomes due to a better eObs patient observation system that has wide-reaching outcomes from mental health to productivity, and reduced need for further clinical intervention.

Immediate benefits will include reduced staff time and reduced human error compared with manual administration. Adopting an open source and standards approach will eliminate prohibitive annual software licensing and adaptation costs while delivering a flexible public asset that can readily be adapted to individual NHS Trust needs.

Our approach is uniquely consistent with secritary of state for health Matt Hancock's vision for Digital Transformation (October 2018) for the NHS and will serve as a vehicle to transform market access for SME's to grow the UK digital healthcare industry through the innovative use of digital technologies.