Using the power of social media in screening

Warrington maternity unit is using Facebook instant articles to transform the way they share learning | via Public Health England

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This blog article explains how a colleague set up a closed Facebook group for continuous professional development (CPD) to:

  • communicate to a wider audience
  • share best practice
  • encourage learning
  • signpost educational opportunities

Initially there was a concern that staff would not take to this new method, because it’s something that people use primarily for leisure and downtime. However, the CPD group is an opt-in, which means people can also opt out, adjust their settings to avoid viewing updates or simply scroll past. So far, most staff have joined the CPD group and nobody has opted out. Currently 130 people are in the group.

Full article at Public Health England

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Technology enables Deaf people to access NHS 111

Technology is enabling the Deaf community to access NHS 111 when they need medical help urgently. Using a computer and webcam, or the InterpreterNow app on a smartphone or tablet, Deaf people can make a video call to a British Sign Language interpreter. The interpreter then telephones an NHS 111 adviser and relays the conversation.

Full detail at InterpreterNow

Ultrasound breakthrough can pinpoint cancer with precision

Heriot Watt University | September 2019 | Ultrasound breakthrough can pinpoint cancer with precision

Experts at Heriot Watt University have found a new technique which uses super-resolution ultrasound methods that improves resolution of ultrasound images by 5-10 times compared to standard current ultrasound images.

Their innovation allows whole organs to be scanned in super-resolution for the first time which, it is anticipated, will lead to earlier cancer diagnoses and allow medical staff to more effectively target treatments to any malignant tissue. Potentially, it could eventually replace the need for biopsy altogether.

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The team behind this innovation  the aim is to start human trials using the new technique in three months’ time at the Western General Hospital in Edinburgh. Patients with prostate issues will be the first to benefit from the enhanced imaging.

Professor Alan McNeill, Consultant Urological Surgeon at the Western General Hospital in Edinburgh said: “Prostate cancer is an increasing problem for our society. Whilst we have a number of methods for detecting it, these don’t always provide us with the important information that we need regarding who has cancer that needs to be treated and who doesn’t.

“A method that maps the blood flow of the tumour accurately could well provide new information about the disease state that allows us to better identify those men who need urgent treatment and those who don’t. It is exciting that we will be the first hospital in the world that will assess this method with patients.” (Source: Heriot Watt University)

Read the full, unabridged press release from Heriot Watt University

Abstract

Objectives The aim of this study was to provide an ultrasound-based super-resolution methodology that can be implemented using clinical 2-dimensional ultrasound equipment and standard contrast-enhanced ultrasound modes. In addition, the aim is to achieve this for true-to-life patient imaging conditions, including realistic examination times of a few minutes and adequate image penetration depths that can be used to scan entire organs without sacrificing current super-resolution ultrasound imaging performance.

Methods Standard contrast-enhanced ultrasound was used along with bolus or infusion injections of SonoVue (Bracco, Geneva, Switzerland) microbubble (MB) suspensions. An image analysis methodology, translated from light microscopy algorithms, was developed for use with ultrasound contrast imaging video data. New features that are tailored for ultrasound contrast image data were developed for MB detection and segmentation, so that the algorithm can deal with single and overlapping MBs. The method was tested initially on synthetic data, then with a simple microvessel phantom, and then with in vivo ultrasound contrast video loops from sheep ovaries. Tracks detailing the vascular structure and corresponding velocity map of the sheep ovary were reconstructed. Images acquired from light microscopy, optical projection tomography, and optical coherence tomography were compared with the vasculature network that was revealed in the ultrasound contrast data. The final method was applied to clinical prostate data as a proof of principle.

Results Features of the ovary identified in optical modalities mentioned previously were also identified in the ultrasound super-resolution density maps. Follicular areas, follicle wall, vessel diameter, and tissue dimensions were very similar. An approximately 8.5-fold resolution gain was demonstrated in vessel width, as vessels of width down to 60 μm were detected and verified (λ = 514 μm). Best agreement was found between ultrasound measurements and optical coherence tomography with 10% difference in the measured vessel widths, whereas ex vivo microscopy measurements were significantly lower by 43% on average. The results were mostly achieved using video loops of under 2-minute duration that included respiratory motion. A feasibility study on a human prostate showed good agreement between density and velocity ultrasound maps with the histological evaluation of the location of a tumor.

Conclusions The feasibility of a 2-dimensional contrast-enhanced ultrasound-based super-resolution method was demonstrated using in vitro, synthetic and in vivo animal data. The method reduces the examination times to a few minutes using state-of-the-art ultrasound equipment and can provide super-resolution maps for an entire prostate with similar resolution to that achieved in other studies.

The original research is available in full from Investigative Radiology

In the news:

BBC News Ultrasound breakthrough ‘can spot cancer earlier’

Hospital Trust and charity launches new innovation programme

Med-Tech Innovation News | September 2019 | Hospital Trust and charity launches new innovation programme

The Chelsea and Westminster Hospital NHS Foundation Trust and its charity CW+, has been launched in a bid to improve patient care and address real-time challenges that healthcare organisations face.

Examples of previous ‘test and scale’ innovations include the UK’s largest study of wearable monitoring technology, the UK’s first cancer clinic of its kind fast tracking patients with clinical suspicions of cancer, and the Mum & Baby app that’s now being rolled out across the North West London catchment and to other national NHS maternity centres.

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Lesley Watts, chief executive of Chelsea and Westminster Hospital NHS Foundation Trust, said: “CW Innovation is designed to connect the frontline clinical and operational staff and partner organisations, both in and outside of the NHS. We strongly believe it will lead to improvements in the care we provide to our patients and the way we run our hospitals. ”

Full news story available from Med-Tech Innovation News

Transforming care through technology

This toolkit outlines examples of how Shelford Group trusts are using technology and digital innovations to transform outpatient services in the NHS

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This toolkit brings together the work of 10 of the largest teaching and research NHS hospital trusts in England, working together under the umbrella of the Shelford Group. The emergence of new models of care using technology is a primary  theme of the work of the Shelford Group transformation directors, who have summarised the progress in their organisations.

The toolkit shows how Shelford Group organisations have started to deliver many of the  changes highlighted in the NHS Long Term Plan, describing how digitally enabled care  can deliver faster, better access for patients.

The Shelford Group is a collaboration of 10 of the largest teaching and research NHS hospital trusts in England. Case studies from these organisations are included throughout the toolkit and include initiatives that support patients to self care; the provision of better information and advice from patient portals; and the development of wearables and apps.

Full document: Transforming care through technology – a toolkit for new models of outpatient care

 

Text message reminders increase attendance at NHS health checks

NIHR | September 2019| Text message reminders increase attendance at NHS health checks

An RCT assessed the impact of patients receiving a text message reminder as a means of increasing attendance at NHS health checks.  Currently, NHS health checks are offered to adults aged 40 to 74 years. Identification and management of cardiovascular risk factors has been shown to save lives. Yet only half of adults attend a check when it is offered.

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This trial was conducted across 28 general practices in South London assessed the effect of sending pre- and post-invitation text messages, along with different forms of invitation letter.  Patients were first assigned to receive either a pre-notification text or not. They were then assigned to receive one of 4 types of invitation letter:

  • standard control letter, detailing the health check in several paragraphs
  • open-ended letter, briefly saying their check was due and asking them to call and book
  • time-limited letter, as open-ended letter but asking them to attend in a limited time period, such as ‘your check is due in March’
  • social-norm letter, as open-ended letter but adding testimonials from patients saying how the health check helped them.

Finally, they were assigned to receive a reminder text or not.

The reminder text appeared to be the most effective addition. For all three intervention letters (open-ended, time-limited and social-norm) fewer people attended a health check when a reminder text was not sent. Although the time-limited letter with both texts was most effective, there was not enough evidence to support the value of the pre-notification text.

Amongst invited patients, 24% attended health checks. This ranged from 18% of those sent the standard control letter with neither text pre-notification nor reminder, to 30% of those sent the time-limited letter with both text pre-notification and reminder. Comparatively, this latter group had almost doubled odds of attending (Source: NIHR).

Sallis, A., et al |2019| Pre-notification and reminder SMS text messages with behaviourally informed invitation letters to improve uptake of NHS Health Checks: a factorial randomised controlled trial| BMC public health| 19|1|P.  1-12.

Abstract 

Background: The NHS Health Check (NHS HC) is a cardiovascular risk assessment to prevent cardiovascular disease. Public Health England (PHE) wants to increase uptake.

Methods: We explored the impact of behaviourally informed invitation letters and pre-notification and reminder SMS on uptake of NHS HCs. Patients at 28 General Practices in the London Borough of Southwark who were eligible to receive an NHS HC between 1st November 2013 and 31st December 2014 were included. A double-blind randomised controlled trial with a mixed 2 (pre-notification SMS – yes or no) x 4 (letter – national template control, open-ended, time-limited, social norm) x 2 (reminder SMS – yes or no) factorial design was used. The open-ended letter used simplification, behavioural instruction and a personalised planning prompt for patients to record the date and time of their NHS HC. The time-limited letter was similar but stated the NHS HC was due in a named forthcoming month. The social norms letter was similar to the open-ended letter but included a descriptive social norms message and testimonials from local residents and no planning prompt. The outcome measure was attendance at an NHS HC.

Results: Data for 12, 244 invites were analysed. Uptake increased in almost all letter and SMS combinations compared to the control letter without SMS (Uptake 18%), with increases of up to 12 percentage points for the time-limited letter with pre-notification and reminder; 10 percentage points for the open-ended letter with reminder and a 9 percentage point increase using the time-limited letter with reminder. The reminder SMS increased uptake for all intervention letters. The pre-notification did not add to this effect.

Conclusions: This large randomised controlled trial adds support to the evidence that small, low cost behaviourally informed changes to letter-based invitations can increase uptake of NHS HCs. It also provides novel evidence on the effect of SMS reminders and pre-notification on NHS HC attendance.

Full article available from BMC Public Health 

Nesta report: A brief introduction to digital transformation

Nesta | September 2019 | A brief introduction to digital transformation

Much has been promised about the potential of digital technologies to positively
enhance the work of government and the public sector. A brief introduction to digital transformation, is a recent report from Nesta – an innovation foundation- counsels against adopting a ‘technology-driven’ approach, the risk of being ‘technology driven; recommending instead that the focus must be on technology’s potential to enable real-world outcomes.

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Image source: media.nesta.org.uk

The report explores:

  • Examples of how digital technologies are being used by public sector organisations to improve their operations, deliver better public services and engage citizens
  • How to put in place project management, governance, team and budget structures to help digitally-enabled projects to thrive
  • The principles that organisations should apply when procuring or building their own technology solutions
  • The roles required in public sector organisations – including in digital and leadership teams – to succeed in the digital age.

A Brief Introduction to Digital Transformation [report]

A Brief Introduction to Digital Transformation [pres release]