Mar 072017
 

NHS England Diabetes Prevention Programme: Call for Expressions of Interest open until mid-day 15th March.

Healthier You: NHS Diabetes Prevention Programme (NHS DPP) is a joint commitment between NHS England, Public Health England and Diabetes UK.

The programme is inviting providers and developers of existing health apps and online platforms aimed at reducing the risk of developing Type 2 diabetes to submit their products for consideration to take part in this exciting opportunity.

Our Mobile Health Ltd have been appointed to undertake a review of available products, and if you have a product that would support this work, you can find out more information and submit your application HERE.

Jan 192017
 

Globe (1)

Untitled drawing

1) Executive Summary

An NHS open digital platform challenge fund will stimulate the development of an open platform in the NHS. Open digital platforms are independently forecast by McKinsey and Co to reduce the delivery of care costs across the NHS by 11%. They will support widescale entry and growth of suppliers into the market, injecting innovation at all levels of service delivery to support improved care outcomes for our patients.

In the context of an NHS struggling through a perpetual winter, open digital platforms present a realisable opportunity to massively stimulate new ways of working, process innovation and a new digital health and care market, based around services. This is independently forecast by McKinsey and Co who predict a positive financial impact in excess of 11% across the whole of health and social care.

By creating an open digital platform and a move towards a services market, the NHS opens up the market to innovative commercial and social enterprises who presently have great difficulty breaching the significant barriers to entry. At the same time it creates an environment where health and care professionals can readily create, contribute and share new digital tools to support transformational new models of care, radically improving the care outcomes of our patients and building a sustainable care ecosystem that is fit for the future.

There is little disagreement that platforms represent the future for digital health. Rather the present debate is about who should own them, and how and when they will emerge. The “status quo” retains the closed platform frameworks, introducing open interfaces for exchange of information. This provides a short term stimulus, supporting improvements in patient care and operational efficiencies. However in the longer term, by seeking to control the rules of engagement and restricting the mobility of data, the retention of closed platform frameworks will stifle competition, impede innovation, and continue to drive-up costs.

Open digital platforms are a radical alternative that overcome the serious shortcomings of closed platforms.
They present the most assured approach to achieve consistent, long term and affordable growth in innovation-led service transformation across the complexities of health and social care. They will enable the full competitive aspects of market supply to be exploited, with associated benefits of the injection of innovations on a massive scale. For this reason, open digital platforms are manifestly in the interest of both the NHS and its patients.

The purpose of the proposed Open Digital Platform Challenge Fund is to stimulate the development of an open platform ecosystem through kick-starting the creation of open platforms, building on work already well underway, and the development of exemplar applications to exploit them.

We propose that the fund is created through diverting 1% of the investment each year in NHS digitisation into the challenge fund. This fund would be made available via an annual open competition in the form of relatively small awards to innovative organisations (public, private and third sector). The selection of projects will be balanced to stimulate and develop an open ecosystem of shareable and reusable applications to service across health and social care. We are inviting submissions of expressions of interest into this Open Platform Fund. In so doing, we will gauge the wider interest in this Open Platform fund proposal to then quickly bring these related responses to the attention of both NHS Digital and NHS England by the end of February 2017 and seek the related funding.

2) Current Situation

To introduce this bid for funding we need to review the current situation with important context on the bigger picture issues that are at play. We need to acknowledge and understand the current mediocre state of health IT, as an immature and problematic market with mixed/relatively poor value for money and results seen from billions of £ and $ of investment from the UK to the US and elsewhere.

We also need to recognise the related digitisation of the NHS has been over promised and under delivered for some considerable time. Compounding this people/process/technology problem is the ongoing and perpetual winter faced by the frontline in the NHS that is in the news.

We restate the need to continue the critical push towards more personalised, integrated care at home and in the community to meet the 2020 vision. This clearly requires an underpinning patient centred infrastructure to do so. Last February Jeremy Hunt announced £4.2 billion for NHS Health IT. In the last 18-24 months while there have been plans in the form of Integration Pioneers, Vanguards, Local Digital Roadmaps (LDRs), Sustainability Transformation Plans (STPs), there has been little/no allocated funding to date to make these happen.

In Autumn 2016 we were able to read and digest the latest review of the NHS IT, authored by US physician Dr Bob Wachter. Dr Wachter built his reputation as establishing the hospitalist as a medical specialty in the US. In recent years he has become a fearless and honest critic of the state of Healthcare IT in the US, with his book “Digital Doctor : Hope, Hype & Harm at the Dawn of Medicines Computer Age” (2015) exposing the real mediocre state of the health IT market in the US. The book and related opinion pieces on the state of health IT industry he explains some of the real problems with the current supplier market is clear. In a New York Times Op Ed piece on “Why Health Care Tech Is Still So Bad” (2015) he highlights that

“In today’s digital era, a modern hospital deemed the absence of an electronic medical record system to be a premier selling point...That hospital is not alone. A 2013 RAND survey of physicians found mixed reactions to electronic health record systems, including widespread dissatisfaction. Many respondents cited poor usability, time-consuming data entry, needless alerts and poor work flows”.

However in the NHS, Dr Wachter’s recent review led to funding being provided to “digital exemplars” all of which are a small group of hospital trusts in the NHS who will invest in those very same health IT monoliths. While understandable as a means to “do something”, rather than nothing, given the state of affairs is understood, it is sadly limited in its thinking and perpetuates the usual tactics that we have seen in the NHS IT for years, i.e. investing in the same 20th Century monoliths of old. We know that doing the same thing over and over and expecting different results is futile.

Simply put, if a small elite are getting the focus of funding for investments in 20th Century health IT monoliths over the next years then inequity within the system will increase, while original ideas in the sector to bring care into the modern era will decrease.

We have been left asking where has the requirement for integrated person centred care gone, that is ingrained in the other plans that NHS and local authorities have been working towards with STPs and LDRs etc.

What is sorely missing is the open patient centric platform that Dr Wachter looks forward to and that healthcare awaits. As this is a glaring omission, our paper recommends a focussed investment towards that end as part of a bimodal strategy for NHS IT at this challenging time.

3) What can be done

The changes required are radical, if we are to simply survive, yet alone thrive in the years ahead. We know we need a mix of people + process + technology changes. We know too that the leaders of the NHS understand and value the role of innovation and the crucial role of information technology in achieving same.

3.1) The role of an open platform

For some time now leading thinkers on both sides of the Atlantic, in the NHS and indeed the US has been calling for a move towards a more open platform approach. From within the US market, the establishment of Healthcare Services Platform Consortium aims to address the mediocrity of the “big 6” monoliths and the concurrent problem of the thousands of small unrelated vendors.

“EHRs are becoming commodity platforms. The winner will be the EHR vendor that provides the best platform for innovation – the most open and most extensible platform.”

In this we wholeheartedly agree and concur with our US colleagues.

We believe there is now a compelling case for a small but useful investment in Health IT from the bottom up, to the princely sum of 1% of the planned £4 Billion NHS IT expenditure, aimed deliberately at the integrated, patient centred care vision of Personalised Care 2020, based on the principle that all projects should aim to leverage elements of a common open platform.

4) 1% Case for an open platform

We are making a case for an investment of just 1% of available NHS IT funds to offer a way forward to improve the care of 99% of the population. To do so we have highlighted Dr Watchers analysis and writings to focus on the key problems and issues we seek to address;

Usability

“This principle of user-centered design is part of aviation’s DNA, yet has been woefully lacking in health care software design.

Interoperability

“[There are] Political obstacles to overcome, put in place mostly by vendors and healthcare systems that remain reluctant to share.”

Vision for patient centred care

“In essence, there will no longer be an EHR in the traditional sense, an institution-centric record whose patient portal is a small tip of the hat to patient-centeredness. Rather, there will be one digital patient-centered health record that combines clinician-generated notes and data with patient-generated information and preferences. Its locus of control will be, unambiguously, with the patient.”

So in order to address these real issues and support the national ambitions - usability, interoperability and patient centred care we will use the investment fund available to benefit the broader public. We wish to draw attention to that part of the population who could be better served by the NHS with an improved patient centric platform today. We are also mindful of the need to support;

  • Prevention, Self care and management
  • GP patients
  • Community Care Patients
  • Mental Health Patients
  • Social Care

We look to the leadership provided by the Gov UK Digital Service standard to highlight the principles to underpin the approach we commend.

Pursue User Centred Design & Agile Development

Leverage Open Source & Open Standards

In our work to date (on the Ripple programme and Code4Health platform based on openEHR) we have deliberately pursued these principles to useful effect and recommend them to others who wish to transform healthcare with information technology. We welcome wider scrutiny of our open platform work to date. Our work and the leading work of others (such as the Endeavour Foundation and the INTEROPen CareConnect API Collaborative) in this field, leads us to believe there is now a real, significant appetite for wider and deeper moves towards an open digital platform in the NHS.

By creating an open digital platform ecosystem, the NHS opens up the market to innovative commercial and social enterprises who presently have great difficulty breaching the significant barriers to entry. At the same time it creates an environment where health and care professionals can readily create, contribute and share new digital tools to support innovative new models of care.

We firmly believe that a small but focussed 1% investment can deliver against some of the key challenges in Personalised Health and Care 2020 on an open service oriented platform- to stimulate the public & private sector. An open healthcare platform fit for the 21st Century.

 

5) What is an Open Platform?

Platform based architectures power the internet, with the platform providing the plumbing (the infrastructure, data and services) that applications need, freeing the application developer to focus their efforts on their application without the need to build the infrastructure it needs to operate. Platform approaches speed development, make applications more robust and interoperable and open up a new services market in healthcare IT, where suppliers compete on services and the value they add rather than on the proprietary nature of their software.

An Open Platform is based on freely available open standards, so that anyone can play. As no one party can control the platform - they must collaborate - just like the Internet.

An Open Platform has the following characteristics:

  • Open Standards Based - The implementation should be based on wholly open standards. Any willing party should be able to use these standards without charge to build an independent, compliant instance of the complete platform;
  • Share Common Information Models - There should be a set of common information models in use by all instances of the open platform, independent of any given technical implementation;
  • Support Application Portability - Applications written to run on one platform implementation should be able to run with either trivial or no change on another, independently developed;
  • Federatable - It should be possible to connect any implementation of the open platform to all others independently developed, in a federated structure to allow the sharing of appropriate information and workflows between them;
  • Vendor and Technology Neutral - The standards should not depend on particular technologies or require components from particular vendors. Anyone building an implementation of the open platform may elect to use any available technology and may choose to include or exclude proprietary components;
  • Support Open Data - Data should be exposed as needed (subject to good information governance practice) in an open, shareable, computable format in near to real-time. Implementors may choose to use this format natively in their persistence (storage) layer of the open platform itself or meet this requirement by using mappings and transformations from some other open or proprietary format;
  • Provision of Open APIs - The full specification of the APIs (the means by which applications connected to the platform a should be freely available.

The key to an open platform is the definition of a set of standard interfaces (APIs) to the range of services that might be provided on a platform defined by an open process that all interested parties can participate in (like Internet standards) and that are freely available for all to use.

While it may be encouraged, not all elements in an open platform need to be open sourced. We believe that “infrastructural” components that are generic, reusable and utility like (e.g see Appendix 1 below) should be open sourced, while the overlying applications do not necessarily need to be open sourced, as long as they leverage open data models and offer open APIs.

6) Why an open digital platform?

We have seen across all sectors how platforms are changing the way people lead their everyday lives, from how we communicate and interact, how we travel and where we stay, how we manage our finances to how we shop, to name but a few. Platforms transform. An open digital platform supports:

  • Unconstrained innovation – ideas and ambitions can be shared by people across the office, street or globe
  • Collaboration - clinicians and care professionals inherently want want to share their good work with the rest of the medical world.
  • Alignment to medical science progression, been based on the spread of ideas - health IT can do the same.
  • “Publish or perish” culture of modern medicine demands that healthcare advances are laid open for scrutiny by our peers
  • Grassroots progress - Complex adaptive systems require decentralized control so people can locally innovate. Amendments and improvement can come from the grassroots and bottom up, without the bureaucracy that innovators often face.
  • A shift in the market towards a healthy, commercially sustainable, services oriented marketplace.

7) Open Platform Fund mechanism

The main aim of this Open Platform bid is;

Support the development of services towards Personalised Care 2020 -

support the development of an NHS ecosystem around an open digital platform

To be clear, while we do not currently have any secured funding for an open platform fund, our aim is to gauge interest in this approach and make the evidence based case to NHS Digital.

The fund is intended to support innovative projects that stimulate the creation of an open digital ecosystem and as such aims to support a large number of small projects that are unlikely to be supported as part of “business as usual” investment by health and care organisations. The aims are to driving innovation and transformation that is scalable, shared, flexible and adaptable and ultimately improve health IT for clinicians and improve care outcomes for patients. Winners will show that they will concentrate their efforts on usability, interoperability, patient centred care that meet the vision. To do so we suggest;

7.1) Request for Expressions of Interest

We initially invite the submission of expressions of interest into this Open Platform Fund. In so doing, we wish to gauge the wider interest in this Open Platform fund proposal to then quickly bring these related responses to the attention of both NHS Digital and NHS England by the end of February 2017 and seek the related funding .

Please submit a brief expression of interest (1-3 page) via this Google forms link; https://goo.gl/forms/4SaNvAgkAe2AfLZ82 by Friday 10th February 2017.


We will acknowledge expressions of interest, collate and feedback the results of our findings, pass on related submissions and summary findings to the Apperta Foundation CIC which we believe is ideally placed to independently oversee this process and support the case for funding from NHS Digital and NHS England. The Apperta Foundation is a not-for-profit community interest company supported by NHS England and NHS Digital led by clinicians to promote open systems and standards for digital health and social care.

While the focus of this paper relates to the NHS in England, we know that colleagues in the health systems of Scotland, Wales, Northern Ireland and indeed the Republic of Ireland are facing the same challenges at the frontline, while aware of the same opportunity on offer from an open platform from a 1% investment, particularly if done openly and collaboratively. Therefore we invite related submissions towards an open platform fund on an All Islands basis - which we also will pass onto the Apperta Foundation and the UK and Ireland CCIO Networks.

7.2) Outline of Proposed Allocation

A) Infrastructural component projects

45% of £40m = £18m over 3 years (until 2020)
Open source tooling & infrastructure components - underpinning standards and compliant components that provides services useful in an open ecosystem (See Appendix 1 examples)

B) Personalised Care: Innovation Incubation and Exemplar Implementations

50% of £40m = £20m over 3 years (until 2020)

Open APIs & open data models based projects as showcases of an open platform in action. (e.g. may include open APIs (e.g. INTEROPen CareConnect FHIR based APIs) + open data models +/- open source data repository (e.g. openEHR based). Examples may include Person Held Records/Electronic Patient Record/Integrated Digital Care Record etc. related projects.

C) Oversight/Custodian of process by an independent CIC such as the Apperta Foundation

Along with the CCIO Network and INTEROPen Collaborative to oversee clinical merit and technical connectathons.

5% of £40m = £2m over 3 years (until 2020)

7.3) Eligibility

We suggest that this open platform fund is open to:

  • UK Registered for-profit commercial entities (Companies and LLPs) and
  • UK Registered not-for-profit entities (CICs,Trusts,Companies limited by guarantee and other recognised forms) meeting UK definition of an SME (In the UK a company is defined as being an SME if it meets two out of three criteria: it has a turnover of less than £25m, it has fewer than 250 employees, it has gross assets of less than £12.5m)
  • UK Public Sector bodies (NHS Bodies, Government agencies and local authorities etc.) irrespective of size.

7.4) Match funding obligations

We suggest that applicants will be required to match fund any award from the fund as follows

  • Social or commercial micro-enterprises 1
    -
    No match funding obligation
  • Social or commercial SMEs 2
    -
    Match funding equal to 50% of the award
  • Public sector bodies - Match funding equal to 100% of the award

 

1 A business with less than 10 employees and (a turnover < £2 million euro or a balance sheet total of less than £2 million euro)
2 A business with less than 250 employees and (a turnover < £50 million euro or a balance sheet total of less than £43 million euro)
These are the current official definitions applying in the UK

8) Criteria

We suggest that an Open Platform fund is open to projects that stimulate and support both the creation and adoption of an open digital ecosystem which meet the definition in section 5 of What is an Open Platform.

While the main aim of all projects will be to improve NHS services towards personalised health and care 2020, the criteria by which the funding from this fund will be allocated will depend on the concurrent creation of value add in the form of;

  • Collaborative - all projects must establish open channels of communication and means of engagement with other parties in the bid at the time of their application (e.g. INTEROPen Ryver etc).
  • Transparent - all projects must be willing and evidence how they will partake in regular clinical and technical reviews. We suggest these should be in the form of bi-annual CCIO Network led review along with INTEROPen led Connectathons with a minimum of 3 out of 6 Connectathons undertaken.
  • Share Ideas, Knowledge, Experience - i.e. willing and able to openly collaborate with others in this initiative (e.g via online community building via tools such as the Open Health Hub, Ryver etc) and partake in Open Data connectathon against INTEROPen FHIR APIs

9) Judging process

Initial Bid and Review Point Principles

We suggest the related submissions into this fund will need to evidence the following as part of their bids and progress at agreed review points:

  • Clinical merit - against the Personalised Health and Care 2020 Vision
  • Technical merit - against the open platform principles outlined
  • Clinical gap / need / demand
  • Clinical Leadership - all projects need nominated clinical lead
  • User Centred Design - include/demonstrate a commitment to open publish UX design
  • Alignment with Agile Development methodologies
  • Business readiness (preparatory work, governance etc in place)
  • Collaboration with other parties in the open platform bid
  • Open Source track record

10) Conclusion

If public monies are for one purpose, they should be for the common good. Our proposal aims to ensure the efficient and effective allocation of public monies to projects that can impact the health and care of millions of citizens in England, supporting local NHS & Social Care organisations in their hour of need, while leveraging Britain's long held reputation for industry and innovation to enable a new global open platform fit for the 21st Century.

Our proposal for an open platform technology fund aims to offer a means towards the integrated care vision of Personalised Care 2020 that is in the best interests of the NHS. In aligning patient, clinical and care needs with the investment potential offered by open platforms in healthcare, we believe there is a clear win-win on offer here.

At times of challenge and change the natural instinct may be to withdraw from risk or novel action, yet all our instinct is telling us that now is very time to embrace this challenge and seek the opportunity - which is why we are taking a public lead in getting this Open Digital Platform for Healthcare into action and welcome your interest and support in this effort.

Dr Tony Shannon, Ewan Davis
14th January 2017

Questions or Comments?
Email us at 1percentfund@ripple.foundation or tweet @rippleosi with #1percentfund

11) Declarations of Interest

Both of the authors are unashamedly proponents of an open platform in healthcare for some time. One might argue that this constituents a conflict of interest with the proposed approach. Rather we would suggest that our track record in leading the effort to disrupt the market towards an open platform, equates to a confluence of interest with the approach now required.

Dr Tony Shannon, Director - Ripple Foundation C.I.C
Director - Frectal Ltd

Ewan Davis, Director - Synapta C.I.C
Director - Handi Health C.I.C
Director - Open Health Hub C.I.C
Director - Operon Ltd
Director - Woodcote Consulting Ltd

12) Related Links

Ripple Foundation Community Interest Company http://rippleosi.org/
HANDI Health Community Interest Company http://handihealth.org/
Synapta Community Interest Company http://synapta.org.uk/
Endeavour Health Charitable Trust http://www.endeavourhealth.org/
Apperta Foundation Community Interest Company http://www.apperta.org/
INTEROPen Collaborative http://www.interopen.org/
openEHR Foundation http://openehr.org/
HL7 FHIR https://www.hl7.org/fhir

Appendix 1 - Open Platform Infrastructural Component Candidates

The aim here is to initially outline examples/suggestions of a “top 10” set of federated service components in a Service Oriented Architectural world that would be useful to in healthcare. In doing so we welcome further suggestions and related expressions of interest that would aim to provide open source solutions to plug gaps / provide enhancements towards the open digital platform movement. The fund may support the open sourcing of existing components or their development.

Identification & Authorisation
Master Patient Index
User Interface framework
Integration technologies
Clinical Data Repository
Terminology services
Workflow services
Rules engine
Scheduling
Business intelligence
Clinical content collaboration/authoring tools (i.e. openEHR/FHIR etc)

Applications for these open source infrastructure projects are encouraged to state their preferred OS license (weighting towards non copyleft (Apache 2/MIT/BSD) or AGPL licensing)

 



 

 Posted by on January 19, 2017 at 12:43
May 152015
 

 

The Health App Challenge was a one-year project that supported patients with diabetes or pre/post weight loss surgery to design and/or develop their very own health apps (e.g. mobile app, website or social media) to help manage their condition. Participants were offered advice from intellectual property experts, technical developers and medical professionals. Other patients were invited to review existing health apps they had used to help inform others, and review the Challenge entries to determine a winner.

Five teams entered the Challenge with their unique diabetes apps designs:-

BWell Sugars System, a simple data entry and blood glucose trends tracker design.
BetterBGs, a clever real-time insulin and food dose advisory system design.
EasyDiabetes, a useful organiser design with a range of tools specifically for teens.
Dap’n, a motivational game design for better adherence to medical recommendations.
Gluco-Drive, a sensible alert design for monitoring blood glucose levels before driving.

Dap'n’, the app design by Reina Yaidoo and her team, was chosen as winner for its high ratings (5/5) and praise from peer reviewers. “...I love the concept of setting challenges and presenting health monitoring in a 'game' form...”

Since winning the Challenge, Reina and her team’s app design Dap’n has gained much interest and is currently shortlisted for funding support, to turn their design into a published health app, in two national programmes - Nominet Trust’s Social Tech Seed and Virgin’s Pitch to Rich.

Patients gave over 140 reviews of the Challenge designs and existing health apps (including bariatric apps), with The Diabetic Lounge and Carbs & Cals receiving the most reviews and praise amongst the existing health apps. You can still view the designs and reviews at www.healthappchallenge.org.uk.

Online Community Area

Although the Health App Challenge has come to a close, the project team is in the process of arranging an online community area to support discussion and networking between people interested in health app development (e.g. patients, developers, health professionals etc.), including the potential for collaboration and further support for Challenge participants in turning their designs into working apps.
Anyone interested, is welcome to email emily.ashurst@plymouth.ac.uk

Interest in Future Health App Challenges Booklet

As a key outcome of the project, the team produced a booklet for interest in future Health App Challenges, and is available online HERE. ‘Patient-led innovation: How to run, take part in and support a Health App Challenge', is a combination of project experiences and information as asked by participants during the Challenge.

Survey

The project team would really like to know your views on this patient-led approach and on health app development in general in a very brief, anonymous, 3-question survey. Everyone is encouraged to complete it HERE and all feedback is much appreciated.

The Health App Challenge project was run by Plymouth University, funded by the Intellectual Property Office Fast Forward Competition 2014 and supported by Diabetes UK, WLSinfo, HANDI, and Britain’s Nurses.

Nov 272014
 

Your action IS required.

Passing on the request from Dr Marcus Baw

I've mentioned this on the list before, but there is an area on StackExchange where suggestions are accepted for new areas. A Healthcare IT section has been suggested but the first time it did not get enough votes to become an official Beta.

This time, we have a limited opportunity to get it voted up enough it will be created.

This is a potentially helpful resource for discussing the technical aspects of healthcare IT and I think would overall benefit the NHSHD community. Could I therefore ask you ALL to take the 30 seconds to go to this site, login or create an account, and vote for the Healthcare IT Forum.

Of course, if you already know everything there is to know about Apple HealthKit, FHIR, HL7, SNOMED-CT, Read Codes, CTV3, openEHR, IHE, CE marking of medical devices, medical UX, etc, then you personally have no need of it - although I'd still like you to vote because we'd need a place to ask you questions 😉

Sep 172014
 

OPENeP has selected the HANDI-HOPD to built its initial prototype app. It will provide further proof of concept and is the most ambitious project to be attempted on HANDI-HOPD so far.

OPENeP is an open source project intended to deliver a suite of medicines management apps to improve the safety and efficiency of prescribing and medicines management and demonstrate how new business models can create commercial opportunities for vendors focussed on delivering high quality service.

Medication errors and one of the biggest single cause of harm to patients in NHS Hospitals, causing death, disability and suffering and represent a significant cost to the NHS with wider negative economic impacts.  Many errors are amenable to mitigation through the application of digital technology and OPENeP is intended to help address these problems.

There are already a number of digital tools that support various aspects of the medicines management process, most are proprietary products and many of these are of good quality, but they are not designed to fit in the emerging open digital health ecosystem or take advantage of the latest technology.

OPENeP is intended to  explore how we build apps for the emerging digital ecosystem and  to enhance, not replace, existing EHR and Pharmacy systems and create new opportunities for vendors of such systems, who we hope might  include these components to enhance their existing product and service offerings. OPENeP apps  will be designed to facilitate integration with PAS, EHR, order communication and  pharmacy systems as well as proprietary  knowledge and decision support components.

The starting point for OPENeP will be the ePrescribing and Medicines Administration modules of  Think!Med Clinical which its creators Marand have agreed to release under the GPL open source licence. This product which is based on OpenEHR provides a proven solution using the latest technology  already successfully deployed in a large hospital and gives us a great starting point for our work. Our aim is to develop this to provide the suite of apps described below which will initially be deployable via a common interface (API) as either the eP/eMA component of a OpenMaxims EHR or as a "standalone" solution which will operate on any OpenEHR backend

The focus of OPENeP is on the hospital inpatient setting, where it is intended to integrate with existing systems and other apps to deliver digital care at the beside. However, it is designed so that it can be extended to deliver facilities in other settings.

The currently identified components of the OPENeP suite are:

  • Medicines reconciliation – With modules for both the patient and healthcare professionals to ensure an accurate view of a patient’s medication at handovers of care.
  • ePrescribing – To help ensure safe, efficient and appropriate prescribing compliant with national guidance and local policies.
  • Medicines Administration – To help ensure safe, accurate and timely medicines administration.
  • Personal Medication Record – To give patients a view of their medication to support self-care, concordance and the safe and effective use of their medication.
  • Medicines Utilisation and Audit – To support pharmacists and others in the review totality of a patient’s medication and monitor and audit medication usage, administration and patient concordance.
  • Medicines supply management  – To support the transfer of orders for medication both for individual patients and for local stock to pharmacies, including support for orders for discharge medication to hospital or community pharmacy.

The Initial focus with be on prescribing and administration and we intend to use HANDI-HOPD to build some initial prototypes. Like everything on HANDI-HOPD these prototypes will be purely experimental and will not be used with real patient data. However, because HANDI-HOPD uses open standards we expect others to take them and deploy them in an operation environment.

Our priority is to create a user interface (UI) that delivers a user experience (UX) that make the apps a joy to use and in doing some makes the processes they support more efficient, easier and safer. To do this we want to bring together domain expertise in medicines management, frontline clinicians and patients with engineers, designers and informaticians working together using user centred design techniques.

In order to operate effectively and efficiently OPENeP apps will need to interoperate with a range of others systems including:

  • GP Systems – To support medicines reconciliation on admission and discharge
  • Patient Administration Systems (PAS)  - To identify and track patients
  • EHR Systems (EHR) – Access the clinical data about patients needed for safe, effective prescribing.
  • Hospital Pharmacy Systems – To manage medication orders and supply
  • Community Pharmacy System – To support delivery of discharge medication in the community.

We will use existing open interface and define new open interfaces where none exist, ideally in collaboration with target system vendors.  The OPENeP apps will be designed to work with FHIR APIs on target systems (with openEHR archetypes mapped to FIHR resource profiles) but we will provide middleware components to allow interworking with APIs based on other standards.

Basic functionality can be implemented without interfaces to most of the above systems, but certain basic EHR data is essential for safe prescribing and OPENeP will provide basic EHR functionality, using openEHR to allow these data to be recorded with within the OPENeP suite when an external EHR data source is not available.

Partners in the project are:

  • NHS England Open Source and e Prescribing Programmes
  • Fivium http://www.fivium.co.uk/ - A mid-sized SME with experience of delivery solutions based on source to Government in the UK and elsewhere including the provision of the system to operate the Pharmacy Benefit Scheme to the Australian Government. http://www.fivium.com.au/health.html
  • First Data Bank http://www.fdbhealth.co.uk/ –The UKs most experienced provider of drug knowledge for use in ePrescribing systems.
  • Neova Health www.neovahealth.co.uk/  – A UK based SME successfully delivering open source solution in the NHS include eObs a nursing observation app which is a natural companion to OPENeP at the bedside.
  • Marand  www.marand-think.com/   – A Slovenian SME that already provides much of the technology for HANDI-HOPD and who have delivered ePrescribing for the Slovenian Health System
  • IMS Maxims - http://www.imsmaxims.com/opensource/ - Original authors of OpenMaxims open source EHR

 

Jul 302014
 

An opportunity has arisen for software development intern to work with HANDI on the HANDI-HOPD project www.handi-hopd.org

The role will involve developing the platform software, which is already deployed in prototype form, to extend the range of components and content available via the platform and improve the facilities it provides to support health and care professionals and software developers to use the platform to learn how to use open standards based systems to create and curate clinical content and build apps able to participate in the emerging open digital ecosystem in the NHS.

Candidates should have completed at least two years of an undergraduate course in computer science, software engineering or a scientific/mathematical discipline with a strong computing element, have an evidenced expectation of a first class or upper second degree and demonstrable experience of software development in a Internet/Cloud environment with a good working knowledge of Linux and at least two programming languages preferable including either Javascript, Python or Ruby.

We are also interested in hearing from candidates who have completed their first degree and who might be able to pursue HANDI HOPD as part time as an element of study for a higher degree.

Candidates should have some knowledge of the health and care sector and a desire to pursue a career in digital healthcare or healthcare informatics.

The initial engagement would be for approximately 3 months and there is the possibility of an extension beyond this for candidates in a position to offer a longer commitment.

Location would be Central London or Central Birmingham (to be agreed) and payment would be between £12.5k and £25k pa depending on qualification, experience and length of commitment offered (the lower rate would apply to a short term undergraduate internship.)

Candidates MUST be able to start immediately and have substantially unrestricted availability over the summer period.

Interested candidates should send a CV and covering email to jobs@handihealth.org – All applications will be acknowledged and we will also endeavour to answer any questions you may have via this email.

Closing Date – Due  to our desire to make an appointment quickly we will process applications on receipt and close applications once we have a pool of suitable candidates.  Applications for this post are currently open.

Date issued 29 July 2014

Apr 222014
 

Run by Plymouth University and funded by the Intellectual Property Office, the Health App Challenge is running two user-led app challenges: one for diabetes in collaboration with Diabetes UK and the other for weight loss surgery in collaboration with WLSInfo (a smaller charity), with support from HANDI.

 

The Health App Challenge (HAC) offers patients with diabetes or post weight loss surgery the opportunity to join us in reviewing or creating an app (i.e. mobile application or website) to help manage the conditions and improve healthcare outcomes with technology innovations: for patients and by patients.

 

We plan to follow on from the success of the Diabetes App Challenge of 2012, a two-part challenge where young people with diabetes and teammates created innovative apps to help with preparing for clinic appointments, then offered to other young people with diabetes to try out and review.

 

We aim to develop a best practice model for similar competitions to allow medical charities to collaborate with patients and developers, to create new condition-related apps to benefit patients.

 

Supporting the challenge is a community interest organisation, HANDI, whose work with patients, developers and healthcare professionals aims to encourage innovation of digital technology to improve patient health and wellbeing.

 

HANDI will be offering their skills and expertise to the Health App Challenge with involvement in our one-day developer workshop, technical support to participants in bringing their innovative ideas to life and appraisal of the submitted apps.
To review or create an app for the Health App Challenge, visit our website from mid-May 2014 to find out more at www.healthappchallenge.org.uk

 

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Feb 232014
 

HANDI has had an invitation from NHS England for HANDI Members who are developing apps for health and care to "Show and Tell" in NHS England's Entrepreneurs Zone on  Monday 3rd March at the Health and Care Innovation Expo 2014  in Manchester.

NHS England is looking for developers with work in progress, prototypes and early production versions who want to show people what they have done and seek suggestions for improvement and share their experiences with others. They are particularly keen to hear from people developing free and open source apps and from clinicians and other health and care professionals who are "Coding4Health"

Those accepted will be granted free admission to Expo on the 3rd and allocated a slot and a place on the NHS England Entrepreneurs Zone where they can "Show and  Tell" with power and dedicated WiFi.

Space is limited -  to express your interest please register via this link.

Jan 302014
 

HANDI are looking for panel speakers and session facilitators for the HANDI Spring Symposium on Wednesday May in London.

The HANDI Health Apps Spring Symposium builds on the successful event run at EHI Live in November. Again working with EHI The HANDI Spring Symposium will take place at the Royal College of GPs, Euston Square, London on Wednesday 14th  May.

The symposium will provide an opportunity for the audience to discuss issues of concern to health and care app developers amongst themselves and with leading experts. Each session will consist of brief (5 minute) presentations from a panel of  three leading experts and practitioners after which the audience will be able to ask questions and make their own contribution which we hope will lead to a lively and informative discussion.

The sessions will be cover the following issues:

  • Finance, business models and startups
  • Quality assurance, safety and regulation
  • Informatics standards and interoperability
  • Tech and tools for app developers
  • User centred design
  • Digital Mental health and Wellbeing
  • Open source apps
  • UI, UX and information design

Were looking for experts and those currently struggling with the issues above who are willing to share their expertise and experience as well as a facilitator for each theme.

If you think you can help, or want to propose alternative themes please email ewan@handihealth.org outlining your interest

Jul 052013
 

 

I’m off to “Entrepreneur's Day with NHS England”  being organised by Cambridge Health Networks where I expect to see a lot of HANDI members and be able to recruit some new ones.

I’ve been a serial, if not always successful, commercial and social entrepreneur since I was 13 and through my work with HANDI I have spoken  literally many hundreds of aspiring entrepreneurs in the digital health and care space, most of who are a lot closer to 13 than I am today.  So from my own experience and that of others I hope I know what entrepreneurs want.

Well , like all of us, they want some mixture of money, glory, power and sex and are driven to achieve this by a heady mixture of love and fear. But, to be more specific about what they want in the digital health and care world I think this falls in to three areas in this order:

A route to market

They want to understand which business models will enable them to deliver sustainable products and service and achieve the commercial and/or social return they seek. This means:

  • Help in getting an enterprise of the ground in particular investment and mentorship (although too many young entrepreneurs don’t recognise their need for the later)
  • Guidance on business models and in particular support for novel business models that have the potential to provide a better way to buy and sell than traditional ones.
  • If the target payer is the public sector, help through the procurement jungle and public procurement channels that are accessible to start-ups and micro-enterprises.
  • A sales channel. Many entrepreneurs have neither the capacity nor inclination to do the required selling and would find the assistance of a appropriately configured sales organisation really helpful.

Help with quality and regulation

This is a fraught area for entrepreneurs in health and care. They recognise the need for regulation where poor quality can cause serious harm, want to comply with regulatory requirements and recognise the value of being able to demonstrate they meet appropriate quality standards, but they don’t want to be mired in onerous bureaucratic processes. They want:

  • Clarity with regard to legal requirements so they can properly address their compliance and risk management.  Today, it can be near impossible to get such clarity from regulators like the MHRA.
  • Access to independent quality assurance services which can provide meaningful but lightweight quality and safety accreditation that allows those who invest in quality and safety to distinguish their products and services from those who don’t. There are too many “snake oil” salesmen in the health and care apps market.
  • Help and guidance in meeting those quality and safety requirements that are required or useful to them.

Help to play nicely together

Delivering the real promise of digital tools requires that individual products and service from different, maybe competing, suppliers can work together orchestrated so they provide a unified experience to user, sharing data where appropriate with access to the common services they need to achieve this. This means:

  • Help and guidance with regard to interfaces, standards, software orchestration and interoperability.
  • Meaningful access to open interfaces (APIs) on relevant third party systems.
  • Access to a digital health ecosystem that provides the infrastructure and services required to support interoperability, orchestration and playing nicely together.

HANDI can help with all of these things. I look forward to hear how NHS England can help.