FoodMaestro:Bridgette Wilson:
What I usually do is recommend the app to patients if they are someone who already regularly uses apps on their smartphone, I explain that it is a handy tool to learn more about the low FODMAP diet and it is really useful in that the videos give a lot more detail than what is possible in a one hour consultation. From a patient perspective the feedback I have had is that the bar code scanner is the most useful aspect of the app and I believe that due to the ease of being able to check suitable products that patients are more compliant on the diet when they use the app which in turn leads to a greater symptom response. I also use the app to guide patients on the reintroduction phase, it is helpful in that there are prompts in the phone each day during a challenge phase advising patients what portion and what food they should be challenging with that day. I do still think patients need to seek guidance from a dietitian so that their diet as a whole can be assessed and patient specific advice can be provided but the app really does help to simplify what has previously been perceived as a complicated diet to follow.
Walk With Path:
Ernest Lim:
"Having seen the difficulties of managing the various aspects of Parkinson's first-hand, I found Walk With Path's problem-centric approach to alleviating some of Parkinson's most debilitating symptoms such as freezing of gait extremely refreshing and promising. In particular, the Path Finder product aims to address the "Freezing of Gait" (FOG) phenomena seen in some Parkinson's patients. FOG can be notoriously difficult to manage, often resistant to medication, furthermore, there is yet no consensus on its underlying pathophysiology.
Path's solution is to provide a visual cue for patient's with FOG in the form of a laser-projected target line for the patient to aim for with each step. The device provides a calibrated visual cue to break the cognitive cycle of freezing, and studies with early prototypes in Holland have demonstrated very promising results. As the current treatments involve complex drug regimes or deep brain electrodes, I am excited to see the potential impact such an elegant, non-invasive solution will have on the way we manage Parkinson's Disease."
StepJockey:
Teeside University:
Backed by the Department of Health, with funding through the Small Business Research Initiative, its aim is to encourage office workers and commuters to sign up.
Alan Batterham, Professor in Exercise Science at Teesside University and a Fellow of the American College of Sports Medicine (ACSM), is on the StepJockey advisory board.
As an expert in measurement and evaluation issues associated with physical activity, exercise and their health outcomes, he has been helping StepJockey evaluate the algorithm for calorie-burn in stair climbing.
Professor Batterham said: 'StepJockey helps individuals to build vigorous physical activity into their daily routine and is an excellent, time-efficient way to increase fitness and control weight. 'Stair climbing is also a surprisingly powerful form of exercise and has benefits that go beyond weight control. It reduces the risk of chronic diseases including cardiovascular disease, diabetes, osteoporosis, and breast and colon cancers.'
Once signed up online to the free StepJockey website, participants can enter details relating to the number of stairs in the office or building where they work. The website then calculates the number of calories used each time they climb the stairs in the building.
Buildings can also be signed up to the scheme, with the introduction of StepJockey smart sign scan points by the stairwell on each floor to enable climbers to log their stair count.
Teesside University researchers are carrying out a validation of the stair climbing equation used in the StepJockey project to allow users to accurately record and ‘gamify’ their stair climbing.
In trials involving more than 250,000 journeys involving stairs and lifts, stair climbing rose by up to 29 percent when the building was equipped with StepJockey smart signs. And when office workers were able to track and gamify their stair climbing, stair use jumped by over 500 percent.
Patients Know Best:
Dr Zoe Warwick at Derriford Hospital:
In 2014, Derriford Hospital in Plymouth became one of the first NHS hospital trusts in the UK to use Patients Know Best’s online patient controlled records system to manage the care of its entire cohort of HIV patients - through a pilot study supported by Janssen, a pharmaceutical company of Johnson & Johnson. Spearheaded by sexual health and HIV consultant Dr Zoe Warwick, today the system is being actively used by well over 300 HIV patients across Plymouth and the South West of England.
Responsible for overseeing the introduction and ongoing roll-out of PKB to Derriford, Dr Warwick was a keen advocate for the deployment and use of PKB – right from the beginning. “PKB goes back to some basic principles of mine – which is why I saw it had such potential,” said Zoe. “Medicine can be very paternalistic – we hold all the records, we write about patients, they don’t own their records and have to apply to have access to their records – I’ve always felt that’s wrong.”
“Sometimes in the NHS we know we can’t really solve the big problems in the system – so we find workarounds. PKB wasn’t like that. It could potentially solve a very big problem. It gives us the potential to work differently and that was the thing for me that kept me advocating for it and persisting.”
Central to Zoe’s belief in the system was the role she saw it could take to positively impact the lives of her patients – albeit for different reasons, as Zoe explains. “My patients can differ extremely. There are those who are very vocal and well informed – they want more control and PKB gives them that. But there’s another group who are the opposite. They’re very disempowered and disconnected from mainstream society. They might not instantly engage with PKB, but they have the potential to benefit from it hugely because they desperately need to have more control over their care.”
Once PKB had been given the green light by hospital administrators, Zoe began the process of introducing the system to her patients – something that quickly confounded her expectations.“I thought I knew who would and wouldn’t want to use PKB – but boy was I wrong!” said Zoe. “Some of the patients who I knew didn’t even have a computer at home really wanted the system. So instead of picking off people to approach to use PKB I just offered it equally as enthusiastically to everyone – and that’s been my approach ever since.”
Now the system is up and running, Zoe and her team are already seeing benefits – both to patient care and to their own time management. Derriford’s HIV team are making particular use of the secure messaging functionality within PKB which means that patients can contact their doctors at a time that suits them. “Understandably, our patients can get very anxious about elements of their condition,” said Zoe. “Before PKB, patients were often reluctant to contact us because they didn’t want to be a bother. Now, patients can send a message in the middle of the night and feel reassured that we’ll answer the next day. Just the act of sending a message can reduce their anxiety.”
Despite giving patients an additional channel of communication to use to reach the HIV team, Zoe has found that lowering the barriers to access has led to fewer messages being left and crucially, improvements to patient care. She said: “When patients feel they can’t get hold of you they panic and that leads to more messages being sent and left. When you lower the barriers to access then people become more relaxed about making contact because they know a channel is there if they need it. That means we get to hear about problems earlier than we would do otherwise and we can catch issues before situations become potentially dangerous.”
“For example, I have a patient who noticed a rash while on holiday and contacted me thinking they were having an adverse reaction to their meds. They were on the verge of stopping their meds altogether and flying home. I asked them to immediately send me a photo of the rash over PKB and was able to tell them it was nothing to do with their HIV medication. Some simple skin cream cleared things up the next day and we avoided the whole situation from escalating.”
Today Patients Know Best is an integral part of Zoe’s work at Derriford Hospital and she is leading the way at normalising the use of PKB in her own specialist department and further afield. “PKB is an essential part of what we do here,” said Zoe. “Every single GP letter gets put on PKB regardless of whether the patient uses the system. They might not engage with it now – but they might in the future. Nurses and pharmacists use the system too and really like it.” “My ambition is to make PKB a normal part of how we care for people. Our next step is to increase patient education – that’s really important – and integrate the system with our primary care colleagues.”
Dr Andrew Ustianowski at Manchester General
The Regional Infectious Diseases Unit (RIDU) based at North Manchester General Hospital is one of the largest units of its kind anywhere in the UK and offers specialist clinical services to patients across Greater Manchester – and more widely.
Most notably, Andrew and his team are using Patients Know Best to slash the amount of time that stable HIV patients need to spend in clinic – something that’s often welcomed by the patient, as Andrew explains: “When I talk to patients about PKB, one of the things that really switches them on is the idea that using the system might mean they have to spend less time in clinic – that’s something that’s normally of great interest.”
“When an HIV patient’s stable we don’t need to see them very often – unless they want to see us. At the moment, they visit us every six months after getting their bloods done. But when a patient is doing well, dragging them into clinic can be inconvenient for them,” he said.
“Why should we force someone to take time off work and come in when it’s 99.9% certain they’ll be fine. And if they’re not fine, then why wait for the six month check up – come and see me now.”
“For those stable patients who want to, our aim is to drop down face-to-face contact to annual visits and I’m confident that the vast majority of these patients will want this,” he said. Whilst the process of dropping down the frequency of face-to-face reviews was underway before PKB, Andrew sees that the patient-controlled system enables them to move forward faster with this ambition. Andrew also sees that using PKB gives him the assurance he needs that patients have a secure channel to contact him – should they need it. “I need to feel 100% confident that patients know they have a highly secure route of access and patients must feel sure they can always message me and get a response – PKB enables this,” he said.
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