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Patients prefer their consent to share their data and to manage it digitally

Patients with diabetes often have to see many different stakeholders who each specialise in different aspects of their treatment. Researchers from WMG, University of Warwick surveyed patients on their understanding of how their data was shared, and found they would prefer to have it shared digitally using the Dovetail Digital consent application.

Patients prefer their consent to share their data and to manage it digitallyThere are 4.7 million people in the UK live with diabetes, and will spend a lot of time visiting different specialist in different practices, who each specialise in some aspect of their treatment. Furthermore advances in digital technologies have resulted in innovative applications, which supported by healthcare professionals enable self-management, empowering patients to take control over aspects of their care. This requires a lot of data sharing, which is currently done by one practice requesting the medical records off another practice; with the need for doctors consent to share, this can be a long process to sign off. Furthermore, the process tends to be obscure with the patients forgetting the transfers for which they have given consent, as well not being very easy to revoke consent should the want so. The ability of patients to have control is one of the fundamental ethical and legal rights of the patient, and in many cases is difficult to balance against beneficial but data sharing intensive applications.

However, researchers from the Institute of Digital Healthcare (IDH) at WMG, University of Warwick propose that a new system called the Dovetail Digital consent application is favourable, and have analysed it in the paper; ‘Evaluation of patient perception towards dynamic health data sharing using blockchain based digital consent with the Dovetail digital consent application: A cross sectional exploratory study’, published in the journal Digital Health, SAGE Publications.

The Dovetail digital consent application is a robust, trusted and flexible mechanism for patients to offer their consent for their data to be shared between GP practices; they can also revoke consent at any point, therefore empowering them to manage their condition within an integrated care setting.

Dovetail sees a mobile application and blockchain-based infrastructure, meaning they can trace where their data has been shared. Blockchain is a state-of-the art technology originating in the financial industry, which has allowed implementing healthcare applications with the confidence and robustness found in the financial sector.

To survey whether it would work, IDH researchers asked 23 patients and 13 staff with diabetes, at a GP practice, to complete a series of questionnaires, followed by a focus group discussion, to determine their understanding of current methods to share data in a medical setting, and to see if they recall giving consent.

IDH Researchers then conducted a thematic analysis of the focus group transcripts and descriptive statistics of the questionnaires were performed.

Professor Theo Arvanitis, Director of the Institute of Digital Healthcare at WMG, University of Warwick explains what they found:

“We discovered there was a lack of understanding of existing consent processes in place, in fact many patients did not have any recollection of having previously given consent to their data being shared. When we asked them what they thought about the digital consent application patients overwhelmingly favoured the digital consent application over existing practice, as they recognised the value of the capability offered by the application.”

Dr George Despotou, Associate Professor at the Institute of Digital Healthcare and lead in the study comments:
“The study participants welcomed an application that would ultimately contribute to improving their quality of case, whilst maintaining control over their data. In particular the study participants acknowledged the clarity of the consent application, and the ease with which they could review, as well as revoke existing consents. This was a very promising study on a technology that may be opening the way for highly innovative applications improving quality and efficiency of healthcare services, which patients would welcome, assured that ultimately they are in charge of their data.”

IDH Researchers were able to conclude that the digital consent was received favourably as patients were able to recognise that it addresses the main limitations of the current process, but also acknowledged the traceability and transparency of the Dovetail app. Further research can now be conducted to see if patients across a wider demographic prefer the Dovetail Digital consent application, and if successful could revolutionise the way that patient data is stored and shared.

Paper available to view at: https://journals.sagepub.com/doi/10.1177/2055207620924949

DOI: 10.1177/2055207620924949


Coronavirus brings dawn of digital healthcare

In light of the highly-infectious Coronavirus pandemic, healthcare systems across the world have had to adapt rapidly for the evolving situation for three reasons:

1. The need to triage and treat large number of patients with respiratory problems

2. The need to protect healthcare workers to ensure they can treat the sick

3. The need to protect the elderly and most vulnerable in society from being infected

In the editorial, 'Covid-19: A new digital dawn?', published in the journal Digital Health (SAGE Publications), researchers from our Institute of Digital Healthcare at WMG, University of Warwick (together with colleagues from Warwick Medical School, University Hospitals Coventry & Warwickshire NHS Trust and Bristol Heart Institute, United Hospitals Bristol NHS Foundation Trust) provide insight into how these three reasons have led to an increase in digital healthcare.

Professor Theo ArvanitisProfessor Theodoros Arvanitis, from the Institute of Digital Healthcare at WMG, University of Warwick comments:

“Covid-19 will unfortunately have a human cost that will be remembered for many years to come. Its impact on healthcare, the economy and society, as a whole, will be rather significant. However, it could also be the start of more digitised healthcare, as new ways of remote and digital health working have had to evolve so rapidly. We can learn from this time and take it further to make one positive come out of coronavirus, a more digital healthcare practice.

“A more digital healthcare practice could help slow further spreads of infections, as if you have an infection and go to the doctors, you could pass it to people in the waiting area. It can also help GPs communicate more quickly and internationally, sharing advice more freely in the future.

“It can also improve the economy of the healthcare system by managing better the clinical load of frontline staff, while provide flexibility in the way citizens access healthcare services.”

Innovative digital healthcare responses come into various aspects of coronavirus, from communication, to education and patient management.

In terms of communication, clinical groups are using messaging services such as slack and WhatsApp to manage rotas as high levels of staff may be off sick or in self-isolation. They are also using social media, such as Facebook to make groups such as the ‘COVID Doctors Forum (UK)’, which on the 6th April 2020 had 14,813 members.

The group covers a range of topics, from PPE to procedures of self-isolation and lessons from colleagues internationally, as well as a number of blog posts.

There’s also been further examples in change of communication as the Discourse Digital Health Network had a page with multiple threads considering the digital response to Covid-19, as well as a webinar on the response, hosted by NHSX ,which would have previously been face to face.

Education wise many conference, training courses, post-graduate exams have been cancelled, however the need for rapid education of the healthcare workforce to deal with respiratory problems and deployment education to staff who have changed roles during the pandemic is still needed. It has therefore been carried out virtually.

Doctors in training have had their Annual Review of Clinical Progression assessments virtually, e-learning packages have also been set up much more rapidly than previously. For example, University Hospitals Coventry and Warwickshire produced a training package in just 72 hours to help staff train to deal with viral respiratory diseases.

One of the most significant changes is to patient management, in order to protect the elderly and vulnerable telemedicine consultations have taken place rather than in person.

There’s also been a rapid reaction in the MedTech industry to roll out digital tools and packages, such as EMIS, (Egton Medical Information Systems), the largest supplier of electronic health records, introducing a range of interventions, including modifying coding, alert tracking and all EMIS web GPs in the UK being able to host vide consultations for free.

Most GP practices are now offering appointments over the phone, video call or via an app.


WMG Professor appointed Director of the Institute of Digital Healthcare

Professor Theo ArvanitisProfessor Theo Arvanitis has been appointed as the new Director of the Institute of Digital Healthcare (IDH), at WMG.

Professor Arvanitis takes over the new role replacing Professor Sudhesh Kumar from Warwick Medical School.

He joined WMG in 2007, as a Professor of e-Health Innovation and Head of Research in IDH, and his research interests span the areas of biomedical engineering, neuroimaging and health informatics.

Professor Arvanitis will manage his new role alongside his current research responsibilities within WMG. He will be supported by a new IDH Advisory Board which will be appointed in the new year.


New approach helps computers deal with conflicts and duplications when applying more than one clinical practice guideline to a patient

Researchers in WMG at the University of Warwick have developed a new method that could solve the problem of how to automate support of managing the complexities of care when applying multiple clinical practice guidelines, to patients with more than one medical issue.

This will preserve the speed and accuracy of automated treatment decisions without introducing serious treatment conflicts or wasteful duplication of treatments and procedures.

Clinical Practice Guidelines (CPGs) are evidence-based statements or flow charts, which are used to support the decision-making of health professionals. CPGs are a body of knowledge representing best practice, based on the available evidence. Guidelines are relatively straightforward to input into a computer (a.k.a Computer Interpretable Guidelines (CIGs)), enhancing the speed and accuracy of patient care in many situations.

However, it becomes more problematic for patients who have more than one conditions. In such cases (known as multimorbid patients), the guideline recommendations for each treatment can be at odds, produce serious treatment conflicts and ultimately potential harm to the patient.

For instance, one drug-based medication might assist one condition but could worsen the other. This is particularly critical for elderly patients who are most likely to have dynamic and multiple health conditions.

The research team from WMG’s Institute of Digital Healthcare at the University of Warwick (Ms Eda Bilici, Dr George Despotou and Professor Theodoros Professor Theo ArvanitisArvanitis) have implemented a framework of automating computer-based management of multiple Clinical Practice Guidelines to overcome this problem.

The new framework is called MuCIGREF – (Multiple Computer Interpretable Guideline Representation and Execution Framework). It allows development CIG models for each CPG. Once the CIG models are created, they are then concurrently executed to generate a unified personal plan for each individual multimorbid patient.

It ensures care optimisation to avoid unnecessary resource use or potential care duplications because of the multiple plans (e.g., carer time, lab test).

It identifies potential conflicts in the care plan and resolves them through the modification of clinical activities (e.g., activity start time, duration), or its associated care element (e.g. the drug dose level)

The researchers tested the new framework on several CPGs from the UK National Institute of Care Excellence (NICE), and they hope to conduct further work that will involve user validation and application in real-world cases.

This first stage in the work has just been published in a chapter entitled “Concurrent Execution of Multiple Computer- interpretable Clinical Practice Guidelines and Their Interrelations” in the Ebook Health Informatics Vision: From Data via Information to Knowledge  

 ENDS

4 OCTOBER 2019

NOTES TO EDITORS

Paper Available to view at: https://www.ncbi.nlm.nih.gov/pubmed/31349252

Eda Bilici has received a PhD scholarship from WMG, University of Warwick. Prof Theodoros Arvanitis and Dr George Despotou have been supported by the EU H2020 C3-Cloud Project

FOR FURTHER INFORMATION PLEASE CONTACT:

Alice Scott
Media Relations Manager – Science
University of Warwick
Tel: +44 (0) 2476 574 255 or +44 (0) 7920 531 221
E-mail: alice.j.scott@warwick.ac.uk

 


WMG and Birmingham Hospitals launch new degree for new NHS role

WMG at the University of Warwick has launched an exciting new fusion science degree, accredited by the National School of Healthcare Science as part of Health Education England, and is designed specifically to train people for a brand new, and first of its kind health role within the NHS - Digital Healthcare Scientist.

The BSc degree, which has been developed in partnership with University Hospitals Birmingham NHS Trust, will be open as both a full-time undergraduate course, and a Degree Apprenticeship.

Graduating students will be eligible to apply for membership of the Academy for Healthcare Sciences under the new heading of Digital Healthcare Science. This represents the formation of a new healthcare professional and a new branch within the Academy, the first for many years.

The course has been designed with the aim of augmenting the existing workforce in the NHS and breaking down silos, adopting a fusion science approach: taking into consideration aspects of digital science, academic and professional development, clinical decision making, physiological science and behavioural science. Students will learn in an integrated way, applying knowledge, and ensuring that no subject is taught in isolation from any other.

Four fusion sciences: Behavioural Science, Healthcare and Physiological Sciences, Digital Healthcare, and Shared Clinical Decision-making, will be interwoven throughout the programme giving students a breadth of scientific training.

Professor Ed Peile, from the University of Warwick comments:

“Rarely do patients and health service users have a single problem. They have multiple, often complex, problems affecting their health and wellbeing. Thus, the help they need is not confined to a single discipline. They need broad, holistic, scientific professionalism.

“The ‘Fusion Science’ approach developed here is specifically designed to ensure that the new Digital Healthcare Science workforce can meet these needs”.

Tim Jones, Executive Director of Workforce & Innovation at University Hospitals Birmingham NHS Trust comments:

“This is an exciting new degree which will help us train people for a significant new role in the NHS. University Hospitals Birmingham NHS Trust is also offering six full-time undergraduate students the opportunity for a paid summer vacation placement at the end of the first year of study.”

Berne Ferry, Head of the National School of Healthcare Science, adds:

“The National School of Healthcare Science has been closely involved in initiatives to develop a health workforce fit for the digital future. This includes the use of digital technologies and computer science in all areas of healthcare from artificial intelligence and bioinformatics to patient-focused apps and devices. We are delighted to see universities such as Warwick working quickly and responsively with the health service to develop exciting new programmes to meet these needs.”

The programme would suit students who are interested in medical and healthcare sciences, life sciences, data sciences or psychology. For more information on where to apply please call +44 (0) 2476 525724

ENDS

11 JUNE 2019

NOTES TO EDITORS

The programme would suit students who are interested in medical and healthcare sciences, life sciences, data sciences or psychology. For more information on where to apply please call +44 (0) 2476 525724

FOR FURTHER INFORMATION PLEASE CONTACT:

Alice Scott
Media Relations Manager – Science
University of Warwick
Tel: +44 (0) 2476 574 255 or +44 (0) 7920 531 221
E-mail: alice.j.scott@warwick.ac.uk

Tue 11 Jun 2019, 09:03 | Tags: Undergraduate Education IDH

Unfit people are more physically active because of the Sweatcoin app that pays you to walk

More people are physically active due to the Sweatcoin app which rewards you for walking – researchers at the Institute of Digital Healthcare, WMG at the University of Warwick have found. Sweatcoin gets people outdoors and walking to earn a virtual currency to spend in their marketplace.

Reaching your target number of steps a day is a little easier for those using the app called Sweatcoin which rewards users with a virtual currency for walking.

Sweatcoin works by converting the number of steps recorded on your phone into a virtual currency of Sweatcoins.

Every 1,000 steps generate 0.95 Sweatcoins and these can be used to purchase products on the in-app marketplace, (with prices ranging from 5 to 20,000 Sweatcoins), in local shops, or be transferred between other users.

Currently, steps recorded outdoors are rewarded due to the use of a GPS-based verification algorithm used to stop people cheating their phone’s step-counting algorithm.

The Institute of Digital Healthcare, WMG at the University of Warwick analysed daily step count data from 6000 users of the app, and found that there was a sustained average increase of nearly 20% in daily step count over a 6-month period after users had registered with the app, in comparison with a 3-month period prior to downloading the app.

Following a survey on a sample of the original 6000 users, those who were classified as less physically active and overweight were found to be most likely to increase their daily step count when using the app, meaning that Sweatcoin was having impact on an important section of the population who previously had low levels of physical activity.

Dr Mark ElliotDr Mark Elliott, Assistant Professor at the Institute of Digital Healthcare, WMG - University of Warwick comments:

“We were delighted to have the opportunity to work with Sweatcoin and investigate how their app impacts on physical activity behaviour change. By analysing the daily step count data from a sample of Sweatcoin users and combining this with data from the surveys and focus groups facilitated by our researchers, we were able to identify which types of user had shown the biggest change in terms of increased physical activity from using the app.”

Anton Derlyatka co-founder at Sweatcoin comments:

"Incentivising people to walk more is key to improving levels of sustained physical activity. Yet, traditional ideas such as providing educational seminars or discounted gym passes, just don’t deliver. The University of Warwick found that an economy built on movement, as created by Sweatcoin, establishes sustained motivation for people to be more active. For an increasingly sedentary population facing an obesity and wellness crisis, these are significant findings.”

Lord Philip Hunt, Sweatcoin Advisory board member commented:

“Most health apps and initiatives tend to be aimed at those who are already active. Sweatcoin has huge potential in encouraging and incentivising non-active people to get walking. Given the health gains that can be achieved through increased physical activity, this is the kind of breakthrough we need to help motivate who can benefit most.”

 

 


WMG project tackles data sharing issues in the healthcare sector

Researchers from the Institute of Digital Healthcare (IDH) at WMG are working with healthcare software experts at Dovetail Lab on ‘General Practice of the Future.’

Using Blockchain Technology, our team of Assistant Professor George Despotou, Research Assistant Jill Evans, Professor Theo Arvanitis and PhD student Tim Robbins are developing a digital consent service for the exchange of patient data across electronic health records in an integrated care setting. High levels of encryption allow information to be shared securely with consent, and audit records stored on a “Blockchain” to ensure compliance with information governance rules.

Patients using this consent mechanism will be able to actively control how they share their data, and approve or refuse (case-by-case), from a mobile app.


New pelvis motion tracking technology to transform hip replacement decisions

A new pelvis motion tracking device developed by WMG, at the University of Warwick, can help detect flexible pelvises without numerous x-rays, to determine who will benefit from more advanced surgical planning before hip replacement surgery.

Mark Elliot 3Researchers at WMG’s Institute of Digital Healthcare and Professor Richard King, of University Hospital Coventry and Warwickshire - and Honorary Professor at Warwick Medical School, have developed a small device that can be put at the bottom of your back to scan the movement of your pelvis prior to a hip replacement.


Using e-health to support the challenges of an ageing population

Researchers at our Institute of Digital Healthcare have published a systematic review on e-health based active ageing interventions.

As life expectancy is at an all-time high, this type of research has become an international priority offering enormous potential to support individuals, communities, clinicians and policy makers.

Our Professor of e-Health Innovation and Head of Research, Theo Arvanitis, Dr Timothy Robbins and Dr Sarah Lim Choi Keung, worked alongside experts at University Hospitals Coventry and Warwickshire to establish the extent to which current research literature considers e-health-based and telemedicine-based active ageing interventions.


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