Oxford’s digihealth innovators rising to the Covid-19 challenge

Nye Health is a start-up working to create a new digital infrastructure to link patients with their doctors in an intuitive, accessible way, that integrates into pre-existing health system processes, structures and information systems. In March the team retooled to build an NHS-compliant, browser-based telephone and video phone system, which can be used for free with any NHS email address.

The Nye Phone interface. Pic: Nye Health

While the accelerated use of video conferencing for work has been one of the defining factors of the pandemic, the importance of telephone consultation should not be discounted.

Dr Benn Gooch of The Manor Surgery in Oxford says: “When we first started remote consulting, some of my patients were nervous about using video, and some colleagues feared it could exclude patients who did not have the technology it required. The fact that Nye offers secure telephone, as well as video, means that risk of exclusion is minimised, as all a patient requires is a landline or mobile telephone.”

But it’s not just patients who require links with clinicians. GP’s also need access to specialist opinions. Consultant Connect was founded when a GP expressed frustration that connecting to a hospital specialist required them to go through the hospital switchboard and it could take time to find an available consultant. After five years of operation, the company is past the initial start-up phase, working with 60 hospitals and covering 26 million patients. With the system, a wide range of clinicians such as paramedics, GP’s, nurses and GPwSI’s (GPs with special interests) can connect to a specialist within 25 seconds (UK average). Consultants are on a rota to ensure availability.

The Consultant Connect platform has both a telephone and photo messaging option. Using the IG (information governance) secure photo system, a GP can take a photo of a skin lesion and send it directly to a dermatologist, sometimes receiving advice within a minute. This service reduces hospital visits and cuts demand on the two-week wait pathway for cancer patients, meaning the patients that need to be seen urgently are seen in a clinic.

The Consultant Connect service primarily connects clinicians to their local trust. However, with shortages of specialists in some areas and the massively enhanced demand of the pandemic, there is now an option for NHS areas to use Consultant Connect’s National Consultant Network (NCN), composed of NHS Consultants able to answer out-of-area calls in their spare time. The NCN can support local consultants, acting as a backup when they can’t respond to requests, and provide specialties that are not available locally, such as neurology, dermatology, etc. Or they can answer all telephone advice and guidance calls from GP’s, leaving local consultants free to help the patients they need to see.

NHS guidance on mental health during Covid-19, published in March 2020, stated the increased need for verbal advice to be provided to mental health wards, as inpatients were at risk of contracting Covid-19. Consultant Connect’s platform gives many mental health trusts access to an even wider range of physical care specialists. Where mental health providers need physical specialties that can’t be provided locally, they can have access to the NCN. GP’s and other clinicians can use Consultant Connect to source near-instant mental health advice for their patients and, with this type of consultation, the patient is also involved in the conversation.

The pandemic has created a strain on people’s emotional wellbeing, and The Institute for Fiscal Studies has concluded that the economic downturn effects alone could lead the number of people of working age suffering from poor mental health to rise by half a million. This is before calculating the mental health effects of the lockdown and the human reaction to unprecedented and often frightening times.

RCube Health was set up with the mission of democratising evidence-based mental health support. Its core product is an employee well being platform, which empowers users to overcome stress and build resilience, thereby helping businesses to reduce costs stemming from poor mental health and decreased productivity. The RCube mobile app paired with a wearable helps users to measure and understand their mental well being, and provides personalised tools created by resilience experts. In response to the global pandemic, the company adapted to produce a free version of its app, called Resony, for consumers. This was well received by 200 early users, with one-third using it three times daily to manage their stress levels during the lockdown.

The Resony app. Pic: RCube Health

Understanding the physical effects of the coronavirus is essential for accurate diagnosis and treatment. Team RAIQC (Report and Image Quality Control), which took part in TheHill’s Innovation Showcase at Venturefest 2019, was created by a group of radiologists with expertise in clinical governance and quality assurance. Its interactive platform enables training and self-assessment of people who review medical imaging with a large database of diagnostic quality images, allowing staff to assess their medical image reporting skills. Now, with the help of Oxford-based Interactive Pharma Solutions, the team has developed a new module to help front line clinicians recognise Covid-19 on patients’ chest x-rays and CT scans, as well as other life-threatening conditions that can be confused with these images.

Many of the currently published images of Covid-19 are of low quality, and the number of reference cases in any individual location is too limited to capture the full spectrum of findings. “To get the most from the images and to diagnose as many cases correctly as possible, it’s important that as many medical staff as possible are trained in recognising Covid-19 related imaging findings,” said Sarim Ather, specialist registrar in clinical radiology at Oxford University Hospitals NHS Foundation Trust and one of the RAICQ founders. Beyond the immediate benefits, the tool will enable the training of the NHS workforce and improve the diagnosis of time-critical diseases such as lung cancer.

As has been widely reported in the media, the logistical impact of the pandemic has been considerable and worrying for healthcare staff. The situation has caused huge logistical challenges for healthcare; staff are changing their ways of working to respond to the pandemic and are witnessing problems in real-time on the frontline. Healthcare workers need ventilators to give oxygen, stock to take blood tests, deep-cleans, and personal protective equipment (PPE), both to protect themselves and their patients, and to prevent the spread of infection. However, with hospitals and GP practices in crisis-mode, responses are understandably uncoordinated.

MediShout’s founder is a surgeon inspired by the frustrating experience of having to cancel several operations because a lightbulb in theatre was broken. The company’s smart technology and allied app company enable swift and easy reporting of issues with IT, equipment, housekeeping and stock, saving clinician time and improving efficiency and care.

The platform is free for hospitals to manage Covid-19, and MediShout’s app is now live at Mid and South Essex NHS Foundation Trust. The company is joining TheHill’s Market Access Accelerator this month, as one of nine (of 18 in total) companies in the growth stream.

In these unprecedented times, individuals and companies have to act and think quickly to respond to the changing needs of healthcare and allied industries. TheHill is part of a thriving life sciences community in Oxford and the Thames Valley, full of resources and opportunities for entrepreneurs. The network runs regular workshops as part of the Innovation Support for Business programme, social mixers (now taking place online), an NHS Market Access Accelerator and European programmes supported by EIT Health, an EU-backed network of health innovators, including an Open API Bootcamp.

About the Author

Rhiannon Lassiter

Rhiannon Lassiter is the author of fourteen science fiction and magical realism titles for young adults and is Head of Marketing for TheHill, a digital healthcare catalyst team in Oxford University Hospitals NHS Foundation Trust. She graduated from the University of Oxford and continues to live in the city. Her ambition is to be the first writer-in-residence on the Moon.