The Brief

• Scale of the problem• What are the trends?• The do nothing scenario• What is the innovation• What can the future look like?• The Challenges• Wessex

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Scale of the problem• There are 15.4 million people with long term conditions and

prevalence is rising

• COPD alone accounts for >£1bn/yr, responsible for 13% of acute medical admissions

• Over 90% of patients with asthma and COPD unable to use their inhalers correctly

• Current PR programs £400-£600 /yr with limited penetration

• Diabetes predicted to rise to 5 million over next 5 yrs – average cost £2500 pp/yr

What are the trends?

• No improvement in inhaler technique in 40yrs• Rising hospital admissions• More complexities and more patients with co-

morbidities• Less money in the health service• Everything else in our lives is going digital but

the Health

The do nothing scenario

What is our innovation?

Our innovation

• Double the rate in recovery of CAT scores during exacerbation

• All inhaler errors corrected in 95-98% patients

• On line PR with same outcomes as class based programs

• CAT score improvements 5-12

• Reduced exacerbations

• Reduced consultation time

• Analytics philosophy• Disease burden• Disease phenotype• EWS• Pandemic Plan

COPD Example90% of patients unable to use therapy correctly

98% of patients using therapy correctly

150-200 patients per CCG receive face to face pulmonary rehab to completion at a cost of £200-@400 per head. Dropout rate 45-55%

1000s of patients receive pulmonary rehab for a lifetime with double the walking distance improvement achieved against standard class based programs

Limited access to specialist services Open 7 days a week including physiotherapy and psychology modules

Variation in the quality of care delivered. In some studies, 90% of clinicians failed to deliver correct inhaler education

Reduces inequality with an NHS approved set of educational modules and inhaler videos

Leads to the creation of an ever expanding clinical team with multiple touch points

Improves quality and reduces cost

Reactive health service Provides medical intelligence to manage the system efficiently

Challenges

Implementation

• Change• Clinicians• Organisational• Pathway changes necessary

Scaling

• CCG by CCG• STPs and Vanguards• 3rd Party• Champions

WHAT ARE WE WAITING FOR?Wessex