Global Digital Exemplar Chelsea and Westminster Hospital NHS Foundation Trust announced earlier this month that it had launched a digital postnatal discharge system in a new partnership with Lumeon. This week, MobiHealthNews visited the company’s London office to find out more about their work with the NHS trust and plans to scale operations in the US after securing $28m in funding in December last year, with LSP as the lead investor.
Q.: What can you tell us about the new initiative at Chelsea and Westminster Hospital NHS Foundation Trust, your first direct NHS customer?
A.: It’s our firstly directly contracted work with an NHS organisation, we’ve actually been working with NHS organisations for probably six or seven years now, but under the banner of other companies. One of the aspects of the UK health care system is that they will outsource a lot of care delivery to third-party organisations, and those organisations will typically contract on a fixed price basis, and so they care hugely about being able to monitor the quality control of what they’re doing. Those organisations have found a lot of success in using our platform, because they can manage the patient process end-to-end in a very deliberate and controlled way. Logically, it would make sense that NHS organisations would want to have that same capability, but it’s been a struggle for us to be able to engage these organisations directly. It was two years ago that we went on the DigitalHealth.London accelerator, which gave us access to a lot of NHS-type people, and through that we met Chelsea and Westminster.
Now, the problem we’re working with them on is obviously around discharge planning, specifically in maternity. Fundamentally, what Sunita [Dr Sunita Sharma, Consultant Obstetrician and Gynaecologist at the Chelsea and Westminster Hospital] picked up on was, through customer surveys and other kind of anecdotal feedback, she found that […] the management of expectations around discharge led to a problem around patient experience. Patients, new mums, new dads, with their young family desperately wanted to get home, and the challenge of getting a patient out of hospital, whether it’s in maternity or anything else is a difficult one. The unpredictability you see when the patient’s leaving through that care transition is at its most acute when you have all the emotional sensitivities around taking a new child home, you just want to get home.
I’ve been through this twice at St George’s and again the delays and the complications and the uncertainty is very disruptive. So, they wanted to bring predictability and they wanted to bring in some structure to it which would allow them to manage the process better and basically make a much, much better patient experience.
So we came in, and we have a particular methodology that we deploy, which basically allows us to map everything that happens along a particular process. And then we can wrap that into our software, and the reason we do that is that it allows us then to identify inefficiencies, identify communication gaps, identify where there are problems, and then we can use software to eliminate those issues. And that’s what we’ve done.
Q.: And when did the process start?
A.: We actually started the engagement over the summer, and the end-to-end process around engagement took about six months, the actual work activity on the ground was about two weeks of work […].
We’ve developed this process because we found that, when you bring people to a room, they all mean very well and they bring lots of ideas, but what happens on the ground is often quite different, so we have a shadowing process we use. And there’s a great story that Jeff [part of the Lumeon team] will tell around getting everyone following the process through and identifying that the cleaners were in fact one of the biggest bottlenecks because of the patients being discharged and the turnaround for the next patient coming in. If the bed’s not been cleaned, then the bed can’t be used. But the cleaners were on the eighth floor, and the maternity wards on the fourth floor. And so nobody thought on the clinical team or on any of these other process improvement teams to bring in the cleaners, that’s one of the things we spotted. We did that and we brought a dashboard then to the cleaners so that they could say, I need to do this bed at this time, etc.
Again, it’s just making stuff better, leaner, more optimised, more efficient, more effective, which all translates to a better patient experience.
Q.: And if I am a maternity patient there, what has changed for me?
A.: Well, as a nurse, what would happen is, you have an iPad now and you work through a list, essentially like a checklist, but the checklist is going off and doing things in the background, and checking for things in real time.
From a patient's point of view, all that happens is, the things that you’ve been told are all being managed to conclusion effectively and more precisely. So, whereas what might have happened in the past is, you might be told you’re going to get discharged this morning and you get out of the hospital in the evening, in this case, you probably would get discharged in the morning.
It’s very mundane, very simple, very boring, but very important.
Q.: In a recent blog, one of your colleagues mentioned that you were working with Chelsea and Westminster to implement additional product capabilities. Can you give us an example of what those are?
A.: Our platform has a lot of capabilities in it, we use it in a wide variety of care settings, ranging from community to patients at home, remote monitoring, etc. So for us, when we deploy it, we’ll start typically with something quite small, and then add in more and more and more capabilities. The ability to follow the patient all the way home, for example, is something that we can do today, but we’re not activating yet, so that will come on stream shortly.
And again, starting before the birth as well, so optimising [the process for] the patient as they come in, making sure that they are managed through the whole process so that they have a companion, a digital companion following them through the birth.
Q.: Will you now be looking to scale the system across the NHS?
A.: Our hope is that, Chelsea and Westminster are very much a thought leader in this space and they are well known within the UK as an amazing brand, particularly in maternity, but also in other areas. My hope is that other institutions will look to them and say, this is how best practice looks, and will want to work with us as a result. And Sunita’s done an amazing job of being an advocate for the system.
Q.: Lastly, in December, you announced that you had raised $28m in funding, with investment led by LSP and support from MTIP, Gilde, Amadeus Capital Partners and IPF Partners. What will you be using the new money for?
A.: So, we are principally using the money to scale the organisation to the US. Since December, we’ve grown our US operational team to 15, and we are in the process of deploying our first customers, the first of which went live two weeks ago out of the West Coast, and that’s very exciting. They’re rolling out to 60 sites over the next couple of months.
We then have, I think we’re forecasting, our run rate last year was six million patients across our entire installed base in the UK and Europe, and we expect to have I think five and a half million new patients this year, just from the US base alone, and that’s from customers we’ve already booked, so there’s still room for more.
