Back in May, the South London and Maudsley NHS Trust (SLaM), in association with Microsoft, launched MyHealthLocker, the UK’s first online service designed to give users of SLaM’s mental health services greater control, participation and collaboration in their care programmes. Four months later, we return to see how the service has progressed.
Using the MyHealthLocker service, underpinned by Microsoft’s HealthVault specialist clinical data repository, SLaM service users can record their responses to medication and care, goals, sleep patterns and more. It is backed up with comprehensive additional information resources (local services, benefits advice, etc.), and regular surveys and questionnaires, allowing care providers to engage more effectively – and more often – with users than ever before.
At the launch, Lord Howe, Parliamentary Under-Secretary of State at the Department of Health, called the initiative a “pioneering approach [which] truly puts people at the heart of their care” and “an example of the information revolution in action”.
Four months in, and MyHealthLocker is attracting extraordinary interest. As well as several press appearances and being a nominated finalist project for the Health Service Journal’s Innovation in Mental Health Awards (results to be announced later in the Autumn), it was referenced more than once in the Department of Health’s flagship new Information Strategy.
Mike Denis, SLaM Director of Information Strategy and project lead, explains that the service is now available to 1000 service users in five clinical teams; specifically in two areas: Psychosis and Child & Adolescent services. Denis says, “There are two challenges here; that of using new technology, and that of a change in the service experience. We chose Child & Adolescent because children naturally take to technology much more easily; they’ve grown up with it, and are best equipped to jump the first hurdle of technology adoption. The second group, Psychosis, put themselves forward on an entirely voluntary basis. Both clinicians and service users simply presented themselves as interested parties. In this way, we have two very disparate groups with different approaches to the service whose feedback we can monitor; and also isolate in an evidence-based way the effect of technology separately from the effect of user take-up and experience.”
SLaM’s trustees and an award from the South London Health Innovation and Education Cluster are assisting with funding for training and take-up. Today, Denis is focused on encouraging service take-up and delivering initial support. Whilst initial comment on both experience and value added to the service are hugely positive, he expects to have statistically and clinically valid experiential feedback to report in the coming six months – feedback which many Trusts are eager to hear. Denis is already in discussions with healthcare commissioners and also his colleagues at Kings’ Health Partners in other specialist chronic disease areas like renal care and diabetes. He says, “I’m absolutely of the view that this is an innovation that’s going to last the test of time and be truly transformational.”
Co-designers in care provision
Denis hopes to give other Trusts a best-practice service and approach to using data collaboratively. “Our focus is very clear”, he says. “MyHealthLocker is about empowering service users to play a far more active role in their self-care experience. We are moving on from purely the choice agenda to empowering service users as partners in the design of their care, from the outset and based on good evidence”.
The Trust expects that this collaborative process will move patients from being passive recipients of information and health experiences to being fully informed about their own disorder and the service choices available; and furthermore able to make informed decisions about how they want their care to be designed. They will be able to reflect their experiences in terms of outcomes and share those experiences with care providers fully and effectively as co-owners of the information. Says Denis, “Records access is, of course, an important step, but it’s time to think about the next phase – the end point of this journey is that the patient will be an informed member of the clinical team.”
Arif Govani, Director, HealthVault, Microsoft UK, adds, “MyHealthLocker is a great example of what we want emerging healthcare data projects to be remembered for: a measurable improvement in outcomes, evidenced by academic dedication from specialists within the NHS. We have invested many millions globally in HealthVault, and we are committed for the long term to generating value for healthcare professionals from the collaborative use of knowledge, whether that’s generated by the patient, the clinician, or public resources”.
In use, MyHealthLocker is multi-device, multi-platform, and always available. It is not designed to replace emergency care or face-to-face meetings, but it will allow both parties to better prepare for face-to-face care. “Consultations will become more productive”, says Denis. “Both sides can attend consultations fully prepared, and with clinically relevant data at their fingertips. And without the questioning process, you’re not just saving time, you’re removing the sense of ‘us and them’ or ‘expert and patient.’”
Contributing to the Connected Health agenda
MyHealthLocker is being held up as an example – and key component – of Personal Health Records in action. It is currently being assessed by the London Connect Project, a programme supported by the Greater London Authority to examine the potential applications of Personal Health Records across London. Denis says, “The capital is recognising the potential and we’re looking to make this experience available to its eight million citizens.” Says Govani, “The economies of scale should also be tempting for healthcare commissioners – we are on the cusp of truly consumerising PHRs.”
Denis adds that SLaM’s new approach to data also has a role to play in today’s transformation of healthcare provision. “The NHS is going through a hugely complex service redesign at the moment to implement the Connected Health model. Personal Health Records and services like MyHealthLocker are crucial in keeping the patient at the centre of the relationship.”
The first validated data from MyHealthLocker is expected in a matter of months. The signs are that, by then, given the current level of momentum, the service will have extended to more people, more long term care sectors, and more Trusts across the UK.
By Nick Saalfeld, Microsoft UK Health journalist