Using digital health to transform the management of long-term conditions in the NHS: Assessing real-world patient experience and empowerment and improvements to productivity and capacity

Background: Healthcare systems face increasing demands for monitoring and treatment of long-term conditions. Remote digital monitoring avoiding hospital visits offers many advantages. During the Covid-19 pandemic safety from transmission has become a major benefit. Itecho has developed the AscelusTM platform, which enables patients to send information through a 'symptom checker' to their clinical team, which reviews this, and the patient s blood tests. Patients then receive encrypted clinical advice, results of blood and other monitoring sent directly to their smart phone/device (Figure 1). Patients deemed at risk are called for face-to-face appointments. Aims and objectives: To assess, in the real-world setting, how AscelusTM impacts long-term condition management, hospital capacity/productivity and patient experience/empowerment to then support procurement, commercialisation and scale up. Methods and timelines: We will assess real-world implementation of AscelusTM in 7 haematological conditions across a comprehensive series of domains in eleven interlinked work packages, encompassing: Co-design of new digital haematological care pathways, underpinning bespoke platform amendment/integration into hospital IT systems. Patient validation and safety cohort observational studies, drawn from cohort of 4,560 patients in 3 London and 1 Sheffield site(s). Evaluation of patient experience and empowerment using focus groups, Ux laboratories, discrete choice experiments and PAM-13 scores. Economic modelling and cost/benefit analysis. Mixed methods qualitative study of clinician motivators/barriers to adoption Feasibility of future AI development for MGUS monitoring. A new (post-stage 1) work package to assess the enablers and barriers around digital inclusion. Impact and dissemination: The project will allow patients more convenience and control; hospitals/clinicians to have additional capacity for complex cases; the NHS to save resources. It will also facilitate environmental benefits (less driving/car parking). Our highly skilled, multi-disciplinary team with academic, commercial, PPI and clinical backgrounds and national leadership roles provides a great opportunity to spearhead digital transformation in haematology across the UK.