Katherine Ward, Chief Commercial Officer and UK/ Europe Managing Director for health-tech innovators Healthy.io, tells us about their award-winning work to help people with diabetes monitor their kidney health in Yorkshire and the Humber.
We are three years into our work with the Yorkshire & Humber AHSN to enable self-care through smartphone technology – and the evidence is now shining through, showing better health outcomes for patients whilst relieving cost and resource pressures on the healthcare system.
To ensure they stay healthy and their condition is well managed, people living with diabetes should complete eight “care processes” each year as part of their annual diabetes review. Diabetes as a condition makes them vulnerable to complications, like the risk of developing chronic kidney disease (CKD), yet the annual diabetes audit still shows that the care process with the lowest uptake is the urinary albumin test.
The test measures the albumin to creatinine ratio (ACR) and is used to monitor kidney health. While the test is clinically critical, 60% of people living with diabetes do not engage in the care process through the traditional models of care. This has worsened during the COVID pandemic with only 16% of people living with diabetes undertaking their urine test from January to September 2020.
This low uptake means CKD can be missed until it becomes symptomatic and much more serious for people’s health. But we are turning that around in Yorkshire and Humber by giving people with diabetes the opportunity to complete the urine test themselves at home, without the need for an appointment at the GP surgery.
We pioneered this in 2018 in Hull, Airedale and Wharfedale – enabling 500 patients with diabetes, across ten Modality Partnership GP practices, to test their own kidney health from home using our ACR test kit and smartphone app.
An independent evaluation of this work commissioned by the Yorkshire & Humber AHSN showed the NHS could save £209m in care costs over five years by adopting the model nationally for people living with diabetes. Furthermore, testing other at-risk groups, like people with hypertension, could save £660m in total.
In September 2020, funded by NHSX, the Accelerated Access Collaborative, the National Institute for Health Research (NIHR) and in partnership with Yorkshire & Humber AHSN and NHS Leeds Clinical Commissioning Group (CCG), we began rolling out the programme in Leeds. Within the first six weeks, nearly 800 patients were contacted, and as it stands today, nearly 2,000 have been contacted by our patient support team.
So far, 1,200 patients agreed to be sent the test, and of those 1,024 (88%) have completed the test successfully from home with 236 (23%) patients identified as having abnormal ACR result. This means that those 236 patients are being followed up on the appropriate care pathway, allowing early intervention where necessary. Satisfaction on the use and recommendation of the service is high with 93% reporting the test “very easy” or “easy” to use and patients up to the age of 100 have used the app to complete the test.
Funding from NHSX, the Accelerated Access Collaborative and the NIHR has enabled further roll-out to patients living in the area covered by West Yorkshire and Harrogate Health and Care Partnership.
The aim of the project is to roll out urine ACR home testing across West Yorkshire and Harrogate, with around 20,000 patients eligible for the service. This is now going to be doubled in 2021 through additional national funding and as a result of the interest from Leeds CCG and Primary Care Network (PCN) colleagues.
I am proud of how we have worked with the Yorkshire & Humber AHSN to spread innovation around kidney health self-care for at risk people in this region, because CKD is a silent killer and if our tests can help avoid unnecessary deaths, transplants or dialysis then, aside from the NHS savings that will be generated, we will be achieving significantly better outcomes for many people.
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