Healthy.io’s has developed a smartphone-based urinalysis device that supports early identification of chronic kidney disease (CKD) by enabling more untested patients to complete a test at home using a CE marked postal testing kit and app.
People at increased risk of kidney disease should complete regular urine testing to ensure they stay healthy. But uptake of these tests is low amongst at-risk groups, e.g. only around 50% of people with diabetes complete the test as part of their annual review. This contributes to under-diagnosis of chronic kidney disease, incurring unnecessary costs in terms of patient health and care.
This end-to-end home testing service increases adherence to kidney health testing by enabling disengaged patients to complete a urinary ACR kidney health test in the comfort of their own home, improving early detection of kidney disease in at-risk demographics, such as people with diabetes or hypertension.
Results are returned directly into the GP’s electronic record so that patients with deteriorating kidney health can be identified early and optimised for treatment.
How we helped
We first became aware of Healthy.io when their urine test solution was added to the NHS Innovation Accelerator in 2017. Impressed by the product’s functionality and the potential to transform care pathways for patients who require regular urinalysis, we worked with Healthy.io to support them in expanding their evidence base for cost savings.
In 2019 we commissioned York Health Economic Consortium (YHEC) to evaluate the innovation’s cost-effectiveness compared to standard care in the NHS. Diabetes is one of the most common causes of Chronic Kidney Disease (CKD). Detecting albumin in urine early helps prevent CKD complications and slows disease progression. It 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 NHS, the Accelerated Access Collaborative, the National Institute for Health Research (NIHR) and in partnership with what at time was the NHS Leeds Clinical Commissioning Group, we supported Healthy.io with the roll-out of the programme in Leeds. Within the first six weeks, nearly 800 patients were contacted.
Impacts and outcomes
We have continued to work with Healthy.io helping to secure funding and supporting with the roll-out of the service across our region. To date, the Minuteful Kidney home testing have been offered to a total of 51,040 eligible patients, of which 51% have completed a test (26,216). Out of those, over 11,000 tested abnormal or high abnormal – a high abnormal strongly indicating they have CKD. This means that those 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.
Based on the economic modelling that we commissioned to YHEC, it is estimated that 5,119 new cases of CKD have been identified. The economic benefits of the service outlined in the YHEC study, shows that across West Yorkshire the estimated net cost savings over the first year are £289,652 increasing to £20,150,494 by year five. The savings are calculated based on the costs associated with management of End Stage Renal Disease (ESRD) and incidents common in later stage CKD.
Historically, it has been difficult to encourage diabetic patients to bring urine samples to the practice for this to be tested for proteinuria. The home ACR testing programme has made it easier to obtain urinary ACR results from some hard-to-reach patients. As a result, we have seen an increase in the number of our diabetic patients having their urinary ACR tested this year
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.
Yorkshire & Humber has been fantastic partners to us over the years. Not only they supported us with things like the evaluation, but they have fantastic expertise both commercially and in innovation and scaling. And they have those local relationships that we just couldn't do without them.