South London and Maudsley NHS Trust

Background

South London and Maudsley NHS Foundation Trust is one of the largest mental health Trusts providing the most-extensive portfolio of mental health services in the UK. The staff serve a population of 1.3 million people across four South London boroughs: Lambeth, Southwark, Lewisham and Croydon, as well as providing specialist services across the UK and beyond. Each year, South London and Maudsley provides acute inpatient care for over 5,000 patients and treats more than 40,000 patients in the community.

The Challenge

South London and Maudsley wanted to move from point to point interfacing into an enterprise wide, single integration platform. The platform adopted with ReStart was a Cloud hosted system using a Trusted Interface Engine (TIE) supporting interoperability to connect across the whole Healthier South East London ICS and the wider LHCRE One London. This solution offered scalability, high availability and connectivity ensuring that future needs could be met.

South London and Maudsley also wanted a managed support service ensuring that mission critical healthcare applications were available and always on to support clinical and financial decision making.

With the TIE in place, interoperability is provided across the entire enterprise from a single integration platform supporting a variety of systems and applications. It does this securely in real time.

Utilising the TIE, South London and Maudsley have carried out world first research regarding a new point of care (PoC) testing process aimed at anti-psychotic blood testing. The test uses a finger prick of blood with results produced in 6 minutes. Normally this process takes 5-10 days per test with conventional laboratory testing.

The benefit of rapid access is important in making quick decisions regarding dose adjustments according to symptoms and side effects profiles. The new process could save time and resources, reducing inpatient bed stays to 3 weeks, instead of 3 months.

The work utilises TIE interoperability across data collection points, patient records and AI for processing of results.

The Results

Having instantaneous results at the PoC meant patients were better informed about their care and demonstrated better adherence and increased engagement in their treatment. This resulted in fewer relapses and associated re-hospitalisations. This has led to improved patient outcomes.

To aid this work, the South London and Maudsley team have created a visualisation display for the outputs of the PoC test results, which gives clinicians direct access to results and the ability to calculate trends across defined time periods. This allows clinicians to see the patient’s clozapine level in real-time and make dose adjustments accordingly. This involves collating the PoC test results with historical data and feeding it through an algorithm in Cogstack, Artificial Intelligence. Mitigating factors such as gender, size, weight, other medications, blood glucose and smoking can all affect dosage and efficacy and are considered to derive each individual’s optimum medication level.

Overall, the published studies that have been carried out to date, show considerable benefits in financial, planning and patient outcomes related to this new test technique. Under the new testing and medication regime, patients can be stabilised on clozapine at a much shorter time, saving thousands and improving patient’s lives.

The PoC research has already been shared in published papers and it is also hoped that the PoC blood testing process will be seen and accepted as “best practice” in the near future and extended to other therapeutic treatments over time.

Stuart MacLellan Chief Information Officer for South London and Maudsley said “The managed services, guidance and support provided by ReStart is second to none. My life is easier knowing that the systems and services are secure and always there when clinicians need them.

Restarts project manager is a real champion and has worked alongside the Digital Services team. Being mindful of supporting staff during all the phases of the project work is critical and Restart has complimented our team amazingly well!”

Join ReStart and Stuart MacLellan from South London and Maudsley to find out more about the ground breaking work at a webinar on 25th November at 12.30pm. View the agenda and register by visiting Digital Health website.