Kidney care costs the NHS £1.5bn a year. Minuteful Kidney, from Healthy.io, is a home kidney albumin to creatinine ratio (ACR) test. It identifies more patients at-risk of chronic kidney disease (CKD) and associated cardiovascular disease (CVD), which is a leading cause of morbidity, disability and health inequalities. Damian O’Boyle, Director of Client Services at Healthy.io explains more, including how this helps prevent the escalation of these serious conditions, reducing the significant care needs associated with cardiovascular events and End Stage Renal Disease (ESRD), as well as saving lives and money.
Tell us a little bit about your innovation. The what and the why?
Minuteful Kidney targets the untested, underserved, and underdiagnosed population. As with most inequalities, this tends to be in lower socio-economic groups.
The test is posted direct to the patient. Our app, which is also supported by our inhouse contact centre, assists the patient in the completion of the test and returns the result to their GP. The usability (scored at 99.5% in 18-80 year olds) means that the vast majority of patients complete the test, unaided, within three minutes.
The Minuteful Kidney team ensures maximum test completion and that patients receive an instant ACR result which is also immediately integrated to the GP’s electronic patient record. Patients with raised ACR will be identified and return to their usual care process to be optimised by the GP or Medicines Management and Optimisation team.
Over the past three years the service has engaged 435,000 patients of whom, 238,000 have tested at home at a time of their convenience.
The test saves the patient travel, work and care time by enabling them to undertake their ACR in the comfort of their own home.
Patient surveys following tests show:
- Net Promoter Score (NPS): +56
- 90% rated the app ‘easy’ or ‘very easy’ to use
- 94% said they have no issues
- Only 8% said they’d prefer to test at the GP practice
- 78% of patients used the app without help or support from a relative or carer
- 91% said the information for managing results and what to do next was helpful or very helpful
Which health innovation networks have you been supported by?
We’ve had great support from health innovation networks across all the 22 integrated care boards we currently operate within and are ever grateful for the backing. Research, evidence generation, and cost effectiveness have been crucial to underpinning our scaling and the networks have always assisted along the way. We have also been very fortunate to have network colleagues help us identify potential funding pots, guide and navigate systems and introduce us to key decision-makers.
What’s been your toughest obstacle to date then?
Ongoing sustainability continues to be a difficult issue. In a cash-strapped environment commissioners inevitably want to get their hands on any funds for innovation or pots that support scaling, but it is then difficult for them to sustain that within ongoing budgets. I’d welcome innovation funds that enable technologies to pilot and scale over a period and then have further tapered support to gradually take the innovation into sustainable annualised budgets. Equally, I think we need to consider different contract models – a lot of innovators trust their technology and are willing to take risk – gain share contracts offer that offer a share of risk and reward can encourage better collaboration and outcomes.
What are your hopes for the future?
I think we are so close to tipping over from being a scaling innovation, into something that is the standard of care for those that do not routinely test. When we get to that stage, we know we can find and test thousands of patients out there who are at risk of kidney damage but are asymptomatic and have no idea. The outcomes for these individuals could be incredibly poor but if we can identify, diagnose and treat in a timely manner we can help them lead healthy, normal lives.
What’s the best part about your job?
Always the people. The team I work with are delightful, charming, funny, incredibly bright and endlessly hardworking. Their passion is felt by the customer, be that direct with the patient or with our NHS colleagues. I get to hear some incredible patient stories and they all start with the positive initial interaction with our team.
What are your three pieces of advice for budding innovators?
- Build your resilience – if it was easy someone else would have done it already. Delivering an innovation needs perseverance, endless effort and patience. Celebrate even the smallest incremental gains as they edge you closer and closer to the goal, and closer to helping a patient in need.
- Build the evidence – it’s tough but necessary. For every pilot think about how you can evidence the benefits of the product/service. What are the quantitative and qualitative measures that will help convince the doubters. Can you deliver a high-quality case study or publication? Commissioners are willing to take a risk to improve care, but think about how you can help them make that decision easier.
- Build your team – not a day goes past where I am not staggered by (and thankful for) the people I get to work alongside. People are motivated by doing things that are exciting and make a difference. A strong vision and a patient focused mission resonates and enthuses good people, and their enthusiasm is infectious. Get to the point where you are constantly enthused and impressed by your team.
What do service users say?
Rebecca, 46 years from Bicester said: “It was easy to use and I liked being able to do it at home on a day convenient for me.”
Jennifer, 39 years from Gloucester said: “It was extremely easy to use the test and app, and it was nice to be able to take my urine test in the privacy of my home.”
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