Detection of one of the biggest killers in the NHS has been cut from hours to minutes at the Royal Free Hospital in London thanks to the introduction of a new mobile app.
That is one of the key findings of an evaluation of Streams – an alerting tool which has been developed by DeepMind Health in collaboration with clinicians at the Royal Free London NHS Foundation Trust (RFL) to help identify patients at risk of acute kidney injury (AKI).
According to the evaluation led by UCL, published in Nature Digital Medicine and the Journal of Medical Internet Research, the app improved the quality of care for patients by speeding up detection and preventing missed cases. Thanks to Streams, clinicians were able to respond to urgent AKI cases in 14 minutes or less - a process which, using existing systems, might otherwise have taken many hours.
It also concluded that the app reduced the cost of care to the NHS – from £11,772 to £9,761 for hospital admission for a patient with AKI.
According to the evaluation, the app has improved the experience of clinicians responsible for treating AKI.
Dr Chris Streather, Royal Free London chief medical officer and deputy chief executive, said: “The findings of the Streams evaluation are incredibly encouraging and we are delighted that our partnership with DeepMind Health has improved the outcomes for patients.
“Digital technology is the way forward for the NHS. In the same way as we can receive transport and weather alerts on our mobile devices, doctors and nurses should benefit from tools which put potentially life-saving information directly into their hands.
“In the coming months, we will be introducing the app to clinicians at Barnet Hospital as well as exploring the potential to develop solutions for other life-threatening conditions like sepsis.”
Acute Kidney Injury – known as a silent killer because it can often be diagnosed late and is often hard to predict – contributes to nearly 20% of all hospital admissions, accounts for 100,000 deaths every year in the UK, and costs the NHS £1.2 billion annually.
Clinicians at the RFL worked closely with experts at DeepMind Health who developed Streams with the aim of improving outcomes for patients by getting the right data to the right clinician at the right time. Like breaking news alerts on a mobile phone, the technology notifies nurses and doctors immediately when test results show a patient is at risk of becoming seriously ill with AKI, and provides information they need to take action.
Approximately one in three deaths from AKI may be preventable if clinicians are able to intervene earlier and more effectively.
Dr Dominic King, lead at DeepMind Health, said: “We’re proud to see these findings demonstrate how modern digital technologies can support nurses and doctors in delivering faster, better care at the same time as delivering cost savings for the hospital. We’re excited to now explore how earlier warnings of patient deterioration could improve outcomes for more patients at the Royal Free London.”
Positive feedback from clinicians interviewed by researchers for the qualitative evaluation related to the speed with which clinical data was available, the ease of it being accessed on a mobile device, efficiencies in care and communication enabled by the app and the clinical impact of detecting sick patients earlier and being able to intervene.
Dr Chris Laing, consultant nephrologist, who clinically led the implementation of the Streams project and co-led the evaluation, said: “AKI is common, harmful, costly and may present across multiple clinical settings. It is often an early sign that a patient is becoming gravely Ill.
“Thanks to Streams we are able to monitor the kidney function of patients through real-time analysis of blood tests 24/7. If a potential change in kidney function in a patient is detected, at any time or anywhere at the Royal Free Hospital, a specialist will be notified and the case will be reviewed, in-application, in a matter of minutes, with follow-up bedside assessment as required.”
