In terms of Desirability, we received very positive feedback. Patients found alke’s features to be useful for their rehabilitation and carers acknowledged the benefit it could bring to ease their caring responsibilities. “I can really see the value in features such as the seizure detection alert. Sometimes it's difficult for me to understand if she is having a seizure or it it’s something else”, a carer stated. Patients were very interested in the data generated and were willing to share their data anonymously for research purposes. A patient, who was a former nurse said that “It would be really great if I could actually show my clinicians my progress, rather than just trying to put it into words.” In terms of the business side of the service, people were worried about data being misused to support charities’ own profit, as a patient stated: “Alke stands up because it’s a stand-alone service, not affiliated with any other organisations.” From the in-action testing, we were pleased to hear that the users were really happy with the aesthetic and the contents of the box and set activity-dates every evening in order to interact with it. The patient’s children were also excited about it, which pushed her and made her more motivated to interact with the kit and complete activities with her family.
In terms of Viability, people could see the value of the service and acknowledged its potential, motivating us to continue with the project and push through. “I love it because it’s patient-centric, carer-centric, physician-centric, system-centric. Think big! Make it reach people’s hands early through private hospitals and then go to NHS.” - Dr James Somauroo “It’s worth trying for the NHS App Library. You already tick all the boxes for user-centric approach and involving the patients.” - Matt Edgar In terms of Feasibility, we were assured that both the App and the Bracelet are technologically feasible and the Inertial-based MEMS (Micro-Electro-Mechanical Systems) sensors and in particular IMU (Inertial Measurement Unit) motion-capture systems required are available.
No two brain tumour cases are the same. Furthermore, one’s rehabilitation needs differ greatly based on their clinical image and personality. There is no doubt that brain tumour rehabilitation is a complex and unique challenge. With our patient-centric approach, Alke brings value to the people and organisations involved in one’s rehabilitation journey, while incorporating other stakeholders’ needs and offers into the system.
Alke benefits patients and carers by increasing medication adherence, improving the communication between them and offering personalised and guided rehabilitation activities to patients. Furthermore, it transforms consultations into a more effortless and efficient experience and provides alerts and guidance for emergencies. At the same time, Alke benefits hospitals and clinicians by providing accurate monitoring of patient’s progression at home and helps them attain a complete understanding of patient’s health state, allowing them to make improvements depending on the progression.
As a final deliverable of the project, we were able to deliver a presentation of the service, a video explaining the service and illustrating how Alke helps ease the rehabilitation journey, a Facebook Page & Chatbot, the website for the service, a physical prototype of Alke Box and a digital prototype of Alke App.
Implementation of the service has not finished as we didn’t have a specific partner for the project, therefore we can not provide metrics on its impact. In the future, the impact will be measured through a combination of data analysis and cognitive and neurophysical progression monitoring, as well as individual case studies illustrating qualitative improvements. After our feasibility and viability validation, we saw a big interest and potential in implementation, as Alke can benefit both its users and the providers. More specifically, patients receive personalised support, they become more in charge of their own rehabilitation and avoid the frustration of unnecessary emergency visits or
ineffective consultations. They become pro-active proprietors of their rehabilitation and their data. On the carer’s side, through Alke, we relieve some of the stress off of the carers and allow them to reclaim their role as family members and not as ‘nurses’. This allows them to spend more quality time together as a family, while receiving the necessary information and medical knowledge to handle the rehabilitation and possible emergencies.
As the journey of a brain tumour patient isn’t linear, data collection (image 5.1) plays an important role in their rehabilitation, as it allows clinicians to notice symptom patterns, exacerbations and hints of imminent deterioration early on and intervene accordingly. Alke supports patients to cope in everyday life, connecting them with the support they need (image 5.2) and increasing their autonomy and self-monitoring, which helps the clinicians have a complete understanding of the patient’s progression and health state. This has an associated cost benefit for the NHS, as it reduces readmission rates and unnecessary emergency visits and promotes in-home monitoring
and digital consultations.
As we have previously seen in the case of stroke, which affects patients in a clinically similar way to brain tumour patients, rehabilitation interventions have reduced readmission rates, saving NHS over £75,500 per person. At the same time, the reduction of emergency visits can save NHS and additional £197.50K per year, by reducing the number of attendees. Therefore, patients with brain tumour monitoring their conditions could help NHS meet part of its £20bn cost-savings programme.
As our ultimate goal is to reach NHS, get an endorsement from NHS Local hospitals and join the NHS Apps Library, we would need to go through a step by step approach in order to provide adequate validation on how our service has improved the quality of rehabilitation in action. Therefore, our business plan consists of five steps: Get initial funding in order to develop the MVP, test the MVP in 5 rounds of 20 people (total 100 people) and iterate the prototypes according to the feedback and then pilot the service to private hospitals and sell to insurance companies. For the Insurance companies, this would be an appealing service as it can save service pay for brain tumour patients through the reduction of EMT visits which would cost £100 and up for each visit per patient, the reduction of readmission fees (£250-300 per night, per patient), as well as the reduction of additional side effects as patients medication adherence, is improved, which would result in consultations that cost: £150-£200 per consultation.