Health Service Focus

01.10.15

NHS to develop innovative blood transfusion app for clinicians

Source: NHE Sep/Oct 15

Aman Dhesi, regional lead for patient blood management at NHS Blood & Transplant, talks to NHE about the development of a new app that could change the behaviour of clinicians in blood transfusion. David Stevenson reports.

NHS Blood & Transplant (NHSBT) is working with digital marketing agency HMA to develop a new app to help clinicians when prescribing blood components. 

The app, being developed as an element of the patient blood management (PBM) initiative, is expected to be complete by November and – following a testing cycle – is to be trialled at two un-named hospitals in 2016. 

It will be used to assess behaviour change in prescribing blood transfusions, with the aim to make them safer and encourage the use of evidence-based practice. 

Aman Dhesi, PBM regional lead at NHSBT, told NHE: “The main thing about PBM is that it is actually there to reduce the inappropriate use of blood and blood components, to improve patient outcomes. 

“A key part of ensuring inappropriate use of blood is reduced is in the decision of whether to transfuse, but it can be quite difficult for medics whose primary remit is not transfusion to get that information. 

“Having the app there by the patient’s bedside allows them [clinicians] to focus more time on other aspects of patient care because they have the information with them on the app.” 

He added that having the information in an app format, which will be available for iOS and Android devices, will help remove the “burden on admin” and “remove barriers to checking NICE guidelines”. 

To deliver the solution HMA has been working with a diverse group of medical professionals including junior doctors, consultant haematologists and transfusion practitioners. 

Danny Pritchard, a developer of the app at HMA, told us: “The main focus of the app is to try to take people down specific pathways through multiple-choice questions to get to one final answer on what course of action is needed for that person. 

“If it is a transfusion, for example, it would also indicate how many units of blood need to be transfused.” 

Dhesi added that successive clinical audits have shown inappropriate use of blood transfusion in the NHS. For instance, some patients may have been transfused for treatable anaemia when it was not needed. 

The app has been funded through a research project and will be focusing on red cell transfusion and anaemia management. NHE was told that NHSBT aims to get the app CE-marked as a medical device. 

NHE reported in our May/June 2015 issue that the Royal College of Physicians (RCP) issued new guidance to doctors on using medical apps. There were two key pieces of advice: 

  • Do not use medical apps, including web apps, that do not have a CE mark; and
  • Always exercise professional judgement before relying on information from an app. 

Dhesi told us: “There is a lot of discussion over calculator apps that medics use and whether these should be CE-marked.

“For our particular app we are going to try to get it CE-marked and regulated as a medical device, so that when doctors are using it they know it is something that hasn’t just been made by a software company for revenue or selling ads – it is something designed with the NHS in mind to help it improve and to save the lives of patients.” 

Once the app has been trialled, NHSBT will evaluate its use to see if behavioural changes have occurred. “We are going to audit the areas of clinical practice, such as single unit prescribing, and based on this we’ll be able to get the evidence on how effective the app is.” 

We were told that the app is going to be designed for use by everyone in the NHS, but the ‘target audience’ is junior doctors or doctors going into specialisms 

The essential goal after the trials and evaluation will be to try to roll the app out nationally. It is also hoped that while potentially improving patient safety, the app could help also improve efficiency and deliver cost savings in the long term by reducing the number of transfusions. 

Pritchard added that it is a “great opportunity” to show that apps can work and help the NHS in delivering high-quality care. “Over the next few years we are going to see a huge change in how apps are used in hospitals to help diagnose problems and help with the outcomes.”

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