Meet the team
National Medical Director's Clinical Fellow
Care Quality Commission
- England - London (South)
- Michael Kosmin - Consultant Clinical Oncologist, National Hospital for Neurology and Neurosurgery
- Hani Marcus - Consultant Neurosurgeon, National Hospital for Neurology and Neurosurgery
- Andrew Gvozdanovic - Neurosurgical Trainee, National Hospital for Neurology and Neurosurgery
- Georgina Kirby - Data Scientist and CTO at Vinehealth
- Vinehealth Expert Patient Advisory Board
What is the positive change that has emerged through new collaborations or partnerships during Covid-19 that your project is going to embed?
We collaborated with Royal Marsden NHS Foundation Trust to undertake a mixed-methods longitudinal study evaluating the platform’s impact on patient wellbeing, health-related quality of life, PROMS data collection and self-management in cancer patients during COVID-19, at a time of higher anxiety and reduced face-to-face time. 49 patients receiving SACT were recruited across all tumour types from Royal Marsden.
- 97% patient engagement
- 100% digital completion of EQ5D
- Positive trends in QoL
- Extensive learning and positive qualitative feedback from independent patient semi-structured interviews
Findings suggest the app can support self-management in patients not already employing self-management strategies. We demonstrated that the app is an attractive tool and source of information for patients.
Having evaluated the app across all cancer types, we now plan to specifically tailor it to brain cancer to be able to embed at NHNN.
What does your project aim to achieve?
Unfortunately, brain cancer patients have a high degree of unmet needs, largely due to the complex and multimodal requirements of their care. These needs are exacerbated by COVID due to higher anxiety and less face-to-face time with care teams. The Vinehealth app will work alongside current care pathways at NHNN to enhance the patient experience by empowering patients to actively engage in their care; by capturing highly relevant data points (symptoms, side effects of their treatment, and medication adherence) and through machine learning driven educational content provision.
Through this, people living with brain cancer can better self-manage from home and make more informed decisions about their care.
This project aims to investigate whether use of the VineHealth application can:
- Improve the patient experience of their care pathway by providing remote, personalised support
- Remotely collect PROMS data in a patient-friendly, convenient manner to enable better understanding of patient needs during COVID
How will the project be delivered?
The project will be delivered in phases according to the IDEAL framework for surgical innovation at the National Hospital for Neurology and Neurosurgery (NHNN).
Phase 1 will deliver the VineHealth application to 6 patients for a focused 1-2 week proof of concept study to evaluate the outcomes and study parameters planned for use in future studies. This will also aim to generate areas of improvement for both application integration into the cancer pathway, usability and function of application, and research planning.
Phase 2a will include 30 patients. This will be a single armed, prospective feasibility study aimed at evaluating in more depth, the holistic impact of the VineHealth application on the biopsychosocial aspects of patient health. We will also use this phase to begin assessing impact as a clinical decision support tool. We will undertake concurrent fine-tuning of the app to adapt to patient needs throughout.
How is your project going to share learning?
- Effects of providing remote supported self-management to patients, to better cater to their needs during COVID
- Benefits of better self-management in reducing burden on stretched cancer services during COVID and remotely gathering patient-reported (PROMS) data to better understand patient needs
- How this data can be integrated into clinical services to support triage, inform telemedicine and enable more effective outpatient care
We will also produce a report evaluating how better patient self-management & tracking of key PROMS can better inform new models of care. These learnings will be shared among our clinicians and organisational partners, as well as at key national cancer conferences, to our charity partners and at NHS stakeholder events. We will also make this available to the wider Q community.
How you can contribute
- Q members with an interest in supporting patient self-management
- Q members interested in using data to redesign services
- Q members with an interest in behavioural science
- Help from across the community in distributing the app in NHS Trusts across the UK
- NHS managers looking to collaborate on instigating the project in clinical settings
- Collaboration with expert patients to help develop our ideas and learn from the patient experience
- Oncology specialists from the multi-disciplinary team with experience in telemedicine to support the project (oncologists, CNSs, dieticians, physiotherapists)
|1 Nov 2020||Project planning meeting with all stakeholders|
|15 Dec 2020||Project defining meeting with all stakeholders|
|17 Jan 2021||Final project planning meeting with all stakeholders|
|1 Mar 2021||Rolling patient recruitment 1/3/20-1/6/20|
|15 Apr 2021||Half-way point patient focus group: qualitative feedback|
|15 Apr 2021||Quantitative engagement metrics from app reviewed|
|21 Apr 2021||Half-way consultations: qualitative feedback from clinicians|
|21 Apr 2021||Webinar for Q community to update with progress|
|1 May 2021||Plan for report writing agreed|
|31 May 2021||Project group meet - ongoing review and adaptation|
|7 Jun 2021||Final formal patient focus group completed|
|7 Jun 2021||Full data analysis completed|
|7 Jun 2021||Project Report writing begins|
|30 Jun 2021||Results evaluation and report writing plan review|
|5 Jul 2021||Project group meeting to review data analysis findings|
|15 Aug 2021||Report completed and distributed|
|1 Sep 2021||Focus on dissemination (publication, Q webinar) - 1/9/21-1/3/22|