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Clinician turned tech entrepreneur secures funding to trial rehab software within NHS

By Charlotte Giblin, Assistant Psychologist, Clinical Neuropsychology Services and Dr Penny Trayner, Clinical Neuropsychologist, Clinical Neuropsychology Services

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Clinical Neuropsychology Services (CNS) was established in 2012 by Dr Penny Trayner, a Clinical Neuropsychologist specialising in providing community-based rehabilitation services for children with acquired brain injury (ABI).

Effective rehabilitation is underpinned by a goal-focused philosophy (WHO, 2001), which is crucial for collaborating within multi-disciplinary teams, motivating service users and tracking progress (Barnes & Ward, 2000; Gauggel & Hoop, 2004; Tucker, 2015).

However, effective goal setting is inconsistent within clinical practice (Plant et al., 2016).

This is likely due to time-constraints, as evidence demonstrates that gold-standard processes take up to 70.5 hours for one patient for a four person MDT over a period of 6 months (Trayner et al., 2019).

Therefore, the team at CNS co-designed a revolutionary platform: Goal Manager to co-ordinate gold-standard rehabilitation goals.

The unique software encourages interdisciplinary collaboration by allowing clinicians to analyse goal progress with ease, identifying facilitators and barriers to the rehabilitation process and generating automatic reporting of outcome data.

The software was designed following growing frustrations from healthcare professionals with current technological solutions (DHSC, 2020) and has been shown to reduce the time taken to track goals by 43 per cent (Trayner, 2020). 

The team at Health Innovation Manchester (HiM) have been invaluable in supporting the development of Goal Manager.

This support began with a ‘Step into Healthcare’ webinar series back in 2020, which provided essential foundations in knowledge of the landscape and requirements for working with the National Health Service (NHS) for a small and medium sized enterprise (SME).

Following this, the team at Goal Manager received Specialist Business advice (level 1 support) from HiM in 2021, which provided access to expert health economic advice, basic IP legal guidance and an introduction to potential clinical partners, laying the foundation towards developing a collaboration with HiM. 

“Health Innovation Manchester helped us see that Goal Manager would be of wider benefit to patients outside our service and in many different sectors concerned with rehabilitation.

“The goal therefore became to make Goal Manager available wherever it was needed, providing support all the way through from the acute inpatient stage to community-based health and social care” – Dr Penny Trayner, Clinical Neuropsychologist, Director of Clinical Neuropsychology Services and Goal Manager.

In 2022, the Goal Manager team secured a Small Innovation Voucher through the R&I Health Accelerator scheme.

This support allowed the SME to conduct a patient and public involvement (PPI) study, which was the early-stage development for the Patient Portal feature of Goal Manager; an access portal allowing service users and carers to retrieve rehabilitation data in an accessible, useful format.

As part of this study, focus groups were held in Headway organisations, a large brain injury charity, enquiring about service user needs.

Findings demonstrated a consensus that comprehensive, graded, and accessible information through a patient-centered portal would be invaluable.

Additionally, utilising digital infrastructure would provide service users and carers with an access point to treatment information, without clinicians providing additional services (Trayner et al., 2023). 

Following this, in 2023, an R&I Health Accelerator Follow-on Voucher awarded from European Regional Development Fund (ERDF) via HiM, allowed the SME to conduct an initial trial within the National Health Service (NHS), brokered a direct research partnership with two NHS trusts and provided financial assistance for the trial to be practically conducted.

The trial considered: 1) user experience and training needs, 2) interoperability with NHS Electronic Patient Records (EPRs) and 3) the effectiveness of new elements of Goal Manager including a Patient Portal and Data Dashboard; allowing easy access to clinical research data within services. Goal Manager was subsequently deployed at two sites within the NHS. 

Previous evidence demonstrates that one of the main barriers for adopting technology is a lack of necessary support (Trayner et al., 2022).

As a result, the Goal Manager team have developed a comprehensive support package for users including CPD training courses, online and telephone support, accessible help videos and personal support at multi-disciplinary team (MDT) meetings.

Training within the trial utilised this support package and was delivered based on the needs of each service.

Following training, staff input new service users’ data into Goal Manager throughout the trial period and generated reports at discharge to add to patient files.

Clinicians were also consulted regarding the face validity of the Patient Portal and Data Dashboard. 

Staff satisfaction levels and the effectiveness of Goal Manager were analysed using Thematic Analysis of interview transcripts and Statistical Analysis of questionnaire data, developed in conjunction with health economists at HiM.

Thematic analysis produced the themes of 1) Accessibility, 2) Involvement, 3) Maximising resources and 4) Technology readiness.

Questionnaire analysis demonstrated utility of the software as a digital alternative for goal setting, particularly in outcome measurement and monitoring, but highlighted areas for improvement to maximise this utility.

This feedback on improvements will be used to directly inform system improvements, as well as the development of the Patient Portal and Data Dashboard interface, ensuring the software most effectively serves public need.  

The journey has not been without challenges as each NHS trust has differing processes and requirements for software implementation, meaning the Goal Manager team have been forced to pause trials at the mid-way point when approval was not granted from Information Governance teams.

The team are hoping to generate insight from trials, that will be generalisable to the implementation of other software packages in NHS settings, including the process of completing an ORCHA baseline review as a step towards getting the Digital Technology Assessment Criteria (DTAC) criteria, which is a prerequisite for adoption within wider NHS services.

Learn more about Goal Manager at goalmanager.co.uk

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