Periodic Reporting for period 1 - SAEPP (Smart Ambulance: European Procurers Platform (SAEPP))
Periodo di rendicontazione: 2015-01-01 al 2015-08-31
Background and Context
The aim of the Smart Ambulance European Procurers Platform (SAEPP) project is to improve pre-hospital healthcare delivery (typically ambulance-focused) with information and communication technologies (ICT) that enable better outcomes for patients (e.g. faster and more effective treatment) and for health services (e.g. economies gained from fewer unnecessary hospital attendances).This was achieved through rigorous Consortium-wide consultation, and validation in terms of technical and commercial viability. The most valuable ICT opportunities were identified to be developed, prototyped and tested under a Pre Commercial Procurement (PCP) process.
It is estimated that in the UK alone by providing appropriate on-the-spot treatment, up to 40 per cent of patient journeys to hospital could be avoided, resulting in a significant reduction in operational costs for the healthcare system, and a significant increase in quality of the overall patient experience and clinical outcomes.
The project is comprised of a group of European ambulance services, academic healthcare research bodies, hospitals and other healthcare organisations who formed a consortium with the objective of designing and building a 21st century prototype emergency ambulance vehicle which will allow frontline clinicians to provide more high-level patient care on-scene and thus help reduce the number of unnecessary hospital transports currently made by ambulance services across the Euro-Zone.
Consortium partners are NHS Commercial Solutions, Helen Hamlyn Centre for Design, BITECIC Limited, University of the West of England, Sheffield University, Tecnalia Research and Innovation, Saimaa University of Applied Sciences, Fundation for Biomedical Research of Cordoba, Ambulance Today Limited, South Karelia Social and Health Care District, Lappeenranta University of Technology, South East Coast Ambulance Service NHS Foundation Trust and University Medical Centre Groningen. This team is represented by specialists with expertise in areas such as ambulance vehicle manufacture, frontline emergency healthcare, project management, public healthcare innovation and EU procurement.
The project goal was to work together as a pan-European team to create a mobile treatment unit incorporating state of the art ICT solutions, not only capable of combined patient transport and treatment, but which will also create a patient treatment area which will maximise space, minimise the risk of infection, reduce hospital admissions and handover times, decrease overall costs and, most importantly, offer an overall safer environment for patients and clinicians alike.
Overall Objectives
As well as exploring further ICT opportunities and producing a basis for development under PCP, the overall objective was to validate the concepts with a wider (EU) audience and produce a basis for further development under the PCP process.
The SAEPP project activity and methodology was developed in order to ensure that the project aims and objectives were delivered. The Helen Hamlyn Centre for Design had been working on this concept over a five year period at the Royal College of Art, London; this historic project was taken as a starting proposition for the project.
Project Structure
The project was structured in six work packages with a designated lead and consortium partners appointed to deliver the outcomes;
WP1 - Management and coordination
WP2 - Procurer Engagement
WP3 - Data and Evidence Gathering to Support Business Case for change to new model of Care
WP4 - Description and Specification of New Care Model
WP5 - Outline Specification for PCP Call
WP6 - Outline Programme Plan for PCP
Project Outcomes
A logic model was developed to identify priority innovations and map them to expected changes in service delivery. The logic model showed potential effects on operational efficiency and outcomes, and a greater range of potential benefits beyond reducing transports to hospital. A Delphi survey was utilised that enabled an expert panel to evaluate and rank a disparate range of proposed ideas or concepts against suitability, to address a specified requirement or challenge. Underpinning and supporting this activity was intensive engagement with healthcare service providers, commissioners, procurers and suppliers across Europe to validate the process and outcomes.
The logic model illustrated five key areas of opportunity for ICT through consortium partner consultation using the Delphi model. The five key areas that will improve patient outcomes and system efficiencies are;
1. Access to key patient health and social care records, advice, support and effective referral pathways, and the capability to leave discharge summaries and advice at scene when the patient is discharged.
2. Real-time stock control within the ambulance.
3. Support for crew welfare and performance.
4. Access to caller-generated information (patient or first aider) to support clinical care and decision-making; and opportunities to enhance the patient experience.
5. System resource management.
The consortium partners conducted technical feasibility studies and engaged procurers and suppliers in response to the five key areas of opportunity. Added value was achieved by exploring a wider scope of ICT opportunities and integration of emergency services, and the broader healthcare system. The technological and financial feasibility of developing these ICT capabilities over the coming three years has been verified by credible suppliers or developers. The commercial desirability of these ICT capabilities has been verified by commissioners, procurers and economic buyers confirming their willingness and ability to procure them in three years' time.
The project defined a PCP consortium and programme, and identified that there was support from healthcare organisations and healthcare commissioners. In addition, a network for procurers was identified and an understanding of processes and future requirements gained. These results were achieved through responsible and efficient use of Horizon 2020 funding.
The aim of the Smart Ambulance European Procurers Platform (SAEPP) project is to improve pre-hospital healthcare delivery (typically ambulance-focused) with information and communication technologies (ICT) that enable better outcomes for patients (e.g. faster and more effective treatment) and for health services (e.g. economies gained from fewer unnecessary hospital attendances).This was achieved through rigorous Consortium-wide consultation, and validation in terms of technical and commercial viability. The most valuable ICT opportunities were identified to be developed, prototyped and tested under a Pre Commercial Procurement (PCP) process.
It is estimated that in the UK alone by providing appropriate on-the-spot treatment, up to 40 per cent of patient journeys to hospital could be avoided, resulting in a significant reduction in operational costs for the healthcare system, and a significant increase in quality of the overall patient experience and clinical outcomes.
The project is comprised of a group of European ambulance services, academic healthcare research bodies, hospitals and other healthcare organisations who formed a consortium with the objective of designing and building a 21st century prototype emergency ambulance vehicle which will allow frontline clinicians to provide more high-level patient care on-scene and thus help reduce the number of unnecessary hospital transports currently made by ambulance services across the Euro-Zone.
Consortium partners are NHS Commercial Solutions, Helen Hamlyn Centre for Design, BITECIC Limited, University of the West of England, Sheffield University, Tecnalia Research and Innovation, Saimaa University of Applied Sciences, Fundation for Biomedical Research of Cordoba, Ambulance Today Limited, South Karelia Social and Health Care District, Lappeenranta University of Technology, South East Coast Ambulance Service NHS Foundation Trust and University Medical Centre Groningen. This team is represented by specialists with expertise in areas such as ambulance vehicle manufacture, frontline emergency healthcare, project management, public healthcare innovation and EU procurement.
The project goal was to work together as a pan-European team to create a mobile treatment unit incorporating state of the art ICT solutions, not only capable of combined patient transport and treatment, but which will also create a patient treatment area which will maximise space, minimise the risk of infection, reduce hospital admissions and handover times, decrease overall costs and, most importantly, offer an overall safer environment for patients and clinicians alike.
Overall Objectives
As well as exploring further ICT opportunities and producing a basis for development under PCP, the overall objective was to validate the concepts with a wider (EU) audience and produce a basis for further development under the PCP process.
The SAEPP project activity and methodology was developed in order to ensure that the project aims and objectives were delivered. The Helen Hamlyn Centre for Design had been working on this concept over a five year period at the Royal College of Art, London; this historic project was taken as a starting proposition for the project.
Project Structure
The project was structured in six work packages with a designated lead and consortium partners appointed to deliver the outcomes;
WP1 - Management and coordination
WP2 - Procurer Engagement
WP3 - Data and Evidence Gathering to Support Business Case for change to new model of Care
WP4 - Description and Specification of New Care Model
WP5 - Outline Specification for PCP Call
WP6 - Outline Programme Plan for PCP
Project Outcomes
A logic model was developed to identify priority innovations and map them to expected changes in service delivery. The logic model showed potential effects on operational efficiency and outcomes, and a greater range of potential benefits beyond reducing transports to hospital. A Delphi survey was utilised that enabled an expert panel to evaluate and rank a disparate range of proposed ideas or concepts against suitability, to address a specified requirement or challenge. Underpinning and supporting this activity was intensive engagement with healthcare service providers, commissioners, procurers and suppliers across Europe to validate the process and outcomes.
The logic model illustrated five key areas of opportunity for ICT through consortium partner consultation using the Delphi model. The five key areas that will improve patient outcomes and system efficiencies are;
1. Access to key patient health and social care records, advice, support and effective referral pathways, and the capability to leave discharge summaries and advice at scene when the patient is discharged.
2. Real-time stock control within the ambulance.
3. Support for crew welfare and performance.
4. Access to caller-generated information (patient or first aider) to support clinical care and decision-making; and opportunities to enhance the patient experience.
5. System resource management.
The consortium partners conducted technical feasibility studies and engaged procurers and suppliers in response to the five key areas of opportunity. Added value was achieved by exploring a wider scope of ICT opportunities and integration of emergency services, and the broader healthcare system. The technological and financial feasibility of developing these ICT capabilities over the coming three years has been verified by credible suppliers or developers. The commercial desirability of these ICT capabilities has been verified by commissioners, procurers and economic buyers confirming their willingness and ability to procure them in three years' time.
The project defined a PCP consortium and programme, and identified that there was support from healthcare organisations and healthcare commissioners. In addition, a network for procurers was identified and an understanding of processes and future requirements gained. These results were achieved through responsible and efficient use of Horizon 2020 funding.
The work performed to achieve the project aims and objectives was organised in six work packages. The project work packages are shown as follows;
WP1 - Management and coordination
1.1 Coordination and Management Kick off
1.2 Finance legal and admin management & monitoring
1.3 Communications Plan & Website
1.4 Management of programme risk and issues registers
WP2 – Procurer Engagement
2.1 Develop engagement plan
2.2 Dissemination of project objectives to Procurers
2.3 Meetings with procurement agencies
WP3 - Data & Evidence Gathering to Support Business Case for change to new model of Care
3.1 Generic Business Case template for each Partner to follow a common process
3.2 Baseline data gathering of current situation, costs, outcomes
3.3 Healthcare Service Provider Engagement
3.4 Predictive Modeling of performance and outcomes of New Care Model
WP4 - Description & Specification of New Care Model
4.1 Market Consultation & Supplier Engagement (Concept Viability)
4.2 Healthcare Service Provider Engagement
WP5 – Outline Specification for PCP Call
5.1 Technical
5.2 Legal
5.3 Commercial
5.4 Evaluation Methodology Specification
WP6 – Outline Programme Plan for PCP
6.1 Gantt Chart & activities
Five key areas were identified that will improve patient outcomes and system efficiencies were;
1. Access to key patient health and social care records, advice, support and effective referral pathways, and the capability to leave discharge summaries and advice at scene when the patient is discharged.
• Provide a digital workstation for use inside and outside the vehicle, that will provide real-time electronic access to health and social care records, advice, support and effective referral pathways. The system needs to be secure, consistent and resilient to interruptions to internet connection
• Benefits: Exploit improved diagnosis and treatment capabilities to reduce unnecessary ED admissions or expedite admission to the most effective medical facility. Staff can be more confident in the execution of their professional responsibilities. Improve patient outcomes and satisfaction.
2. Real-time stock control within the ambulance.
• Provide an automated stock control system that shows what equipment and consumables are present, and which are missing from the vehicle. This communicates in real time so that staff in charge of restocking are aware before a vehicle returns to station, and can efficiently re-stock it, re-order fresh supplies, etc. It will also alert crews to missing items, depleted stocks, nearly out of date drugs, etc. in an automated way.
• Benefits: Gives greater confidence that correct equipment and consumables are always available. Makes overstocking unnecessary and thus reduces weight. Reduces turnaround time. Improves efficiency of stock purchasing and hence reduces costs.
3. Support for crew welfare and performance.
• Provide systems to support the welfare of crew and their ability to remain in active, fulfilling long-term service. These will address physical factors (e.g. manual handling) and mental factors (psychological stress e.g. time pressure or difficult cases). The system can also promote safe and efficient driving, and provide cumulative behavioural data to ensure that staff receive adequate rest breaks, psychological support etc.
• Benefits: Reduces stress and fatigue, adverse incidents and, in the long term, helps to retain highly trained staff.
4. Access to caller-generated information (patient or first aider) to support clinical care and decision-making; and opportunities to enhance the patient experience.
• Provide a system capable of receiving data (e.g. video, images, location and other information) directly from patients via smart devices, to assist and inform the clinician. The system will also be able to transmit data, e.g. to reassure individuals that a response is on its way. The system will also enable patients and clinicians to reduce stresses, e.g. language difficulties, immediate domestic / social concerns, etc.
• Benefits: Improves communication, enhances the clinical and pastoral experience for clinician, patient and relatives.
5. System resource management.
• Provide a system that optimises, and builds on current state-of-the-art ‘black box’ capabilities, for example transmitting real-time information from vehicles to inform fleet utilisation, maintenance, and sustainability. Potentially also linking to road congestion data, traffic signalling, scheduling systems for cleaning and decontamination, etc.
• Benefit: Improves operational efficiency of the ambulance fleet on all levels
The project defined a PCP consortium and programme, and identified that there was support from healthcare organisations and healthcare commissioners. In addition, a network for procurers was identified and an understanding of processes and future requirements gained.
WP1 - Management and coordination
1.1 Coordination and Management Kick off
1.2 Finance legal and admin management & monitoring
1.3 Communications Plan & Website
1.4 Management of programme risk and issues registers
WP2 – Procurer Engagement
2.1 Develop engagement plan
2.2 Dissemination of project objectives to Procurers
2.3 Meetings with procurement agencies
WP3 - Data & Evidence Gathering to Support Business Case for change to new model of Care
3.1 Generic Business Case template for each Partner to follow a common process
3.2 Baseline data gathering of current situation, costs, outcomes
3.3 Healthcare Service Provider Engagement
3.4 Predictive Modeling of performance and outcomes of New Care Model
WP4 - Description & Specification of New Care Model
4.1 Market Consultation & Supplier Engagement (Concept Viability)
4.2 Healthcare Service Provider Engagement
WP5 – Outline Specification for PCP Call
5.1 Technical
5.2 Legal
5.3 Commercial
5.4 Evaluation Methodology Specification
WP6 – Outline Programme Plan for PCP
6.1 Gantt Chart & activities
Five key areas were identified that will improve patient outcomes and system efficiencies were;
1. Access to key patient health and social care records, advice, support and effective referral pathways, and the capability to leave discharge summaries and advice at scene when the patient is discharged.
• Provide a digital workstation for use inside and outside the vehicle, that will provide real-time electronic access to health and social care records, advice, support and effective referral pathways. The system needs to be secure, consistent and resilient to interruptions to internet connection
• Benefits: Exploit improved diagnosis and treatment capabilities to reduce unnecessary ED admissions or expedite admission to the most effective medical facility. Staff can be more confident in the execution of their professional responsibilities. Improve patient outcomes and satisfaction.
2. Real-time stock control within the ambulance.
• Provide an automated stock control system that shows what equipment and consumables are present, and which are missing from the vehicle. This communicates in real time so that staff in charge of restocking are aware before a vehicle returns to station, and can efficiently re-stock it, re-order fresh supplies, etc. It will also alert crews to missing items, depleted stocks, nearly out of date drugs, etc. in an automated way.
• Benefits: Gives greater confidence that correct equipment and consumables are always available. Makes overstocking unnecessary and thus reduces weight. Reduces turnaround time. Improves efficiency of stock purchasing and hence reduces costs.
3. Support for crew welfare and performance.
• Provide systems to support the welfare of crew and their ability to remain in active, fulfilling long-term service. These will address physical factors (e.g. manual handling) and mental factors (psychological stress e.g. time pressure or difficult cases). The system can also promote safe and efficient driving, and provide cumulative behavioural data to ensure that staff receive adequate rest breaks, psychological support etc.
• Benefits: Reduces stress and fatigue, adverse incidents and, in the long term, helps to retain highly trained staff.
4. Access to caller-generated information (patient or first aider) to support clinical care and decision-making; and opportunities to enhance the patient experience.
• Provide a system capable of receiving data (e.g. video, images, location and other information) directly from patients via smart devices, to assist and inform the clinician. The system will also be able to transmit data, e.g. to reassure individuals that a response is on its way. The system will also enable patients and clinicians to reduce stresses, e.g. language difficulties, immediate domestic / social concerns, etc.
• Benefits: Improves communication, enhances the clinical and pastoral experience for clinician, patient and relatives.
5. System resource management.
• Provide a system that optimises, and builds on current state-of-the-art ‘black box’ capabilities, for example transmitting real-time information from vehicles to inform fleet utilisation, maintenance, and sustainability. Potentially also linking to road congestion data, traffic signalling, scheduling systems for cleaning and decontamination, etc.
• Benefit: Improves operational efficiency of the ambulance fleet on all levels
The project defined a PCP consortium and programme, and identified that there was support from healthcare organisations and healthcare commissioners. In addition, a network for procurers was identified and an understanding of processes and future requirements gained.
The progress beyond the state of the art and expected potential impact is illustrated by the models and methodologies used. The expected impacts are;
To the Patient:
- Decreased mortality and morbidity.
- Higher quality, safer care.
- Improved patient experience and satisfaction.
To the Service and system:
- Decreased health service utilisation.
- Improved response time performance.
- Improved operational efficiency within existing resources.
- Cost savings.
To the Staff:
- Improved workforce health and satisfaction.
To the Patient:
- Decreased mortality and morbidity.
- Higher quality, safer care.
- Improved patient experience and satisfaction.
To the Service and system:
- Decreased health service utilisation.
- Improved response time performance.
- Improved operational efficiency within existing resources.
- Cost savings.
To the Staff:
- Improved workforce health and satisfaction.