AliveCor developed a portable ECG device to detect undiagnosed atrial fibrillation (AF). With the AHSN network the product has now been taken up across 11 AHSN areas and has contributed to the detection of 365 patients with undiagnosed AF in one year. This means that the equivalent of one stroke per day has been prevented by this work, saving lives, reducing disability, and saving almost £8.5 million for the NHS and social care service.
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Nationally, it is estimated that nearly 1.4 million people in the UK are affected by atrial fibrillation (AF), and a quarter of these people are unaware that they have AF.
AF causes an irregular or abnormally fast heart rate. It increases the risk of stroke by up to five times, with about 12,500 strokes per year directly attributed to AF. Recognising and receiving proper treatment for AF is important because the strokes due to AF are often more severe, with a survival rate of only 50 per cent and a risk of increased disability among those who do survive, compared to those who have a non-AF related stroke. At the age of 40, we all have a one in four lifetime risk of developing AF.
“The AliveCor device is now part of my toolkit along with my blood pressure machine and stethoscope.”
Linda Hilton, community health specialist nurse
How did the Innovation Exchange help?
Across the AHSN Network, diagnosis and management of AF was identified as a significant need in the system and it became a major focus for innovation exchange activity across the network. To support this, an AHSN Network AF community was formed, with the aim of preventing an additional 4,500 strokes over the next five years. The innovation exchange teams recognised that the charity sector must be a key partner in their work, and that they needed a multi-layered approach to the AF challenge.
the AHSN AF leads established interest groups on a range of key topics to address this need:
- Don’t Wait to Anticoagulate: A quality improvement programme supporting primary care, led by Yorkshire and Humber, and West of England AHSN.
- AF Landscape Tool: This provides data to influence decision makers and monitor the progress of improvement, led by Greater Manchester AHSN.
- Detection and Diagnostics: Led by Wessex AHSN.
- Heart Rhythm Congress: Led by Yorkshire and Humber AHSN.
- NHS Innovation Accelerator: An NHS England initiative delivered in partnership with the 15 AHSNs, it has supported Kardia’s AliveCor AF detection device since 2015.
- Metrics: Led by Public Health England.
The AHSN network identified that there are more than 35 different digital technologies to support the identification of AF. These and other digital solutions play a significant part in the efforts to improve detection and management of AF. Devices such as Alivecor’s Kardia, WatchBP, MyDiagnostick, and Cardiocity have been used and evaluated in a variety of settings and services. These include patient-led use in hospital clinics, primary care use in consultations, screening during clinics for flu jabs and opportunistic screening in outreach drop-in clinics.
Impact & Outcomes
- Plessey’s ‘low-cost’ handheld device that can detect an irregular heartbeat in a home or GP setting was brought from prototype to production in less than 12 months by West of England and South West AHSNs.
- The Innovation Agency (AHSN for the North West Coast) used MyDiagnostick and AliveCor in public facing campaigns in which 502 pulses were tested and 46 abnormal pulses detected, reducing the likelihood of stroke – saving £23,000 per person in NHS and care costs in the first year alone i.e. a potential £1 million.
- Through the AHSN Network SBRI programme, £1.2m of funding has supported the deployment of Rapid Rhythm. The hand-held device, originating in GM AHSN, wirelessly connects to any ECG machine to diagnose AF and other major cardiac conditions, produces a clinically credible eight-lead ECG. The convenience of this device eases workflow in general practice.
- The Innovation Agency has also supported the integration of digital technology into a commissioning tool for CCGs.