A team of Brighton-based consultants and technology specialists have created the first interactive digital patient assessment app.

Called `LifeBox’, the assessment tool has been in development for the past two years at The Montefiore Hospital in Hove. It is hoped that its success will help it be adopted nationally by NHS trusts.

Instead of filling in preassessment forms with a nurse, patients who need a medical procedure or operation can now answers questions about their health via LifeBox, in the comfort of their own home. The answers they give will generate more patient-specific questions to fully identify their level of risk. All patients are then called by a nurse to discuss the findings. Those with low or no risk may not need to come back into hospital for further tests before they have their medical procedure. The app will also generate information and videos specific to the patient’s condition, so they can prepare for the procedure.

“When a consultant has just told you that you need a medical procedure, your head is not often in the best place to be answering questions or taking on board information about your condition and the forthcoming operation,” says Mr Sandeep Chauhan, Consultant Orthopaedic Surgeon at The Montefiore and lead consultant for LifeBox. “With LifeBox, you can answer questions in your own home, when you feel calmer. You’ll have easier access to paperwork, medication or the help of family members to ensure questions are answered correctly. Patients can elaborate on their health with guided questions to enable the medical teams to better assess risk. For instance, we may have several patients with angina coming in for a similar procedure but the answers they each give will be specific to them and means we can grade their angina and therefore assess individual risk.”

By reducing paperwork and unnecessary testing, LifeBox is expected to save around £215,000 per 5,000 patients. There are also significant time savings. On average a patient spends around 3.2 hours coming back into The Montefiore for a pre-op assessment and tests, including travel time. If they are fit and well and don’t need those tests, they won’t need to come into the hospital before their operation and won’t need to take time off work or find childcare. 

Each patient is given their own unique LifeBox login and they can decide who the information can be shared with. As their health changes in the future, their individual LifeBox can be updated.

“It is their health story in one place, in one digital box, and stays with them for life,” says JP Hamilton Savory, a member of the LifeBox technical team. “They can take the app with them wherever they go - on their phone, tablet or computer - which can be very useful if they fall ill away from home or on holiday, or in a situation where they need to give details of their medical condition and health history but are too stressed or anxious to do so.”

However, LifeBox isn’t just about pre-assessment and health history. It also allows the patient to do a post-op questionnaire, so they can compare how they felt before and after the procedure. And they can give satisfaction feedback. The app will direct any complaints straight to the hospital manager.

The LifeBox team predicts that soon every patient in every GP surgery will have access to the technology and be able to update their own health records as they go. Hospitals will be able to use LifeBox to send group messages with information to people with similar conditions, and, as well as physical health, LifeBox users will be able to upload details about their lifestyle and mental wellbeing. And eventually there will be a communication portal, so a patient can have a video call with a nurse at a time that suits them.

 Mr Chauhan says LifeBox is not a replacement for human intervention “but a supplement”.

“You could have a traditional pre-assessment with a junior nurse or one who has been on a long shift.  They may not dig deep enough into the answers that you give about your health, which means something could be overlooked. LifeBox overrides human error. It introduces the safety bar much higher which means patient risk will be reduced and that will lead to increased quality of care and better outcomes.”

LifeBox was tested on patients on wards at The Montefiore and already 100 patients are using the app. From now every new surgical patient at the hospital will be signed up. The hospital has also invested in five iPads for its reception area so a patient can be guided through the LifeBox programme by a nurse if they prefer.

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