How we worked with Health Innovation Kent, Surrey, Sussex
As experts in health economic evaluation, Unity Insights were commissioned by longtime partners Health Innovation Kent Surrey Sussex to create a budget impact model (BIM) assessing the cost of changes in healthcare activity associated with implementing an automatic oxygen titration device in pulmonary rehabilitation (PR) at a community care site in Kent. This user-customisable model assessed how this new device may impact a variety of health outcomes and subsequent healthcare usage, allowing innovators and NHS commissioners to see the budgetary implications of a wide range of implementation scenarios.
What did the evaluation show?
Agility
Unity Insights was originally commissioned to conduct a quantitative analysis, exploring various health-related metrics and outcomes of using the device in pulmonary rehabilitation. Delays in deployment of the device meant that usable data would not have been available during the original timescale of the evaluation, hence it was agreed among the project partners that Unity Insights would pivot to creating a budget impact model instead.
Constructed using a base of academic literature, public datasets, and expert opinion, the model was created with future use in mind. Being customisable, it allows the user to edit a variety of assumptions utilised within health economic calculations, meaning that the model will be of use when reliable data becomes available in the future. This means that the innovators and NHS representatives have a tool available to them to easily estimate the financial impact of implementing the device as data and insights are generated.
Appropriateness
The device has been the subject of previous clinical trials conducted in Europe, assessing the effectiveness of the device both within pulmonary rehabilitation and long-term oxygen therapy. This model was designed to fit the NHS use-case for the device, meaning that the results generated by the model are appropriate for a UK setting, providing key decision-makers with greater confidence when deciding whether to scale up implementation.
Value
Existing academic literature has shown that the device allows patients undergoing PR to complete more exercise than if they had been using constant-flow oxygen. Although there isn’t yet supporting data available to validate assumptions, it’s possible that the device can generate a variety of monetary benefits over and above usual-case PR; see below:
Improved patient eligibility for PR
It’s possible that the device makes more patients eligible to receive PR, which would increase the number of people having fewer exacerbations each year.
Increased completion rate of PR
A greater proportion of people may be able to complete the PR course when using the device. This would increase the number of people having fewer exacerbations each year.
Reduced rate of exacerbations
As a result of being able to complete more exercise, patients may receive a greater physical benefit, and a greater reduction in exacerbations than normal.
Increased completion rate of PR
When exacerbations happen, they may be less severe on average, meaning greater amounts can be managed in primary care at a far lower cost.
What value did this add?
As a result of our work, the innovators and clinicians alike have a dynamic tool which can be used to support a variety of business case-creating activities, and know what future data collection should aim to achieve in supporting the proliferation of the device.
Some more of our insights:
A mixed-methods evaluation into transformed community mental health services
Community mental health transformation evaluated using mixed-method; health economics, inequalities analysis, and system
Creating a Budget Impact Model for an automatic oxygen titration device in pulmonary rehabilitation
A health economic model exploring the budget impact of an automated oxygen titration device at a community site in Kent.
Blueprinting the development of an innovation sandbox
Rapid review of existing sandbox models to inform the blueprint of a sandbox.