We find out more from Adrian Flowerday, Managing Director at Docobo remote monitoring about opportunistic screening, also known as opportunistic assessment, why it is so important in today’s healthcare landscape and how it can benefit people and support the NHS.

Can you tell us a bit about opportunistic screening?

Yes, of course.  With the NHS facing challenges such as long waiting times for treatment and an increasingly ageing population with long term conditions and related diseases, one of our main focuses at Graphnet is and always has been proactively identifying early warning signs and supporting interventions to be put in place to prevent more significant deterioration in people’s health. This not only offers better health outcomes for individuals, but also reduces burden on the NHS.

Sounds great – tell us more!

Screening is a health assessment that is offered with the intention of identifying people who may have an increased risk of a particular condition, also to determine health indicators and potentially reveal undiagnosed medical problems that people are unaware of.

We have a long experience of working with –  and providing the technology for – care providers to deliver opportunistic screening. In fact, we’ve been doing remote patient monitoring since 2001, and worked with AGE UK to create our own unique device – CAREPORTAL® – which is easy to use for people who may have dexterity issues or limited experience of using technology. CAREPORTAL enables people to easily input health measurements, and it also has the capability of taking an ECG reading while in a community setting. Digital inclusion is something that’s really important to us here and our CAREPORTAL enables just that.

Tell us about the benefits of screening?

Screening programmes can reduce morbidity, disability, and mortality, whether done opportunistically or in a more targeted way. For targeted screening, the use of population health management software coupled with our remote monitoring technology is undeniably effective. By developing a robust and efficient pathway to reliably identify ‘at-risk’ cohorts, these people can then be offered screening, early intervention techniques and health promotional advice to reduce prevalence of deterioration within that cohort. We're in a unique position in that our remote monitoring and population health platform is integrated, meaning that we offer a complete package for this pathway.

Tell us more about what you can use opportunistic screening for?

You can use it for anything. In essence, screening is an opportunistic and proactive process: collecting unplanned data in a community setting.

Screening can take many forms; a patient survey or extracting health data with monitoring equipment such as oximeters or blood pressure monitors. Assessments may be targeted at people who have an elevated risk, or simply to explore data from a geographical location of the general public. It can be a really effective method to proactively identify potential health concerns early on, increasing the possibility of better outcomes.

We’re focused on and have recently launched an updated version of cardiovascular monitoring functionality, which provides the opportunity to screen, assess and potentially detect undiagnosed atrial fibrillation (AF) and hypertension, two conditions strongly associated with an increased risk of stroke.

Sounds interesting. How would you set up opportunistic screening?

We make it simple to set up and run opportunistic screening services. Using our screening app is so easy to use, even if people have no previous experience and it can enable health services to carry out screening in any community setting.

For instance, a tablet could be made accessible for patient surveys to be carried out in a GP surgery or a pharmacy while people are waiting for their appointment. People could complete the survey from a designated private area or from the general waiting room, whichever is most appropriate.

But, it’s not JUST for screening, DOCOBOAPP can be used for any questionnaire, such as the Kansas City Cardiomyopathy Questionnaire (KCCQ), a self-administered questionnaire that quantifies physical limitations, symptoms, self-efficacy, social interference and quality of life and others such as EC3Q.

Can you tell us about the benefits of opportunistic screening?

Yes of course.  As the NHS continues its journey from a reactive safety response, towards a proactive and ultimately generative safety culture, responding to safety issues in real-time, opportunistic screening is a valuable resource for identifying early symptoms and intervening at the earliest opportunity.

Screening enables clinicians to quickly and easily capture and analyse data across a selected cohort. This may be medical data, or it could be social or symptomatic information, such as lifestyle or mood. It’s the collection of measurable data that supports early detection of disease. If someone  inputs a measurement that presents potential concern, the system can immediately alert the relevant clinical team, who are then able to complete a clinical assessment and manage potential risks.

Essentially, screening is a digital process that could increase early detection and subsequent treatment of specific diseases, improving health outcomes for individuals and optimising the proactive model of care.

Who does Graphnet work with on screening?

We are working with several clients to provide technology for screening. For example, we support some services to deliver the NHS England initiative Innovation for Healthcare Inequalities Programme (InHIP). InHIP aims to address local healthcare inequalities experienced by deprived and other under-served populations. West Midlands Health Innovation Network are a service who is successfully using our technology to deliver the InHIP project – collaborating with local communities to identify, address and minimise health inequalities and improve access to health technologies and medicines.​ This closely aligns with the national Core20PLUS5 approach, reducing health inequalities in NHS services such as maternity, mental health, respiratory, cancer diagnosis and cardiovascular disease. ​

We have also been supporting clients to implement screening of those attending for the flu vaccine, incorporating brief assessments for AF and hypertension at the time of vaccination, individuals at increased risk of stroke could be identified and preventative care pathways offered.

Opportunistic screening sounds great – but what happens if we want to identify specific cohorts to screen?

We can provide the whole package; using the population health tool to identify individuals with an increased risk, then remote monitoring software to carry out the screening. Equally, we can integrate with other population health tool providers if preferred.

So what sets Graphnet apart for opportunistic screening?

Our technology enables data to be collected quickly and easily, it is far more comprehensive than many other remote monitoring platforms and we are proud to offer such flexibility that can be adapted to a wide range of services and pathways, including screening. We support our clients with a dedicated project team who work tirelessly with the client to ensure the service is implemented and maintained as effectively and efficiently as possible. We have been providing remote monitoring since 2001, we understand our clients’ needs better than most and are active advocates for preventing unnecessary escalation of illness or hospitalisation.

Part of our screening experience has been our work with clients to support NHS care pathways which reduce the occurrence of stroke in ‘at-risk’, local and regional populations. The programme is used to identify undiagnosed AF and hypertension, empowering individuals to make healthier lifestyle choices and to use relevant early interventions to proactively reduce their risk of stroke.

It’s exciting to be working together with the NHS on these screening projects that make such a difference to individuals with increased risk of disease. We look forward to continuing our work in this area.