More NHS clinicians get their hands on pioneering app

10 January 2020

A ground-breaking app which provides a rapid alert when patients are at risk of acute kidney injury (AKI) is soon to go live at Barnet Hospital.

The Streams app – a secure alerting tool which has cut the diagnosis of AKI at the Royal Free Hospital from hours to minutes – will be available to clinicians at nearby Barnet Hospital in January 2020.

The app was developed by technology experts at Google Health in collaboration with clinicians at the Royal Free London NHS Foundation Trust (RFL) and launched in November 2016.

Its roll out has been so successful that up to 60 doctors and nurses at Barnet Hospital, which is part of the RFL, can now also receive alerts on their mobile devices when patients are at risk of AKI which accounts for 100,000 deaths every year in the UK.

It means they will be able to deliver vital treatment rapidly, improving outcomes for patients and potentially saving lives.

Dr Chris Streatther, RFL group chief medical and deputy chief executive, said: “We are incredibly excited to be able to extend the use of the Streams app to clinicians at Barnet Hospital

“Its use at the Royal Free Hospital has been a huge success and embedding technology which has a proven track record at a greater scale is something we need to do more of in the NHS. I know clinicians at Barnet Hospital cannot wait to get their hands on the app – the next step for us now is to extend its use for other life-threatening conditions like sepsis.”

According to an evaluation by UCL which was published in July in Nature Digital Medicine and the Journal of Medical Internet Research, the app improved the quality of care for patients by speeding up detection and preventing missed cases.  Thanks to Streams, clinicians were able to respond to urgent AKI cases in 14 minutes or less - a process which, using existing systems, might otherwise have taken many hours.

It also concluded that the app reduced the cost of care to the NHS – from £11,772 to £9,761 for hospital admission for a patient with AKI.

According to the evaluation, the app has improved the experience of clinicians responsible for treating AKI, saving them time which would previously have been spent trawling through paper, pager alerts and multiple desktop systems. 

Acute Kidney Injury – known as a silent killer because it can often be diagnosed late and is often hard to predict – contributes to nearly 20% of all hospital admissions, accounts for 100,000 deaths every year in the UK, and costs the NHS £1.2 billion annually.

Clinicians at the RFL worked closely with experts at Google Health who developed Streams with the aim of improving outcomes for patients by getting the right data to the right clinician at the right time. Like breaking news alerts on a mobile phone, the technology notifies nurses and doctors immediately when test results show a patient is at risk of becoming seriously ill with AKI, and provides information they need to take action. 

Clinicians face real challenges when it comes to detecting conditions like AKI – patients deteriorate rapidly and, without the app, it could be hours before this was picked up due to the limitations of current NHS technology and the reliance on manual observations and intuition. Approximately one in three deaths from AKI may be preventable if clinicians are able to intervene earlier and more effectively.

Deborah Sanders, Barnet Hospital interim chief executive and RFL group chief nurse, said: “We’re delighted that doctors and nurses at Barnet Hospital now have the Streams app to help deliver even better, safer care to patients.”

The RFL retains control of patient information at all times. Personal data can only be used for providing the Streams app and for no other purpose.

The Information Commissioner’s Office said in July 2019 that it was satisfied with the use of Streams and the data sharing agreement the RFL has with Google Health UK.