A smartphone app and home test kit enabling people to test themselves for chronic kidney disease (CKD) using their mobile phone camera is now being rolled out across all GP practices in Kent and Medway.
This exciting collaboration between Kent and Medway CCG and health technology partner Healthy.io has been funded by the AI in Health and Care Award.
This is delivered in partnership with the Accelerated Access Collaborative (AAC), a strand of NHS England focused on delivering health innovations, NHSx, the digital transformation arm of the NHS, and the National Institute of Health Research (NIHR).
As GP surgeries continue to face immense pressures as a result of the Covid-19 pandemic and ongoing vaccination roll-out, Kent and Medway join a growing number of NHS organisations across the country who are using this digital innovation to reduce the burden on the primary care workforce, and enable at-risk patients to complete urine tests safely from home.
The chronic kidney disease early detection service uses image recognition and computer vision technology to turn the smartphone camera into a clinical-grade medical device, allowing people with diabetes to complete their annual ACR urine test at home, without needing to visit the GP’s practice.
Urine testing for kidney health has the least uptake of all eight tests which are recommended by NICE and NHS England as part of the annual diabetes review.
Whilst the test is clinically critical, 60% of people living with diabetes do not engage in the care process through the traditional models of care. It is estimated that 77k people living with diabetes across Kent and Medway do not complete their annual urine CKD test.
Now, all patients with diabetes who have not completed a test in the last 12 months, are being invited to take part in the new home testing programme.
One in ten people in the UK suffer from chronic kidney disease, a long-term condition where the kidney functions gradually decline, costing the NHS £1.5 billion annually to treat.
It is often difficult to spot symptoms until it has reached an advanced stage.
People with the condition have a greater risk of having a stroke or heart attack. It can also cause kidney failure, when sufferers will need to have dialysis and a possible transplant.
However, lifestyle changes and medication can stop it getting worse if it's diagnosed at an early stage.
For high-risk populations such as people living with diabetes or hypertension, a yearly urine test to monitor ACR can detect early signs. Until now this has only been possible by providing a urine sample in person at a doctor’s surgery, medical centre or hospital.
Despite its importance 6.8 million people at risk in the UK don’t complete the annual test.
The current Covid-19 pandemic has exacerbated the problem, as people who are at risk are often medically vulnerable and can be anxious to leave home.
This means many cases of chronic kidney disease are not being detected until they’re at an advanced stage, sometimes when a person is suffering from end stage renal disease and needs a transplant or dialysis.
According to research, the app could prevent more than 11,000 cases of end-stage kidney disease in the UK and save the NHS £660m in 5 years.
The health economics evaluation of the original service pilot, delivered by York Health Economics Consortium, also suggested that offering home-testing to the at-risk population in Kent and Medway could save the local NHS £24,860,000 over five years and help to detect over 12,613 new cases of CKD.
The service has been commended for how easy it is to use. In a recent deployment in Leeds, after six weeks of testing, 93% of participants were reporting the test “very easy” or “easy” to use.
Patients up to the age of 94 have successfully downloaded the app and completed the test from home.
After being identified by their GP or local health service as someone at high risk of chronic kidney disease who hasn’t had an ACR test in the last year, patients are contacted through SMS text or a phone call and, if they agree, are sent the app from Healthy.io via text.
They are then sent an ACR home based urine test by next day post, which includes a standard dipstick, a urine collection pot in which they dip the stick after giving a sample, and a patented colour board.
They download the app onto their phone, which then guides them through the test, including how to scan the dipstick on the colour board with their mobile phone camera. Using AI and colourimetric analysis, an algorithm reads the dipstick results with accuracy equivalent to a lab-based device. Then, the app sends a real-time clinical grade result to the user’s GP or clinician directly, so they can follow up with the patient with a diagnosis and treatment plan.
If you’re a patient who would like to find out more information about how the service works, you can read more here.
If you’re a local GP who would like to activate this service, follow this link.