A smartphone app and home test kit enabling people to test themselves for chronic kidney disease (CKD) using their mobile phone camera is now available to all GP practices in Hampshire, Southampton and Isle of Wight CCG. It has been made possible through a collaboration with health technology partner, Healthy.io, and the Accelerated Access Collaborative (AAC), NHSx 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, we 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 service has already been live in parts of Southampton and West Hampshire since March, and 2913 patients in these areas have already completed their test from home. To find out more about the service click here.
The home based albumin to creatinine ratio (ACR) test uses image recognition and computer vision technology to turn the smartphone camera into a clinical-grade medical device. Therefore allowing people with diabetes to complete their annual urinary ACR 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 62,505 people across Hampshire, Southampton and Isle of Wight CCG do not complete their annual urine ACR 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.
Why the service is important
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 service has been commended for how easy it is to use. Patients up to 100 years old have successfully downloaded the app and completed the test from home. Recent patients have described their experience of completing a home test:
“This was so much better than having to take a urine sample into my doctors or the hospital. The app guides you through a simple process. Love this new innovation”.
“I am 81 years old and not very computer savvy, but the instructions were very helpful so I managed to complete the test”.
“It was brilliant. I got the results soon after so it wasn’t a case of waiting anything up to a week to get a result back from the doctor’s surgery”.
How the service works
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 sent a link to download the ‘Minuteful - kidney test’ smartphone app. They are then sent an ACR home based urine test called ‘Minuteful’ 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.
At their earliest convenience they complete the test, with the app guiding them through the process with audio and video support, 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. The app then sends a real-time clinical grade result to the patient’s GP or clinician directly, so they can follow up with the patient with a diagnosis and treatment plan.
Healthy.io’s phone support service is available at any time for patients to contact, with the team on hand to help with any part of the process, from downloading the app to understanding how to complete the test.
GP Practices are encouraged to begin activating the service. To do so, please fill in your details here and Healthy.io will begin the set-up process.