ExpertCare

ExpertCare, a digital health intervention developed by DXS, designed for medication optimisation in hypertension management within primary care settings. ExpertCare functions as a clinical decision support tool that automates the collection of personalized information and provides prescribing recommendations aligned with relevant NICE guidelines.

Cardiovascular disease (CVD) kills more than 18 million people worldwide annually, a third of all global deaths. It is a leading cause of mortality in England and is responsible for close to 25% of all mortalities, incurring £7.4 billion in treatment costs and £15 billion in costs to the wider economy annually (1). Raised blood pressure or hypertension is the leading risk factor for CVD with the global potential savings from effective BP management projected of about £78.6billion p.a. In the UK, high BP is controlled in only two out of five cases despite treatment. Improved control significantly reduces the risk of heart attacks and strokes in CVD patients (2). Cardiovascular disease (CVD) often manifests as more than one long-term condition. Multimorbidity, commonly described as the presence of multiple concurrent medical conditions, is more common with age and associated with high mortality, reduced functional status, and increased hospitalisation. Inappropriate polypharmacy often results in non-optimal treatment and patient injury because of adverse effects from multiple medications.

ExpertCare is designed to assist clinicians with managing BP using evidenced-based medicinal recommendations consistent with individual patients’ health record profiles. Most guidelines are built on evidence-based medicine and are generally designed for the treatment of single diseases. ExpertCare is innovative in that it simultaneously deals with multiple guidelines, automates and time-compresses these tasks into a seamless 3-minute process. Deployed in the clinician workflow and at the point-of-care, ExpertCare combines comprehensive patient demographic and clinical data to evidence-based treatment considerations in pursuit of precision medicine and optimum medicines treatment outcomes.

Findings from the two studies suggest that ExpertCare is a usable and effective tool for clinicians to use within primary care management of hypertension with benefits to both patient and economic outcomes.

Based on experience using ExpertCare in clinic, as well as during the research session, participants commended ExpertCare for being a useful, efficient tool. The current iteration of the platform was considered effective, intuitive, usable and beneficial to end-users, especially when prescribing for ‘complex’ patients.

The economic evaluation concluded that ExpertCare is a cost-effective method for improving the optimization of hypertension management. It leads to a higher proportion of individuals with optimally managed hypertension compared with standard care.

DXS are now working towards an exploitation plan to make any recommended adjustments to the ExpertCare to further improve outcomes for clinicians and patients and progress adoption and spread within additional UK PCNs.