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Transforming surgical outcomes with digital health

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Dr Robbie Huddleston (pictured second-left with co-founders) is CMO of Surgery Hero – a UK health tech company aiming to improve surgical outcomes through health coaching.

Launched during the pandemic, the company is set to scale up following a £2.5 million investment in November 2022.

Health Tech World called up Dr Huddleston to find out how the health coaching platform is helping patients play an active role in their own recovery.

You originally trained in emergency medicine. What drew you to the health tech space?

About three years into my specialty training, I realised it wasn’t the career for me. It can be tough to just keep going. So I looked for an alternative career.

I ended up joining Medopad [now Huma] as their clinical safety officer and got some exposure to digital health.

Where did the idea for Surgery Hero come from?

Working at Medopad opened my eyes to how effective remote patient monitoring could be. But it was also clear just how difficult it is to get patients to change their behaviour.

Unless you give them a support infrastructure to help them make that change, it’s unlikely to happen. And that’s backed up by well-established behavioural science.

And on the other side, I had always felt that there was this missed opportunity with surgery. There’s this belief that preparation begins on the day of surgery itself.

But it’s more helpful to think of it like running a marathon. You have to start getting ready physically and mentally in the days, weeks and months before.

That preparation can have a huge impact on the surgical outcome and your eventual quality of life.

So this is where health coaching comes in

I describe it as facilitating a person’s active participation in their own healthcare.

If we make the patient a member of their own care team, we can really start to influence behaviours and outcomes.

It was the combination of these different factors that led us to create Surgery Hero.

How does the app work?

After being referred by the hospital, the patient receives a text message with an invite to download the app and complete a health questionnaire.

They are then invited to a welcome call with their one-to-one health coach.

There is also a self-directed learning platform housed within the app.

The content is tailored according to certain modifiable risk factors for surgery. It could be sedentary behaviour, poor nutrition, smoking or alcohol.

The patient can talk with their coach via weekly video or phone calls, stay in touch via a messaging service, or a combination of both.

Some people are happy to go it alone, others really enjoy the coaching and can’t wait for their weekly call and they’ll be sending messages between calls.

What feedback have you had so far?

Patients really appreciate having that one-to-one interaction with another human being.

The health coach is there to advocate, inspire and help the patient navigate their own healthcare.

Patients tell us that they feel inspired because finally, they have someone there who listens.

Where is the app being used at the moment and what kind of impact is having?

We’re pretty much all over England. And I’m delighted to say that the results have been really promising across the board.

We use patient activation measure (PAM) as a metric to assess an individual’s knowledge, competence and ability to manage their own health.

It’s a good fit for what we do because health coaching is all about teaching people to better self-manage.

We’re consistently seeing big improvements from entry to exit – and those in the greatest need of additional support seem to benefit most.

People with the lowest PAM scores often feel overwhelmed by their care. They access unplanned healthcare more often and have higher healthcare spend.

It is among these individuals that we’re seeing the biggest improvements.

We’ve also been measuring self-reported scores for physical health, nutrition, sleep and mental wellbeing.

And, again, we’re seeing improvements across the entire cohort.

We did a 60-person pilot study covering our partnership with South Tees Hospital.

Across the board, we saw improvements in both PAM and patient-reported outcomes.

But on top of that, we were able to demonstrate a one-day reduction in the average length of stay – equating to a £273 per-patient saving. Scaled over the year, that’s a significant saving.

We’ve now just got to keep generating that evidence to build the business case for across the UK.

What about the wider impact?

Health outcomes on an individual patient level are obviously very important.

If you’re going for surgery, you want to know that this process will improve your chances of a successful operation.

But we also want to think in terms of population health.

If we can get everyone moving a bit more, eating more healthily and reducing alcohol, that can translate into massive population health benefits – saving Trusts a lot of money.

What can we expect from Surgery Hero in 2023?

We’ve just closed a £2 million seed funding round which will help us to scale the company and support more people going into surgery.

We’re also looking towards the US market as a potential next step.

There are more than 50 million major surgeries in the US every year, compared to maybe 12 million total surgeries in the UK. So the market is significantly bigger.

Two-thirds of Americans are covered by employee health insurance. And surgery is the third most common cause of employee absenteeism.

Meanwhile, a third of all employer healthcare is spent on surgery.

We have a very strong value proposition there, so we hope to make some new connections, run a few small pilots and maybe build a business case for something larger.

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