Spirit Digital Ltd

Clinitouch

Evidence-based digital health app providing remote clinical monitoring and education to patients with chronic, long-term health conditions.

Class 1 CE marked health platform accessed via smart devices (patients' own, or provided at-cost).

Dynamic monitoring via data inputs (from patient-provided peripherals) and health questionnaires.

Two-way clinician-patient on demand communication.

Features

• Remote patient monitoring deployable in patient homes and care homes
• Virtual Ward deployable for early supported discharge
• Educational resources for specific conditions to support self-management
• Dynamic algorithms triangulate data for real-time health status RAG rating
• Clinical monitoring staff alerted to deterioration to enable corrective action
• Automated triaging of patients on clinician dashboard supporting resource allocation
• Care pathways designed by NHS clinicians and subject matter experts
• Secure, in-built, bi-directional communication
• CE marked Class 1 Medical Device
• Peer reviewed evidence base to support comprehensive implementation

Benefits

• Emergency admission avoidance (proven 67% reduction)
• Supports elderly patients in care homes
• Quickly identifies patients at risk of exacerbation
• Enables patient self-management of disease
• Increased staff productivity and efficiency
• 24/7 access to service for patients and clinical staff
• Reduces requirements for clinical visits at patient residences
• Integration and data sharing with existing healthcare systems through HL7/FHIR
• Dashboards to show individual patient and whole caseload data
• 40.3% reduction in length-of-stay in step-down care model

£100 to £100 a licence a month

Service documents

• Pricing document

  PDF

• Service definition document

  PDF

• Terms and conditions

  PDF

Request an accessible format

If you use assistive technology (such as a screen reader) and need versions of these documents in a more accessible format, email the supplier at bruce.adams@spirit-health.com. Tell them what format you need. It will help if you say what assistive technology you use.

Framework

G-Cloud 14

Service ID

300254231752728

Contact

Bruce Adams
07814440511
bruce.adams@spirit-health.com

Service scope

• Software add-on or extension: No
• Cloud deployment model: Private cloud
• Service constraints: Any planned maintenance to cloud services is scheduled for periods of very low user activity (typically early morning).; ; Clinitouch is device agnostic, allowing connection to Bluetooth peripherals from any device provider, provided they conform to the required standards. ; ; Additionally, as an organisation we are brand agnostic, operating a purchasing standard operating procedure that ensures that samples of all orders are tested to ensure they meet quality standards which gives us greater depth and certainty of supply chain when required to provide supporting hardware, equipment or devices.
• System requirements:
  • Android 10 and above
  • Firefox 63 and above
  • Chrome 64 (Latest Version)
  • Microsoft Edge (Latest Version)
  • Safari 12 and above
  • IOS 16

User support

• Email or online ticketing support: Email or online ticketing
• Support response times: Within Business hours: ; Priority 1 Issue — 1 elapsed hour ; Priority 2 Issue — 2 elapsed hours; Priority 3 Issue — 8 elapsed hours ; ; Outside Business hours: ; Priority 1 Issue — 2 elapsed hours; Priority 2 Issue — 4 elapsed hours ; Priority 3 Issue — 12 elapsed hours
• User can manage status and priority of support tickets: No
• Phone support: Yes
• Phone support availability: 24 hours, 7 days a week
• Web chat support: No
• Onsite support: Yes, at extra cost
• Support levels: Clinitouch is a software with a personal service and support levels can be flexed as needed by our clients.; ; Clients have access to an online/real-time reporting tool which is triaged by the development team. Clients receive receipt of issues and confirmation of any action taken.; ; Clinicians have a designated Customer Success Manager who can access any level of support for the client which can include collaboration with the development team if required.; ; Cloud support is provided by Spirit’s own dedicated IT Team in partnership with a dedicated Microsoft Azure support engineer. Spirit’s internal IT Team are on site and are monitoring the platform continuously. ; ; Training support is provided using static and video content. This can also be delivered at a team or individual level where required using screen sharing and Q&A sessions. ; ; User guides are supplied for clinical and end user process confirmation and future guidance.; ; We offer face-to-face, onsite, or remote training for all user levels (e.g., clinicians, patients, administrators). ; ; Training is supplemented by online resources via our training portal. Resources include a library of bite sized ‘how to’ videos, a full user guide, frequently asked questions, and other useful information to help with use of the platform.
• Support available to third parties: Yes

Onboarding and offboarding

• Getting started: Responsibility for helping users to start using our service will be taken by our Customer Success Manager. ; ; The on-boarding package will comprise: ; ; For individuals receiving a Clinitouch installation through Spirit, training will be provided at the time of the installation.; ; For all system users and system super users commencing one month prior to go live date, training will be delivered on the clinical and patients’ systems and associated interfaces. ; ; This training will be delivered either virtually or in-person, depending upon commissioner preference. ; ; Ongoing training and refresher support can be delivered virtually or on-site as required throughout the duration of the contract for new starters and for existing users to explain system updates and new functionality.; ; Our written user manuals are approved through our medical approval process and through user accepting panels. These are available as hard copies and are updated regularly and available online.; ; All patient and clinical users have 24/7 access to the online Clinitouch training portal and resources therein.
• Service documentation: Yes
• Documentation formats:
  • HTML
  • PDF
• End-of-contract data extraction: We have significant experience of importing and exporting patient data to and from clinical systems and have robust processes and procedures in place for when the contract ends. ; ; We adhere to the guiding principles laid out in the NHS Digital Exit and Transition Process 2015, Confidentiality; NHS Code of Practice 2003, The Data Protection Act 1998, Caldicott and Caldicott 2 and DH Records Management Code of Practice. ; ; We will implement a secure method of data extraction and: ; • Ensure contractual/permissions in place for data sharing ; • Agree timetable for extraction and supply of data to ensure data sets complete prior to transfer ; • Agree procedures/new contractor compliance with GDPR data sharing rules ; • Identify and agree datasets required ; • Agree format for extraction (Excel, CSV, etc) ; • Provide test data set prior to fully supply of data ; • Arrange for safe archiving of data ; • Arrange cessation of customer helpline ; • Remove system permissions as required ; ; We delete all data from the system and provide assurance via System Retirement Notice to the customer that no data is now stored within the Spirit system.
• End-of-contract process: At the end of a contract process Spirit will implement the co-developed and signed off exit plan strategy. This will involve off-boarding patients from the system into the traditional services and closing the contractual requirements with the commissioner. ; ; Patient off-boarding: ; • Communication with each patient to discuss the end date of the service ; • Step-down procedures into existing local clinical services ; • Collection of any Clinitouch tablet and peripherals that were provisioned during the contract; • Decontamination of equipment; • Reporting ; • Provide an end of contract KPI delivery report ; • Provide a summary service report ; • Co-develop a lesson learned report ; ; Other ; • Arrange commissioner exit meetings and communication requirements ; • Produce case studies ; • Notify referrers TUPE (if new service provider and Spirit is delivering the clinical service for monitoring and management) ; • Identify staff who will transfer ; • Consultation process (if required) ; • Due diligence meeting with new employer ; • One-to-one meetings with transferring staff ; • Production of ELI data ; • Communication plan and roll out ; • Advise pension authority

Using the service

• Web browser interface: Yes
• Supported browsers:
  • Internet Explorer 11
  • Microsoft Edge
  • Firefox
  • Chrome
  • Safari
  • Opera
• Application to install: Yes
• Compatible operating systems:
  • Android
  • IOS
  • Linux or Unix
  • MacOS
  • Windows
  • Other
• Designed for use on mobile devices: Yes
• Differences between the mobile and desktop service: Patients access the Clinitouch service via a the Clinitouch app that is downloaded from either Apple Store or Google Play App store.; ; There is no patient facing website - it is solely app based, no website exists for patient use.; ; Conversely - there is no clinician app - the clinician portal is only accessible via a website.
• Service interface: Yes
• User support accessibility: WCAG 2.1 AA or EN 301 549
• Description of service interface: The Clinitouch patient app is downloaded onto a smart device (e.g. phone, tablet) that interfaces wirelessly with a variety of peripheral devices (e.g. pulse oximeters, blood pressure monitors) to capture biometric data. ; ; The Clinician web-based portal displays data collected from Clinitouch apps reporting from individual patient smart devices and provides a RAG-rated risk score for each patient.; ; Clinitouch is a Class 1, CE marked, registered medical device approved by the MHRA. ; ; The data server sits within a secure data environment, which enables it to push and pull data securely between healthcare provider data systems and service users.
• Accessibility standards: WCAG 2.1 AA or EN 301 549
• Accessibility testing: WCAG 2.1 AA compliance and evidence of User Needs being met on a rolling basis. Evidenced within our Product Delivery Manual.; ; The user interface in Clinitouch was designed to be clear and convey information to the user in simple language. The system was designed in collaboration with a user interface specialist, so we could ensure that screens were made with a high readability level, considering text and background colours, text size (whether at normal size or zoomed in by 400%), not using images of text, ensuring that the design is responsive. ; ; We ensure that every effort has been made to caters for a wide range of accessibility requirements and continues to review on a regular basis with our clinician and user forum. ; ; We can cater for hard of sight with increased contrast or larger text, or text to speech.; ; Extensive User Acceptance Testing was done as part of the CE marking process.; ; Testing follows Double Diamond design process standards.; ; Clinitouch leverages User Interaction mental models to facilitate usability.; ; We follow ISO 13407 (Human-centered design processes for interactive systems), ISO 9241 (Ergonomics of Human System Interaction) and the Atomic Design approach to ensure our interfaces are easy to understand and use.
• API: No
• Customisation available: Yes
• Description of customisation: Users can customise the platform but it’s limited to ensure the platform is used safely as intended. Clinical experts supervise the creation of algorithmic health questionnaires, which go through a rigorous clinical approval and testing process before being implemented within Clinitouch. ; ; Additionally areas within Clinitouch that can be customised by the client include:; ; Clinicians can change/set baseline normal parameters for individual patients. This happens within Clinitouch accessed via the Clinician’s portal.; ; Clinicians can assign individual customised educational resources to their patients to address individual needs. This happens within Clinitouch accessed via the Clinician’s portal.; ; Clinicians can create customised health questionnaires from patients. ; ; Clinicians can customise fields within Clinitouch (as long as the changes do not contradict the intended use statement for Clinitouch software). ; ; Creation of additional fields within Clinitouch is possible after consultation with Customer Success Manager.

Scaling

• Independence of resources: Spirit’s Clinitouch service is hosted on Azure servers, which are all located in the UK with a 24-hour per day response time provided every day. ; ; We are able to set up capacity warning systems via Applications Insights in Azure to alert of any critical server capacity issues. We mitigate against reaching any server limits by having full capability to rapidly flex our server capacity as needed in response to requests. ; ; Azure Server capacity can be increased instantaneously, although alerts are in place to monitor capacity allowing us to increase space or performance before they become critical.

Analytics

• Service usage metrics: Yes
• Metrics types: Clinitouch can be configured to produce reports to the exact specification of each commissioning Clinical Service Provider, based on data collected via individual patient and care professional user accounts.; ; Clinitouch has the capability for user-defined KPIs to be inputted into the system and reports run at a user-defined frequency to report parameters set by the customer.; ; Clinitouch can deliver the following (non-exhaustive) metrics: Number of goal sessions completed within target time; Number of RAG alerts; Number of video calls (as a proxy measure for home-visits avoided); Number of one-to-one, one-to-many patient messages.
• Reporting types:
  • Real-time dashboards
  • Regular reports
  • Reports on request

Resellers

• Supplier type: Not a reseller

Staff security

• Staff security clearance: Other security clearance
• Government security clearance: Up to Security Clearance (SC)

Asset protection

• Knowledge of data storage and processing locations: Yes
• Data storage and processing locations: United Kingdom
• User control over data storage and processing locations: No
• Datacentre security standards: Managed by a third party
• Penetration testing frequency: At least once a year
• Penetration testing approach: ‘IT Health Check’ performed by a Tigerscheme qualified provider or a CREST-approved service provider
• Protecting data at rest:
  • Physical access control, complying with another standard
  • Encryption of all physical media
• Data sanitisation process: Yes
• Data sanitisation type: Deleted data can’t be directly accessed
• Equipment disposal approach: In-house destruction process

Data importing and exporting

• Data export approach: Our Head of Governance provides oversight to the data export approach. ; We have developed data export processes in line with GDPR requirements. Approved Clinicians or Admin users can request an export of any data within the database, customisable in a variety of formats to either CSV or PDF format.
• Data export formats:
  • CSV
  • Other
• Other data export formats: PDF
• Data import formats: CSV

Data-in-transit protection

• Data protection between buyer and supplier networks: TLS (version 1.2 or above)
• Data protection within supplier network: TLS (version 1.2 or above)

Availability and resilience

• Guaranteed availability: Servers are hosted by MS Azure who offer 99.9% up-time and have fail-over servers located in a different city, if required. ; ; Clinicians access Clinitouch through their own employers network, which is outside the scope of our product. ; ; Clinitouch is provided as a software programme that is cloud based so accessed via any internet connected device e.g. mobile telephone device, a tablet or computer on a 24/7 basis.
• Approach to resilience: Information is available upon request.
• Outage reporting: Due to patient data regulations, patients cannot be contacted by Spirit when there is a network outage as they would not have access to their contact details. ; ; Outages are communicated by email to all clinical service users and admin(s), as well as by telephone to all clinical leads. All clinical users are then kept up to date, where appropriate. Local arrangements are put in place for clinical users to contact the patients directly. ; ; If the issue is due to cyber threat, we will consider keeping service offline until safe and communicating this with the relevant users.

Identity and authentication

• User authentication needed: Yes
• User authentication:
  • 2-factor authentication
  • Identity federation with existing provider (for example Google Apps)
  • Username or password
• Access restrictions in management interfaces and support channels: Management interfaces are restricted to a limited number of individuals. ; ; The individuals must connect to Microsoft Azure via their Azure active directory account and can only connect using their public facing IP address.; ; Only authorised employees to include clinicians/administrator will have access to Patient Identifiable Data. ; ; Based on the clinician/ administrator role type, there are a set number of security groups available that define the access made available to the specific user.
• Access restriction testing frequency: At least every 6 months
• Management access authentication:
  • 2-factor authentication
  • Identity federation with existing provider (for example Google Apps)
  • Username or password

Audit information for users

• Access to user activity audit information: Users contact the support team to get audit information
• How long user audit data is stored for: At least 12 months
• Access to supplier activity audit information: Users contact the support team to get audit information
• How long supplier audit data is stored for: At least 12 months
• How long system logs are stored for: At least 12 months

Standards and certifications

• ISO/IEC 27001 certification: No
• ISO 28000:2007 certification: No
• CSA STAR certification: No
• PCI certification: No
• Cyber essentials: Yes
• Cyber essentials plus: Yes
• Other security certifications: Yes
• Any other security certifications: Data Security and Protection Toolkit

Security governance

• Named board-level person responsible for service security: Yes
• Security governance certified: Yes
• Security governance standards: Other
• Other security governance standards: Cyber Essentials Plus
• Information security policies and processes: The cloud environment used within Spirit Digital is run over Microsoft’s Azure cloud network. ; ; All data (including backups) will be held in Spirit’s Microsoft Azure system over encrypted SQL databases within the UK. ; ; Patient Identifiable Data is transmitted over the internet is encrypted and is received by the Azure hosted servers, where the data is analysed and stored within the UK. ; ; All data in transmission and at rest is encrypted to modern standards.; ; Our cloud partners on whose infrastructure Clinitouch is hosted are compliant with ISO27001 standards.

Operational security

• Configuration and change management standard: Supplier-defined controls
• Configuration and change management approach: Change is controlled via ISO13485 accredited QMS. ; ; This requires Spirit to rigorously record and trace all changes made to the software.; ; The process and its records are audited on an annual basis. All non-conformances must be rectified with 90 days of audit.; ; This compliance regime includes the need to assess the security impact of changes.
• Vulnerability management type: Supplier-defined controls
• Vulnerability management approach: Spirit follow OWASP recommendations and best practices. We review cyber alerts raised by NHS Digital and co-assess against Clinitouch technologies, making changes, where required. Depending on the level of severity, potential threats are patched either same day, same week or the following week. In addition, Microsoft will regularly update and maintain their network security to meet the latest standards.; ; In response to penetration testing results we address any critical or high level vulnerabilities and re-test immediately until they are eliminated.
• Protective monitoring type: Supplier-defined controls
• Protective monitoring approach: Spirit’s Clinitouch service is hosted on Azure servers, which are all located in the UK with a 24-hour per day response time provided every day. Servers are constantly monitored by Microsoft and patched to the latest service packs.; ; On a regular basis we conduct audit information searches and our protective processes are likely to detect and respond quickly to attacks, or attempted attacks.; ; If an issue/incident is due to cyber threat, we will consider keeping the service offline until safe and communicating this with the relevant users.
• Incident management type: Supplier-defined controls
• Incident management approach: We don’t have any common events, but the process is the same for any incident or event. ; ; Incidents are reported by phone or email, whatever is quickest to enable an immediate response. ; ; Template report to include a risk assessment, notification requirements, disciplinary action, root cause, trend analysis, corrective action, preventative action and later, effectiveness. ; ; Policy to ensure that incident reports are provided to users in the event of a major incident, which details the root cause and the steps that have been undertaken to mitigate the risk of it occurring again in the future.

Secure development

• Approach to secure software development best practice: Conforms to a recognised standard, but self-assessed

Public sector networks

• Connection to public sector networks: No

Social Value

• Social Value:

  Social Value

  • Fighting climate change
  • Covid-19 recovery
  • Tackling economic inequality
  • Equal opportunity
  • Wellbeing

  Fighting climate change

  Clinitouch software enables patients to be remotely monitored within their own homes. This negates the requirement for patients to travel to medical care facilities away from their homes. In turn this will help to reduce carbon emissions from reduced use of private vehicles, supporting wider commitments towards net zero greenhouse gas emissions.

  Covid-19 recovery

  Clinitouch supports people and communities to manage and recover from the impacts ; of COVID-19 by enabling remote monitoring of people with various medical conditions in their own home, which is especially beneficial for those worst affected or who are shielding.; ; Clinitouch software supports the deployment of digital healthcare services, which is a key component of the NHS reset initiative to help overcome difficulties caused by the Covid-19 pandemic, providing a solution for new ways of working and new methods of service delivery in healthcare.

  Tackling economic inequality

  Clinitouch remote patient monitoring software supports the development of scalable and future-proofed new methods to modernise healthcare delivery (treating patients at home instead of as in patients) and increase productivity of healthcare staff (clinicians can manage a virtual caseload of more patients that possible with inpatients).

  Equal opportunity

  Clinitouch software is suitable for use by all adult patients without any impingement on any protected characteristic.

  Wellbeing

  Clinitouch developers have demonstrable collaboration with clinical and patient users and communities in the codesign and ; delivery of the software.; Clinitouch has published peer-reviewed data that shows improvements in wellbeing scores in patients using the software.; Clinitouch has a number of testimonials from existing and prior users attesting to improved wellbeing across a number of domains.

Pricing

• Price: £100 to £100 a licence a month
• Discount for educational organisations: No
• Free trial available: No

Service documents

• Pricing document

  PDF

• Service definition document

  PDF

• Terms and conditions

  PDF

Request an accessible format

If you use assistive technology (such as a screen reader) and need versions of these documents in a more accessible format, email the supplier at bruce.adams@spirit-health.com. Tell them what format you need. It will help if you say what assistive technology you use.