New app turns smartphone into a medical device for detecting infections in transplant patients

Patients who have had a kidney transplant are benefitting from the latest smartphone technology to improve the way infections are detected and treated at Salford Royal NHS Foundation Trust, part of Northern Care Alliance NHS Group.

A cohort of 22 post-transplant patients – who are particularly prone to urinary tract infections (UTIs) – is trialling home-testing kits that are linked to a unique and clinically-approved phone app.

Using the latest in image recognition and artificial intelligence (AI), it transforms the patient’s smartphone into a clinical-grade scanner – with the same pinpoint accuracy as lab-based analysis.

The trial has been developed by Salford’s kidney transplant and Future Digital teams in partnership with clinical technology specialists, Healthy.io, and will be formally evaluated later this year.

Previously, at the first sign of infection, these patients would have to make an appointment to visit their GP, give a urine sample for lab diagnosis, and wait – sometimes up to three days – for the results and the start of medication.

Now they simply undertake the same dipstick test in the comfort of their own home in a matter of minutes, using their smartphone camera to capture the readings.

At the touch of a button, these results are then transmitted to the kidney transplant team, who can prescribe appropriate antibiotics – according to the established protocol – straight away.

The Salford team believes that the way this technology has speeded up diagnosis and treatment has prevented hospital admission in some cases.

And because it is so user-friendly, it has also given patients the confidence to self-manage their condition.

Furthermore, initial feedback from our patients has been extremely positive with a score of 88 being reported by the Net Promoter tool analysing client experience and loyalty – in an environment where over 70 is considered world-class.

Salford’s kidney transplant team currently cares for around 700 patients, aged between 20 and 93, from across Salford as well as Wigan, Bolton and Oldham – so the potential benefit is huge.

Consultant nephrologist, Dr Rachel Middleton, said: “With a weakened immune system following transplant, our patients are particularly prone to UTIs.

“Early detection plays an important role in reducing the severity of the infection and the risk of contracting life-threatening conditions, such as sepsis and acute kidney injury (AKI).

“The technology we are testing turns an everyday smartphone into a diagnostic device, transforming the way urine tests are performed.

“It has taken a tried and tested medical tool – the dipstick – and taken it into the 21st century to analyse a range of different infections.”

The kit – known as Dip.io – contains detailed instructions for home-testing and disposable test strips and testing cups.

But the major clinical innovation is a panel of patterns and colours that guides the smartphone camera to read the test strip accurately, regardless of lighting or environment.

This means that unlike many existing at-home lab kits, patients don’t have to mail anything back, and they can get results in an instant.

The same process is followed by patients at the end of their course of antibiotics to ensure the treatment has been successful and they are free of infection.

Although in its infancy, the initiative has already triggered interest at the British Transplant Society, which has invited the clinical team to give a presentation at its annual national congress in March.

Healthy.io is also one of four innovative companies selected to improve care in the NHS through the Greater Manchester Digital Health Accelerator.

The Greater Manchester Digital Health Accelerator, run by Health Innovation Manchester, launched in September, 2018, offers successful SMEs the chance to receive one-to-one support, specialist training, support with produce development and other opportunities in order to help England’s NHS meet current challenges. Find out more about the Greater Manchester Digital Health Accelerator here.

Given that urine analysis is the second most frequently-conducted diagnostic test, the technology has the capability to benefit patient care in a raft of other conditions.

Salford Royal NHS Foundation Trust was chosen to be one of 16 NHS acute Global Digital Exemplars in 2016. This trial is among the latest innovations to go live as part of the programme of more than 50 world-class projects being brought to life by the Global Digital Exemplar and Future Digital teams.

The photos show kidney transplant clinic team members (from left) consultant nephrologist Dr Rachel Middleton; specialist nurse Lucy Griffiths; and staff nurse Angela Bailey with the home-testing kit being trialled.