Modernizing Healthcare Communication Through Smart Apps

James Dickson, Founder & CEO of Piota shares how he is modernizing healthcare communication for over 100 NHS Trusts through smart apps.

Piota (Put It On The App) is a smart app development company that specializes in creating apps to improve communication in healthcare. We caught up with his founder James Dickson to learn how his company is improving the healthcare system and what others can learn from him.

1. Hello James, can you tell our audience about yourself?

I worked in finance as an investment manager for 21 years, mainly for a hedge fund company called Meditor. Between 1998 and 2013, we increased the value of our client’s funds by about 500%, beating the stock markets which rose by about 15%. In late 2013, the founder closed down the business for lifestyle reasons, and I started to investigate whether an app idea I’d had while volunteering as a school governor could be a viable business.

In mid-2014 I started Piota (Put It On The App) to make apps helping schools improve communications with parents. Within a few years we started selling into other sectors too. Such as the NHS, social care and charities, helping them improve engagement and communications with their service users and staff members.

Our sales to schools and charities collapsed during Covid, but demand from the NHS rose substantially and has remained high ever since. We see more potential for our apps to improve service delivery and save time and money in the NHS than elsewhere. So Piota has become a dedicated health and social care apps company with all the product features, regulatory compliance profile and client breadth that you’d expect.

Six months ago Piota was acquired by NED Holdings, a UK company with much larger resources which has enabled us to accelerate product development and demonstrate the financial strength required for a long term partner to NHS trusts (local NHS secondary care delivery organisations) and ICSs (regional primary and secondary care strategic organisations). Everyone at Piota has stayed on through the acquisition, and personally I am more excited than ever about the prospects ahead.

Outside Piota, I play hockey and backgammon in London, follow current affairs with ever-increasing exasperation (an age thing?!) and still vainly hope to run a 20 minute Parkrun some day.

  1. Can you tell our audience about Piota?

Piota supplies apps to 100+ services, departments or teams within 20+ NHS trusts and ICSs in the UK. Each app is customised for the service concerned and the flexible design means they can be used by any service looking to improve communications and engagement with its patients, their families and carers, and/or staff members. This video shows some NHS apps in action:

In addition we’ve supplied apps to 300 schools, charities and other organisations in UK and 15 countries abroad. This video shows some school apps:

The apps are easy to use and the content on them is uploaded and edited in real time directly by staff members of the service. We offer any healthcare service a comprehensive free trial of their customised app before they have to decide whether to buy it or not. If they do choose to buy, it’s a license arrangement which generally costs £2,000-6,000 p.a.

We don’t have any healthcare clients abroad at present but actively want to explore whether our apps could be useful outside the UK, either now or with some localisation work. Anyone reading this – please get in touch if you’re interested to discuss or would like an app to test?

  1. What problem is Piota solving & how?

Communication between NHS trusts and their patients and staff is a longstanding problem. The chart below shows it’s consistently the number one patient complaint. We don’t have data about internal staff communications but anecdotally it is universally considered poor too.

Image Provided by Piota

So why is NHS communication so poor? – a mix of reasons:

  • It is hard to communicate effectively and efficiently with the large number of people with diverse needs accessing a trust’s services.
  • Internal systems are often outdated and/or do not interoperate with each other.
  • Historic systems and processes don’t adapt easily in a personalised care world.
  • Old world communication models still in place:
    • Patient resources. Each service typically has only a sub-page buried on the trust website, to which they don’t have direct access, plus a stock of paper leaflets.
    • Staff resources. On an intranet, often only accessible onsite from fixed terminals.

With an app from Piota the service itself can create, upload and edit all its resources for patients, their families and carers (handbooks, leaflets, resources, signposting recommendations, best practice videos, updates, contacts details, clinic timings etc) and collect symptom reports, feedback surveys and consent forms. 

For staff members they can post anything ranging from good news stories, training and development resources, staff benefits information, induction materials, policies, protocols, and internal contacts’ directory. And request pulse surveys or other feedback.

The patient or staff member can then browse all the above on their phones whenever they choose in 100+ languages, whilst the service can alert key items to them by push notification. It brings the healthcare service more into line with the ‘on the fly’ way other services (banks, news sources, schools etc) communicate with their people.

For the NHS service, simply delivering an immediately better quality of service to patients, without absorbing extra staff time, via an app is enough of a benefit for many (“social capital ROI”). Others are looking for more and to quantify the benefits in different ways – some examples include:

  • Workflow and throughput. An oncology service with a 40-question pre-consultation patient symptom report gets 3x as many responses by requesting them on the app as it does by traditional email or letter in the post. With the information in advance, the consultation slot can thus be more productive and/or shortened. And the responses can be immediately uploaded into the patient’s records rather than first being manually transliterated from a handwritten form.
  • Safety. With an app which is updated in real time, information needs never be out of date. If you’re a diabetes service and the local care pathway changes, or there’s a dosage recommendation change, or the device manufacturer warns about a fault, or the emergency out of hours number changes, there’s a real safety benefit of being able to notify everyone immediately and update the app information. As well as the cost saving of not having to jettison old paper documents and reprint new versions.
  • Clinical benefits. Imagine a patient due for a hip replacement or a stroke service outpatient. In the case of both their compliance with prehab/ rehab regimes as well as other healthy living advice will affect their clinical outcomes and possibly readmittance rates. A patient and/or their carer provided with an app stocked with videos showing them which exercises to do, back up advice about all other aspects of their condition and care, and report forms, so they can keep the service updated as to how they are feeling, should progress better than one without.
  1. What have been the biggest achievements of Piota in the last year?

In early 2022 we embarked on an internal ‘Upscale’ project to try to convert Piota from one of the many suppliers of apps to individual NHS services dotted here and there across the UK, into a true App Partner to NHS trusts and ICSs. We defined an App Partner as a company which:

  • Produces apps suitable for every service within a trust or ICS (diabetes, oncology, paediatrics, maternity, mental health, respiratory, dementia, dental, surgery etc etc)…
  • With an overall trust/ ICS branding, but very flexible design and feature set customisation at each service’s app…
  • With a company size and resources guaranteeing we will be around for the long term…
  • Delivering on an ambitious development roadmap towards personalised care…
  • All backed by top notch data security, processing and information governance standards…
  • And all at an affordable cost

Long story short, it nearly broke us! But after Upscaling our tech platform, internal processes, selling approach and documentation, and finding in NED Holdings a new owner with aligned motivation and the financial and personnel strength to provide the long term security part, we got there.

I’m pleased to say it seems to have worked too. We’re on the brink of announcing App Partner agreements with trusts and ICSs which will enable them to deliver their communication strategies for patients and staff more quickly, at far lower cost and without the complexity risk of having multiple suppliers. Watch this space!

  1. What is your boldest prediction about how healthcare will change in the next 5 years?

I learned in my days as an investment manager that predicting the timing of industry trends and changes is a mug’s game. And I’m no expert in healthcare having been immersed in it for only the last five years, so I hope you’ll excuse me if I only offer one general hunch about the future.

That is, that ‘true AI’ will not have a significant impact in healthcare over the next 5 years (but it will be transformative over the next 20 years). 

By true AI I mean the type of thing I experience when playing against XG, the best ‘bot’ in backgammon. It’s a neural net which taught itself world champion human beating game strategy astonishingly quickly, without employing old-style brute force techniques or massive computing power resources. It basically works by mimicking the way neurons behave in the human brain, but better.

A lot of hope is pinned on true AI in healthcare because its decision making is or will be innately better than that of humans, and it’s a lot cheaper. But I think it will be very problematic for healthcare professionals to let true AI loose on their patients soon because (being un-programmed) no one can explain how it arrived at its conclusions. And its conclusions are really its best current judgment, not a scientifically proven technique with fixed parameters or variables or the outcome of a peer-reviewed controlled trial. I don’t feel UK healthcare organisations are ready to hand over control of patient safety and outcomes to an unexplainable evaluation engine quite yet.

So for the next few years I think true AI will remain a research activity in most of healthcare. In the long term it will win when the necessity to do healthcare cheaper becomes overwhelming and we accept that statistically better outcomes are desirable, however opaquely achieved.

  1.  What is your top advice for the new healthcare entrepreneurs who are just starting out?

If you’re not a natural optimist, do something else. Seriously – the number of blows you are going to take to your head, your heart and your wallet will knock you off course too easily otherwise.

Write a central case plan for your business, then do a version 2 based on double the costs  expectations per annum and twice the time to market. Whichever one you show to investors, version 2 is the real plan. And don’t follow my mistake by showing version 1 to your wife/partner rather than version 2. That way leads to a lot of expectations resetting…

Tell everyone about your idea, even when it’s just a notion on a piece of paper. I used to be reluctant to share my vision, thinking it was so brilliant someone would copy it. In reality, very few ideas are brilliant and anyway no one else will have the same passion for it that you have. And passion for your product, service or idea is what will convince your future clients, employees and investors to join you.

Thank you, James. I really appreciate your time and insights. I wish you the best with Piota.

Contact details for James and Piota

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