affigo.io

About Affigo.io

Affigo CIC is a Manchester-based social enterprise company established in December 2015. A team of clinicians, University of Manchester academics and software engineers, we work closely with mental health service users to develop innovative digital technologies which we test in the health service to ensure they are safe, acceptable and helpful.

The ClinTouch app has been developed in partnership with service users, caregivers, clinicians and the public. Throughout development Affigo worked with a service user advisory group to get a range of opinions as to how our technology can best serve service users and the community.

Our products have been developed in conjunction with service users and with the NHS by internationally renowned clinical academics, clinicians and expert software engineers
Funded by the highest quality Medical Research Council funding
Rigorous testing with randomised controlled trials
Successful integration of our technology system within NHS Trust ICT systems
Proven safety, feasibility, acceptability, and validity

ClinTouch was first endorsed by the NHS Confederation in 2013. A formal collaboration agreement was put in place such that the NHS Confederation (Mental Health Network) would publicise and recommend the ClinTouch system to all its members nationally – ie Mental Health NHS Trusts

CUTTING EDGE RESEARCH

ClinTouch was first developed in 2009 in SMS and Android smartphone formats. It was expanded using “experience-driven design” with further functionality, beta testing, field trials and the first randomised trials. People with severe mental illness (psychosis, schizophrenia, for whom the app was developed) were involved in all aspects of development.

The ClinTouch item set was formally validated against the gold standard interview ratings scales of the Positive and Negative Syndrome Scale (PANNS) and the Calgary Depression Scale in a Medical Research Council study. The core items in the app were found to correlate highly with standard interview ratings, at r>0.7 and these findings were published in a peer review journal (Palmier Claus J, Ainsworth, J., Machin, M., et al (2012), BMC Psychiatry. 12, 10 pp 172-7)”.

In 2012, a second MRC grant allowed the development of remote monitoring. This system allowed the care coordinators and clinical teams to receive real time information on a service user, as well as alerts if a service user showed personalised early warning signs for relapse, allowing for early intervention.

The ClinTouch app has also been used in a variety of clinical studies and was well received by service users. An in-depth randomised, controlled trial was conducted with 81 service users from across two NHS Mental Health Trusts in Manchester and South London to examine the benefit of the ClinTouch-Integrated management system over routine care over a 3-month period.

About 45% of eligible service users offered use of the app took it up – so it is not for everyone. Of those who chose to use it, a high level of adherence (90%) over at least three months was recorded, and participants with recent-onset of psychotic symptoms showed an improvement in symptoms when using the app.

Qualitative studies have been undertaken to assess views of service users, carers and staff from 2 community mental health teams in separate NHS Trusts. All were mostly very positive of the potential for the ClinTouch app to support management of serious mental illness. On the whole, service users felt that is was a relevant platform for health care delivery and was a good way of “moving with the times”.

Staff were asked about their initial views about ClinTouch, and the potential benefits and problems of using such a system within routine practice. They indicated how smartphones have ‘revolutionised’ potential for community based care. One member of staff also mentioned the use of smartphones even for clients with highly challenging illness:

“I’ve got a client who has got chronic schizophrenia… has periodic bursts of energy …then it slips back again, because there’s no energy, but he’s got a laptop and he’s doing this and that with it. So you can see how even the most devastated client in terms of illness could engage with that [referring to ClinTouch]”. (Care Coordinator, NHS CMHT) Sanders et al. (in progress)

UPDATES

From time to time we may automatically update the ClinTouch App to improve performance, enhance functionality, reflect changes to the operating system, or address security issues.

Depending on the update, you may not be able to use the ClinTouch App until you have downloaded the latest available update. If you choose not to install updates or opt out of automatic updates, you may not be able to continue using the ClinTouch App, or if you do continue using the ClinTouch App, you may find that its functionality and/or performance is impaired.

If you find any problems with the app, or have any feedback, please contact support@affigo.io We will aim to fix any critical bugs within 72 hours on regular working weeks

Current products

ClinTouch is both a platform technology and a stand-alone app that helps people with psychosis self-manage their symptoms. It is based around a Smartphone app developed by a team of service users, leading clinicians and academics, software engineers and health professionals at The University of Manchester and Greater Manchester Mental Health NHS Foundation Trust. ClinTouch is built around a Smartphone application which triggers, collects and wirelessly uploads symptom data in real-time to a central server at the clinical team base. The provision of diary entries encourages service users to record information relevant to how they are feeling, allowing for greater contextualization of data, leading to more informed discussions between service user and healthcare professional. Graphical information highlighting general mood and behavioor patterns allows the service users and clinicians to track their progress and understand their experiences more clearly.

ClinTouch Integrated As well as a stand-alone app, ClinTouch Integrated offers complete mobile support technology for people with psychosis and their clinical team. ClinTouch Integrated can be fully or partially integrated with your NHS Trust or service provider ICT systems depending on your needs.

ClinTouch is adaptable to all mental and physical long-term conditions that have fluctuating symptoms. For instance, it has been adapted for use in Rheumatoid Arthritis and Post Natal Depression.

ClinTouch - How it works

ClinTouch is both a stand alone app and end-to-end clinical management system (ClinTouch Integrated) aimed at predicting and averting relapse in psychosis.

ClinTouch works as a personalised Smartphone app that triggers the collection of real-time symptom data from a mobile handset touchscreen that wirelessly uploads data to a secure central server several times daily.

Starting in 2013, we have built ClinTouch into an end-to-end system in community mental health teams in Manchester and South London so that summary data and personalised early warning alerts for relapse are available for healthcare staff. Summary data are viewed by healthcare professionals and a are streamed into e-care records.

Features & specifications

Validated questionnaire for monitoring symptoms, which means clinicians can be confident of high quality data
Prompts for patients to answer questionnaire items several times daily, which means that a highly detailed readout of symptom change is possible
Questions can be personalised to match an individual, which means more accurate and relevant data
Question branching to reduce time taken to complete questions, which means it takes around 70 seconds to complete
Wireless upload of data in real time, which reduced error in recalling symptoms and experiences
Responses stored and wirelessly uploaded to a secure server, ensuring high levels of safety and privacy
Daily diary function encourages people to self-manage
Graphs of symptom changes over time, which enables sharing of summary data with friends, family, GPs and other healthcare professionals
Web-based interface for clinicians that provides real-time access to questionnaire responses
Export of validated results for integration with other tools and further analysis and research, which means ClinTouch is a platform for research as well as clinical management
Third party API integration with e-health records, which means summary clinical data can be streamed into NHS electronic care records

Research Evidence - ClinTouch

2009: Team develop first prototype for ClinTouch in sms and Android smartphone formats.

2010: First Medical Research Council (MRC) grant funds expansion of the programme with further functionality, beta testing, field trials and first randomised trials. We use “experience-driven design”, including people with SMI in all aspects of development.

2012: Second successful MRC grant enabled software systems to be further developed. Fully functional end-to-end solution for remote monitoring embedded in a care service built and tested. The system provides real time information to care coordinators and clinical teams on a client’s progress. In addition, it gives real time alerts if a client shows personalised early warning signs for relapse, allowing for very early intervention to avert this.

2014: In-depth randomised, controlled trial was conducted with 80 service users registered across two NHS clinical care teams in Manchester and South London to examine the benefit of the ClinTouch-Integrated management system over routine care. This detailed roll out and evaluation of the system provided evidence of: i) safety, feasibility, acceptability and validity of the system when embedded in routine clinical practice; ii) clinical benefit for mental health symptoms particularly for those at the early stage of psychosis; iii) functional ability to pick up an individual’s early warning signs.

Highlighted findings

ClinTouch is safe to use and is the only SMI system to have robust safety data: only 5% of users with psychosis reported increased anxiety or paranoia.
Confirmed in 2011, ClinTouch measures positive and mood symptoms accurately as benchmarked by gold standard rating scales.
ClinTouch is acceptable to 40-50% of a representative sample of people with psychosis, 90% of whom continued to use it consistently for at least 3 months.
ClinTouch is acceptable to healthcare professionals: in our largest, trial, 100% of professionals accessed the ClinTouch system on the team desktop an overage of 24 times over 12 weeks.
Compared to standard care, ClinTouch leads to significantly faster improvement in psychotic symptoms in early psychosis.
Findings from our extensive qualitative work show that people feel a greater sense of empowerment and self-awareness of their symptoms and experiences over time, resulting in improved self-management.

TRAINING

Our training package provides the latest training for recognition of early warning signs of psychosis, implementation of the ClinTouch system into routine service delivery and technical support.

Book a one day face-to-face clinical and technical support training workshop with members of the Affigo.io team
Download online training materials
Download our training guide

Our Team

Affigo.io is a social enterprise company (Community Interest Company) limited by guarantee. The Directors have been involved in various stages from inception, through growth and development of our products. Our team is comprised of national and international leading clinicians, academics and expert software engineers, based at The University of Manchester, UK.

Professor Shôn Lewis

Professor Shôn Lewis is Professor of Adult Psychiatry at The University of Manchester, UK and a consultant psychiatrist with Manchester Mental Health and Social Care Trust. He is an internationally leading researcher and clinician in severe mental health problems, with over 200 published academic papers. Professor Lewis represents Affigo.io in face-to-face meetings with potential customers. He is the head of Affigo.io research and funding opportunities, and is the Clinical Safety Officer.

Professor John Ainsworth

John Ainsworth is Professor of Informatics at the University of Manchester. He has wide experience in the Industry sector as well as in academia. He is Deputy Director of the MRC-funded Health e-Research Centre (HERC). Prof Ainsworth is Affigo’s head of software engineering operations and oversees management of the company.

Professor Sandra Bucci

Sandra Bucci is Professor of Clinical Psychology at The University of Manchester. She is an honorary Consultant Clinical Psychologist at Greater Manchester Mental Health NHS Foundation Trust. Prof Bucci is an internationally-leading researcher in psychological interventions for psychosis and has worked around the world as a practicing Clinical Psychologist and clinical academic, with nearly 20 years experience in mental health.

Charlotte Stockton-Powdrell

Charlotte Stockton-Powdrell has wide experience of health research governance and regulatory issues and managing clinical trials. She is a qualified PRINCE 2 Project Manager and Affigo.io company secretary. Charlotte is responsible for administrative tasks and the day to day running of Affigo.io and is the central point of contact for potential customers.

Our mission