Covid-19 has necessitated expeditious adoption of telemedicine in Health Systems around the world. It has enabled care to continue to be provided within the context of appropriate social distancing, therefore helping to protect both patients and clinicians, as well as freeing up vital resources for the care of patients who have contracted the virus. Telemedicine has long promised to resolve issues of access to health services for individuals who otherwise would need to travel such as those living in remote areas or people with physical disabilities. It also provides the basis for increasing the amount of care that can be provided in the community which delivers significant health, social, environmental and economic benefit. In an update in June 2020, the World Health Organisation reported that "globally 58% of countries are now using telemedicine to replace in-person consultations". However, most telemedicine solutions do not directly connect to the patients' medical record and this lack of interconnection is creating the chance that important information could be missed from the patient record. There is currently only a manual approach to mitigate these risks and that requires senior clinicians to duplicate data entry to ensure the details captured in the video consultation are recorded in the patients' record. There is no current method to automate this. The OpenEyes Meet project will resolve this issue by developing a secure, scalable integration between the telemedicine product and the medical record which will ensure all data is stored accurately. This will be implemented and evaluated in Ophthalmology first, due to the high volume of NHS visits for eye care services. The design of the solution will be clinically driven and will leverage investment already made in a successful prototype implemented in Scotland. As a result, senior medical staff will no longer need to duplicate the data entry and so can focus on providing care to more people. The solution will ensure that tele-ophthalmology can continue to be supported at scale and that a significant proportion of the visits that patients need per year to take care of the eyes can continue at safe social distances. The project team has significant experience in implementing health technology in the NHS. ToukanLabs Ltd will lead the project and are the global technical custodians of OpenEyes, and The Apperta foundation will collaborate and are a clinically-led, not for profit organisation that promotes open systems and standards for digital health and social care.

This project seeks to research and implement a new proof-of-concept open standard digitally-enabled electronic observation (eObs) solution for deteriorating patient care. It will address a major unmet need in the NHS where a significant proportion of patients still experience suboptimal care leading to adverse clinical outcomes such as unplanned ICU admissions, emergency surgery, cardiac arrest and death. An estimated 7% of in-hospital deaths are preventable. (_NCEPOD Emergency Admissions_). Core reasons behind poor care of deteriorating patients can be linked to current ineffective paper-based (and digital) systems of observation and management of patients leading to lack of recognition of deteriorating conditions. Incumbent, proprietary digital systems lack interoperability and deliver very low value with unsustainable high costs, plus barriers-to-iteration and evolution required for utility needed to deliver improved outcomes and to advance clinical progress. Our vision is to transform the care process digitally and also to overcome the barriers the NHS faces over proprietary IT systems that cannot be easily or cost-effectively iterated to meet clinician requirements and best practice operating procedures. We will deliver this by innovating the care process informatics design using an approach commonly used in translational medicine. With Coventry University's help, we will analyse current practice at two NHS Trusts (South London and Maudsley, Cheshire and Wirral Partnership), design an optimal approach and trial it with healthcare practitioners in a simulated NHS hospital environment at Coventry University (the first major project for CU at the most advanced simulation lab in UK); and once proven, trial it for real with our two NHS Trust partners. Governance, safety and standards will be assured through working with Apperta and Open UK. Success with our project will bring measurable improved patient outcomes due to a better eObs patient observation system that has wide-reaching outcomes from mental health to productivity, and reduced need for further clinical intervention. Immediate benefits will include reduced staff time and reduced human error compared with manual administration. Adopting an open source and standards approach will eliminate prohibitive annual software licensing and adaptation costs while delivering a flexible public asset that can readily be adapted to individual NHS Trust needs. Our approach is uniquely consistent with secritary of state for health Matt Hancock's vision for Digital Transformation (October 2018) for the NHS and will serve as a vehicle to transform market access for SME's to grow the UK digital healthcare industry through the innovative use of digital technologies.