Rewire was conceived on a Hyperacute Stroke Unit in West Yorkshire, where Dr Raj Parmar was confronted with the shortcomings in stroke rehabilitation. The NICE clinical guideline for stroke rehabilitation recommends at least 45 minutes of physio- and 45 minutes of occupational therapy five days a week.
National audit statistics reveal the extent of the problem. As sobering as these statistics are, they fail to have the same impact as a patient asking you why they only receive therapy twice a week. Raj never could find an answer to this question but in a bid to stop it being asked, he began exploring whether software could enable patients to rehabilitate independently of a clinician.
Amy Ha is a software engineer with experience at a digital health startup that optimises the recovery journey for orthopaedic patients. As Rewire’s Chief Technical Officer, Amy iteratively built Rewire, with patients and clinicians involved throughout the process.
Addressing the needs of a patient population who commonly have a cognitive deficit and may not be comfortable using a smartphone is not easy. Another challenge was creating a solution that does not require clinician input - the last thing that we want to do is detract from in-person therapy.
Working with stroke rehabilitation teams across multiple NHS trusts, we arrived at a solution that adds value to their practice instead of taking from their time. The team at County Durham and Darlington Foundation Trust in particular have been instrumental in Rewire’s development. It is here that Rewire will be launching later this month with a pilot study evaluating engagement.
Minutes of activity will be measured in-app to see the extent to which Rewire can help patients achieve clinically recommended doses of rehabilitation. We will also look to see how using Rewire compares to in-person therapy.
Last year stroke survivors received 27% of the community physiotherapy that they should have had.
Results from the pilot will be presented at the UK Stroke Forum later this year. We are looking to help the NHS increase the intensity of community stroke rehabilitation, an aspiration that constitutes part of The Long Term Plan. Formed in 2019, The Long Term Plan is a set of priorities for the NHS to guide spending over the following decade.
National audit data demonstrates little improvement in therapy provision since the inception of the NHS Long Term Plan, with stroke survivors last year receiving on average 27% of the community physiotherapy that they should have had it.
With a clinician-led team, we are acutely aware of the constraints imposed on our health service. Software must play a role in solving health problems at scale due to its low cost and accessibility. These characteristics mean that digital health solutions can deliver high quality care across a patient population, helping to reduce healthcare inequalities. This is something that drives our team and we want to go beyond rehabilitation, exploring how we can support management of hypertension in the most deprived 20% of the population.
There will be more on our efforts around preventative medicine and we have an upcoming interview with Dr Revin Thomas, a consultant neurorehabilitation and stroke physician, ahead of our launch later this month.