Co-innovation advances medtech The global pandemic may have felt like a once-in-a-generation event, but the likelihood of further COVID-19-scale pandemics could triple in the coming decades – exacerbated by climate change. The scale and complexity of this challenge calls for a new breed of problem solving that’s optimised for speed, scale, and borderless collaboration. We have a far greater chance at innovating digital health solutions at scale when knowledge, capabilities, and diverse industries are connected – by data and a common goal – as part of an innovation ecosystem. Data-driven progress for the healthcare system of the future The COVID-19 response was a huge step forward in this direction, with unprecedented knowledge sharing and data-empowered co-innovation between diverse parties – across science, technology, government, civil society, and beyond. For the NHS, the progress made towards becoming a cloud- and data-enabled organisation will be essential for playing an active and valuable role in evolving medical ecosystems. Together with Zühlke, the organisation was able to transform anonymised test and trace app data into valuable, actionable, and democratised knowledge. This data capability will be essential for helping to co-create tomorrow’s medical solutions and push the boundaries of public health innovation. Read on to discover how the NHS COVID-19 app – the first certified mobile medical device in the UK – advanced digital health and showed the value of collaboration and co-innovation. Zühlke: NHS COVID-19 app developed in 12 weeks Discover how Zühlke’s award-winning team enabled the rapid development of the NHS COVID-19 app and supporting infrastructure in just 12 weeks! The challenge The Department of Health and Social Care (DHSC) oversees the UK's National Health Service (NHS), with the aim to help people live more independent, healthier lives for longer. When the global pandemic hit, however, the DHSC needed to take on a very different role – that of an agile tech startup. That’s because the health department recognised the vital role that data and apps could play in containing the rapid spread of COVID-19. As the world entered lockdown, pressure mounted to accelerate medtech innovation and find a way to reduce the rate of infection and protect lives. In these challenging conditions, the DHSC and its executive agency, UKHSA (previously PHE), urgently needed to: Help contain the spread of the virus, prevent infection, and alleviate pressure on the NHS with a medically approved contact tracing smartphone app. Gain the agility to adapt to changing priorities and needs across core workstreams. Contact tracing solution in 12 weeks with 6 functions The test and trace solution needed to be designed, built, tested, approved, and launched within 12 weeks, and it needed to support six critical features: Trace Alert app users when they’ve been near other users who tested positive for coronavirus. Alert Enable people to understand the level of risk in their area. Check-in Alert people who checked into a particular venue if they may have encountered people who tested positive. Symptoms Allow people to check whether they have coronavirus symptoms and whether they need to order a free test. Test Enable people to book a test and get their result quickly. Isolate Allow people to track their self-isolation countdown and access relevant advice. What we did Thanks to its proven engineering expertise and many years of experience in developing apps for iOS and Android that are both user-centered and scalable, Zühlke was an obvious partner for the DHSC. Together with the DHSC, a multidisciplinary working group of policy makers, researchers, designers, engineers and experts in security, ethics, accessibility and other fields was initially formed. This fluid, cross-border, multidisciplinary approach to innovation - as well as Zühlke's lean delivery approach and cloud infrastructure - provided the speed and agility needed to develop and scale the NHS COVID-19 app in just twelve weeks. Successful beta launch in 6 weeks and continuous further development Despite the challenging conditions, Zühlke was able to develop, test and launch the beta app with users in just six weeks - including all six required functions and classification as a Class 1 medical device by the UK Medicines and Healthcare Products Regulatory Agency (MHRA). After the nationwide launch, Zühlke continued to work on the app - including weekly updates that were tailored to the current pandemic and political circumstances and recommendations. New functions were also added, such as the option to find out about and apply for support payments in the event of self-isolation. Important milestones in the collaboration with the DHSC Scalability: the reliability and scalability of our cloud-based, Amazon-powered infrastructure was essential for supporting the app’s 22+ million users. Fast, user-oriented design process: Through various design iterations and continuous user testing, Zühlke ensured that the app appeals to a very heterogeneous audience. Data-led decision making: real-time, secure, and anonymised data from the app was used to identify trends and inform and facilitate government policy-making. Collaborative innovation: together with our innovation partners Google and Apple, we co-innovated ways to improve the accuracy and performance of contact tracing APIs. Security: we worked closely with the National Centre for Cyber Security (NCSC) who ran surprise scenario tests to ensure the app was secure. Accessibility: Close cooperation with the Open Inclusion organization ensured that the app complies with the Web Content Accessibility Guidelines (WCAG) for the accessible design of websites. Government Digital Service (GDS) approval: the app has passed assessments by the UK digital unit GDS throughout the product lifecycle and fully complies with NHS service requirements. Trust through transparency: we made sure that information about all app updates was publicly available. This helped address privacy concerns – together with the Bluetooth-based Google / Apple Exposure Notification (GAEN) system which protected app users’ personal information. Management of multiple workstreams: In addition to the app and the associated ecosystem, the Zühlke team worked on other workstreams, including digital passports and check-in using QR codes. Round-the-clock support: Zühlke ensured that technical support was always available. Despite the enormous volume of active users, there was never a major incident. The results Together with the DHSC and our ecosystem partners, we designed and delivered a medically approved mobile app and scalable supporting infrastructure in record time. The app was downloaded by more than 22 million people – and analysis from leading science journal, Nature, estimates that it averted 1 million cases during its first year. This corresponds to 44,000 hospitalisations avoided and 10,000 deaths prevented. Together, our teams and partners pushed the boundaries of medical apps and demonstrated the vital role they can play as public health tools. The collaboration also showed their value as low-cost alternatives to medical hardware. The engineering budget to build the NHS app was less than 50p per user, and the app was delivered on time, under budget, and with no significant outages. 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