A daily and weekly remote symptom monitoring system for patients with over a decade of use in research and clinical service
The True Colours symptom monitoring system was developed over a decade ago by a team of psychiatrists and software engineers at the University of Oxford in partnership with the Oxford Health NHS Foundation Trust to solve a specific clinical problem; i.e. the inadequacy of asking a patient with mental health problems ‘how have you been?’. Fluctuating symptoms cannot be described easily in a snapshot in time, and the pertinent information cannot readily be distilled from unstructured paper-based diaries.
True Colours prompts patients to regularly report upon a range of symptoms via text messages and a web interface. Visually effective symptom summaries designed for both patients and clinicians provide insights for patients into their own health, while providing treating clinicians with continuous high-frequency symptom information collected between clinic visits. The True Colours system has been embedded into clinical service as well as providing data for randomized controlled trials, observational and experimental medicine studies over the past decade. It has also been translated to other chronic health conditions with fluctuating symptoms, namely ulcerative colitis and Crohn’s disease (IBD).
True Colours uses validated clinical tools and has amassed a substantial evidence base of acceptability and feasibility across a range of diseases and disorders. 36000 users have generated over 1.4 million data points, with some users regularly using the system for more than a decade. Patients have reported feeling more ‘in control’ and ‘empowered’ through the regular use of True Colours, and clinicians have the potential to predict when more acute symptoms are expected, which can be used to optimise (i.e. reduce unnecessary) clinic visits. The data have also given rise to more than 50 academic publications.
We have developed a steering group to work with researchers, clinicians, policy makers and patients to progress True Colours to the next phase. We have identified a number of ways in which the system could be improved to provide additional information and usability, and to be aligned with requirements for an outcomes-led healthcare improvement strategy. We anticipate that True Colours has further to potential markets to explore including additional NHS Trusts, Clinical Research Organisations and academic research teams.
Our strategic team: Prof Clare Mackay (Academic lead), Dr. Matthew South, Dr. Kate Saunders, Dr. Mary Jane-Attenburrow, Prof. John Geddes, Dr. Sarah Goodday, Dr. Paul Semple (IG), Martyn Ward (Director of Strategy and Performance, Oxford Health), Ali Corfield (Head of Clinical Systems, OH), David Jennings (PM, Oxford Health), Dr. Alissa Walsh (OUH), Mike Denis (Akrivia), Dr. Sara Ward (OAHP)