Season Seven Episode Two: ASCN
Introduction

Narrator: This podcast is intended to support UK healthcare professionals with education. The information provided in this podcast is not a substitute for professional medical advice or treatment, and patients are encouraged to consult healthcare providers, including nurses, for any medical questions or concerns.
Interview
Hannah: Welcome to Stoma and Continence Conversations from Coloplast Professional where health care professionals and experts by experience discuss the latest hot topics in the worlds of Stoma, continence care and specialist practice. I'm Hannah Patterson, I've worked in specialist care and I'm currently the ostomy care associate education manager at Coloplast.
This time, we're looking back at a fantastic ASCN 2023 in Brighton and I'm joined by my Coloplast colleague, Adrian Somerson.
Adrian: That first night he used Halo, it gave him an alert overnight that his bag was starting to seep underneath and he was at risk of leakage. It woke him, he changed his bag, he went back to sleep.
And he said, from that moment, you can trust Halo and I could sleep again. On the outside, Halo appears like it's going to be a technical product, but then there's a real life experience of actually seeing how that it works, learning how easy it is to use Halo, and then seeing the outcomes that happens with patients. It's not just a novelty, hey, isn't this nice? It does change people.
Hannah: Hello, Adrian. For anyone who doesn't know you, can you just tell us who you are and what you do here at Coloplast please?
Adrian: Hello Hannah. Thank you for having me here today. I am head of marketing for Halo in Coloplast. Some
Hannah: Some people may be a little bit more aware of Halo now after ASCN, some people may not. Can you tell us a little bit about Halo, please?
Adrian: So, Halo is a world's first that we're going to be launching in the UK next year. It's a product that is very much designed to help address the worry that people have about leakage. And it works by essentially notifying people if they're starting to get seepage underneath their base plate, which will give them an alert onto their phone, allowing them to make the choice about whether they're going to change their bag there and then, or give themselves a moment, but really puts people into control over their life.
Hannah: As a previous Stoma user myself, I am such a great advocate of this product. I absolutely love it. I don't know about you, but I felt real good buzz at ASCN around it as well. I felt there was some really good vibes about it.
Adrian: Yeah, it was really exciting. I hadn't really thought about it before we got to ASCN, that this was the first time in the world that Colplast had introduced Halo to specialist nurses as a previous focus groups. So it was really good that we had such a good reception and nurses were able to, I think, both see the reason why Halo was important and start thinking about how they would use it and get really into the practical applications of it as a product.
Hannah: Absolutely, now I know you mentioned the focus groups and I think this would be a really good moment for us to play a clip we've got from Ruth Krista, who is one of Coloplast Nurses, who is actually part of that focus group.
Ruth: Hi I’m Ruth Krista, I'm a Senior Coloplast Nurse. I was working on the research study of the Halo with Richard Brady in Newcastle.
When I first was involved in the Halo study, I was a little bit dubious. If I'm honest, because I worried about the technology. I worried that it wouldn't suit all patients. It would only be suitable for young patients. I have to say after using the device, once I got to know it, I found it very easy to use.
The found the app very intuitive and easy to follow and most importantly, the patients found it easy to use as well. We have patients ranging from thirty up to eighty two. She was the oldest patient in the study and she uses the device without any problems at all. I think the benefits for patients with a psychological, it definitely eased the burden of worry about leakage, which led them to be more confident, self managing, able to return to social activities such as work and travel. But it also, you know, the patients, because they were self managing, they actually needed me a little bit less, a bit less dependent on me. So that freed up a bit more time for my work, the work duties as well.
And I think another big benefit was that I worried that patients would change their bags more frequently. Because they were using the advice, you'll be alerted to a leak, but actually it had the opposite effect patients were able to wear their bags for longer, and because the notification told them that everything was okay, there was no need to change.
So, overall, I think great benefits for the patient, great benefits for the nurses, and actually it may even reduce costs because patients are changing their bags less frequently.
Hannah: What a fantastic little clip from Ruth there. And I love the fact that she actually talked about the fact she was a little bit dubious at the start of it.
Adrian: I think Ruth had a really good journey. I think what hopefully will be quite a typical journey for people with Halo. So not only was Ruth part of our focus groups. She was also involved in the clinical studies that we've done around Halo. And so she's one of what's really a handful of nurses who've been practically involved in using Halo in the lead up to our launch.
So she has that real experience of being both uncertain because on the outside, Halo appears like it's going to be a technical product, but then has a real life experience of actually seeing how that it works, learning how easy it is to use Halo, and then seeing the outcomes that happens with patients off the back of it. So I think her story is really good. And I think it frames Halo really well.
Hannah: Yeah. And she mentioned in that Richard Brady, can you tell us a little bit about Richard Brady, who was involved?
Adrian: Yeah, so Richard Brady is a colorectal surgeon who's based up in Newcastle. He led what we call the SUN study.
And this is where we really looked at what are going to be the benefits of using HALO in the real world. It's all run under clinical conditions, but we took ninety two patients through a study over twelve weeks looking at, well, what is going to be the impact of Halo? Some of that is in terms of both reducing leaks, which is great.
You would expect that. But what I think is most interesting with Halo is the impact that it has on people's quality of life. These are a number of criteria to measure and assess people over the study. And what we see is consistently that when people start the study, their quality of life is lower than it is at the end.
So by the end, they can go, actually they are feeling more activated, they are feeling less worried about leakage. And we use things like the WHO quality of life questionnaire, which shows actually that people really have made a difference. And it's not just from an ostomy perspective, we're seeing a real change.
Hannah: And I think one of the perfect examples of that is in our next clip, we're lucky enough to have Pedro, who was actually one of the people that trialed the product.
Pedro: Hi, my name is Pedro Romalo. Speaking about the Coloplast product Halo, who make a massive difference in my life. Basically, it's a product you apply in your soma along your Coloplast pack and allow you to tell you when is potential leak and you have your life in control again, basically give you that little time to move away from the scenario change and come back without any issues and any problems.
With Halo is a product where you actually bring your independence back in the full spectrum of your life. It's a product who changed my life forever.
Hannah: Oh, every time I listen to Pedro, I get a little bit emotional.
Adrian: He's such a great guy. Just to quickly pick up on one thing, he talks about using Halo with Coloplast products.
Obviously, Halo, you can use it underneath any product, as long as it can stick to your skin or fit underneath the base plate. Halo could be used really across for many ostomates out there. But his experiences were so good. He does rave a little bit about Halo.
Hannah: He absolutely loves it, and at ASCN, I think people just loved speaking to him and hearing about how much he loved it. He was in his element, I thought.
Adrian: Yeah, I think it's one of those things, isn't it, it's great that we've got clinical studies that show that Halo works, but in real life you need to go, well, what does this look like on an actual person. And Pedro was talking quite actively about the impact it made on him sleeping.
He would talk about, whilst Pedro didn't leak very much, he had a couple of leaks very early on when he came out of hospital, where he leaked overnight and it ruined his mattress. And he had the same the following week and had those sort of challenges. And then after that, he never slept again.
And then what Halo enabled him to do is it enabled him to, and we do have a video of this where he talks around, he goes, and actually that first night he used Halo, it gave him an alert overnight that his bag was starting to seep underneath and he was at risk of leakage. It woke him, he changed his bag, he went back to sleep.
And he said, from that moment, you know, you can trust Halo and I could sleep again. And afterwards he did. Well, I think it made such a big difference to Pedro.
Hannah: It really did, and I say that video, it's so powerful when he speaks about not sleeping because not sleeping is a massive thing for Osteomers.
I know it's something that's come out in the quality of life study that so many patients, users do struggle with sleep depravity almost overnight. It was something I struggled with a lot myself when I had stoma. Again, similar to Pedro, those early leakages, it does really frame how you can operate throughout the whole time.
Adrian: There's this rhetoric. I think when I speak to people living with their stomas and you talk about sleep there's the waking. And the first thing that you do at night is you check your bag and you know, it's constantly, I wake and check, I wake and check, I wake and check, I wake and check.
Hannah: Yeah, it's the tummy tap.
Adrian: Yeah, and it becomes almost an incidental that you don't realise you're doing. It's almost like a tick for the want of a better phrase. I'm just repetitively do it. I don't notice it. And the impact of you're doing that because you're awake and you're worried that you're going to have leaked.
And I think you see that transfer across all of life into various different behaviours of coping. of how you manage the what if something's going on here that I haven't seen or spotted or was unprepared for.
Hannah: It is that what if, isn't it? And one of the nurses that I thought summed that up very briefly but very, very well was Jess Lane had a little bit of something to say.
I must say as well, well done to Jess. She did actually win Best New Presenter at ASCN as well. So well done, Jess. And this is what she had to say about Halo.
Jess: Hi, I’m Jess, I'm from Oxford, and I think the Halo will be really good for anxious patients.
Hannah: Short and sweet, but I think she sums it up actually perfectly. That the anxiety is something that is a massive thing for patients. And as you said, Adrian, it took away such a massive bit of that anxiety.
Adrian: Yeah, completely. And I think it is understanding really how that anxiety turns up for people, isn't it? I think there's such a broad scale in terms of the way that it lands for people.
I think that there were definitely some people are going to actually, the anxiety is almost overwhelming. And you see it turning up in terms of reducing ability to socialise, reducing contact with each other, not sleeping, not hugging, reducing physical contact, all of those side of things at your most extreme.
But I think you also see it and I hear stories of people who are, they've got their stoma and they're living well with it. But it causes anxiety and concerns in day to day things. I was chatting with one of our ambassadors, who's a driving instructor. And he says, if he starts, if he's driving and he starts to notice his bag changing, or he starts to get an itch or anything, suddenly in his mind, he's thinking, is my bag going to leak. Do I need to find somewhere to stop? And he's thinking that more than he's thinking about his driving lesson. And suddenly it becomes noisy in his head rather than what he wants to be doing. And that's hard.
Hannah: Coloplast Professional offers a lot of educational material for specialist nurses and healthcare professionals. Visit coloplastprofessional.co.uk to find out more.
Another clip I've got here, which is from Jodie Webster. She actually talks again about certain careers, maybe looking at what might benefit people. So this is Jodie.
Jodie: Hi I’m Jodie Webster. I'm the Co Director of Nurse specialists at on Good Hope Hospital at University Hospice in Birmingham.
I think the Halo would be really beneficial to engineers of a similar background because they’ve got more opportunity and control of the leakages, and low key prevent them from worrying, causing anxiety and stress in the workplace, as well because they can log on to the app beforehand and check there's no leakages or any issue.
Hannah: It's again, just talking there about that being ability to be able to check and know what's going on rather than affecting your day to day type of work. Really good thought there.
Adrian: Yeah. And I like the way she used the word, putting people back in control.
We were having a talk last week and, someone rephrased it as being almost like a pseudo sphincter. In that suddenly it's a way of being able to like control continents. I'm not sure that's exactly an official terminology, but you get the thinking, you can choose not to have an accident in that respect.
Hannah: It almost sounds like a superpower, doesn't it? A pseudo sphincter.
Adrian: It does sound like a superpower of some sorts.
Hannah: I don't know if it's a superpower I'd want, but there you go. But it does take us into that revolutionary side of things. And that's something again, it's almost like I've got a clip for everything here. It's another one of my old Birmingham crew here, which is Emma Morris had something to say as well.
Emma Morris:The Halo product looks very next level and it just looks like the next level of technology is coming out.
Hannah: It’s that next level again that people keep mentioning, isn't it? Revolutionary next level. We're almost treading where it never has been trodden before. Trodden? I don't think that's even a word.
Adrian: Yeah, it's not a word. Actually, it may be. Why not? It can be a word. Language evolves. That's like a thing.
Hannah: Language evolves, like technology evolves. There we go.
Adrian: Oh, nice, nice, nice segue into that. And, but I do think there's, there's something that's both quite intuitive about Halo. Of course, why wouldn't you use technology to link to your stoma to tell you if you're having a seepage. It feels when you say it out loud. Well, of course, that feels like quite an obvious thing, but actually it's been years in the making, building the technology so that it works reliably so that it will help people both see where the leakage actually is.
And we'll do that on a consistent level and we'll tell you other bits and pieces. This isn't a full Halo detail side of things, but we'll work consistently enough that people can then rely on it and then we'll talk to the app and then, this is, it's both intuitively right for where we are. but also a big step because no one has done this before and that means we're also in a place whereby we don't know what this looks like in the real world.
Hannah: I mean there's so many other areas in healthcare now that do go down the digital route and the one that is probably the most obvious for me is diabetes. You see people now where they can bop their phone on their arm, their blood sugars are red. They know whether they need to cut back a bit, whether they need to maybe have something, what they need to do.
They can titrate their insulin usage and it's in real time there for them. And they're no longer having to go through that malarkey of like pricking themselves on the fingers. I mean, when I worked in the hospital, you'd see diabetics and the tips of their fingers would just look oh, so sore. And yeah, again, it's just technology is in other areas.
We've all got FitBits on our wrists where you can check your heart rate, things like that. There's even ECG monitors that will link to your phone now. So it only makes sense to me really, that stoma care should be signed to keep up with that side of things really.
Adrian: Yeah, completely. And I think it's about the application. I know in the past, there's been explorations in terms of how do you use technology, in terms of fostering. I think what we've done with Halo and what Coloplast have done with Halo is find an application that actually makes a difference for people.
It's not just a novelty. Hey, isn't this nice. What we know with Halo is that it does change people because this underlying challenge of worry is lurking there all the time as this first, second or third voice in people's heads. This reassurance that there's something there that's going to be, and I'm using the language of some ostomates who I've worked with, this language of being like a security blanket, a safety net, of being something that that will tell them.
In one of our groups, I was speaking to another nurse who'd been really involved in using Halo previously. And she was saying she started a lady on it who was really concerned and really anxious and really checking her stoma. And she was quite worried that when she gave her Halo, that she would then be addicted to the app.
And she would always be checking. But actually the reality was, as soon as she made that link that if there was a problem she would get a notification, she would get a ping, she didn't need to keep checking it. Because she would get the alert when there was a problem. If there wasn't an alert, there wasn't a problem. It created a huge peace of mind.
Hannah: I can imagine, and I say it's, is that once they've got that faith in the product and they will alert them, then you can almost forget about it. If there's no problem there, things aren't gonna be alerted.
Adrian: Yeah. Completely. It's actually as simple as that, which does start to alleviate that. Well, there might be a problem, maybe I will change just in case, which happens.
Hannah: Absolutely. It's that just in case, I'm just gonna go back again to some of the feedback I got from ASCN. I said, the buzz from the nurses was absolutely brilliant. And another clip I just want to play to you here is one from two of the nurses actually from over in the Channel Islands from Guernsey. I've got Andrea and Sadie on this next clip.
Andrea: I’m Andrea LePage. I’m one of the co directors and Stoma nurses from Guernsey in the Channel Islands. Just heard about Halo and it sounds like it will be revolutionary.
Sadie: I'm Sadie Reveillard, ex Stoma nurse in Guernsey. I think it sounds really exciting and we would just say we can already think of patients with it.
Hannah: And what I love there is they're actually already thinking of patients that they'll be putting on it and it's not coming out until next year and there's already, it sounds like you've got a queue forming already.
Adrian: Yeah, and I had that quite a lot, I spoke to loads of nurses and talked to them about Halo and I think Stoma care nurses, you have those people who are the very obvious worriers, who are the, actually I know there are people there who are stressing and actually right now, what do you do about it? You can create as much as you can in terms of physical solutions, in terms of making sure you've got the right product, the right fit, and, you can be as reassuring as you can be, but ultimately, you can't do anything more than be reassuring.
And if someone's worried. they're still going to worry. You can't really take that away. So I think that actually, because you can't do anything about it, and it's not a problem that's easy to fix, it becomes harder to address. And what I'm seeing, and again, this is coming out of my conversations with specialist nurses, is that by actually being able to say, we can see that you're worrying, and actually Halo could fit as a solution, you then are able to address those concerns. And Halo may not always be the answer for people, but it means you're able to start having those conversations about actually addressing those those wider issues and the the mental health challenge that sits around Stoma care.
Hannah: The next clip I'm going to play is from Surinda. Now Surinda also spoke about the patients she thought would be useful for the project.
Surinda: Hi Hannah, my name is Surinda Thorpe and I'm a clinical nurse educator for Insight Company. I've just come over to the Coloplast stand and seen the new Halo device.
And I think it’s really really good for patients with high output Stoma’s and leakages to place underneath their bags. And also great to reclaim their time back and reenvision.
Hannah: So yeah, she was talking about even infusion patients there, so patients that suffer with this chronic high output and have to have their chime infusions. I mean, that's something I'd not even necessarily thought of. She's absolutely right, because those are some of the patients at the highest risk of leakages, because they are in constant high output.
Adrian: Yeah, completely. And I think one of the interesting things with Halo will be how and where nurses find the right places to use Halo. Certainly your high output patients seem like they're going to, would respond really well to Halo.
We have conversations around actually, if people are moving into chemotherapy, so that that was going to be affected that actually they would be potentially the right people to start halo as a preventative right up ahead. We've had conversations around whether you would be using Halo in the pre op stage in terms of letting people know and understand about what's available for them.
I think what we will see is we will see an evolution of practice in terms of finding the right place in the pathway for patients. And that will be, and will vary from person to person, but I can see pathways feel fitting and where Halo's fitting into new pathways, which will impact care.
Hannah: It's that patient centered care where Halo can potentially fit in the part of the journey for most patients, whether it be beginning, middle, end. It's going to be something that I think will benefit so many people, not necessarily at the same points in their journeys.
Adrian: Yeah, completely.
Hannah: And then I've just got one final clip here from Michelle.
Michelle: Hi, I'm Michelle Goffey. I'm one of the Stoma care nurses are Wrexham Heart Hospital.
Halo for me, I'm thinking that although it's not going to take away, from hashening to our patients, it is going to give them increased confidence and early warning from a catastrophic leak, which will have that damage and control that they so often experience coming to clinic and talk to us about.
Hannah: And that's kind of almost going full circle with what Ruth was saying about actually freeing up clinic time there. Because right at the start of the podcast, it was something that Ruth mentioned that actually, with taking away that burden of leakage, it was actually freeing up more clinic time for patients that are anxious.
Because sometimes, and I saw it myself when I worked in stoma care, you get patients coming in, And they tell you they're leaking. It actually turns out they're not leaking, but they're just utterly terrified that they are going to leak. That's exactly what Michelle was saying there. It's these patients that have had that catastrophic leak. And now they're concerned it's just going to happen over again.
Adrian: Yeah, completely. That's exactly where Halo's really. They're really the right people for Halo. Those who are just, who are worrying about the next leakage and that started to impact and land in their real life. I think the other thing that's just worth coming back to that Michelle said, and she got it bang on right.
We're saying that, that Halo, whilst it will detect leaks, you can stop it getting out onto your clothes. It won't resolve the reason for the leakage. And that's one of our key things around Halo. If someone's leaking, Halo is not going to address that problem. It will help them control it and help them prevent it getting out onto the clothes, but really people need to be reassessed if they're continually leaking. They need that stop and let's have a look at you and just make sure we fix the problem.
Hannah: And will that be something that Halo will alert to the clinical team too as well, will Halo alert them if they're getting more, several occurrences of leakage?
Adrian: So what it will do is it will put the person in control in terms of, it will notify them, so if they're getting multiple leaks in one day, you will start being able to get alerts. And what the patient will be able to do, what the person will be able to do, is they will be able to print off a little report or share something from the app, which will let the nurse know where they're having leaks.
So I think, there's an element whereby people with the Stoma will always need to be in control of when they're going back to see the healthcare professional. And some of what we will do is we will provide support off the back of Halo with a support service. So we may prompt people to come and seek help if they need it.
Hannah: That's fantastic and I think that would probably be something that a lot of nurses would worry about as well is could be getting these alerts of leakage, but actually then what's being done about it. But all aspects are being covered. The point of view that we're encouraging patients to see their nurses, contact their nurses if they are having issues. So it's not just papering over the cracks as it were.
Adrian: No completely. Because if you're someone who's worrying about leakage, then Halo will give you peace of mind. And then if over time you start to develop leaks because your body shape has changed or, maybe you got casual with your routine or your template has changed and all of those kind of reasons, and you're starting getting leakages more common, that will start to give alerts. And we'll have a Halo team who will be able to flank this person, see what the changes are and then escalate through to their Stoma care nurse as needed.
Hannah: That's fantastic. Thank you so much for joining me today, Adrian. It's been absolutely great and love having these little lookbacks at ASCN because it really was a fantastic, fantastic exhibition down in Brighton and we were very lucky with the weather as well.
Adrian: It was very warm.
Hannah: I'm hoping that you'll join me in the new year when we get some launch dates and we can talk a little bit more about Halo again.
Adrian: I'd be very happy to join you again, Hannah, anytime.
Hannah: Thank you for listening. To see more of the wide variety of education we offer, please visit ColoplastProfessional.co.uk See you next time.
Outro

Narrator: Stoma and Continence Conversations is a Vibrant Sound Media production for Coloplast Professional.