little journey app

Little Journey

Little Journey is a health behaviour modification tool designed to reduce children’s anxiety before a healthcare procedure by using a smartphone app that provides age-tailored immersive and interactive content.

Hospital-based care Mental health

The challenge

Pre-operative anxiety is common, affecting 50-75% of children, and is the leading complaint in adults before surgery. This anxiety is associated with worse physical and mental outcomes, as well as adverse financial implications for healthcare organisations and society as a whole. Fifty percent of children develop negative post-hospital behavioural changes such as bed wetting, separation anxiety and nightmares at two-weeks after an operation, which are ongoing in 8% at one year.

Research has shown that psychological preparation reduces anxiety but is time consuming and costly to perform. Currently patients are supported through single face-to-face pre procedure interactions and/or paper information leaflets.

The solution

Little Journey is a health behaviour modification tool designed specifically to support children and their family network through a potential stressful and anxiety provoking healthcare procedure. It uses varying active behaviour modification mechanisms tailored to the end user to support them through their treatment. From familiarisation through interactive games, desensitisation using virtual reality tours to coping skills education via child narrated animations, Little Journey engages and empowers families in their care.

Little Journey can prepare and support both children and adults during any healthcare interaction, whether a single blood test or a complex research trial protocol. Through medication adherence and research support tools – as well standard preparation and support for a clinical procedure – Little Journey promotes trial recruitment, reduces early withdrawal and supports adherence to the medication under investigation. Overall, by nurturing positive health behaviours, Little Journey reduces anxiety and distress while engaging families in their care.

The app helped as he was very relaxed. It helped seeing where he would sleep. We could have a look before the day and we felt ready. It helped reduce the stress of coming to hospital as we were unsure how to prepare our son for what was going to happen and it helped encourage him to talk about it . Parents of Freddie (aged 5), service user

• 30% reduction in pre-operative anxiety levels of children with autism and ADHD*
• 97% user satisfaction rate
• Accessed by 71% of patients before surgery**
• 42% reduction in on the day cancellations before surgery**
• £3.50 cost benefit to healthcare organisations and £6.00 to society for every £1 spent on Little Journey**

*Quality improvement project performed in Royal Belfast Children’s Hospital.

**Identified by independent health economic analysis performed in 2019, supported by Eastern ASHN & performed by Kent, Surrey, Sussex AHSN.

Little Journey helps children prepare for hospital procedures and clinical trials. Check out the 12-slide deck it used to raise $3.1 million.

• London-based Little Journey has raised $3.1 million for its children's health platform. 
• The startup helps children and families prepare for hospital procedures and clinical trials.
• Check out the 12-slide deck Little Journey used to raise the fresh funds.

A startup that has developed a platform to support children and their families during hospital procedures and clinical trials has just raised $3.1 million.

London-based Little Journey aims to support all children in the personalized delivery of care, according to cofounder and CEO Dr Chris Evans, who is also an anesthetist. Evans often witnessed how distressed and uncertain children were when they came in for surgery.

This uncertainty can lead to anxiety "which leads to worse health outcomes for children," he added.

"We were giving out adult leaflets to children. I had seen my nieces and nephews interact with technology — and I thought, why can't we do the same for children coming into hospital?" he told Insider.

Little Journey has developed an app that makes children aware of who they're meeting and where they're going and also incorporates animated characters that explain what happens during surgeries and clinical trials. 

Little Journey makes children aware of who they're meeting and where they're going and gives them coping strategies before their clinical procedures. It provides children with coping methods to relax as well as guidelines on how they can keep track of their medication. 

The startup has also developed a platform for management staff at hospitals and clinical trials. Healthcare staff can personalize a patient's pathway on the app, and the platform is currently deployed across over 50 National Health Insurance (NHS) trusts. 

The cofounders decided to tackle pediatric clinical trials because a key issue is a shortfall in recruitment, with many children dropping out — often due to the emotional pressures involved in being a part of a trial . 

Families and carers of children are also regularly kept in the loop, and provided checklists and guidelines to help support patients. The startup claims its platform has reduced anxiety in children by 32%, recovery time by 30%, and, same-day cancellations by 42%.

Amid a drought in the UK's health tech funding landscape since 2022, with pediatric care being an especially neglected sub-sector, Evans found that expanding Little Journey's client base beyond a single market to pharma companies helped cinch the funding. 

"We know in the NHS, there's not a lot of money for patient experience, so there's challenges getting in there," he said. "By working with pharma, keeping a patient in a trial to enable that data collection is of much higher value." 

As a B2B product, the startup licenses its platform to healthcare organizations; its end play is to use that data for personalized care and move that data for use within the life sciences sector. 

The $3.1 million round was led by Octopus Ventures, a London-based venture capital firm that has backed the likes of Cazoo, Depop, and Elvie. 

With the fresh funding, the startup will look at how the data collected from these procedures and trials can drive better-personalized care, based on children's behaviors and needs. 

Check out the 12-slide deck used to raise the funding:

• Main content

Little Journey: A Children's Healthcare Procedure Preparation and Support Tool

Little journey limited.

Contact: Dr Chris Evans - [email protected]

Organisation

Little Journey is a health-tech SME founded in 2019. It was created based off the clinical and research experiences of Dr Chris Evans. Initially Little Journey was focused on supporting children through day case surgery but has now grown to supporting children undergoing multiple healthcare procedures and those participating in clinical trials. The team has grown from two people in 2020 to up to ten in early 2021 and is looking to increase to twenty staff at the end of the 2021. Little Journey licences its solutions to healthcare organisations, life science and contract research organisations, providing a tailored version to their needs. We are providing the NHS with a low-cost solution focusing on the international healthcare and contract research market for ongoing company sustainability.

General Summary

Little Journey is an end-to-end digital psychological preparation and support tool for children and their families undergoing a healthcare procedure. Consisting of a patient-facing mobile application (app) and hospital-facing web application (portal) that enables organisations to control the app in real time, Little Journey provides engaging, interactive and age-tailored content to families from the safety of their own home.

Little Journey was founded by Dr Chris Evans – a peri-operative anxiety management expert and NHS England clinical entrepreneur – with the aim of democratising health information. Working closely with key stakeholders, the platform has grown and evolved based on his research and understanding of key stakeholder needs.

Little Journey has been configured to over 50 NHS organisations. A health economic analysis performed at five NHS organisations identified that 71% of patients verbally offered the app went on to use it, with 98% satisfaction. In addition, premedication rates, on-the-day cancellations, recovery times and fasting times were reduced providing cost-benefit to the hospital (£3.50 per pound invested) and society (£6.00 per pound invested).

Little Journey has since expanded to support families undergoing Endoscopy, phlebotomy and COVID swabs. It was accepted onto the NHS Innovation Accelerator program to increase adoption across the NHS.

The first version of Little Journey was developed and launched in 2018 following an extensive double diamond co-development and design process through informal discussions, focus groups (both parent and Young Person advisory group (YPAGS)), as well as key stakeholder meetings. This version provided an age-tailored virtual reality tour of the rooms’ children would visit on the day of an operation. The storylines, characters and technology itself were assessed through two separate YPAGs.

Following its successful launch, we performed a single-centre usability and acceptability study which identified that parents act as gate keepers of healthcare information. It also identified that parents were using the app independently of their child to enable discussions about what would happen. This led to a second version of the application being co-developed which delivered drip-fed information articles to parents before and after the procedure. After the second versions launch, we held focus with early adopters identifying their desire to:

• create additional information pathways for common procedures such as MRI, Phlebotomy, etc
• collect and report patient reported outcomes for service improvement
• update information in real time

This has led to the significant expansion of our mobile- and web-facing applications to further benefit organisations and families. We have worked closely with organisations before and after launch to achieve ongoing customer success.

• Little Journey has been used over 35,000 times with over 350 app store reviews (4.7 rating). 97% of users rate the information provided as good or very good with an average use of 49 minutes and seven sessions.
• Our usability and acceptability study (IRAS number: 223644) surveyed parents of children undergoing ambulatory surgery to assess the usability and acceptability of the application and gain feedback, identifying that 100% of parents either agreed or strongly agreed it helped them talk to their child about the operation, that it helped prepare them for their child’s operation and that they would recommend to a friend before an operation. A follow-on multi-centre randomised controlled trial is currently underway in 10 NHS hospitals (IRAS number: 251219, REC:19/LO/0255).
• An independent health economic analysis assessing the cost-benefit of Little Journey’s introduction at five NHS Hospitals was performed. It identified a cost benefit to hospitals through lowering anxiety (reduction in premedication rates) and improving flow through the hospital (reduction in fasting times by one hour for liquids and two hours for solids, 30% reduction in the time spent in the recovery room and 42% reduction in on-the-day cancellations). Societal benefits were identified through an improvement in family’s quality of life and reduction in missed days of work.
• Belfast children’s hospital reported a 30% reduction in parent perceived anxiety levels in children with Autism and ADHD undergoing daycase dental surgery.

Standing Out

Several patient-facing applications have been created with the aim of preparing children to come to hospital. Typically, they attempt to support children of a single age group over a wide range of procedures using generic, inflexible content with insufficient depth. Little Journey changes this.

Through provision of a solution designed for both children and their parents, Little Journey promotes discussion and learning across the child’s social network, while provision of content over the whole peri-procedure period makes the information digestible and understandable. For children, the delivery of multi-faceted immersive, engaging and age-tailored content from virtual reality tours, therapeutic games and relaxation exercises promotes ongoing engagement and makes the preparation enjoyable.

A core component of Little Journey is the flexible, modular, hospital portal that puts hospitals directly in control. By enabling organisations to configure the mobile application to their local patient pathways, we create a personalised solution to increase engagement. The ability to update content in real time prevents incorrect and out of date information dissemination.

A key element contributing to the success of Little Journey has been its co-design with key stakeholders including children, families and healthcare professionals. Similarly, creating continual learning loops through formal research and real-world evidence has ensured the solution stays relevant and evidence driven. Finally, the pandemic has heightened the need for a digital solution that can be continually updated to support families from the comfort and safety of their own home.

Key Learning Points

• There is no one-size fits all solution and human behaviour requires variation to engage and satisfy everyone. This is particularly relevant when it comes to health behaviours and information preferences to better understand how people will respond to health information.
• Keep co-design at the core and listen
• Combine subject matter experts, healthcare professionals, children and families voices together to create the ideal solution but also identify how this solution should be implemented.
• Focus is often placed solely on the efficacy of the intervention rather than its ability – or the desire – for it to be implemented into routine care, resulting in a research-to-practice gap. Close this gap through implementation science focusing not only on the effectiveness of an intervention but the cost-effectiveness, security, implementation strategy and interoperability.
• Balance the need for accuracy and speed by generating data from both standard clinical trial methodologies and real-world evidence.
• Actively seek the unheard voice to address health inequalities. Young person advisory groups naturally self-select their participants with those with chronic illness, interests in healthcare or healthcare professional relatives. The voice of the person who needs the intervention most is often never heard.
• Continue to seek feedback and learn. Create continual learning loops to iterate and improve the solution. It is never finished.

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Little Journey 4+

Little journey ltd, designed for ipad, screenshots, description.

Undergoing a healthcare procedure can be a daunting experience for anyone, especially as a child. Whether as part of routine care or a clinical trial, Little Journey supports children and their families from contemplation to full recovery through this award-winning app. The simple-to-use app guides and supports children and their families through their healthcare journey – all from the comfort and safety of their own home. We support children through: • Virtual reality tours enabling them to explore the exact rooms they’ll visit while in hospital. • Age-tailored animations explaining what will happen and why. • Breathing and relaxation exercises . • Therapeutic and distraction games to use during stressful periods. Little Journey helps parents by: • Drip feeding information before, during and after their procedure. • Providing small bitesize chunks of information to assist with information retention. • Making it easier talk to children about what’s going to happen. • Providing checklists, hints and tips, and nudges to make sure you’re all ready to go. Little Journey was founded by an NHS doctor and researcher into children’s anxiety management. With support from children and their families, health play specialists, psychologists, nurses and doctors, the Little Journey app was born! We’ve continued to work with families and hospital staff to improve the app and expand to support families through more procedures. Awards & recognitions: • NHS Innovation Accelerator 2021 • Association of Anaesthetists Great Britain and Ireland (AAGBI) Innovation in critical care and anaesthesia 2018 • Patient Experience Network National Award (PENNA) Innovative use of technology award 2021

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The developer, Little Journey Ltd , indicated that the app’s privacy practices may include handling of data as described below. For more information, see the developer's privacy policy .

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The developer does not collect any data from this app.

Privacy practices may vary, for example, based on the features you use or your age. Learn More

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We use innovation to accelerate paediatric clinical trials through an integrated participant support and clinical trial management system.

The Problem

According to the fda, 25-40% of paediatric clinical trials fail to establish data to determine the safety and effectiveness of the study intervention. this leads to off-label or unlicensed paediatric prescriptions - reported to be as high as 79% and 35% respectively. trial failure is in part explained by the inherent complexities of running a paediatric clinical trial - including challenges in recruitment, adherence to trial protocol and retention of participants., paediatric clinical trial challenges, poor recruitment $1200 - average cost of a failed recruitment, early withdrawal 20% of patients withdraw from clinical trials, low adherence 50% adherence to prescribed medication, delays 80% of clinical trials are delayed, lost revenue $8m lost in revenue each day a trial is delayed, our solution, little journey is a clinical trial esupport and management platform designed to support participants and enable research sites/organisations to effectively manage trials. it comprises a participant-facing smartphone app and accompanying web portal accessed by staff..

An Award Winning Participant-facing App

The little journey smartphone app provides accessible, multi-faceted support for both child and caregiver end-to-end - from screening through to trial completion..

A Configurable Web-portal for Research Staff

The little journey clinical trial web-portal, accessed by research staff and cros, enables teams to collaborate in configuring app content relevant to each site and to monitor trial progres s..

Tailored procedure preparation content for:

• Paediatric Surgery
• Paediatric COVID-19 Swab
• Paediatric Phlebotomy
• Paediatric Endoscopy
• Paediatric Clinical Trials

Coming Soon:

• Paediatric MRI Scans
• Intensive Care
• Neonatal Intensive Care

Why use Little Journey for your clinical trial?

Improved Patient Recruitment

We provide each hospital participating in the trial with Little Journey. This facilitates pre-recruitment engagement and allows for easy information delivery to patients eligible to participate in the trial.

Enhanced Medication Adherence

A gamified medication monitor gently encourages children in taking their medication, supporting routines at home through nudges and notifications.

Better Patient Experience

Little Journey improves participant engagement and satisfaction by supporting families via an end-to-end, customised digital clinical research trial platform.

Expedited Trial Delivery

Streamlined communications between research staff and trial participants, easy tracking of trial progress, and nudge notifications sent via the app ensure patients and staff are informed and working together to progress through the trial.

Reduced Withdrawal

Positive experiences and trial engagement leads to improved participant retention. Furthermore, through a back-end tracking system, research site staff can identify and help families that are struggling on the trial.

Effective Data Capture

Information on each participant’s site interactions and  trial progress, plus overall trial oversight though in-app and behaviour data collection.

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Learn how Little Journey can:

- Improve participant recruitment   - Increase participant retention - Help CROs deliver Clinical Trials 

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References: 1: Pediatric Clinical Trials Market Analysis – Coherent Market Insights (2020). Online: Pediatric Clinical Trials Market Size, Trends, Shares, Insights, Forecast - Coherent Market Insights 2 - Rajeshwari Gore, Preeta K. Chugh*, Chakra D. Tripathi, Yangshen Lhamo and Sandhya Gautam, “Pediatric Off- Label and Unlicensed Drug Use and Its Implications”, Current Clinical Pharmacology (Discontinued) 2017; 12(1) . https://doi.org/10.2174/1574884712666170317161935