For many centuries physicians have been our healthcare leaders. But today technology is changing that dynamic, with trends heading toward patient-driven healthcare instead. Innovators at “Digital Diagnosis: Harnessing Digital Technology to Improve Personal Health,” an event sponsored by Janssen Labs at Microsoft on October 14, 2014, believed that technology would involve patients more deeply in their own treatment. The conference also highlighted the need for collaboration between clinicians and biotech specialists.
“Just delivering care is not adequate. We need to think about the patient experience,” said Naomi Fried, Ph. D., Chief Innovation Officer at Boston Children’s Hospital. James Wilbanks, Chief Commons Officer at Sage Bionetworks, echoed her view. “It’s not a technology problem, it’s the approach,” he said.
Several ideas were brought to the table as viable solutions to patient-driven healthcare. The first, Twine, is a platform we’ve written about before. It promotes patient and family collaboration in care plans, augmenting the physician-patient relationship. Dr. John Moore, CEO of TwineHealth, said that patients want personalized care that is mobile but also human – and Twine meets this need by allowing physicians and patients to create a personalized plan that is sent to the patient’s electronic device and to his or her support coach, typically a nurse. The patient and coach track progress together and make necessary adjustments outside the clinical setting.
Evidence shows that this works, too. In a randomized controlled trial at Massachusetts General Hospital studying hypertension management, all patients using Twine achieved their goal blood pressure in three months at a cost of $70 per patient per year, Moore said. Compared to the present standard of care – a third of patients reaching their goal in one year at a cost of $250 per patient per year – this is a vast improvement. Patient accountability and self-efficacy also improved as a result of regular consultations with coaches. “Twine will help us work efficiently as a team to drive down healthcare costs,” Moore said.
Similarly, Veera Anantha, Co-founder & CEO of Constant Therapy, presented an iPad-based rehab program targeted at patients with learning disabilities or brain impairments such as traumatic brain injury patients or stroke victims who often don’t receive consistent therapy. “Constant Therapy empowers people with brain injuries to lead more fulfilling and meaningful lives,” Anantha said – mostly because they can receive more frequent and higher quality therapy at home.
Currently available on iTunes by subscription for $19.99 per month or $199 per year, the program allows clinicians to help patients relearn skills tailored to their specific micro-needs by providing access to what Anantha calls “a very broad set of science-based therapy tasks available at their fingertips all in a single platform.”
Myomo’s MyoPro offered a different kind of solution to patient engagement. The MyoPro, a custom-fit myoelectric upper extremity brace, is used on patient with deficits from brain & spinal cord injuries, stroke, brachial plexus injuries, ALS, and multiple sclerosis. It has little digital complexity, but gives patients improved strength and control of their arms. The patient’s electromyographic (EMG) signals are detected via the brace’s noninvasive electrodes and the signal processing system provides proportional assistance, according to Myomo founder & CEO Steve Kelly.
“The MyoPRO is not a therapeutic intervention,” Kelly said. “It’s an assist device for something that hasn’t been alleviated through surgery or rehab.” Although the device is aimed to improve function and improve quality of life and has been shown to reduce pain and pain medication requirements, Kelly believes the MyoPRO will shift care from the acute setting to home care.
By driving down costs and increasing patient engagement, participants at this event agreed that technology is slowly changing our healthcare system and making a difference in patient care, especially as device based programs track healthcare data and improve patient education and involvement. The key, though, is to make sure patients have access to these devices or platforms at a minimal cost. “Digital health is here to stay,” Fried said. “We’re just at the tip of the iceberg.”
Monica E. Miller, MD is a plastic & reconstructive surgeon in Boston working to improve healthcare through academia and organized medicine. She received a BS from the University of North Carolina at Chapel Hill and an MD from the Brody School of Medicine. She has a passion for technology, music, and writing. She also works in the community in youth education, development, and empowerment. You can connect with Monica on LinkedIn (monicamillermd) and Twitter @MonicaMillerMD.
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