At the recent Exponential Medicine conference in San Diego, we had the opportunity to spend some time with Vinod Khosla, a prominent venture capitalist. Mr. Khosla has a vision to drive the current practice of medicine toward a more data-driven science of medicine, especially when it comes to behavioral health. One of the companies he funded, Ginger.io, is trying to do just that by combining deep analytics (A) with our social behaviors (B) as revealed by our interactions with our cell phones (C). This ABC approach allows for the creation of a behavioral pattern or signature that can be used to help detect changes in a person’s behavioral health needs.
It’s much easier to understand the plot of a film by watching the whole movie as opposed to watching a short trailer, right? Why would we expect to this to be any different when trying to understand the real lives of our patients? Visits to the hospital happen on an episodic basis; every few weeks to months a patient will be seen by their physician. Clinicians often rely on a patient’s self-reports coupled together with the results of some lab tests to determine what exactly has happened in the interim period between visits. In the behavioral health domain the emphasis is more heavily weighted on the patient and physician’s subjective assessment of progress.
Unfortunately, in this situation accuracy may suffer and patients frequently deteriorate and relapse in between their visits, with many patients not reaching out to their physician until the situation is critical. How does a physician determine which one of their hundreds of patients may need an intervention, or an earlier appointment, or even an ambulance? Clearly the ability to remotely and continuously monitor patients would be a tremendous asset in helping to strengthen the physician-patient relationship and improve timely provision of care.
Two thirds of Americans have smartphones, powerful devices which integrate our voice calls, text messages, social media accounts and games, and often incorporate additional tools like GPS. By analyzing a person’s smartphone use, you can obtain their social behavioral “signature.” And by understanding their patterns of behavior, you may be able to determine if they are experiencing an increase in the symptoms of behavioral conditions such as depression. Conditions such as depression often manifest with disruption to people’s ability to engage with friends & family, increased isolation, reduced undertaking of enjoyable activities and altered sleep patterns. Ginger.io has the ability to analyze this data continuously and provide help in real time. It also has the ability to collect passive data, which means no extra effort or behavioral change is needed on the part of consenting users.
We used the Ginger.io app for a week. The company reported that the app was rated by patients as being easy to use (94%), giving useful tips (88%) and providing an overall satisfactory experience (82%), so we wanted to see for ourselves. These are impressive numbers given that the behavioral health field traditionally places a significant emphasis on the importance of face-to-face human interaction over any computerized tools.
In our experience the app was easy to use and despite our fears, it was not overly intrusive or burdensome. It provided useful health tips and advice. A cool feature we found during testing was that if any of the completed mood surveys suggested a marked change in mood, the app would guide you to resources that could be of help. This feature may be useful for many patients who are often difficult to reach when they begin to deteriorate. Although we were testing a version of the Ginger.io app designed for depression, the company also has software for a variety of behavioral brain disorders such as bipolar disorder, schizophrenia, and anxiety disorders. Recently, Ginger.io announced growing academic partnerships with a group of academic medical centers including the Massachusetts General Hospital and McLean Hospital, an important step towards gaining credibility and acceptance in the medical community.
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