An app to fill the care in­struc­tion gap

Modern Healthcare - - INNOVATIONS - By Joseph Conn

There’s many a slip be­tween a physi­cian’s in­struc­tions, a care man­ager’s plan and the pa­tient’s rec­ol­lec­tion.

Now there are apps to re­duce that slip­page.

Wellpep­per’s en­try in the space pro­vides reg­u­lar com­mu­ni­ca­tion be­tween clin­i­cians and pa­tients about their treat­ment plans. Like many in­for­ma­tion tech­nol­ogy-based med­i­cal in­no­va­tions, there’s a per­sonal story be­hind its cre­ation.

“My mom con­tracted a rare au­toim­mune dis­ease and spent six months in the hos­pi­tal,” said Anne Weiler, co­founder and CEO of Seat­tle-based Wellpep­per. “She was sent home with no in­struc­tions, and a month be­fore she had her next check-in. I thought, ‘This is ridicu­lous.’ ”

It also was com­mon, she said. So Weiler and com­pany co-founder Mike Van Snel­len­berg, now the chief tech­nol­ogy of­fi­cer, launched Wellpep­per in De­cem­ber 2012.

The Wellpep­per app runs on mo­bile de­vices with ei­ther Google’s An­droid or Ap­ple’s iOS op­er­at­ing sys­tems. The com­pany col­lab­o­rates with provider or­ga­ni­za­tions to cus­tom­ize the app to fit their needs.

“We don’t have any con­tent,” Weiler said. “We work with health sys­tems to im­ple­ment their own pro­to­cols, and they per­son­al­ize it for each pa­tient.”

For clin­i­cians, the app ag­gre­gates and cat­e­go­rizes pa­tient-re­ported data on dash­boards so physi­cians and care man­agers can keep track of pa­tient per­for­mance. For pa­tients, the app of­fers in­stant feed­back about their care in­struc­tions.

Pa­tient-en­gage­ment app de­vel­op­ers like Wellpep­per “(are) on the right side of history,” said Dr. Joe Smith, chief med­i­cal and science of­fi­cer at the West Health In­sti­tute in San Diego. “The boomers are not just fa­mil­iar with this tech­nol­ogy, they ex­pect in­for­ma­tion to come to them that way. If we think we’re go­ing to get away with in­struc­tions poorly writ­ten on pa­per, that’s a big mis­take.”

Wellpep­per was cho­sen as one of six fi­nal­ists among 120 apps en­tered in the first Mayo Clinic THINK BIG Chal­lenge. The devel­oper com­peted for a $50,000 top prize at Mayo’s Trans­form 2015 con- fer­ence, which was held last week in Rochester, Minn.

The app’s per­for­mance is be­ing sci­en­tif­i­cally tested dur­ing a 30-month trial by re­searchers at Bos­ton Univer­sity, Bran­deis Univer­sity and the Spauld­ing Re­ha­bil­i­ta­tion Hos­pi­tal, a Har­vard Med­i­cal School af­fil­i­ate. Wellpep­per will be tried with se­nior cit­i­zens who face a loss of mo­bil­ity.

The app, housed on an iPad pro­vided to each re­ha­bil­i­ta­tion pa­tient, will con­tain a recorded video of the in­di­vid­ual cor­rectly per­form­ing phys­i­cal ex­er­cises un­der the guid­ance of a ther­a­pist. At home, the test en­rollees will be able to re­view the videos so they con­tinue to ex­er­cise prop­erly. They will also record and re­port their per­for­mance on a va­ri­ety of met­rics, such as how far they can walk in six min­utes.

“We end up los­ing about 40% to 45% of po­ten­tially el­i­gi­ble pa­tients,” said Dr. Jonathan Bean, an as­so­ciate pro­fes­sor of phys­i­cal medicine at Har­vard Med­i­cal School. Pa­tients can’t make it to lo­cal re­hab cen­ters be­cause of the dis­tance, lack of trans­porta­tion, and their di­min­ished mo­bil­ity. Us­ing the app could en­able those pa­tients to keep up with their re­ha­bil­i­ta­tion plans, he said.

With providers in­creas­ingly be­ing re­warded or pe­nal­ized based on their level of pa­tient en­gage­ment, lost or for­got­ten care plans can be costly for their bot­tom lines, as well as for pa­tients’ health. An es­ti­mated 40% to 80% of pa­tient in­struc­tions are im­me­di­ately for­got­ten, and some of the rest is re­mem­bered in­ac­cu­rately, ac­cord­ing to a re­cent ar­ti­cle in the Jour­nal of the Royal So­ci­ety of Medicine by Roy Kes­sels, a pro­fes­sor of neu­ropsy­chol­ogy at Rad­boud Univer­sity in the Nether­lands.

Wellpep­per is com­pet­ing in an in­creas­ingly crowded space, said West Health’s Smith. Re­flec­tion Health in San Diego, Force Ther­a­peu­tics in New York City and HealthLoop, Moun­tain View, Calif., are also mar­ket­ing post-care in­struc­tion apps.

Phys­i­cal ther­apy apps are “a won­der­ful op­por­tu­nity to per­son­al­ize healthcare, as well as move the site of care to the pa­tient’s home, in­stead of see­ing a phys­i­cal ther­a­pist all the time,” Smith said. “Tools that make it a lit­tle more au­to­mated and co­or­di­nated and con­nected are the right ap­proach.”

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