Guest blog written by Chris Watson, product manager of Exco InTouch.
AstraZeneca and Exco InTouch have announced a program to develop and launch interactive mobile phone and internet-based health tools that will help patients in the UK and their healthcare providers to track and manage chronic conditions. AstraZeneca’s R&D organisation and Exco InTouch are developing the tool with an initial focus on chronic obstructive pulmonary disease (COPD).
Patients enrolled in the programs will have the opportunity to access personalised coaching and information about their disease and treatment via their mobile phones and other web-enabled devices. Patients will also use digital technology to collect, transmit and review their own clinical data. Patients and their healthcare providers will be able to use this real-time information to make informed decisions and tailor care pathways to personalise each patient’s disease management and optimise health outcomes.
Tim Davis, chief executive of Exco InTouch, and Matthew Bonam, pharmaceutical project director at AstraZeneca, talk about how their new real-time disease management tool is set to help both healthcare providers and patients alike and revolutionise the mHealth sector.
What are we doing?
Matthew Bonam: In partnership, we’re bringing together our pharmaceutical expertise with IT systems and digital and communications as a way of augmenting current pathways and augmenting and improving healthcare outcomes for patients. We’ve recognised there is real expertise in this area from Exco InTouch and we’re excited to be working with them.
Tim Davis: As a business we’re trying to put the patient at the centre of everything we do. There are challenges we’re rising to in specific disease areas such as COPD. We’re striving to revolutionise healthcare by utilising everyday technologies to help patients and healthcare providers improve health outcomes. We believe these programs will lead the way in moving the pharmaceutical industry beyond the pill and into providing ongoing support to patients through personalised health solutions and intelligent pharmaceuticals.
What does this collaboration hope to accomplish?
Matthew Bonam: There are three different things: to provide healthcare professionals with the information they need to deliver the best care to individual patients when they need that support; to learn and develop these solutions together as we go along—because we realise that not everything we do is going to be perfect in this first product; and most importantly, to try to make a meaningful difference for patients. COPD is a difficult disease to live with. Symptoms can be frightening for individuals and can impact on activities that we take for granted; when the patients symptoms worsen, especially to the point where they are hospitalised, there is an added risk that their lung function will further worsen. We’re aiming to help patients to manage their condition and maintain their health for as long as possible. In particular, we are aiming to intervene before the patients condition worsens to the point where they need to be treated in hospital.
Tim Davis: Our working relationship with AstraZeneca is excellent. We both realise what we need to do in this area; our solutions need to be flexible and organic. There is a spirit of openness between us and we realise that our program may need to change over time.
How will it work?
Matthew Bonam: There are a lot of resources already spent effectively on COPD within the NHS and many examples of excellent practice and innovation that have and continue to improve outcomes for patients. What we’re doing together with Exco InTouch is setting out on the first step of a journey that will examine how we can help in further improving care to patients. We’re not looking to re-engineer whole processes and programs but to build on what is already there.
Tim Davis: I’d echo that we’re not looking to disregard current care pathways—we’re looking to augment them. There is an ongoing channel of communication between patients and NHS Trusts and our technology allows us to facilitate that very easily. We’re trying to go beyond giving patients a paper diary to fill in; they’re not useful as they don’t get the data to the GP in a usable format. We shouldn’t be taking up more of a GP’s time in this way and we feel our program will allow them to treat more people in an informed way.
Why have you chosen to concentrate on COPD?
Matthew Bonam: We’re starting out with COPD, which is the fifth biggest killer in the UK, and the number of people with the condition is increasing. It is estimated that 1 in 8 people over 35 remain undiagnosed. The department of health has made diagnosis and treatment of COPD a priority and due to the impact on the health of individuals and the overall costs to the health service, the treatment of COPD has attracted funding for the development of innovative solutions. There have been examples of very positive impacts both from increased HCP interventions and telehealth, but these are unlikely to be cost effective solutions for large populations. The great thing about our new program is that, pinned together with current methods of care, we can begin to make a difference.
Tim Davis: One of the reasons that COPD was chosen was that it affects so many other parts of the body; for example, muscles are weakened as your activity diminishes. There is no cure for COPD, which estimates say affects around 3 million people in the UK, though by stopping smoking, taking medication as prescribed and maintaining muscle tone and physical activity, the progression of the disease and its impact on the patients overall health can be reduced. We think our interactive tool will provide a lighter touch and reduce the significant costs associated when a patient is hospitalised.
You say this is a groundbreaking partnership; how does this differ from similar apps already on the market?
Tim Davis: This isn’t just another app. We are looking to integrate with the pathways to care already provided to patients with COPD, to bring together patients and healthcare services. This new program will sit on top of Exco InTouch’s expertise in clinical data collection, ensuring that the patients’ data is secure and managed according to local data protection regulations including those of the NHS.
Matthew Bonam: There have been countless downloadable apps before, but they’ve all come and gone. The beauty of this system is that by expanding our understanding of how individual patients use and respond to various treatment options, we can better focus our efforts to make this product continually relevant for the patient and address their needs.
What does this program look like for a patient and what data are you tracking?
Tim Davis: A COPD patient in the UK may be asked by his or her physician to participate in the program. The patient would access a disease management program via mobile phone and internet. Each patient will be asked to capture their symptoms weekly and track how often they have used their maintenance therapy via a simple form within the app. Patients will also receive a device that attaches to their rescue inhaler and tracks how often it is used. AstraZeneca has tremendous insight into diseases and we bring insight into the technology and interfaces patients are comfortable with. We have that knowledge and we make our solutions extremely intuitive. We’ve scoped out a very different look that is configurable and based around what the individual is familiar with.
Matthew Bonam: We shouldn’t lose sight of the fact that COPD remains a disease that is suffered predominantly by the older generation and they are interacting with technology in different ways. Exco InTouch’s knowledge in this area is invaluable.
What about GPs (or HCPs); how will they use it and will it add to their workload?
Matthew Bonam: We have to be wary of the promise of ‘jam tomorrow’ but the design is quick and simple and can have a new patient up and running within 15 minutes. It costs a huge amount of money every time a COPD patient is hospitalised and this system is designed to reduce that. Because the system also analyses the data, it means that the HCP will not have review all data but will be alerted when a patient’s condition is deteriorating, helping them to focus their efforts on the patients who need the most help.
Tim Davis: The program will allow the patient’s physician to determine if the patient’s COPD is well-controlled. Any worsening of the condition will be picked up, for example, through increased use of rescue medication. At that point, the physician can ask a patient to come into the clinic for assessment or adjust the patient’s medication.
How will you obtain, integrate and protect patients’ data?
Matthew Bonam: AstraZeneca never has access to patient-level data, only anonymous information. The patient identifiable data will only ever be seen by the patient and their HCP, and the HCP will still make all of the decisions about treatment. All the information we’ll collect using this new program will be held within the Exco InTouch system.
Tim Davis: Exco InTouch’s products and services are designed for use in the pharmaceutical and healthcare industries and as such we have since inception focused on protecting patient data. Therefore our systems have been developed to manage patient data and are designed to meet global data protection and privacy regulations.
Is AstraZeneca studying its own medicines as part of the program? Will this only be available to patients on AZ medication?
Matthew Bonham: We’re focusing on patients with long-term conditions. Despite the large amount of resources spent on COPD disease management in the UK, we know there is significant unmet need and believe that more can be done to prevent hospitalizations and other costly disease exacerbations. The program will be provided to patients who have medical need irrespective of what COPD medicine they have been prescribed and this is absolutely critical. It’s about delivering the best care available.