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HEALTH TECH

Shining a light between the rock and the hard place: The importance of information to empower health-app users

Liz Ashall-Payne, CEO, ORCHA

Liz Ashall-Payne, CEO, ORCHA

Shining a light between the rock & the hard place: The importance of information to empower health-app users

Apps, and their use for the promotion of health and wellbeing, are the subject of increasing interest and enquiry; particularly in light of the NHS’ Long Term Plan, and ever-increasing pressures on scarce NHS resources. But finding and downloading effective, engaging, and most importantly, safe health-apps, is a significant challenge. While many have suggested that health-apps could be a ‘silver-bullet’, aimed at quashing the woes that stem from decreasing funding and increasing demand for incumbent NHS services, it is important to tread with caution.

Unlike pharmaceuticals, over the counter remedies, talking therapies, physiotherapy or surgery, health-apps can not only be sought, but readily obtained in absence of gatekeeping and safeguarding. The result is that you or I can download upwards of 200,000 health-apps today, with as little as a click of a button on the app-store. While this can be argued as the unique value-proposition of app-based health technologies, a lack of guarantees regarding the quality and content of such apps, means that this open-access feature of apps also represents the chief concern; and is likely limiting the enthusiasm with which healthcare professionals engage and promote their use.

The number of apps labelled as ‘pranks’ or for ‘illustration purposes only’ has been subject to year-on-year growth. But for those looking for convenient, easily accessible, and often cost-free support; or for those who are either vulnerable or impressionable; such technologies can pose significant health risks, beyond those that are apparent and conveyed (if at all) in the short description within the app store. An app that misleadingly claims to monitor blood pressure or blood sugar for example, may result in either (1) misleading information, (2) modifications to disease management not representative of true disease status (including the use of insulin or warfarin), or (3) serious adverse events including hypoglycaemia or stroke. One such app for monitoring blood pressure has been downloaded upwards of 1,000,000 times on the Android Google Play app store, while boasting a review rating of 4.3/5.

This raises questions regarding the utility of both the subjective user review score (which is inherently limited in only capturing both very positive or very negative views) and the number of prior downloads of an app, as potential surrogates for app quality. Recent research into apps targeted at chronic insomnia disorder conducted by the Organisation for the Review of Care and Health Applications (ORCHA) confirmed this. In this analysis, which is now available in the journal BMJ: Evidence-Based Mental Health, it was demonstrated that both user review scores, and the number of prior downloads of a health-app, were not only unreliable as proxies for quality, but in fact were inversely related; and as these metrics increased, the objectively measured quality of apps decreased (as assessed by presence of clinical evidence, data privacy policies etc.) This has left a considerable void regarding where reliable indicators of the safety and quality of app-based health technologies can be found, something which at least in part, has been tackled by the National Health Service (NHS).

Courtesy of the NHS’s digital assessment questionnaire (DAQ), and the NHS apps library (beta version), the number of ‘accredited’ and NHS-approved health-apps is increasing, albeit at a leisurely pace, with approximately 50 apps accredited so far. While a step in the right direction, the rigour with which such reviews are conducted comes at the expense of speed, and an estimated review time of 6-8 weeks, limits the possibility of such initiatives being conducted at scale. As such, the difference between the total number of health-apps available (~300,000), and those which have been quality-tested and approved by regulators or accreditation bodies (~50); is if anything, increasing; leaving little or no information regarding the validity, efficacy, and most importantly the safety, of 99.99% of health-apps available today; which to date have been downloaded by potential users upwards of 50million times.

This is where the Organisation for the Review of Care and Health Applications (ORCHA) aim to transform the process of health-app research and information provision. Positioned as an open-access, free of charge and publicly facing repository regarding the user experience, clinical efficacy, and data privacy of thousands of health-apps, ORCHA’s aim is simple; to empower and inform potential users of health-apps regarding potential risks and benefits, prior to committing to use. Through a structured, objective and peer-reviewed assessment, consisting of 160 question areas, answered on a ‘yes’ or ‘no’ basis, ORCHA provides information to the 99% of users of health-apps, which are yet to be formally assessed by health technology assessment bodies, and in doing so, ORCHA removes the information asymmetry that is currently clouding the health-app market in, distrust, disbelief, and uncertainty. Publishing a new review of a health-app every 30minutes on average, ORCHA pull in information for all 300,000+ apps available on both iOS and Android Google Play, organise these into medically approved sub-categories (including diabetes, mental health and diet and exercise), and then order these apps from the most to the least downloaded.

In doing so, ORCHA believe that focusing attention on providing information about the risks and benefits of apps currently used the most, and those which others are most likely to download, is likely to have the largest overall impact on the safety and effectiveness with which such apps are used. By providing a short, sharp summary of each app, prior to download, highlighting concerns including the lack of a data privacy policy, a lack of evidence to support claims of effectiveness, or a lack of accessibility options for those who are hard of sight or hearing for example; ORCHA is providing information regarding the ‘many’ health apps currently in use, and eliminating the information uncertainty that not only limits the allure of health-apps, but also puts users at risk when unknowingly using health-apps which do not look after your data, and may cause physical harm if used in the belief that they are approved medical technologies.

HEALTH TECH

Albert Health: A holistic approach for chronic diseases

Recai Serdar Gemici, CEO Albert Health
Recai Serdar Gemici, CEO

About Recai Serdar Gemici

Company: Albert Health

Website: www.albert.health

Management:  CEO

Founded Year: 2018

Headquarters: Hertfordshire, United Kingdom

Description: Albert is an evidence-based multi-chronic disease management platform that leverages AI.

Recai Serdar Gemici, CEO

Albert Health: A holistic approach for chronic diseases

Serdar is the CEO of Albert Health, a voice-based health assistant that enables people to manage their chronic diseases. The company intends to design disease-specific experience and help pharma companies to increase medication adherence in their therapeutic areas. In an interview, Serdar speaks on an array of topics. Excerpts:

Founding of Albert Health

 Says Serdar that chronic diseases are, in fact, a part of all our lives, even if we don’t experience them firsthand. These diseases are health problems that affect individuals throughout their entire lives and require careful attention and care. According to the World Health Organization, chronic diseases are responsible for an average of 86% of deaths and 77% of health expenses. Effective tracking, treatment, and management of chronic diseases help slow down their progression. “Our specific focus is on treatment adherence in chronic diseases. Treatment adherence maximizes treatment effectiveness, while non-adherence is the leading cause of poor treatment outcomes. 50% of individuals with chronic diseases do not adhere to their treatment plans, resulting in the death of 200,000 people annually in Europe alone.” Albert Health assists patients in understanding their chronic disease and help them embrace the treatment adherence required by that chronic condition.

 Post Covid-19 – Challenges galore in healthcare

In the post-pandemic era, healthcare providers should prioritize a holistic approach that combines technological advancements with personalized patient care to create a more resilient and efficient healthcare ecosystem, suggests Serdar. However, he adds that one of the key challenges is to ensure effective population health management. “Healthcare providers need to shift their focus beyond treating illnesses to proactively manage the health of both sick and healthy individuals. This involves allocating more resources to preventive medicine, early intervention, and lifestyle management. Additionally, technology adoption remains a critical factor in realizing the full benefits of healthcare innovations.” It is essential for healthcare providers to   facilitate the seamless integration of technology into clinical workflows and patient experiences. This can be achieved by identifying the most convenient use cases for both doctors and patients and employing user-friendly interfaces, such as voice technology, to enhance engagement and usability.

Albert Health’s platform   for digital natives- Features

Albert is an evidence-based, multi-chronic disease management platform that leverages AI.   With Albert, patients of all ages can easily manage their treatments, granting access to personalized treatment management for users from all socio-economic backgrounds, and helping improve their quality of life by acting as a mediator for lifestyle changes.

The platform offers personalized chronic disease management programs for various chronic conditions, including diabetes, asthma, hypertension, MS, HIV, and cancer. Patients can receive online consultations from healthcare professionals through Albert. They can set medication reminders, access medication prospectuses, and receive alerts about medication interactions. They can also set reminders for tasks like drinking water and measurements. Patients can store their health documents and measurements in one place, effectively track their treatment progress and health status, and share health data with their loved ones and healthcare professionals.

Offering a voice platform that patients can consult anytime, anywhere, Albert’s Natural Language Processing (NLP) technology, users can verbally ask questions on their minds. Through disease-specific trained language models, Albert understands users’ needs based on their conditions and provides them with the most suitable answers. The entire Albert platform is developed to easily adapt and be configured to meet different disease needs” adds Serdar.

Leadership traits

Curiosity, according to Serdar is one of the driving forces in the entrepreneurship journey. “I also think the traits of order and discipline are must-haves in entrepreneurship. Additionally, the perseverance instilled by discipline encourages both my personal growth and Albert Health’s achievements.

Lessons learnt from the healthcare sector

“From my journey in the healthcare sector, I’ve learned the invaluable importance of being patient centric. This principle underscores the fact that the goal of any healthcare endeavour should be improving the lives of the patients we serve. Alongside this, another critical point is to always consider the health economics aspect.”

 Albert Health – The future ahead

Albert aims to reach more patients suffering from chronic diseases and help them with most reliable and scientifically backed support. We have dedicated ourselves to becoming an essential part of the lives of patients with chronic diseases.”

Since the future of digital health is evidence-based, the firm aims to prove the benefits they provide to patients and health economics through clinical studies. “In this direction, we have committed ourselves to become a global digital health company that offers evidence-based digital therapeutic solutions, that have proven clinical value and economic benefits, and are prescription and reimbursable. Digital Therapeutics (DTx) are evidence-based digital solutions that can prevent, treat, or manage diseases, either alongside traditional treatment methods or as substitutes. We aim for our DTx solutions to be prescribed and reimbursed, just like medication. In addition, we want to support our patients not only digitally but also physically. In the long run, we aspire to open our own clinics to enhance the delivery of healthcare services even more. By collaborating with expert healthcare professionals in our clinics, we aim to provide more comprehensive health services and directly and effectively respond to the needs of our users.

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HEALTH TECH

Bold Health: Creating holistic gut care

Elena Mustatea, Co-founder & CEO, Bold Health

About Elena Mustatea

Company: Bold Health

Website: www.bold.health

Management:  Co-founder & CEO

Founded Year: 2018

Headquarters: London, UK

Description: Bold Health is a specialty telemedicine company that offers multi-disciplinary care for Gastrointestinal (GI) conditions.

Elena Mustatea, Co-founder & CEO

Bold Health: Creating holistic gut care

Elena Mustatea is the Co-founder and CEO of Bold Health, a digital health company helping individuals improve their digestive health with holistic gut care. Elena received the 21st Century Icon Technology Innovator award and was named in the Forbes’ Europe 30 Under 30 List, while her company Bold Health has been recognised for digital health innovation in numerous industry awards. Previously Elena worked in venture capital as investor with leading European VC fund Atomico, in investment banking at J.P. Morgan and Goldman Sachs, in management consulting at Oliver Wyman, and ran a media business in university. She also started a political activism group to represent the tech industry voice during Brexit called TechTogether UK, and represented her birth country in Children’s Parliament of the World. Elena is a Romanian native and received her Bachelor of Arts from Dartmouth College in New Hampshire, USA.

In an interview, she speaks on an array of topics. Excerpts:

Conception of Bold Health 

Elena explains that when she started Bold Health, she was coming out of her own health journey of healing her gut and her relationship with food. “After suffering an intestinal infection and as a result of poor lifestyle choices such as stressful job, poor sleep, drinking alcohol and eating too much raw food, I suffered long term digestive issues such as abdominal pain, food sensitivities, bloating and fatigue.” She added that she was quick enough to recognise the benefits and the need for holistic, root-cause medicine that brings together Western science with traditional approaches like food and plant medicine, nervous system regulation and human support in the form of specialist experts. “We brought all these together in an online platform, conveniently accessible and adapted to the needs of the modern individual who is empowered to have agency over their health. We wanted individuals to feel bold and empowered about their health, supported and hopeful!

With Bold, patients feel in expert hands, validated and understood in their health journey, supported with leading edge science-based solutions they can trust from a team of medical professionals, to solve not just their digestive health, but boost their mood and overall wellbeing.”

Healthcare industry- challenges galore 

Says this healthcare professional that in the post pandemic world, health workers face ever increasing patient demand, burdensome regulation and administrative tasks. “The opportunity is to deliver virtual-first, stepped care that triages patients into the right service (which is not always seeing a human, but could be going through a digital program), using data at every step of the care journey, automatising steps wherever possible, and making things easier for the provider by for example using AI to write the charts.” She noted that our providers have to freedom to work from where and when they want to, can spend sufficient time with the patient, and leverage content and tracking in between visits to maximize self-management and treatment impact outside the provider visit.

Key features of Bold Health’s comprehensive platform 

Bold Health’s comprehensive platform offers a set of self-help tools, patient education, psychobehavioral techniques, relaxation and lifestyle change, and where necessary medication and supplements, to support patients in healing their gut for good. “Depending on the symptoms and condition, we also offer the services of a team of clinicians specialized in treating gut health such as doctors or specialist nurses, registered dietitians, health coaches or therapists, who can support patients with the different aspects of holistic care. By bringing together different disciplines and types of therapies, the patient can get the combined benefit to transform their digestive health.”

Leadership traits 

Bold Health has become a global leader in digestive health in a few short years due to a unique combination of daring to think differently about the patient care experience, while staying loyal to medical evidence. “I am focused on service and solving human problems from a place of integrity and care. I also love technology’s ability to make healthcare data-informed, accessible, convenient, so I like to bring in the value of innovation and human-centered design.”

A word of advice for entrepreneurs 

Elena urges startups to not go into regulated spaces, unless you have very strong, unique, defendable IP and solid financial backing. Do a business where there is a clear existing business model and you know for sure someone will pay for your product or service. Develop health economics / ROI evidence early.

Bold Health- The way ahead

We will be expanding our multi-disciplinary, stepped care model across other chronic conditions outside GI, to be able to treat the whole person including when there are multiple co-occurring illnesses that will all benefit from lifestyle improvement, nervous system regulation, dietary improvements and expert medical advice.

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HEALTH TECH

DocHQ: Empowering healthcare through technology

Madhur Srivastava, Founder, CEO- DocHQ

About Madhur Srivastava

Company: DocHQ

Website: www.dochq.co.uk

Management: Founder, CEO

Founded Year: 2018

Headquarters: Worcester , England

Description: DocHQ combines medical expertise with AI technology to make healthcare accessible to all, from virtual physiotherapy to home health testing and travel health.

DocHQ: Empowering healthcare through technology

DocHQ is an UK employee benefits provider, that helps people make informed health choices and inspire them to improve their quality of life. The health service provider is a specialist medical technology provider aimed at enhancing employee wellbeing at work and home – connecting businesses, providers, and consumers through technology. From employee health and wellness programs to physical wellness in the workplace and at home, DocHQ combines medical expertise and technology to offer wellbeing services and solutions in a post-pandemic world.

Founding of DocHQ

In 2018, tech professional Madhur Srivastava embarked on a journey to revolutionise the approach to employee benefits, insurance, and healthcare through the lens of technology. This led to the birth of DocHQ, a platform initially designed as a user-friendly telehealth service, before expanding its reach to include unique offerings such as travel healthcare for those journeying abroad.

“In the healthcare market, we recognised a pressing need for integrated, scalable solutions that facilitate better patient-provider communication. DocHQ emerged as a response to bridge these gaps and offer a comprehensive healthcare solution designed especially for the digital age” observes Madhur.

Healthcare industry- challenges galore 

The pandemic accelerated the digital shift, but it also highlighted the importance of data security, a human and personal touch in digital environments, and the need to constantly validate the accuracy of tech solutions, especially in healthcare, opines. “Providers must prioritise these aspects to maintain trust and deliver efficient care in the post-pandemic era.”

DocHQ’s comprehensive platform – Features 

Central to DocHQ’s offerings is ‘DocHQ Physio’, an AI-driven platform tailored for today’s digital landscape. This platform provides comprehensive patient assessments, both physically and online, leading to personalised exercise prescriptions, explains Madhur. “As patients engage with their rehab exercises via our platform, the AI-movement tracking technology delivers visual and audio real-time feedback, optimising their movements for therapeutic benefit. Behind the scenes, the system gathers vital data, offering physiotherapists a rich tapestry of insights to monitor and guide a patient’s progression.” A standout feature is its asynchronous progress tracking, where physiotherapists can adjust exercise regimens based on the collected data, ensuring a continually optimised recovery journey. With DocHQ Physio, the practitioners have melded the precision of AI with the indispensable human touch of physiotherapy, ensuring comprehensive, effective and dynamic care tailored for the digital native.

Leadership traits

Madhur believes in collaborative leadership, listening to his team, valuing feedback, and fostering a culture of innovation. He feels that all these have played a part in the trajectory of both his personal journey and that of DocHQ. “I’d add that I’m curious and ever adaptive. The healthcare landscape is ever evolving, and staying curious allows me to anticipate changes and adapt swiftly.”

Word of caution for healthcare entrepreneurs

“First and foremost, always keep the customer at the centre of everything you do. In the race to innovate, it’s easy to get swept up in the allure of new technologies and cutting-edge solutions. However, as a CEO, I’ve seen first-hand that the most enduring and impactful solutions are those that directly enhance customer care and experience.” Also, while agility is a strength in the start-up world, in healthcare it’s vital to balance it with thoroughness and caution. Due diligence, customer safety and regulatory compliance are not just boxes to tick, but are foundational to building trust and longevity in this sector. Stay customer centric. Technology and innovation are essential, but they should always serve the primary goal of enhancing customer care and experience.

One principle stands out unequivocally: healthcare is fundamentally about people. Whether we’re discussing patients, their families, or the professionals serving them, every decision we make, every innovation we introduce, and every change we implement should have the wellbeing and betterment of individuals as its guiding star.

DocHQ – Forging ahead

At the forefront of the firm’s innovation pipeline is the integration of behavioural science into the DocHQ Physio AI system. “We believe that the most effective healthcare is holistic, addressing not just the physical but also the emotional and psychological aspects of wellbeing. We’re exploring how subtle behavioural cues, discerned from voice and visual data, can provide insights into a customer’s mental state.” This has enabled them to send targeted nudges to users, not just improving the information they receive but potentially influencing positive health outcomes. Imagine a system that, beyond diagnosing physical ailments, can also sense distress or anxiety and respond empathetically. “By bridging the realms of AI, behavioural science and healthcare, we’re taking a leap towards a future where digital health solutions truly understand and cater to the multifaceted nature of human health.”

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