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August 14, 2018

Real Impact of Digital Health (ePROS)

Commentary
Tom Parsons
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For most of us who are working to identify and nurture innovations at the intersection of healthcare and technology one question really cuts to the core 'is digital health actually having a positive impact on people's lives?'.

While we (at HealthXL) believe there are many examples out there, one area in particular is showing significant promise, digital patient reported outcomes (or ePROs). These solutions are showing evidence that they give people longer to live on the basis of timely communication, simple technology solving a complicated problem.

Symptoms are common among patients receiving treatment for cancers, but they often go undetected. Waiting to capture patient recorded outcomes at clinic visits is often too late; poorly controlled symptoms can lead to unplanned clinic or emergency department visits and unplanned hospitalizations.

ePROs can capture patients symptoms remotely and transmit them to their caregiver. Increasing the frequency and ease of contact between the patient and caregiver can ultimately lead to improved patient outcomes.

As ever, in an effort to help our community be effective advocates for digital health, we have put together a brief example explaining the MoovCare solution and the steps they have taken to prove the efficacy of their approach. We hope you can use this as a practical example of how digital health can have a positive impact on people's lives.

The Start Up

MoovCare, by Sivan Innovation, an Israeli company, have developed a symptom reporting web tool for cancer patients. The app delivers surveys to patients, and based on their reported outcomes, a MoovCare algorithm determines the need for intervention. The system can generate an alert, such as an email, to the patients doctor in the case of a concerning change in the patient’s condition.

The Evidence

MoovCare published a seminal study last year showing their solution improved advanced lung cancer survival, when subjected to a French multicenter phase III randomized control study.

Sample size included 133 patients and the results found that the median overall survival of patients who used the application had a 7 months median survival improvement (19 months vs 12 months). Patient quality of life was also better among patients who used the application.

Sceptics may say, well this was a small trial, can it be replicated at a larger scale? Updated results from a another study from Memorial Sloan Kettering including 766 patients, again with survival as its primary outcome, showed that the the patient reported outcomes groups had a 5.2 month median survival improvement (31.2 vs 26.0 months). There were also improvements in the secondary outcomes of 1-year quality-adjusted survival and tolerance of a longer duration of chemotherapy.

As Harold Burstein, MD, PhD, from Dana Farber Cancer Institute put it “If this were a drug that had a survival advantage of this magnitude, it would be priced in the $100,000s".

The HealthXL Advisor

Marco Giannecchini, MD - Founder & CEO of UYS, a digital health consulting business.

“PROs in practice provide an added level of information collection and assessment for patients. Through the data collected, oncology nurses can identify symptoms earlier and offer helpful interventions in practice. The future collaboration between pharma and devices industry may contribute to the generation of data which will be more increasingly accepted by the EU health authorities. Offering these devices for free to the patients may accelerate the adoption of the technologies.”

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