This week’s Catalyst: How to get patients to take their pills, do their exercises and enroll in clinical trials

An Online Matching Service – for Clinical Trials

One thing that many TEDMED Hive start-ups have in common is that their entrepreneurial founders acted after a health issue for themselves or loved ones.

For Ryan Luce, who founded Corengi, a site that helps patients find appropriate clinical trials, it was when his son was born with congenital diaphragmatic hernia, causing his spleen and small intestines to be misplaced in his chest cavity. Luce searched hard for clinical trials involving prenatal surgery, which were extremely limited at the time (which ultimately wasn’t needed; his son is fine now). Later, his mother developed breast cancer, and was enrolled in a clinical trial for a surgical technique that’s now the care standard.

Luce had advantages in doing his search; he was trained as a chemist and his wife is nurse, and he was able to call his mother’s doctor and ask detailed questions. But going through the process, he realized that finding a clinical trial online can be tough for those not in the medical professions.

Clinicaltrials.gov was really designed for researchers and healthcare people. Fundamentally, it’s almost impossible for a patient to navigate that website and find a trial that’s good for them. You would have to understand some pretty advanced medical stuff to understand which trials are right for you,” Luce says. For example, a search might turn up a number of potential trials, but a patient might be ruled out because of a current medication, time of diagnosis and a variety of health factors.

In response, Luce founded Corengi, an easy-to-use patient portal that helps to connect users with clinical trials based on a series of questions and, importantly, explains in lay language the risks and benefits of each trial.

“There’s a huge societal need to have a better understanding about medical research and to create opportunities for people to be participants. We don’t think of this in terms of what a researcher thinks is important, we use the lens of what is important to the patient,” Luce says.

-1The company has launched with information about trials related to type 2 diabetes, mainly because there is so much study in the area right now that trials have a hard time finding participants.

Corengi continued to accelerate through the end of 2013. They were a semifinalist of the Healthcare Innovation World Cup sponsored by Boehringer Ingelheim, received a nod from Bill Gates on a his personal blog, and have been selected by the Patients to Trials Consortium to help connect patients to clinical trials based on their EMR data.

Finding the Fun in Physical Therapy

If it’s hard for healthy people to exercise, imagine how tough it is for those who are injured or less mobile to stick to regime that involves, say, lifting your arm a certain way a dozen times at precisely the right angle.

But wait – kids do that all the time playing dance and ball games on the Wii.

Why not link the two? The Jintronix rehabilitation system uses virtual games with motion capture technology to offer therapy that’s engaging, as well as being less expensive and more easily accessible. CEO Justin Tan started the journey towards development after helping his father, who had suffered a stroke, through rehabilitation.

Screen Shot 2014-01-17 at 10.52.42 AMDaniel Schacter, co-founder, says that research so far proves what might be obvious: Patients say working out to a game on a screen is just more fun.

“They forget they’re in the human space and are immersed in the game. They do things they would not otherwise be willing to do,” he says.

The system has another big benefit: The 3-D animated visual component models and helps patients do the exercises correctly, and depth sensors measure if they do.

“It’s easy to tell what’s happening on the X/Y plane, but very hard to tell what’s going on with the D plane. For example, if the patient is raising their arm sideways and comes forward a little, that’s probably a problem with your scapula or a muscle in the front,” he says. “Now the therapist is able to more accurately diagnose problems and prescribe exercises.”

The exercises are highly customizable, even remotely, Schacter says, which helps providers challenge patients to move just a few degrees more.

Jintronix is conducting research to measure the system’s benefits and efficacy with DePaul and McGill universities, and Université de Montreal, among others. So far, tests show that patients perform the movements as well or better than if they work with a human. The company is talking with others involved in the telerehabilitation industry with the ultimate goal of introducing it to patients’ homes.

A Spoonful of Mathematical Sugar

Can clinicians tell from looking at a patient whether he or she is likely to take medications properly? If they could, it might save the healthcare system some $290 billion annually and solve one of its most vexing issues.

RxAnte uses predictive analytics to determine who might slip and when, based on variables like diagnosis, side effects and number of medications a patient is taking. Its products suggest interventions and intervals, determine which types of interventions work best for each patient, and monitor outcomes.

Since coming to market in 2011, the program has managed drug therapy for some 8 million patients through health plan and pharmacy clients. RxAnte also launched a national provider decision support pilot with Coventry Health Care (now part of Aetna) giving nearly 600 physician practices nationwide tools to facilitate better medication outcomes. In December, the company was acquired by Millennium Laboratories of San Diego.

“Our two companies are teaming up to address the overuse, misuse, and underuse of prescription medications, problems which deprive millions of patients the benefits of effective therapy and cost the health care system hundreds of billions of dollars each year,” says Aaron McKethan, Sr. Vice President at RxAnte.

Catalyst is a regular blog series highlighting innovation in health and medicine and focusing on companies represented in the TEDMED Hive. Click here for previous posts.