DURHAM – Non-adherence and readmissions are among the most expensive challenges facing the healthcare sector today. Many institutions are working to curb these costs with a direct solution—connecting with patients remotely and empowering them to use technology to improve their care at home.
This has created an opportune market for emerging telemedicine and mobile health platforms. Increasingly, these services are showing high rates of adoption by healthcare providers, both large and small.
Durham mobile health startup Pattern Health has spent the past five years building, testing and implementing this model in both clinical and research settings.
With its platform, providers can monitor medication and treatment adherence and improvement metrics for the patterns of care customized for the patient and their circumstances. The app keeps patients engaged with challenges, quizzes and educational content. It also has a secure chat so providers can contact patients directly.
The startup has primarily focused on two specific areas of care—cardiovascular and orthopedic health. The software is used among patients with conditions such as heart failure and hypertension, as well as joint replacement and chronic joint pain.
Through testing, Pattern Health was able to prove its effectiveness, increasing adherence by 15 percent for these conditions.
The system is live in 85 healthcare sites with over 16,000 active monthly users. In addition to having strategic backing from Duke University, Pattern Health has partnerships at UNC and has expanded to the New York City area, with partners at Columbia University and New York University. It has also partnered with Duke’s Clinical Research Institute for a patient quality improvement trial studying the effectiveness of mobile apps.
The startup’s long-term active research partner is Duke’s Center for Advanced Hindsight. Together, they’re examining the connections between patient behavior and healthcare effectiveness using technology.
Pattern Health is also being used in research settings, currently participating in 10 projects. The researchers use the platform to help execute clinical trials, customizing the experience for the particular research area, which ranges from HIV to heart failure to cancer.
Though the main focus has been on cardiovascular and orthopedic applications, the platform will be branching out into more specialties soon as it further proves its effectiveness to engage with patients.
Back story: Designing a model and proving the concept
Pattern Health CEO and Founder Ed Barber said the motivation behind Pattern Health stems from his own experience with type 1 diabetes, a condition he was diagnosed with when he was five years old.
It was through this experience that Barber says he gathered insight on how patients communicate, and how providers can better engage them in the process of treatment.
Barber has a professional background in technology, with a particular focus on mobile platforms. He previously held a role as VP of Provider Services at Durham startup TouchCare, a digital assistant that serves as a sort of consumer guide to healthcare costs and benefits. The startup recently pivoted from telemedicine to healthcare advocacy.
Prior to that, Barber worked at Appia, helping build the carrier app store business and leading partner implementations. He also helped with integrations and optimization for publishers in the company’s ad channels.
Ed Barber is the founder and CEO of Durham telehealth startup Pattern Health. Photo courtesy of Ed Barber
In 2013, Barber decided to start a venture of his own to find solutions to the challenges surrounding patient engagement. Barber said there were other companies in this market at the time, but he and his team felt they weren’t addressing the core challenges of getting patients to adhere to their treatments.
“The speed of innovation in healthcare can be a challenge,” Barber added. “Failing forward and quickly learning and iterating is hard to do, so we’ve been focusing on having leading specialists join as fast as possible on the platform working on care pattern.”
Cardiovascular care and orthopedics are two specialties that show promise for improving patient engagement and empowering patients to take charge of their conditions. For instance, patients are more likely to reach their target blood pressure if they’re using digital tools at home to help them achieve their goals.
At the same time, cardiovascular and orthopedic conditions are among the most expensive conditions to treat, according to statistics studying hospital stays. Heart-related conditions are particularly expensive, with the most costly conditions including cardiac and circulatory congenital anomalies, heart valve disorders, aortic, peripheral and visceral artery aneurysms, and coronary atherosclerosis.
Pattern Health developed its own mobile solutions to apply the model of mobile health to these areas.
HeartStar BP Monitor, an iOS app, helps customers monitor and track their blood pressure. They can enter readings from their meter device, set reminders for themselves, create goals, earn points, visualize their historical recordings and get feedback on their progress.
Pattern Health’s HeartStar app helps patients monitor and manage their blood pressure. Copyright: Pattern Health
And recently, Pattern Health partnered with Anil Kishin Gehi, MD, an associate professor and clinician in the UNC Atrial Fibrillation Network to launch UNC AFib Assistant, a mobile app that helps patients manage their condition, providing the correct education and care to patients to drive down unnecessary hospitalizations and improve the effectiveness of care.
In addition to its primary focus on orthopedics and cardiovascular care, Pattern Health is currently setting plans to venture into HIV research and branch out to include more specialties as it grows.
Barber says announcements of future expansions to other health systems will be made later this year.
Studying links between health outcomes & human behavior
The concept behind Pattern Health is based on the proven idea that patients are more likely to be successful in managing their health if they are empowered to to do so.
Barber says certain types of patients are naturally more willing to opt in to their own care plans. But the target for Pattern Health is to meet the needs of patients that are not likely to continue their own health plans outside of their doctor’s office.
“Just because a patient knows what to do, doesn’t mean they will do it,” Barber explains. ”For instance, say you’re considering a bowl of fruit vs. doughnuts for breakfast—you know the fruit is better for you, but you might not choose the best option.”
Pattern Health promotes autonomy so patients can be empowered to make better decisions to track their health on their own.
This focus aligns with that of Duke’s Center for Advanced Hindsight, a research facility led by renowned author and behavioral economics expert Dan Ariely.
The CAH mainly studies the intersections and applications of behavior and decision-making. Pattern Health’s strategic partnership with the program is part of an expansion to areas of healthcare and adherence.
“We saw opportunities to collaborate with CAH’s research and working with specialists to identify behavioral interventions for specific conditions, since not every condition has the same types of challenges,” Barber said.
Copyright: Duke University Center for Advanced Hindsight
The research CAH tested with Pattern Health focused on medication adherence, exercise and diet.
“Health has a lot to do with behavior,” Ariely noted. “If we can improve our health-related behaviors, we can also improve our health. But it’s not enough to merely apply what’s already known from behavioral science to health.”
Ariely adds, “The Center for Advanced Hindsight, together with Pattern Health, doesn’t just apply what we already know. Instead, we’re working together to discover and advance both the fields of behavioral economics and health. Through randomized controlled trials and field studies we are trying to figure out the secret formula of using human motivation for better health.”
Adoption in healthcare facilities
Barber says he and his team have noticed that healthcare systems are slowly starting to open up to having tools to connect with their patients and identify different solutions for different patients’ needs.
But, Barber notes that the key component to any adoption is staff workflow and efficiency. Despite widespread employment growth in the healthcare industry, the labor productivity growth has fallen behind as the use of IT solutions in workflow has not been implemented across the board.
Barber says Pattern Health offers enhanced workflow by allowing doctors to easily manage the plans and patterns they want the patient to follow and be alerted to communicate through the tool if they need to.
Pattern Health also looks at self-managed use of the application to achieve better outcomes for education, not just provider-facilitated engagement.
“The core functions of the application are customized based on experience,” Barber explains. “All rules-based engines have someone on board to understand the conditions right for them; it all happens through the patterns set in the app.”
Pattern Health licenses the platforms to its partner healthcare systems based on how many patients are using it. “Depending on the type of physician and the staff, we may integrate directly with the electronic health record system,” Barber says. “We also have handouts and other registration methods to be used, whether online or in-person.”
Barber added that instead of competing with healthcare network software platforms (such as MyChartUNC and DukeMyChart), Pattern Health complements them. It’s integrated with several systems common in any healthcare network, including Epic Systems, Allscripts, Cerner, athenahealth and more. The app is also HIPAA-compliant.
Pattern Health’s future plans
The immediate goal for Pattern Health’s next phase of growth is further broadening its library of care patterns. ”We have a great catalog available now, and we expect to see it expanding as more evidence shows which ones work,” Barber says.
The plan is to offer the library to health systems and industry partners so they can distribute the plans to patients. Barber says this will allow clinicians to take a pattern and personalize it to their clinic, adding their own branding, personalized messaging and video content to patients.
Pattern Health is also looking to raise capital this year, hoping to attract strategic investors in the healthcare space. It previously raised a small seed round through Duke three years ago.
“We are well-funded through customers, but we’re looking to accelerate that growth by an opportunistic capital raise,” Barber said.
Additionally, Pattern Health intends to expand its partnership base to more players in the healthcare ecosystem, potentially reaching pharma companies and manufacturers.
“These are partnerships we’re continuing to explore going forward,” Barber added.
