Since 2010, doctors from UCLA and the University of Michigan have been working with Ironwood Pharmaceuticals on a project called MyGiHealth, which leverages computers and apps to improve doctor-patient communication around gastrointestinal disorders. At an ePharma Summit update session, Dr. Brennan Spiegel, a gastroenterologist formerly associated with UCLA and now working at Cedars-Sinai hospital, shared how the program has grown into its own company that’s getting ready to scale beyond GI health into a variety of other conditions.
“The point that I want to make from the beginning is that this app … was developed with input from social scientists, from electrical engineers, from health sciences researchers, from all walks of life, industry, academia, and even with input from the NIH,” Spiegel said. “This didn’t come from a garage in Orange County. This took four years to get where we are now.”
Spiegel pushed back against a lot of what he sees as the hype of mobile health, which isn’t reflected in actual practice.
“The clinical trenches bear almost no resemblance to what’s being talked about,” he said. “There are almost no examples of mobile health apps that are being used at scale, wearable sensors that are being used. I do not want all that information, and I’m a technophile.”
The antidote to that hype, Spiegel believes, is to zero in on the patient-doctor relationship and to address doctors’ specific pain points, like the amount of time wasted doing patient intake. One part of the MyGiHealth technology is built to address this: Patients fill out a questionnaire, and an app translates that into a history of patient illness — one so detailed and clear that in a blind test, independent reviewers and medicare billers universally found it superior to the patient history created by a doctor. Despite the headlines that followed from that study, Spiegel stressed that the app is just a tool to help doctors use their time better.
“We’re not using apps to replace doctors and we never ever will,” he said. “We need to look patients in the eye and have conversations with people and understand the deep emotional, physical, and social implications of illness and a computer cannot do that. But a computer can suport us very well. It can help us ask the right questions and it can help us spend more time talking to patients and less time clicking away at the computer that is emotionally and physically separating us.”
Since then, the spin-off company, My Total Health, has been focusing on developing a direct to consumer product that combines a similar test with targeted patient education.
“There’s a test and it tells you how you compare to other people suffering in their home with the same symptoms,” Spiegel said. “It tells you exactly where you stand compared to the general US population. And if you’re in the red zone that may be concerning. So it tells you more about that, because then you can learn about what happens. And the app will look at your unique fingerprint of symptoms and draw up a tailored application prescription.”
The applications that can be “prescribed” through the platform are different kinds of patient education apps that include interactive visual journeys through the GI tract or tutorials on how the gastrointestinal system interacts with the nervous system. “When people see this, they get butterflies,” Spiegel said.
The educational apps are just the beginning; they lead patients to other tools including self-tracking features, the ability to directly contact a GI expert, the opportunity to fill out a patient history via the app and print it out to bring into a doctor’s office, and an “eHarmony-like” functionality that matches patients in the system with others who have similar symptoms and provides them with a forum to exchange notes.
And the company has already started to expand into other health areas. In a partnership with Nestle Health Sciences, they’ve developed a My Nutrition Health app, which is designed to help people discover food intolerances and allergies. The app is actually integrated with a wearable sensor that records the sounds a user’s stomach makes during digestion and analyzes those sounds.