@Point of Care is a new mobile, clinical decision-making tool that physicians can use to analyze symptom tracking data from patients at the point of care. The platform also has 14 patient-facing apps for various chronic conditions that allow patients to track their health information in between office visits. Together they provide a streamlined, mobile solution for clinicians to obtain content when it is needed to improve outcomes and potentially offer better care. With 200,000 clinicians already using the platform, PM360 spoke with @Point of Care founder Bob Stern to get an insider’s look at the new platform, discuss how disease tracking apps are impacting healthcare and the various opportunities for pharma and med devices companies.
PM360: Why did you decide to create this platform in the first place?
Bob Stern: A couple of things happened that made us feel this was a good time to enter this area. One was Projects In Knowledge, which is the parent company of @Point of Care, has been in the medical information and reference business for over 30 years. And through that time, we’ve established a very large pool of physicians that subscribe to our various services. And one of the services is a product called Living Medical Textbook, which focuses on 14 chronic conditions and 14 verticals. However, we discovered that while it’s great for physicians to have this textbook, most people know that they get updated every five or six years and are quickly out of date.
So the notion was: Could we take a medical textbook and update it every day if necessary with new information? And that’s what we did. But then talking to our clinicians, we discovered that one of the challenges they face is patients who bring in apps that they’ve downloaded for tracking diabetes—or other chronic conditions—and physicians were opposed to looking at them because they didn’t know what the quality of the data was. They didn’t really understand where it was coming from and how it was being presented. It was sort of a mish mosh.
It was basically back to the days of maybe 10 years ago when patients started bringing in clippings from The New York Times and Wall Street Journal, and the physicians were caught off guard with new developments and new information that they hadn’t been able to keep up with in their medical journals. So likewise, this situation with apps caught them off guard. So we went back to our physician subscriber base in the Living Medical Textbook, and asked, “What if we were able to pull together the Living Medical Textbook and integrate it with patient apps so that you were sure of what you were getting—and then able use our clinical reference tool to explore any potential treatment changes?”
What kind of feedback did you get back from doctors on that question?
We learned that doctors, in addition to being concerned about the information they were getting from patient apps, didn’t want to get emails from patients. There were two main reasons: 1) They’re not getting paid to look at emails, so that adds an extra work burden. 2) They didn’t want a malpractice issue to arise due to a patient emailing them at 3:00 in the morning expecting a quick answer for what could be a major medical issue.
Meanwhile, physicians also expressed concern about having the time to review additional data coming in from these apps for each individual patient.
So we decided to create a unified platform that could port the information patients bring in on various apps, and allow doctors to review it when they’re seeing the patient. That way this was all being done in the clinical setting when the doctor is already seeing the patient, when they’re getting paid and when they want to get this data.
How many apps work within this platform?
The @Point of Care product is really two different facing products. One is the physician-facing clinical reference tool I just described, and the other is a patient app available in 14 chronic conditions—including, diabetes, COPD, Parkinson’s, multiple sclerosis and a variety of oncology conditions—that essentially records patient input and data from biometric devices and tracks everything that’s been going on with the patient since the last office visit. So when the physician comes in and says, “How have you been since I’ve seen you last,” the patient can now synch their info in real time to the clinical reference tool. In about 30 seconds the physician can very quickly see what’s been happening with the patient.
To this point, the patient has been dark to the physician between visits. Most patients only report what’s happened over the last 24 to 36 hours when they actually see the doctor—but the doctor would love to know what’s been going on in the three, four, five, six months since they saw them last.
You said you currently have 14 patient-facing apps. Are there plans to create more for different areas?
Yes, the plan is to become more niche in terms of the oncology areas that we’re not covering, and that’s sort of where the next group of apps will be coming from. So right now we have multiple myeloma, breast cancer, women’s health oncology, and we’re going to get more niche into those areas. We’re also want to expand our cardiovascular offering considerably.
How are you encouraging patients to use these apps?
We’re beginning to partner with associations like the Multiple Sclerosis Association of America, which has a large membership, 17,000 of which are already using a mobile app that they produced. We worked with them to enhance their capabilities, including the synchronization capability, and are beginning to on board these 17,000 patients over to either their primary care physician or their neurologist, depending on who is taking care of them. That’s the mode that we’re going right now. It’s easier for us to work with associations who have large groups that already have an interest in what they’re doing in their disease. Having said that, we’re in the iTunes store as well.
In terms of patients tracking their own data, is that just being done by manually inputting the info or are you taking advantage of say the iPhone’s accelerometer as well?
We have a very easy manual process, but we don’t ask them to type in anything. There’s a series of pull down menus, so they can quickly input new information. But in addition to that, we’re up to about 106 different biometric devices that can get pulled into our device. We’re also device agnostic, so no matter if they’re using something to monitor insulin for diabetes or wearing a device to measure their movements, we want to be able to pull in anything that has Bluetooth or wireless.
Do you think Apple’s recent announcement about their new Health app and HealthKit platform will affect you?
I think that’s great for us because as I said, we’re device agnostic. If they actually do this right and are able to attract an audience, we expect to be able to work with them. We are Apple developers—we’re Android developers as well—but as Apple developers we have already work very close with them on what we’re doing right now, so we expect this to enhance what we’re doing and not diminish it.
Most of our readers are with pharma or med device manufacturers. What are their opportunities to work with you?
First, on the analytics side we are talking to a lot of pharma and med device companies who are interested in this unique area that we’re in—being able to contextualize the patient and the doctor in how both are reacting to the display of the information that the patient is porting over. Let me add that obviously these are all de-identified, aggregated information—there’s no personal information being transmitted.
We gather every piece of information that the patient inputs, including whether there are drug or treatment modality changes. We also measure longitudinally how they’re doing on these drugs and devices. On the physician side, we can track what doctors look up on our clinical reference tool. So if they change the treatment based on a paper that they’ve read, a clinical trial or new drug information, for instance, we can tell you that. While we can’t obviously tell you exactly what they’re thinking when they decide to make this change, we can show what they looked at and what they did with the patient afterward that would correlate to a change or pivot in the treatment.
On the other side, we also make patient education materials available for industry to supply to the physician. So if a patient is on a certain drug or treatment, the physician would have a library of information that they can port over to them. They can also port over coupons and other information that the physician would curate and be able to send to the appropriate patient.
What about sponsorship opportunities for any of your patient-facing apps?
Absolutely, some have talked to us about how patient apps get a mixed review when produced by pharma, and they want to know if we would be willing to look at the app, perhaps even take it over and make suggestions on how it can be made to feel less like an industry sponsored app and more like something that’s a useful tool for the patient. A lot of pharma companies are realizing that the patient apps have not been the most successful tools, and that is because they’ve been made in a very one-sided manner.
You have been in the industry for a long time, and you’ve been an entrepreneur in a few areas. So this isn’t the first time you have seen a new trend and new technology emerging that can help people in the industry. I am wondering if you have any general advice for pharma or med device companies who want to take advantage of a growing trend like this and partner with an emerging player in the space.
I see this all the time. Right now the industry is bombarded with new startups that have a very small niche solution to a very small part of a problem. There is just no way that clinicians or patients are going to have 20 or 30 apps on their phone that can only address one small niche. And I think one of the issues that we’re going through now: A digital bubble.
It is a bubble of too many apps and solutions that are so niche that they’re almost irrelevant, but yet it’s a new shiny object and people buy into it at first, but it doesn’t really answer the total problem for either the patient or the physician. That’s why we’ve taken the platform approach. In fact, a number of niche players like the ones that I’ve just described contact us to see if they can be a part of our platform—because they know that it won’t last as a standalone tool.
What’s going to happen is our company or other platforms are going to get the opportunity to absorb some of these useful niche areas or niche businesses, while others will just disappear. They waste good money, $2 or $3 million, and they burn through it so fast without having a next step in mind beyond developing the cool new thing. Eventually, pharma is going to see that they really need to play in a platform marketplace at the point of care not in an app marketplace.