2014 has been a banner year for Natalie Hodges and Brandi Harless of Personal Medicine Plus. The duo graduated from Xlerate Health, gave 45 59-second pitches at Cleveland Clinic’s Innovation conference, recruited 30 doctors for their Physician Pioneer program, joined Startup Health and presented at the mHealth Summit 2014. They will be making a trip to JP Morgan’s big healthcare conference in January.
Harless (CEO) and Hodge (CMO) want to help people on Medicaid avoid diabetes. Hodge is a pediatrician who sees pre-diabetic patients every day. Harless ran a free clinic and led the project that transformed it into federally qualified health center in Paducah, KY, where the company is based. They understand the challenges of rural health firsthand.
Along with the company’s CTO Jay Campbell, the two have built an app to take on both challenges: pre-diabetes and access to care in a rural community. Hodge said that the app idea was sparked by a patient’s request to check in every day.
“When a primary care doctor diagnoses a patient with pre-diabetes, she often can’t see them back for a year and in that time, 30% of patients progress to full-blown diabetes,” she said. “This app creates a feedback loop within people’s daily lives without them having to go to a hospital.”
Paducah is a town of about 25,000 people on the Ohio River at the western edge of the state. Hodge and Harliss understand firsthand the challenge of getting people on Medicaid with limited resources to use a digital health app.
“Some people don’t even have a permanent residence, or a bank account or an iTunes account,” she said. “So getting a digital intervention on a phone is very different from consumer health.”
Hodge said that it’s the social dynamic between doctors and patients that makes digital health interventions work.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
“You could be selling this to a payer or a health system, but at the end of the day, digital health can be most effective if providers are recommending it as a digital therapeutic,” she said.
She has been following Dr. Joseph Kvedar’s work with apps and patients.
“A key in his research has been accountability, he has found that patients will use the tools because they didn’t want to disappoint their doctors,” Hodge said.
She said that doctors are ready now to start using these digital interventions with patients.
“Even a year ago, people would have said, ‘The pedometer is not accurate, what’s the security, or people don’t have these phones?'” Hodge said. “We can answer all of those questions now.”
Hodge said that many patients want to do something to take care of themselves, and the app provides that daily, direct feedback. The app is based on the NIH diabetes prevention program. The app includes text messaging with a doctor and tracks these six data points:
- Weight
- Blood pressure
- Blood sugar
- Fruit and vegetable consumption
- Water
- Steps
The pedometer is built into the app and runs in the background. A doctor can pick and choose which metrics to track and give a patient the appropriate bluetooth devices as well. Personal Medicine Plus will charge between $5 and $10 per patient per month. There are about 68 million people enrolled in Medicaid around the country and Hodge estimates that there are 22 million people who can benefit from this app.
Hodge’s current focus is the company’s pioneer program. It is free for doctors and includes a software coupon code for patients as well as cards and explainer videos to promote the program in physician offices. Some of the pioneer doctors have been using medical assistants to introduce the app to patients.
“They are having them sit with the patient and get the app on the phone,” she said. “One OB has a full-time gestational diabetes nurse who will do this and make sure the app is woven into the patient educational environment.”
Since this summer, about 30 doctors have signed up, mostly primary care physicians, family practices and internal medicine docs. About a third of the pioneers are outcomes researchers.
The goal is to recruit 100 pioneers in the next few months and to launch more pilot programs with health systems.
Personal Medicine Plus is also working with athena health to be able to identify and contact all the people with pre-diabetes in the company’s patient population.
“They need to make changes to their API before we can do that, and they are hiring people to do this work,” Hodge said. “Tt’s in their vision to expand the API to do population health.”
Harless will be working on a fund raise next quarter. Hodge said that this will be a seed round or an angel round. She wants to focus on the pilot programs with health systems for now as a way to keep money as well as insights about the app coming in.
Hodge is speaking on “Reaching and Engaging the Disconnected” at the mHealth conference in Washington DC today at 2:30 PM.
