The Brigham and Women's Hospital, Inc.

Transforming chronic disease prevention and care through global multi-local innovation

Health care access

To scale a platform that empowers individuals to prevent or manage chronic disease in their communities and to collaborate in ongoing innovation to transform healthcare

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Project Summary

Non-communicable chronic diseases with proven solutions still kill the majority of the world’s population and reduce the productivity of many more. Overcoming the barriers of traditional medical models of care, we have created a simple ‘operating system’ that encodes core healthcare transactions in a flexible personal software system that can be deployed on a phone and supervised remotely. The system enables non-trained individuals to diagnose diseases, to decide when to start new drugs, to optimize drug doses and to monitor individuals triggering subsequent care at specific thresholds. The system has been tested and validated in one setting, but we recognize that transformative disruption in biomedicine requires organic global innovation from diverse cultures around shared transactional data from health and disease. We propose to deploy our platform in marginalized populations in the US and Africa to accelerate uniform global access to care and to unleash biomedical innovation using non-traditional medical models

Problem Statement

It is clear that even in the richest economies access to evidence-based healthcare is limited and where there is access variation in care is massive, consistently disadvantaging those at greatest risk. In parallel healthcare costs have exceeded the ability of all economies to readily afford them. The last few decades have seen dramatic advances in the development of effective treatments for patients with multiple forms of chronic disease. As our knowledge advances, so some fields in medicine have begun to move to address maintenance of wellness through changes in behavior, diet and other interventions. These innovations enable individuals to contribute to their individual communities and to participate in the global economy, only if they are available to all. The platform we have developed employs a patient-centered strategy for the seamless integration of wellness, care and discovery that directly enables individuals to take varying degrees of control in their own care, but importantly creates an operating system for core healthcare. This platform is designed to result in a level playing field where advances in our understanding of human biology are open to all for access and innovation

Solution Overview

Available evidence suggests that most eligible patients do not receive optimal prevention or medical care for common chronic non-communicable diseases. In many societies, as infectious diseases are overcome, these same chronic disorders are now the dominant sources of mortality and morbidity. In even the richest nations, new therapies take a decade to reach full clinical use. Implementation barriers include cost, perceived need for highly trained personnel and local culture. Extant knowledge suggests that almost all common chronic conditions could be algorithmically managed with great success. Combining rigorously encoded clinical transactions with all the necessary safety signals and dense coaching cues we have succeeded in using untrained navigators to deliver complex medical care virtually. This approach allows for the real-time implementation of optimal medical therapies, carefully calibrated behavioral input and a rigorous ‘learning and discovery’ component. The clinical transactions are designed to create highly reproducible data outputs-the medical equivalent of machine events creating high-volume, high information content data flows. This redesign of much of healthcare as a series of logical operators where a given set of inputs leads to a given set of outputs enables truly systematic execution of what we know already works, and allows the uniform, low-cost delivery of the right intervention, in the right person, at the right time and with the right supervision - every time. These core elements also powerfully enable the refinement of current wellness and healthcare management in real time using machine learning driven optimization and workflow innovation that can engage populations worldwide

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Project Funders

  • Novartis

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