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Dan Housman: Welcome to another episode of the novel cohort podcast. Today, we have with us Eamonn Costello. He is the Co-founder and CEO of patientMpower. Thank you, Eamonn for talking with us today.

Dan Housman: So Eamonn, tell me a bit about your background and why you built patientMpower?

Eamonn Costello: I’m kind of a techie, no real healthcare experience. I worked in a variety of R&D and sales roles, initially in telecommunications & then in e-commerce. How I got interested in healthcare?  I suppose, like a lot of people through personal circumstance. A family member was going through pretty difficult healthcare encounter. And I just felt that the transition from hospital facility to self-managing at home just didn’t exist. So, that’s where my initial ideas and thoughts came about from. But I had a friend working in healthcare. So, over the course of some discussions, I agreed to join up with him. And he was a co-founder originally, and that was about six years ago. The initial idea was around pitching into some of the hospitals and helping them put together some frameworks and applications. The idea was to help their patients in managing better care at home and transitioning from acute care to long-term chronic disease management.

Dan Housman: Great. So, what is patientMpower now and how does the system work?

Eamonn Costello: So patientMpower today is very much a specialist, chronic disease management platform in kidney and lung disease. And probably, we’re having more traction in lung disease at the moment. What it is today? So as an example, a customer of ours would be NYU Langone Health. Their lung transplant centre uses our platform in their post discharge process. So when a patient has a lung transplant, before they leave the hospital, they’ll be prescribed an app with connected medical devices. And they will use that at home at prescribed intervals by the healthcare team. The healthcare team can monitor them remotely. So, during the pre COVID-19 times, such applications were able to cut down their number of patient visits into the hospital by 67%. That percentage is much higher now, but it allows them to safely monitor their patients from home. And in fact, NYU had detected early signals of COVID-19 in some of their lung transplant patients through remote monitoring. Subsequently, two of them, did get confirmed positive, and were intervened early and treated successfully. So the connected devices ranges from connected spirometry, oximetry, blood pressure waves and temperature.

Dan Housman: Yeah! So you are collecting a lot of advanced data. What types of data do you end up within the system overall?

Eamonn Costello: So it would be objective data types including lung function, oxygen saturation, blood pressure waves. Then a lot of subjective and geo data. So, patient reported outcome measures and scales, things like the EQ5D, mMRC, it’s a scale that’s used to by pulmonologist for levels of breathlessness of patients. Then, the activity data including the steps counting from phones or from fit bits. We pull in step count data which can be assigned. We’ve done some interesting research looking at that as a correlation for general quality of life. We also pull in data such as altitude, like the oxygen saturation. The context of knowing where you are exercising and how much above sea level you are is important when you look at a data like that. So we try and make the data as contextual and relevant as possible.

 

Dan Housman: And what’s the scale of the data? Is it all US? Is it international? What’s the sort of deployment?

Eamonn Costello: Yeah, it’s a mix. So we’ve got customers in the UK, the US and Ireland. We’re just starting to do some work in Germany and continental Europe. But yeah, it’s a real mix across these regions.

Dan Housman: And it seems well suited to help with COVID-19. Have you put specific programs in place for COVID-19?

Eamonn Costello: Yeah. So in February, I suppose as we all start to see the news feel like, this was becoming a clear and present danger to all of us. Our Chief Scientific Officer was the first to have the idea that we should repurpose what we had already for respiratory disease. As it being a respiratory virus. We looked at the WHO final reports on their mission to China. They laid out clear categories of the disease including mild, moderate, severe & critical. And then a couple of objective markers for each stage of the disease. Oxygen saturation was one of those and that’s a variable marker that we could already use, or could already monitor with a Bluetooth device into our platform. So, we said about creating a COVID specific solution. We pitched it into the Irish health service, which is a public health service system, predominantly here in Ireland. Yeah, we were successful. So we went over that in March, it was deployed across 20 hospitals and industry. Kind of wave of COVID-19 that we had in April, May, March & April. Thousands of patients were managed with that solution. Predominantly, those that were severely or critically ill in the hospital and were discharged earlier than they would otherwise have been. So, it saved significant number of bed days in the hospital. More recently that we’ve also been deployed with Mount Sinai in the New York. So we’re part of their COVID-19 discharge and recovery program as well. So we’ve got a lot of the long term patients who were in the hospital and are being discharged with remote monitoring using our platform. And that’s kind of data is fed back into the, the clinical team at Mount Sinai for triage. So, yeah, those are the two main areas that our platform has been using COVID-19 so far.

Dan Housman: And so changing gears a bit to the research use cases. I mean, have you thought through what kind of research applications or talked to life sciences companies about research applications of the data you’re collecting and the tools you’ve put in place?

Eamonn Costello: Not specifically, we’ve talked with the pulmonologist in those various hospitals. We’re very much in Europe. We’re a data processor and in case of Mount Sinai in the US we’re business associates. So that’s where we’re having discussions with those parties who control the data around the possibilities and research. And this is definitely an interest and an appetite around doing research in this area. And what we want to be is helping them, you know, facilitate research and better understanding into the disease.

Dan Housman: And are there certain applications you think that makes sense like trial recruitment and virtual studies? Any specific kinds of analyses that have you been thinking about?

Eamonn Costello: So we haven’t looked at trial recruitment. But definitely virtual studies, understanding the demographics and long-term quality of life of patients. So what we are seeing is, some patients get over the acute phase of COVID-19. But, there are many patients who are left with a heavy long-term symptom burden. And I think, there is a need for doing a lot of long term research into patients that don’t recover from COVID-19 quickly.

Dan Housman: Interesting. Have you seen any specific obstacles in progressing the research side of what you’re doing? And are you doing things to move things ahead?

Eamonn Costello: I suppose from our perspective, one of the obstacles is, you know, we are business associate and data processors. We are not the owners of the data. So I suppose it’s not within our remit to progress. It’s really up to the hospital systems that we’re working for. So we’re providing them a service for collecting that data. We’re making ourselves available to help without research. But, ultimately in terms of progressing, that’s really in their chords to progress research agenda.

Dan Housman: And are you working to build relationships with the patients at all for getting consent or direct interest in participating research?

Eamonn Costello: So as part of that, enrolling them into the platform. We are capturing electronic consent for using the application. Then, there is capture of a secondary consent for research purposes. So, we’re engaging with the patient in that regard. But again, as the processor of the data. In general, historically in our work, we would always have gone direct to patient groups ourselves. For example, we haven’t had the opportunity in COVID-19. You know, it’s obviously wasn’t any patient groups, but I am aware now that there’s patient groups being set up online now. Talk to those patient groups that are now being created who are dealing with that longer term symptom burden.

Dan Housman: Excellent. And what’s your vision for the future, say five years in terms of especially Patient centred research? And what do you think is big changes are coming based on what you’re seeing today?

Eamonn Costello: So I think the one big change is remote monitoring and collection of data, either for care delivery or for research. It’s arrived, a lot of people were hesitant about us three, four months ago. But, there is no option other than to do that now. So I think that’s one major transformation that is now happening. And I think that will drive a lot of efficiency in both care delivery and clinical research. For example, we’ve done a lot of work in validating, the accuracy of home spirometry. And in a lot of pulmonary research, the data points from the pulmonary function tests will be the key endpoints in those studies. And more studies have primarily being built around clinical capture of that data. Now, with so many studies, I think, people designing studies need to think of collecting that data remotely from patients in their own home. That’s going to be better for the patient as well. They can participate in clinical research much more easily if they can do it from inside their own home.

Dan Housman: And I’m curious what what’s going to be the role of the physician in this future state? Will there be physicians that don’t work at a centre? Will work in some national group of pulmonologists? What will it look like?

Eamonn Costello: So, you know, I think the role of the pulmonologist will still be as vital as ever. But yeah, I think a lot of it could be done more remotely. And the one thing with this type of data is, they won’t have the need to see the patient as often in person. But they still will have the need to see the patient in person. So where the data trend that lung function is showing a sign of an exacerbation, they will want to see that patient and bring them in. So I think in person visits are here to stay. But really, it’s about, deciding which patients you need to see and deciding the priority. Those that aren’t as urgent where maybe their data is stable, virtual visits are sufficient. But making sure that they have the telemetry, lung function and oxygen saturation data to really understand how they’re doing. In addition to the quality of life questions, I think in person still important, but it’s going to be more selective

 

Dan Housman: Great. Well, is there anything else you want to talk about? I know, we’re sort of at the end of this podcast.

Eamonn Costello: No, I think, you know, it’s obviously been a really difficult time for everyone. I always try and look at the positive and a lot of good things in terms of how healthcare is delivered. I think it’s going to come from this. It’s going to be more patient centred. I firmly believe we’ll be able to get more care delivered to their own home, and that has to be good for patients.

Dan Housman: Great. Well, thanks, Eamonn Costello. Thanks for participating with us, and hopefully we’ll be talking again as partners working together on some cool projects.

Eamonn Costello: Sounds good. Thanks, Dan.