Digital health and digital therapeutics are not just the providence of Silicon Valley startups these days. More traditional players like big pharma companies and academic medical centers are teaming up to create their own digital offerings.

At a HIMSS21 Pharma Forum session moderated by University of Massachusetts CRIO Dr. Adrian Zai, speakers from AstraZeneca and Mass General Brigham described one such program, the AMAZE disease management platform announced back in April, sharing some preliminary results and lessons learned from the implementation.

“These types of partnerships [between academic medical centers and pharma] have existed for a long time, however the partnership in the past has always been enacted around randomized clinical trials and drug research,” Zai said. “Now the exploration is more around how new collaboration can work in terms of the development of new digital health technologies with the goal of improving patient outcomes.”

Early results

Karan Arora, chief commercial digital officer, and global vice president at AstraZeneca, laid out some of the outcome measures the company was looking for.

“We were looking for three things,” he said. “One is adherence: Are clinicians and patients actually using it, why or why not? The second was operational efficiency. And the third was actual data: Did we drive better outcomes? Did we reduce 30-day readmissions? For asthma, did we slow the progression, and did we catch exasperations before they were admitted to the ER?”

While the partners are planning to publish later this year, they shared some preliminary results at the show.

“Adherence rates after 90 days are almost two to three times market digital platforms and I think the main reason is because they’re prescribed by the clinician and they’re integrated into the EMR. So it is really clinician-driven and that’s what drives adherence,” Arora said.

“We’re also finding that readmission rates for heart failure are almost a third of industry average, I think driven by the fact that the data is looked at by clinicians and acted upon. We’re finding 90% acceptance rates of patients wanting to stay in the commercial use of the platform.”

But the most compelling feedback, Arora said, was anecdotal, from clinicians who said the platform was helping them catch at-risk patients early.

“And they’re able to treat them remotely and improve outcomes for them,” he said. “That’s the North Star we started with, and to see that happen is amazing.”

Lessons learned

Shawn Murphy, CMIO at Mass General Brigham, said the project taught them a lot about the importance of having both gold-standard patient data from the app and EHR data – and harmonizing those two data sources.

“Putting together this virtual clinical trial platform, but also putting it together with the EHR and other kinds of data that are available is really important, because without it you lose two things,” he said. “One is, you can’t figure out who to recruit for the studies.

"The complexity of some of the enrollment criteria is so severe that just trying to find enough patients is hard. But they are there. You just have to figure out who they are. You need EHR data to figure this out. You can’t do it with claims data, and even if you could, claims data doesn’t allow you to identify the patient.

"And the second piece is enhancing the collection of the data.”

The mobile app data needs the EHR data for context, but in turn can enhance the quality of that data, Murphy said.

“In research, we crave gold-standard data, data that’s actually collected from the patients, because that tends to be much more truthful than the EHR data itself,” he said. “But you can train the EHR data to be as useful as gold-standard data if you have gold-standard data to train it on. The fact that you can put these two together and train this EHR data using gold-standard data is a huge opportunity.”

The other major lesson is, as Arora said, to create an app that creates value for both the patient and physician, so they will choose to use it, rather than having to be cajoled or coerced.

“The patient app was designed to not only offer them the PROs or the device data to be inputted, but we pulled their scheduling and drug information from the EMR, so you created a one-stop shop from an ecosystem standpoint that helped them manage their health,” he said. “And that was critical, because it drove value for them, and providing that holistic care was important for use.”

Next steps

AstraZeneca and Mass General Brigham are planning to continue with a productive partnership.

“I think we’re at the point where we’ve proved the value of the platform,” Arora said. “We should see these results come out at year end. Now we’re in the process of scaling the platform. We have some deals already signed, and we’re looking for new providers to work with.”