Can big data be effectively deployed to manage disease? We look at NTD, a network of physicians who have pioneered the digitalisation of personalised healthcare.
It all began in 2003. A group of 12 neurologists and psychiatrists decided they would meet several times per year and exchange ideas, experiences and ‘best practice’ strategies. A few years later, these 12 physicians decided to extend the notion of cross-practice cooperation and coordination to a larger group of like-minded neurologists and psychiatrists. In 2008, they founded NeuroTransData (NTD).
At the first shareholders’ meeting, NTD had already encompassed 50 practices with 100 doctors. This number has steadily grown to more than 70 sites with 180 doctors and 650 nurses and assistants, treating about 600,000 patients per year in the neurological and psychiatric field. In only a decade, NTD has covered almost all regions of Germany. It has reached a size which makes the network a valued partner in epidemiological and pharmacological research, as well as the development of new and innovative treatments and digital tools.
Digitalisation and personalisation
NTD’s objective is a high standard of individual treatment for patients through the use of modern technology and treatment methods. It is a pioneer in the digitalisation of personalised healthcare, and since 2008 has managed a database compiling data on bipolar disorders, dementia, epilepsy, migraines, multiple sclerosis (MS), Parkinson’s disease and motor disorders, and schizophrenia. The main focus is the MS database, in which 22,000 MS patients are currently being recorded over an average observation period of five years.
What resulted was the comprehensive digital platform, DESTINY® – a database-assisted therapy decision support system – which is a pioneering concept for the outpatient neurological sector via the inclusion of various IT components. Through the active involvement of physicians and patients in DESTINY®, the individualised treatment of patients with the assistance of personalised healthcare at practices in the NeuroTransData network is already a reality.
DESTINY® is unique in that it offers physicians and patients an integrated system that promotes networking and communication between both parties as partners, with the patient actively involved in the treatment process. It helps to achieve significant improvement and acceleration of treatment outcomes and optimises adherence and compliance. In turn, this can lead to substantial cost reductions – fewer hospital admissions, physician visits and days of incapacity for work, lower medical costs.
“This patient portal is like a direct channel between doctor and patient. I can see my patient’s status at first glance, and so does the patient. This is a really valuable tool for visits and discussions with the patient,” says Dr Andreas Peikert, neurologist at Neurologicum Bremen.
The accumulation of data, in turn, can enable a better understanding of the disease and its effects.
PHREND is your friend
One of the key modules in DESTINY® is the predictive model PHREND – short for ‘predictive healthcare with real-world evidence for neurological disorders’ – for Multiple Sclerosis (MS). PHREND makes it possible to locate the most suitable MS medication for an individual patient and predict disease progression under a specific treatment. Working with an experienced team of mathematicians and statisticians from PricewaterhouseCoopers (PwC) AG, Switzerland, a unique algorithm was developed that can use past data from the NTD database to calculate how, in all likelihood, the disease will develop in a specific patient under the influence of various treatments.
To obtain this type of prognosis, the physician first enters the patient data, such as gender, month and year of birth, date of MS diagnosis, current treatment, any previous treatments, current EDSS value, date of the last relapse and the number of relapses in the previous twelve months. The software uses the data to create a graphic, showing the degree of probability of the patient remaining relapse- and progression-free under a particular medication for a set period of two to four years. Physician and patient, therefore, receive an independent qualified second opinion that they can discuss together.
In addition to the clinical data, important factors and preferences for the individual patient are taken into consideration in the treatment decision-making process. Ideally, there will be up to two or three treatment options from which doctor and patient can choose. The physician also has the option of printing out the result or emailing it to the patient so that they can think about again quietly at home.
The system makes it possible for a genuine partnership to be enabled. It not only improves the relationship between physician and patient but also has an impact on the success of the chosen treatment by increasing treatment compliance.
As Prof. Dr Stefan Braune, neurologist at Neurozentrum Prien and professor for neurology at the Technical University of Munich, says: “The name says it all. PHREND is a friend and helper for the doctor and patient, taking shared-decision making to a new level.”
The future of medical practice
The existing healthcare market is a crowded field of digital experiments. However, most are limited to single areas of use. A real patient management system containing the complete patient journey in an outpatient setting does not exist in the market. As a result of its innovative features, DESTINY® enters an open field in the outpatient sector and provides a unique solution that doctors cannot find elsewhere.
In contrast to other solutions, DESTINY® also has high usability and practicability and can be easily integrated into the day-to-day work of doctors. It also offers high-quality medical content because of the knowledge pool and expertise of the medical professionals contributing to the system’s development.
NTD has set an ambitious goal of providing high-quality, individualised treatment for patients using modern technologies and treatment methods. Its technological innovations mean it will cement its reputation for excellence in the field of neurology and digital healthcare solutions and also create an entirely new model of patient care.
“As a treating physician, I am always up-to-date as regards my patients. The patients, in turn, are much more involved in their treatment; they can adhere to therapy plans much easier and control their success. This way, patient care is significantly improved and optimised,” Dr Monika Körwer, neurologist and psychiatrist at NeuroCentrum Grevenbroich, explains.
Physicians often talk about patient partnerships, but reality often falls short. DESTINY® provides the platform for real patient participation in their treatment, increasing compliance, personal control and ensuring better treatment outcomes.
And the innovation does not stop there – due to its modular construction, the system can easily be extended to cover other indications and areas of application. DESTINY® is also suited for integration into healthcare systems of other countries.
In a digitalised healthcare environment, all stakeholders will be connected via systems like DESTINY®, from relatives and caregivers to pharmacies and hospitals. New models like value-based payment, individual therapy management and teleconsultations will mark the new standard of care. NTD ambition is to be on the forefront of this digital healthcare revolution.
