Motion tracking remains a cutting-edge technology and it’s being adopted by a small number of digitally-savvy healthcare companies. One such company is Reflexion Health, who have introduced the technology as part of their advanced patient recovery. The system works using with the integrated assistance of a motion tracking camera and an on-screen avatar, to demonstrate proper form. The software provides audio-visual feedback for patients.
This technology allows the recovery process to take place within the patient’s own home. One key application is with assisting post-surgery patients and optimizing patient post-operative recovery. To find out more about this innovative health technology, Digital Journal spoke with Dr. Joe Smith, who is the CEO of Reflexion Health.
Digital Journal: Please explain how motion capture technology works?
Dr. Joe Smith: “Emerging technology has made it possible to use commercially available 3D camera technology to capture the human form, calculate the position of the various skeletal elements, track the motion of the various bones and joints in a number of dimensions and determine whether a specific movement fulfills specific criteria.”
DJ: How is this technology applicable to healthcare?
Smith: “We see a broad spectrum of uses of affordable motion capture and quantitative motion analysis in healthcare. One obvious application is in home-based physical therapy for patients recovering from injury or surgical repair, our first target.”
DJ: What can be revealed from the technology?
Smith: “At present, patients are typically given paper-based instructions for a set of exercises to be performed between visits. Compliance to this approach is poor based on a combination of misunderstanding of the tasks to be accomplished as well as the absence of any objective data flowing back to the clinician.”
“By providing an engaging avatar that demonstrates each motion to be achieved, providing patients audio-visual feedback about their motion, and recording each motion for off-line review by the treating clinicians, we put home-based rehabilitation on a new, more objective, more transparent footing.”
“Going beyond the initial applications, we see the ability to screen large numbers of patients for fall-risk or other conditions that might benefit from specific intervention, measure subtle changes in motion that may have additional diagnostic value, provide reproducible, objective measures that can be critical for assessing treatment effect, etc.”
Recovering in your own home
DJ: What are the advantages of rehab away from the hospital?
Smith: “Patients prefer to recover in the safety and comfort of their own homes, whenever possible. By providing a rich link between the expert, a busy clinician and the patient in their home, patients are more comfortable going directly home from acute-stay hospitals, and can avoid travel, saving time, steps and money, Additionally, improving compliance to home-based therapy can shorten overall recovery time, returning patients more quickly to the ‘game of life.’”
DJ: How have patients reacted to the technology?
Smith: “We routinely survey patients for their feedback using net promotor scores (NPS). At values in the high 80s and low 90’s, patients appear to like our Virtual Exercise Rehabilitation Assistant (VERATM) more than AppleTM products. Some anthropomorphize VERA, and tell us they don’t want to let her down, others tell us that with the camera, they believe their clinicians are watching them, still others appreciate the fact that they save themselves some travel to their PT’s office, with co-pays and parking fees.”
“We even have anecdotes of patients switching surgeons so they can get VERA’s help for their recovery. The feedback from the patients has been inspiring for all of those working here at Reflexion Health.”
Positive responses to telemedicine
DJ: What has been the interest from the medical profession?
Smith: “We conducted blinded interviews early on, and surgeons, therapists and directors of rehabilitation all loved it. In use, all continue to see the value, though therapists sometimes ask whether VERA is meant to replace them. Of course this isn’t the case, or even the ultimate goal, but it’s an understandable question. As an adjunct that provides engagement, education, motivation, objective documentation, and a telemedicine link between clinician and patient, everyone can see the value.”
DJ: Has the technology been reported to any journal or presented to conferences?
Smith: “Reflexion Health has been published in the International Journal of Physical Medicine & Rehab and JMIR for fall prevention. We also present regularly at the American Academy of Orthopaedic Surgeons (AAOS) annual meeting, the American Academy of Hip and Knee Surgeons (AAHKS) annual meeting, and the Healthcare Information and Management Systems Society conference (HIMSS).”
“This week, our chief clinical officer, Anang Choski, is at the Telemedicine and Telehealth Service Provider Showcase for a poster presentation on showcasing the effects of a telerehab system on adherence and patient satisfaction.”
“Additionally, we are concluding a large, randomized controlled trial with the Duke Clinician Research Institute. This trial, the first of its kind comparing standard of care with virtual rehabilitation for patients undergoing knee replacement, is due to be completed in Q1 of 2018.”
Development and security
DJ: What were the main obstacles with developing the technology?
Smith: “Developing the technology has involved an interesting mix of talented professionals, from game developers, to artists, to user-interface experts, to software engineers, to regulatory and reimbursement professionals. Getting the culture right for all of these professional to function at the top of their game has been crucial to our success.”
DJ: Are there any data security concerns with the use of the technology?
Smith: “We have gone to some lengths to assure data security, including developing our own proprietary approach to encoding recorded information even before it is stored to disk. And of course, we have performed the traditional penetration testing to help assure our systems are secure.”
DJ: What has the take up been to date? How do you see the market share developing?
Smith: “Healthcare payment reform has been a potent driver of uptake. As payors look to control costs while measuring and improving outcomes, they welcome an approach such as ours that provides additional visibility into patient recovery without requiring office- or home-visits.”
For those interested in using digital health technology, we asked Dr. Smith about his career.
DJ: Dr. Smith, please can you explain a little about your background and career to date.
Smith: “With training as an engineer (Johns Hopkins and MIT) and as a physician (Harvard Medical School), I have understandably enjoyed a career at the intersection of healthcare and technology. From developing algorithms to identify patients at risk of sudden death, to refining procedures for mapping and curing of cardiac arrhythmias, to treating patients with complex heart problems, to moving hearts and minds of policy makers in DC, to designing and conducting clinical trials of innovative technology, to using capital market tools to advance innovation, I have loved, and sought to focus, the energy at the interface of engineering, technology, and medicine to make a positive difference.”
Future digital health innovations
DJ: What other projects are you working on?
Smith: “We have just acquired a sister-company, Constant Therapy, renamed The Learning Corp, that focuses on home-based rehabilitation for patients in need of Speech, Language and Cognitive Therapy. We see an enormous opportunity to improve outcomes at lower costs by providing patients tools to continue and even accelerate their recovery from home.”
DJ: What other developments in healthcare technology interest you?
Smith: “Artificial intelligence, or computer-assisted decision support needs to come on-line. The need has been obvious for a long time, as the pace of relevant information creation vastly exceeds the bandwidth of even my superhuman clinician colleagues.”
Dr. Joe Smith, CEO of Reflexion Health, develops motion tracking technology to optimize patient post-operative recovery.
