Innovator Spotlight Q&A Series: Jehan Alladina, MD
Q: Tell us about your innovation and the challenge(s) you were trying to solve.
JA: Asthma is a chronic respiratory disease that affects one in 12 people in the United States, about 8% of the population. Despite advances in therapies, asthma is increasing in every demographic group. In a collaboration with AstraZeneca, I partnered with Peter Moschovis, MD, MPH, and Bernard Kinane, MD, of Pediatric Pulmonary Medicine at Massachusetts General Hospital for Children, to create and validate a clinical pilot centered around digital health solutions to establish new standards of care for managing chronic illness, including asthma. The AMAZE disease management platform includes a patient mobile application and clinician dashboard designed to improve patient engagement, care-team communication, disease monitoring, and clinical outcomes in a real-world healthcare delivery paradigm.
Q: The innovation process can be long and challenging, but also rewarding. What inspired you to begin this journey?
JA: As an adult pulmonary and critical care doctor, I have seen firsthand the debilitating effects of chronic asthma on patients both in the pulmonary clinic and, unfortunately, in the intensive care unit as well. For patients with asthma, inadequate disease control can often go unrecognized and lead to asthma exacerbations, need for additional medications, emergency room visits, and hospitalizations. These experiences motivate me to create novel solutions to manage chronic illness and close gaps to deliver better patient care. Our goal is to empower patients to manage and share their own health information, provide the healthcare team with important and timely patient data outside of the clinical setting alone, and work to seamlessly integrate the platform into the clinical workflow.
Our goal is to empower patients to manage and share their own health information, provide the healthcare team with important and timely patient data outside of the clinical setting alone, and work to seamlessly integrate the platform into the clinical workflow.
Q: Please tell us about your overall experience and some of the major milestones you’ve achieved so far? What are the next steps?
JA: We completed an implementation clinical pilot from April to August 2021 and enrolled pediatric and adult asthma patients at MGH. We assessed the platform’s feasibility, along with metrics, including patient and provider engagement, system usability, and user experience, by collecting data, administering surveys, and performing interviews. We had overwhelmingly positive feedback from patients, with most patients reporting that they would recommend the AMAZE platform to another patient at MGH who has asthma. In particular, the daily log where patients tracked their symptoms, medication use, triggers, and air quality index features were rated highly by patients.
Taking into account feedback from patients, there was a strong interest in further personalizing the platform based on their baseline disease severity, triggers, and symptoms. Additional work on integrating the platform into provider workflow and creating digestible data points is further needed. A blessing and a curse in many digital health applications is the large quantity of data collected, and managing this information is crucial moving forward in the field. Finally, taking advantage of passive data collection (e.g., smart inhalers) is an exciting direction for this work in the future.
Q: What resources have been most helpful to you, and that you think other MGH innovators would benefit from?
JA: The highly collaborative approach of this project that involved clinicians, nurses, and research coordinators from both adult and pediatric pulmonary at MGH, along with members of the Center for Innovation in Digital HealthCare (CIDH), AstraZeneca, and product developers, has been invaluable. I have learned a great deal working on this project, and each collaborator provides a fresh perspective and distinct outlook on the work while all focused on the common goal of improving the care of patients with chronic illness. The expertise of CIDH in this area was instrumental in moving this multi-center collaborative project forward.
Q: What advice would you give to other innovators at MGH that you wish you had been given early in your innovation journey?
I recommend partnering with the institutional IRB office and centers with expertise, such as CIDH, early on to help navigate the regulatory process and set yourself up for success.
JA: Implementing digital health platforms has unique elements and has been quite different from other clinical pilots and trials that I worked on previously. I recommend partnering with the institutional IRB office and centers with expertise, such as CIDH, early on to help navigate the regulatory process and set yourself up for success.
A key component of patient and provider-facing digital health platforms is to notice from the beginning how the product will integrate into the existing workflow. Even with a provider dashboard integrating into the electronic health record, we still directed efforts to avoid duplication of information delivery and work. Ultimately, providers were motivated to use the platform if it was beneficial for their patients. I have found that the patient and provider buy-in is key to the process, and one of the most helpful approaches is clear communication around the mission of the product and goal to improve the burden of chronic illness.