Hackathons: Unlocking the Code ( Clinical Innovation + Technology)

Team BreakFix was awarded $25,000 at CajunCodeFest, which took place at University of Louisiana at Lafayette in April 2013. (L-R) Bryan Sivak, CTO, HHS, Stacy Crochet, Bill Fentsermaker, Monica Suire, Amy Hanchey, Teri Leblanc, William Zhang, Michael Venable, Trent Poche, Clay Allen.

“Out of the box” innovation may very well emerge from hackathons, or code-a-thons—short-term competitions in which interdisciplinary teams of engineers, clinicians and business experts are tasked with developing apps and devices that will change health and healthcare.

Hackathons are popping up everywhere—some are sponsored by government entities like the Office of the National Coordinator for Health IT (ONC) and the White House—while others are emerging from the academic or industry scene. To get a glimpse of what’s on the horizon in healthcare innovation, we profiled four winners of recent hackathons:

CajunCodeFest 2013: Elixr (Team BreakFix)
The Innovation: Elixr is a web- and mobile-based app aimed at promoting medication adherence. The physician creates a profile and enters treatment plan information and the patient inputs who is on the care team—which includes both clinicians and family members. The app notifies the patient when it’s time to take a medication, and the individual must acknowledge it was taken. It continues to prompt the patient every five to 10 minutes until acknowledged, and if there is no acknowledgement it notifies the care team and physician.

“One of the things we sold this on is that it builds rapport with patients. It makes patients feel someone cares for them and makes them want to be more accountable,” says team member Monica Suire, who works as a project manager at Schumacher Group in Lafayette, La.—where all the BreakFix team members work.

Other features of the innovation: Pharmacies are notified if a prescription is unfilled.

The app also allows for the storage of a family’s immunization history and triggers notifications for immunizations.

The innovation is especially cutting edge because it utilizes near-field communication technology, meaning that a user can bump a sensor on the pill bottle to a mobile device. The medication, dosage and time are logged on the back end, thus the entire history of adherence is recorded for viewing and analysis.

But Team BreakFix also realized that patients could trick the device into believing adherence took place when it hadn’t, thus it also captures data on response time post-notification. “If response time is repeatedly within a few seconds, obviously you want to question it.” Also, if a patient is repeatedly silencing an acknowledgement, those data are captured. “All of these behavioral patterns we can analyze and trend,” says Suire.

Suire says this technology enables better negotiation with payers, as patients can prove they are adherent. “Pharma companies want this information, too,” she says.

Thoughts on the experience: “The one thing that surprised me is that, even with the insanity, [the hackathon] was a calm, quiet environment. It’s an opportunity to truly put innovation and creative skills to the test and see what you can come up with. We literally did everything in a 27-hour period. I honestly don’t think it would have been as successful even if it took place over two years,” says Suire, adding that she would do it again.

Future Plans: “Our team has changed structure since the competition and we are working to get our feet off the ground, further develop our product and hopefully catch the attention of interested venture capitalists,” says Suire. The group has looked at intellectual property and copyright matters and is conducting preliminary research on its marketability.

Brigham & Women’s Hospital 2013 Hackathon: RingLeader
The Innovation: With the goal to create high-quality, low-cost devices that will reduce healthcare costs while maintaining high quality of care, the RingLeader team identified cardiac stress testing as an area where technology is ready for disruption. “New accountable care organizations are actively seeking cost reduction, in a way that healthcare providers had not in the past,” says team member Anwar Hussain, a Massachusetts Institute of Technology graduate working alongside a Brigham & Women’s Hospital (BWH) cardiology fellow, a biomedical engineer and a healthcare economist.

The ring developed by the team is a 3D printed, multi-sensor, low-cost device incorporating hardware and software innovations that measures a patient’s cardiac performance during normal daily activity. By enabling patients to measure their cardiac performance, RingLeader enables particular patients to avoid undergoing a stress test. While the original prototype used pulse oximetry technology, the team is investigating other forms of testing sing additional sensors such as accelerometers to augment the device’s capabilities. The team is examining modes in which this device can be used in a home environment, allowing the greatest amount of flexibility for the user while capturing high resolution data needed by clinicians, according to Hussain.

Thoughts on the experience: It “was a mix of adrenaline, working as fast as we could on an idea; frustration, quickly changing course as one idea did not pan out (while counting down the hours left); and passionate discussions with people we met for the first time a few hours before. I think hackathons super-charge innovation in a way that allows individual experts to come together and create something phenomenal in a matter of hours,” says Hussain.

Future Plans: The team plans to validate RingLeader through additional testing. The team is interviewing leaders in medicine, technology and healthcare finance to ensure that the device meets market and consumer needs.

ONC’s Blue Button Co-Design Challenge: GenieMD
The Innovation: The GenieMD platform is a “content-rich” tool that helps patients diagnose symptoms, locate a nearby doctor, hospital or pharmacy or generally learn more about medical conditions and healthy living. The platform adds a user’s medical records using Blue Button Direct+, which the app parses and presents in an actionable way.

GenieMD allows users to create a comprehensive summary, manage treatment—including reminders for better medication adherence—and communicate with their care team and monitor the health of a loved one. Users can print out their summary or email it to their provider to save time in the physician’s office and drive the conversation in a productive way.

“We looked to make that data actionable to drive insight, and allow the user to use data every day,” says Tory Kelso, vice president of market strategy and business development at GenieMD.

GenieMD plans to integrate data with remote monitoring devices like Fitbits and scales as well, she says.

“Our goal is to empower individuals to be more active participants in their healthcare process,” she says.

Thoughts on the experience: “We were very excited about the win,” says Kelso. “With more than 40,000 medical apps out there, any sort of recognition that sets our brand above the noise in the market is exciting.”

For GenieMD, aligning with ONC’s Blue Button initiative is critical. “We want to do whatever we can to support ONC and push the message that patients should have the ability to ask for their data and use it as they see fit.”

Future Plans: GenieMD is available on iOS and Android markets. The company is working on a future release that will build in additional capabilities.

Health 2.0 San Francisco Code-a-thon: Mind Mentor
The Innovation: Mind Mentor—which team members consider a prototype at this point—features basic capabilities to trend and track a patient’s psychiatric tests and treatments (medications, psychotherapy, etc.) and correlate them with more quantifiable markers from sensors like weight, activity and amount of sleep. The team was entirely composed of Edge Interns, a California-based mentorship and professional internship program for students of healthcare technology.

Mental health often is linked to physical health (e.g., heart disease and depression and oncological outcomes and depression), thus the goal is to help bridge psychiatric treatment and medical treatment, says team member Steven Chan, MD, MBA, resident physician at the University of California, Davis.

“Mental health doesn’t have a strong presence or representation in health technology. Most of what we’ve seen addresses quantifiable numbers such as heart rate, blood pressure, medication dosages, weight, etc., but in psychiatry, we often deal with qualitative factors. What activities does the patient partake in? What social factors are there? Psychological factors? Those are not as quantifiable,” says Chan.

Thoughts on the experience: “Hackathons are a fantastic, fun way to come up with different ideas from those with a fresh perspective: those who may have an outsider’s perspective, those who don’t care (or know) about the constraints, those who even come from different industries with different experiences. What better way to spend the weekend than in the company of energetic, smart people who want to make a difference?” says Chan.

However, Chan notes that health hackathons tend to be more business focused with less emphasis on engineering, “which means here’s more ‘pitching’ than ‘hacking’… I think part of this is due to the closed nature of healthcare data and devices.”

Future Plans: Team leader Ivan Zhou, CEO and cofounder of San Francisco-based Navi, is incorporating Mind Mentor into Navi, a startup focused on mind and body health app platforms in elementary, middle and high school students. The team already has conducted trials in high school students with positive results, says Chan. “We’re already in talks with folks who want to invest in our platform.”