MindMaze receives FDA clearance to bring VR rehab platform to the US

Swiss neurogaming company MindMaze has received FDA clearance for its MindMotion Pro platform, a motion capture system similar to the Microsoft Kinect which can be used in rehabilitation of stroke and traumatic injury patients.

“In the last few years we’ve launched products at the intersection of the brain and VR,” MindMaze CEO Tej Tadi told MobiHealthNews. “What we’ve done today very specifically is talking about the MindMotion platform, which got FDA clearance. The MindMotion platform is really a hospital-based product. It’s a really early acute app usually meant to accelerate neural recovery for patients who have ended up with movement deficits.”

MindMotion Pro is designed for use in the hospital as soon as patients start their rehabilitation. For stroke victims who have lost the use of the left hand but retain the use of the right, for instance, the computer will project a virtual reality depiction of the nonfunctional left hand, which is controlled by the patient’s movement of the working right hand. This can trick the brain into kickstarting the functionality of the other hand.

“This device is the first thing they see when they come out of surgery or acute care,” Tadi said. “This is the first device that’s going to help accelerate their recovery. We have of course commercialized it in Europe and now the FDA clearance lets us bring this to the United States.”

According to Tadi, MindMotion Pro is live in about 35 facilities in Europe. It was launched there in 2013.

Tadi said that the company opted to build its own motion-tracking camera after finding that off-the-shelf units like the Kinect weren’t robust or accurate enough for clinical use.

MindMaze, which raised an impressive $100 million funding round in February, is also working on a more portable version of the product called MindMotion Go. Though it does not yet have FDA clearance, the company has completed more than 200 clinical trials on MindMotion Go, which could be used in outpatient clinics and eventually even in the home.

A third product, called Mask, received some attention when it was announced last month for its crossover value beyond the health space. Mask is a thin sensor that can be worn with a VR headset. It can detect the user’s facial expressions and map them onto an in-game avatar.

“If you go into, say, the autism spectrum or other aspects of social interactions, you can imagine a scenario where a patient is controlling something and you’re able to emote,” Tadi told MobiHealthNews. “It’s helpful in a therapeutic context, but also in a true clinical monitor for other kinds of deficits, not necessarily stroke. The Mask is designed to capture emotions either for therapeutic effect or just for consumer gameplay. It just works on both metrics.”

Ultimately, MindMaze wants to use virtual and augmented reality to treat many different neurological conditions.

“One of the things we need to do is address cognitive issues and neurodegenerative diseases,” Tadi said. “So we started with movement deficits and then we move into cognitive deficits eventually neurodegenerative deficits. So we need to become the standard of care platform that eventually brings together VR, AR, neurosciece to help accelerate recovery across a wide range of indications.”

Improving medication adherence is on the wish list of many healthcare stakeholders. Given the multitude of reasons why people don’t stick with their prescriptions, there isn’t just one successful modality to improve their adherence.

But a small study suggests using text messages to engage in two-way communication with patients could be more effective than coming at them with a fully developed tool based on the idea that they are simply forgetting. Moreover, it could lead to a more nuanced understanding of exactly why each individual isn’t taking their medication, thereby informing personalized adherence efforts as well as valuable drug efficacy and safety data.

Looking at de-identified data from 25 patients living with HIV, researchers at Washington University in St. Louis examined the impact of the fully automated, two-way text-messaging intervention program from adherence-focused digital health company Epharmix. In addition to reminding patients to take their meds, Epharmix (referred to as EpxMedTracking by the researchers) also asks why they missed doses and alerts providers to help address the issue in near real time. Researchers found engagement levels to be high, never dropping below 75 percent over an 11-week period, and found that the technology offered opportunities to intervene.

“A distinct strength of our system seems to be detecting when there is an actionable problem with a patient’s regimen, as 62.4 percent of the missed doses were due to ‘out of meds,’ ‘felt better,’ or ‘felt sick,'” the researchers wrote. “Importantly, this indicates that the EpxMedTracking system can be used to direct provider attention to where it is both needed and most useful, thus making the system well suited to improve the efficiency of provider time and clinical outcomes in a wide range of disease states where non-adherence may be an issue.”

People living with HIV were specifically selected because medication adherence is critical for these patients, and the researchers also selected from a group that was all considered to be of low socioeconomic status and could thus have many differing reasons as to why they weren’t staying on track with their medications.

While the researchers concede that the technology and interventions are not novel, they write that the “nature of the invention” was, as the Epharmix tool works both as a functional medication reminder as well as a method of categorically identifying the problems that lead to nonadherence. Additionally, it allows for bidirectional patient-provider interaction, they write.

“In theory this should lead to more targeted and effective provider intervention in the realm of medication adherence and improved patient outcomes in a way that would be impossible with other text message–based medication adherence systems,” they write.

They also believed the high engagement rates of the tool suggest feasibility for long-term use, and patients who reported not taking their medications because they were sick – or the medication itself made them feel sick – offered an opportunity to learn more about adverse side effects from the drugs.

“Our data also raises the possibility that the wording and message algorithms of eHealth interventions might affect patient engagement and behavior, which would have important implications for the design of future eHealth interventions as well as the evaluation of the eHealth literature to date,” they write.

Austin, Texas-based MAP Health Management, which works with a variety of healthcare stakeholders to offer a remote patient monitoring and engagement platform focused on addiction treatment, is bringing cognitive computing into their toolset through a new partnership with IBM Watson Health.

Over the six years since MAP Health was founded, the organization has amassed numerous partnerships representing multiple points in the treatment of substance abuse disorder. Their large network includes treatment centers, providers, payers, clinics and technology companies, which altogether work to offer analytics geared at improving clinical and financial outcomes for chronic behavioral health illnesses. At this point, MAP Health Management CEO Jacob Levenson said, it was time to bring in cognitive computing.

“There is an immediate value of unstructured data that we are otherwise not able to fully realize,” Levenson told MobiHealthNews. “For example, we have millions and millions of words from case notes which have what I personally think is some of the best data available. A lot of our data comes in binary, black and white forms, and Watson will enable us to turn the lights on and understand the value of it.”

MAP Health primarily seeks to fill gaps in treatment programs that can arise from a number of factors, such as a lack of standards in data collection and interoperability, or insufficient follow-up support after treatment. The company has embarked on several initatives as of late to improve their population health management abilities. Last month, they teamed up with Lief Therapeutics to pilot the use of their stress-monitoring patch in people with substance abuse disorder. In February, the company announced a partnership with Soberlink, makers of a high-tech, FDA-cleared remote Breathalyzer, and just earlier this month teamed up with relapse reduction app WeConnect.

While the Watson integration will be global for MAP Health, one of the first partners to deploy the cognitive computing abilities will be Aetna Behavioral Health, which will use the tool to help predict substance abuse relapses among its members. MAP Health and Aetna are working with addiction treatment providers to collect and analyze the patient data with the goal of develop treatment protocols and long-term strategies to support each patient in the way that works best for them.

“IBM Watson Health and MAP have the potential to positively impact the tens of millions of people and families suffering from addiction in the United States,” IBM Watson Health VP of Partnerships and Solutions, Kathy McGroddy-Goetz, said in a statement. “MAP Health Management is widely recognized as having a robust addiction outcomes database. IBM’s Watson cognitive computing technology is a natural fit to further empower what MAP is doing to help improve qualitative and quantitative outcomes in the behavioral health and addiction treatment fields.”

With Watson, Levenson said they saw a way to advance their mission of laying down the tracks for data to move around between stakeholders on their network, and on a much bigger scale than MAP Health has previously been able to.

“This is an extremely fragmented space, even though the front page of most news these days includes at least one opioid addiction story,” said Levenson. “I’ve never seen a big brand like IBM move into this space, which shows that there is a recognition that this kind of population health management platform is starting to lead people to expect positive results.”

The jury may still be out on whether IBM’s cognitive computing can deliver on its promise to transform healthcare – Social Capital CEO Chamath Palipitiya recently called IBM Watson “a joke” – but that doesn’t seem to be hindering the company’s ability to take up new partners. The research arm of IBM is working with Sutter Health to develop methods to predict heart failure based on under-utilized EHR data.

In order to predict heart failure, doctors currently document signs and symptoms in the EHR for the purpose of ordering diagnostic tests that could ostensibly give them enough warning to prevent an acute attack. However, most patients are admitted to the hospital following exactly that, and often at the point where there is irreversible damage to their organs. So IBM and Sutter Health spent three years employing the latest artificial intelligence capabilities such as IBM’s natural language processing, machine learning and big data analytics tools to train computer models to help them more accurately predict heart failure. In an article published in the American Heart Association’s journal Circulation, the researchers outline how they were able to learn about the types of data needed to train models and potential new application methods.

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