I always wanted to be a children's nurse, and never thought of doing anything else. I never thought however that my career would take such a path.
After years of clinical nursing I moved to work in research, specifically clinical trials of new drugs being developed for rare, life limiting and life threatening diseases. During that I time I got increasingly frustrated with how clinical trials were being conducted. Not only the high failure rate because of poor study designs but also because of the enormous amount of unnecessary stress imposed on both the child and family.
That was back in 2001-3, and I would like to say that since then since has improved, but unfortunately not. A publication in 2014 highlighted that 42% of recently completed paediatric trials failed to establish either safety or efficacy.
Since then I studied for a PhD to identify new outcome measures at University College London, and went to work for the European Medicine Agency (EMA) in 2007 to implement the Paediatric Regulation in Europe. A legislation that forces pharmaceutical companies to consider the needs of children when developing new drugs.
During my six years at the EMA I greatly enjoyed the global scientific discussions, and noticed a great shift in mind-set that children should be protected through research, and not protected from research.
However the inherent challenges of conducting successful trials that generate clinically meaningfully results remained, and the ethical and economic impact linked to this is significant. The more I saw and learnt the more my personal frustration increased.
Which is why I looked to technology to find a solution!
Founding aparito was part serendipity in terms of timing, part long time hope to find a solution that could make a difference.
Our approach at aparito is to move patient monitoring away from the hospital and into the home by using wearable technology and smart phone apps. This moves away from relaying on sterile, snap shot assessments during clinic visits to continuous, real-time data at home, school, with friends and family.
The objective data captured from the wearable is partnered with meaningful data capture from the smart phone on four different aspects: medication adherence, health care usage, adverse events (drug and/or disease) and patient reported outcomes (quality of life scores).
To date we have ran a small study in India, and have larger studies up and running at Great Ormond Street Children's Hospital and Manchester's Children's Hospital. We also soon be operating from Newcastle General and the National Institute of Health in America.
Wearable devices are evolving rapidly, and with increased battery life and a prettier feel and look (rather than clunky medical looking like devices) now available; adherence in using such devices is also improving rapidly. Especially in disease where disease morbidity is high, and patients are motivated to learn more about their disease progress.
Furthermore, as wearable devices eventually become more commoditised, the functions that they can monitor increases and the prices drop. All of which become important factors to consider in the digital health, med tech landscape.
However the wearable, mHealth evolution can only move as fast as the regulatory framework that governs it. After six years of working as a regulator however, I am fortunate enough to understand the regulatory landscape well, the reasons for such regulations and the commercial implications. All of our work so far therefore has embraced the regulatory steps required, and the addressed these requirements at the offset of our design and work.
The digital landscape is transforming fast, driven by the vast opportunities that tech can now offer, but also by the ever changing needs of healthcare, and the increased associated cost which can't be sustained. Tomorrow's healthcare can't be sustained to be just a more effective continuation of what we have today.
Self-made diseases linked to over eating, alcohol and drugs, and an increased lifespan demands a change in healthcare provisions. Coupled with major scientific advances of personalised medicine such as stem cell therapies and gene therapy.
Our approach at aparito is therefore not just created to address the needs of children taking part in clinical trials. Far from it. Our approach in aparito underpins the emerging needs of all aspects of healthcare. The opportunity to have a genuine impact on the healthcare of the future is one that we are eager to play an active part in.
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