Filling in the Care Management Gaps for Parkinson Disease With Software Technologies

Suketu Khandhar, MD

Over the last several years, we have seen healthcare systems strained as pent-up demand for in-person clinical visits has skyrocketed. Unfortunately, the pandemic caused significant stress and burnout for many healthcare workers, from physicians to nurses and medical lab teams. This led to many leaving the industry, with one out of five professionals quitting their jobs during COVID-19.

Not surprisingly, neurology is part of the disheartening conversation, where the shortage of physicians in the field is expected to continue. This problem is particularly true for movement disorder neurologists, who specialize in care for patients with motor disorders like Parkinson’s disease. A recent study found that there were just over 600 movement disorder specialists practicing in the U.S. With over 1 million individuals with Parkinson’s and almost 100,000 new cases diagnosed each year, that leaves minimal opportunity for patients to receive the care they need.

One way we can address this significant gap in care management is through wearable technologies and software ecosystems that provide in-depth, comprehensive data that both the neurologist and the patient can leverage. By taking this approach, we can gain a better understanding of a patient's daily challenges, such as those at high risk of emergencies, alter medications to address those problems, and identify those patients who would benefit from clinical trials.

StrivePD: a software ecosystem for tracking Parkinson’s

Most Parkinson's patients will see their neurologist once or twice annually. During these in-person appointments, the doctor will ask the patient how things are progressing since the last visit, with inquiries pertaining to symptom progression, medication usage, and treatment efficacy. It can be difficult for patients to reflect on months past, collate objective information on how well their meds are working, or how their motor symptoms have progressed. It is an incredible challenge for these patients to provide a comprehensive overview of an entire year of their disease, so we need advanced technologies to help fill the gaps.

Among the health technologies available for Parkinson’s patients, the StrivePD app from Rune Labs is an ecosystem that patients and their neurologists can use to monitor the disease continuously. Coupled with the Apple Watch (FDA cleared on the Apple Watch for tremor and dyskinesia measures), the StrivePD app can generate a wealth of information, providing a comprehensive, and most importantly longitudinal, overview of a patient’s disease. We now know that Parkinson’s is an incredibly heterogeneous disease, and having an app that can characterize a patient’s condition over time and daily can be critical to inform treatment strategies.

What is unique about StrivePD is that it continuously compiles data about motor symptoms (like tremors, dyskinesia, and gait) and tracks medication compliance, exercise activities, and sleep.

As physicians, we can take this information, which is easily understandable through the app’s dashboards, and leverage the objective data to inform care management decisions. We can alter treatments as needed to continually improve a patient’s quality of life before they experience a significant worsening of symptoms.

How to address the challenge of technology adoption for patients and providers

While technologies such as the Apple Watch with StrivePD hold tremendous potential, many Parkinson’s patients can be hesitant to incorporate them into their care management. The main challenge is that technology, on average, is not as accessible to as many individuals as we would like it to be.

To address this concern for patients, clinicians should 1) recruit family members or caregivers who can be pivotal in helping patients make that leap and 2) work with companies like Rune Labs, which are building their technology for easy access and usability, making it easy for patients to be organically engaged.

On a higher level, many patients are excited to be involved and use these technologies because it makes them feel like they are part of something bigger, where their data can help advise on treatment decisions for the larger Parkinson’s community in the future. This type of empowerment dramatically improves the level of engagement, allowing patients to take ownership of their condition and help others at the same time. That’s a major win.

One caveat is that as providers, we don't want to lose our human touch and mechanize medicine so that we forget the essential human connection with patients. Many patients will tell you one of the biggest complaints about healthcare systems is they are becoming more robotic.

We need to use technologies like StrivePD to boost the quality of our in-person visits. Instead of rushing through a 30-minute appointment and wasting time going over information that could already be evaluated beforehand, we should leverage these tools to help us prioritize the clinician's relationship with the patient.

The future of Parkinson’s care management

Platforms like StrivePD act as a conduit of communication between clinicians and patients because they signal to both whether a treatment is working. Even subtle changes that cannot be seen by the naked eye but are identified in StrivePD could offer a glimpse of how to tailor therapeutic regimens in the future. We are fortunate that in today’s healthcare system, patients have better access to managing their care and do not necessarily need an in-person appointment to address their needs.

Wearable technologies and software allow us to objectively see how patients respond to therapy, whether their bradykinesia or tremor is improving in real-time. These tools will enable clinicians to pivot, adjusting medications to provide patients with more on-time and less off-time. Using wearable technologies that can collate data points before a patient’s visit to help us understand a patient’s trajectory is incredibly useful, saving time and costs for all parties involved and, ultimately, better patient outcomes.

Beyond directly impacting clinical outcomes, StrivePD allows patients to influence the future of medicines through participating in research. Using real-world data generated from these advanced technologies provides insight into developing more precision medicine for Parkinson’s, and getting drugs into the hands of patients more efficiently. Unfortunately, less than 10% of Parkinson’s patients participate in clinical trials. The healthcare industry needs to push patients towards adopting these novel solutions and being involved in these research efforts to bring safer and more effective therapies to market.

Through tools like StrivePD, we can allow the patient to be their navigator, empowering individuals to be involved in their Parkinson’s journey.