As the number of U.S. diabetes diagnoses expects to grow from 24 million to 44 million people by 2034, the high cost of caring for individuals with chronic diseases is one of the most pressing issues in healthcare in the United States today.
For those afflicted, managing diabetes is a daily balancing act that requires constant vigilance of so many variables – food, exercise, stress and general health – to keep blood sugar levels in the desired range.
Yet the available tools for managing the disease are disjointed and lacking patient engagement. To address the weaknesses in the current monitoring system, Stevens seniors Justin Williams ’15, an electrical engineering major, Bryan Bonnet ’15 and Nishant Panchal ’15, both computer engineering majors, created “embrace,” a cognitive decision management platform for diabetic patients and providers, for their senior design project.
Consisting of a software application for patients that can run on tablets, computers and cell phones, and an electronic medical record (EMR) add-on for providers, "embrace" is intended to personalize diabetic care by collecting an array of metrics about a patient’s lifestyle, including sleeping, mood and activity levels, to create an image of the “quantified self.”
“We do that by scraping APIs (application program interface) from things like wearables and other applications, even using a person’s phone to check for activity levels and where they’re walking around and things like that,” explains Williams, who is leading the senior design team.
The information that is collected, he adds, is then used to make recommendations to the patient about lifestyle-related changes.
“Maybe it is meal replacements, a better exercise routine, or even shifting mealtimes,” Williams cites as examples. “We also take all that information and give it to providers so they can make, in real-time, better healthcare decisions about the way drugs are prescribed, whether a nutritionist should be involved, and so forth.”
This data-driven model, according to Williams, allows for the kind of holistic, personalized diabetic care not available in today's market.
“Currently, there are quite a bit of issues with patients adhering to care and not getting the feedback they need. There are also issues for the providers with not getting the information they need,” Williams says. “Right now the only metric that’s collected is blood sugar, which is typically done with a finger stick or with a constant monitor.”
But a reading that is potentially erroneous by plus or minus 20 percent, 95 percent of the time, he says, is woefully inadequate for basing important healthcare decisions.
Cutting-edge computing techniques in the fields of machine learning, data mining, visualization and cognitive computing, are now making it possible to connect the previously disjointed world of diabetic care to a model that works for patients, providers, payers and researchers alike, explains Williams.
“We came up with a way to meet everyone’s needs by leveraging technology to create a space that’s not available right now.”
In developing the "embrace" platform, the team performed extensive research, spending a considerable amount of time speaking with patients, providers and payers, to determine what is and isn’t working. They also took full advantage of the on-campus expertise available to them, including their advisor Professor Bruce McNair, distinguished service professor of electrical and computer engineering at Stevens.
“If we ran into a technical issue, he was the first person we went to. But we also leaned on the community as a whole at Stevens,” says Williams, who also credits Dr. Donald Lombardi, program director of healthcare leadership & management in the Howe School, Ralph Giffin, vice provost for strategic initiatives, and Dr. Peter Tolias, director of the Center for Healthcare Innovation at Stevens, for their valuable counsel.
Supporting student centric research and entrepreneurism is central to the Stevens educational philosophy, says Tolias.
"These three talented students are well on their way to developing a cognitive application and associated electronic medical record tool that addresses the needs of diabetic patients and their care providers. This technology will be valuable to accountable care organizations, particularly as they move toward managing patients in their homes," he says.
The system will undergo beta-testing, using a focus group of patients and providers, from now until the end of this summer. Williams, Bonnet and Panchal hope to release “embrace” into the marketplace next year through their company Data Minded Solutions, and are looking into the various methods for raising capital.
“We’re considering a Kickstarter-type platform for medical technology called MedStartr. We’re also talking to some angel investors and some venture capital groups that are aligned with the medical community.”
The potential application of "embrace" across the healthcare spectrum can be tremendous, says Williams.
“We built it to be able to transition it to congestive heart failure. The issues that are with diabetes are not unique to diabetes. They’re very much applied across the rest of the chronic diseases, which are the hardest things in healthcare to treat.”
Working on their senior design project has been deeply rewarding and possibly life-changing for the team members, according to Williams.
“All three of us have job offers or have been accepted into graduate school. But we’re trying to postpone those plans for as long as we can because this is 100 percent our focus right now.”
This level of investment and commitment to an important healthcare issue and to the senior design project itself comes as a pleasant surprise for Williams.
“If you had asked me in January of last year, I wouldn’t have said healthcare, specifically diabetes, would be at all my focus for applying my engineering skills. But we’re working really, really hard to make this work.”