Digital biomarkers show doctor how you are really doing

With digital biomarkers, you can measure health more objectively. This gives doctors a better picture of a patient. The Nijmegen-based company Orikami develops such biomarkers for practical use, including in cooperation with Radboudumc and Radboud University.

In the consulting room, doctors often only get a limited picture of how a patient is doing. Someone might talk about the pain he is feeling today, but not how well he was doing last week. The young medical technology company Orikami has found a solution to this problem. Doctors can now measure how someone is really doing.

Orikami from Nijmegen specialises in developing digital biomarkers for the healthcare sector. The first products have recently come onto the market. You can ask someone if they are tired or in pain. But you can also measure it with a test. These so-called digital biomarkers measure various indicators that tell you how someone is doing. Or what is not going well. "For example, whether someone is tired, whether someone can still walk properly or whether their cognitive abilities are up to standard," says Bert Seegers. He is one of the three owners of Orikami. "We have developed tests that very simply provide reliable and objective measurements."

Walking test
The results are shared with the patient and the medical team. As a concrete example, Seegers mentions a system for MS patients, MS Sherpa. "There are two important indicators in this disease pattern, namely mobility and cognition. We have developed tests that specifically measure how things are going. For example, how far someone can walk in two minutes. You don't do a test like that every day, but you can do it every week or every fortnight."
The purpose of the digital biomarkers is to give both the patient and the doctor more information about the course of the disease. In this way, the course of the disease can be better predicted, giving patients more control over their lives.

Pilot in the hospital
More than five years have been spent developing the medical aid and getting it approved. Recently, a pilot with the Orikami product was started at the Jeroen Bosch Hospital (JBZ) in Den Bosch. "We see that the pressure on healthcare is increasing. In the future, it will even be untenable to provide all care. Therefore we want to move more care to home," says Hanneke van Heijst. She is project leader for e-Health innovation at the JBZ. "Orikami's app fits in perfectly with our strategy. You keep more track of someone's health, without them having to come to the hospital for it. Orikami had already developed the product further and was ready for the market. That is quite something, because these are long-term processes that are subject to heavy regulation. Of course, we are curious to see how patients and doctors experience the app in practice. That is why we are holding a three-month pilot."

A few times a year
Normally, a doctor sees the patient perhaps once or twice a year. Otherwise, the healthcare provider has to make do with the necessary subjective information and the patient's story in the consulting room. With biomarkers, Seegers expects that it will probably be clearer and more objective to see how a patient or the clinical picture is developing. He emphasises that the measurements can help not only with (chronically) ill patients. "Think, for example, of the large group of elderly people living at home. You can also monitor them so that you have better insight into how someone is doing at home. For each target group, you can use specific tests that have clinical value. We are now discussing this with the Geriatrics Department of the Radboudumc, among others. Marcel Olde Rikkert, Professor of Geriatrics at the Radboudumc: "We have analysed some games for monitoring cognition in previous research at our department. On the basis of this, we are now working with Orikami to develop this material further and make it accessible to various groups of elderly people. In concrete terms, you can think of interventions that can improve cognition and for the follow-up of people who undergo major surgery requiring anaesthesia. We are now carrying out such pilot projects with Orikami."

Better affordability
Digital applications and data science such as those of Orikami make it possible to keep healthcare more affordable and still of good quality. Seegers: "The disadvantage is that we in the Netherlands have not yet reached the point of how we can implement these kinds of systems in healthcare practice. The financing has not yet been arranged. For example, we are currently in talks with a healthcare insurer. However, that is not a long-term solution. We would rather see this fall under reimbursed care."

Multiple Sclerosis
For further research into MS Sherpa, Ioan Gabriel Bucur of Radboud University recently received a Take-Off grant from NWO: Multiple Sclerosis (MS) is a chronic neurodegenerative disease, in which the deterioration and response to treatment varies greatly per person. Continuous monitoring is therefore very important. In this project, dynamic state-space models are implemented to improve the clinical relevance of the digital self-monitoring app MS Sherpa. MS Sherpa collects and evaluates digital biomarkers using clinical tests and questionnaires. The technical feasibility study will examine the extent to which the new models can separate noise from actual change in performance measurements and produce visualisations of disease activity and progression.

Sources: Radboudumc, Innovation Origins en Open Technologieprogramma, Take-off en Open Competitie