A new digital tool is aiming to cut last-minute chemotherapy cancellations and improve outcomes for cancer patients.
eAltra is a web-based, AI-powered conversational platform that helps triage patients ahead of treatment, reducing the likelihood of their chemo session being cancelled due to a last-minute issue.
Its founder is Denis Roche, who is no stranger to the application of technology in medical settings. In 2011 Roche founded Vivartes, a web-based system to improve the quality of life for those in long-term care and in May last year, his second venture, eAltra, spun out of Trinity College Dublin.
Cancer treatment can be a long and arduous process and it’s very upsetting if a chemotherapy session is postponed because an issue, such as an adverse reaction to medication. These unforeseen problems result in roughly 20 per cent of treatments being cancelled when the patient has already arrived at the hospital.
Key to improving the situation is good patient feedback, or what’s known in medical circles as Patient-Reported Outcome Measures (Proms). Proms are crucial for understanding the impact of treatment on a patient. The better a patient can explain how they’re feeling, the easier it is for clinicians to make an informed judgement about their fitness for their next treatment before they arrive for their appointment.
Patients’ ability to articulate their health status varies widely, as does their means of communicating with the hospital. As a result, specialist cancer nurses must juggle texts, calls and emails to get that information, often interpreting vague updates.
Making it easier to get more value from Proms has huge potential benefits because if patients are more engaged with their symptom management, their outcomes will be better, while a more comprehensive Prom gives the care team a deeper insight into how well a patient is coping.
“Current barriers to the more effective use of PROMs are a lack of understanding of their value amongst clinicians and patients, a lack of suitable IT infrastructure to deliver them and a lack of functionality and configurability to integrate them into existing workflows. Our system addresses all of these issues,” says Roche, who hasa background in art, music, IT, law and data analytics.
He originally studied for an MA in fine art/sculpture at the National College of Art & Design and also has an MA in cognitive computing from Goldsmith University in London and an advanced diploma in data protection law from King’s Inns.
During his career he has worked as manager of the Creative Life Centre at Mercers Institute for Successful Ageing, set up Vivartes, spent time as the research lead for patient experience at the Chelsea & Westminster Hospital and more recently as a consultant in digital patient experience at the independent charitable hospital the London Clinic.
eAltra has been developed with input from clinical nurse specialists, consultants, surgeons, and radiotherapists in Ireland and the UK. “The idea began with a collaboration with a lead cancer nurse specialist in the head and neck cancer service at the London Clinic, who was struggling to get patients to engage with information that could help them manage their symptoms,” Roche says.
“We have made the engagement process much more user-friendly with a first-of-its-kind conversational AI approach to patient-reported outcomes and needs assessments. This has been done by synthesising the dialogue from nurse-led interviews with standardised patient questionnaires.
“The second unique feature of our system is the conversational Patient Concerns Inventory (PCI), which helps patients to identify the key things about their treatment they want to discuss with clinicians during a consultation. It’s easy to forget something at the time, and as these consultations are often short,t it’s important for patients to make the most of them,” Roche adds.
Apart from improving the patient experience and reducing the repetitive administrative burden on staff, Roche says eAltra will have a positive impact on waiting lists by increasing patient throughput by up to 25 per cent. He also estimates the system will save an average of 2.5 hours of nursing time per day in a typical cancer service.
The company’s web-enabled system, which allows interactions via smartphone, tablet or browser, works by sending patients a link 24 hours before their scheduled treatment. They complete their assessment and return it via a secure interface with no app or downloading required. Prompts are built into the system to ensure it’s sent back in time.
Currently, it takes a clinician around seven minutes to conduct a review. With the eAltra system, this time is cut in half. In a busy cancer centre, treating 80 or more patients a day, this adds up to a meaningful time saving, Roche says.
eAltra is a Trinity campus company, working closely with St James’s Hospital, Tallaght Hospital and the Health Innovation Hub Ireland to develop its platform. Potential customers are hospitals and health systems and the revenue model will be subscription-based.
eAltra is an Enterprise Ireland high potential start-up and has raised roughly €1.4 million between State assistance and angel investors.
A further fundraising round is planned for later this year. The company is one of a handful of companies chosen to participate in the Hill Oxford University Hospitals NHS market access accelerator in the UK and its system is currently being piloted in St James’s Hospital in Dublin, with a further pilot to follow in the UK.
The NHS is a big potential customer and, in the longer term, the company is looking to enter the US market.
