Introduction to Patient Experience

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Digital transformation in healthcare is going mainstream, promising higher quality of care at a lower cost for all. And right on time, as only two years ago World Health Organization calculated the cost of not taking action to address the spread of noncommunicable diseases – 7 trillion dollars in 20 years.

Telemedicine allows for a cheaper infrastructure of medical consultations, connected hardware means remote monitoring 24/7 and big data helps researchers find patterns in the spread of diseases and better target preventive activities.But the biggest change happened in relation to the model of patient relations. The biggest transformation in medicine since Stone Age is happening right now. The model of patient relations has changed irreversibly as the digital transformation of healthcare turned patients from passive beneficiaries into active decision makers. Internet brought with it the emancipation of patients who gained a much wider access to information, which led to the raise in decisiveness. Companies in healthcare are no longer primarily in B2B communication with other medical entities and public administration, but in B2C for the first time having to work this hard to gain their trust.


We’ve sat down with Sergey Balandin, President and CEO of FRUCT, to talk over building mobile health products for end users.

FRUCT is very active in providing enhanced services for health monitoring, especially for patients with chronic diseases. But are people willing to work for their health? What’s your experience from various apps you’ve published?

We see that at least 30% of our users are healthy people and in the last two years we see continues increase of a share of fitness users. Thanks to mHealth apps and cool wearables, it is getting effortless for people to monitor and gradually adjust own behaviour to be more healthy, which directly reflects to the quality of life. I’m optimistic that we are in the middle of major transformation of the mindset on how people think about their help. For the first time in history everyone could make detailed monitoring and proactively take care of wn health and ask for doctor’s help only when it is needed. Moreover, when asking for help the patient will be able to provide detailed results of health monitoring over long time and know exact questions to ask. An important role of mHealth services is to slowly teach people on how to be healthy. In fact the corresponding methodologies are available for many years, but in the past it was too difficult to follow these recommendations, while now almost all operations are automated and people can enjoy better life.
You’ve just published the first version of B2C MDDCloud to involve citizens in monitoring and taking good care of their health. What’s the role for doctors in this new ecosystem?

We released MDDCloud for our apps users to give access to overall picture of their monitoring results and so illustrate how simple daily activities are transformed into personal health profile. We believe that this shall further stimulate our users to be even more active, start using new apps and probably even purchase some additional services that will help to even better preserve the health.

Doctor is a special type of consumer of health data collected in MDDCloud. Currently the system allows to export collected health records in various formats to show them to the doctor. We get a lot of positive feedback both from patients and doctors that this service is very useful. But in the near future we are planning to publicly release the special version of Doctor’s profile in MDDCloud, so that patients can directly connect personal health profiles to the trusted doctor, and doctors will be able to monitor health records almost in real-time. Moreover, the paid extension of Doctor’s profile in MDDCloud will provide a lot of additional services that save time on route operations that doctors perform on the data, and enable completely new services to the patients.
Managing a chronic disease is a job for years, patients can get discouraged easily with negative outcomes or fatigue so how do you choose the features to make them user friendly and useful at the same time?

Patients with chronic disease are among the most friendly and committed to the system. This group of patients has strong motivation and they can easy value our services, as their life quality directly depends on these services. The chronic disease patients are the most interactive and gave us majority of improvement suggestions. So in fact to continue to be user friendly and useful for this category you just shall carefully listen what they asking, discuss how it could be delivered and fulfil your promises on making the apps better.
MDD provides support to over 90 models of medical sensor devices. It’s a very wide range, are you doing it for research purposes or does it really help doctors with managing health of a bigger group of their patients?

This has very practical reason – we want to lower the entry threshold to personalized eHealth. Obviously patients need sensor devices to collect medical data. Depending on region and income group, various patients can/want to buy different medical devices. We target to support as wide range of devices as we have an ultimate goal that any person in any region with any income will have an access to personalized mHealth services.
Let’s talk for a moment about the security of running health platforms in the cloud. How end users can check if they can trust a service with their data?

Of course security is the key issue when we talk about such sensible data as health records. First I want to say that architecture of our service ecosystem gives user full control of what data shall be copied to MDDCloud and what shall only stay locally on their personal mobile devices. In development of MDDCloud resource we follow high data security standards. But we realize that in practice even most secured systems can be cracked. So we created such an architecture that anonymous data in MDDCloud so even if somehow the system will be compromised, the hacker will only get huge pull of row data, which cannot be connected to actual individuals without breaking also their personal devices, as all personal data and setting are stored in these devices.

By the way, security is the reason why we haven’t released Doctor’s profile in MDDCloud. This services will create a new potential threat, which requires proper addressing and this is the main reason why we need so much extra time.

You’re working both in Scandinavian region and Eastern Europe – how do you design for such different target groups?

We have users from all around the world. Among top countries we have USA, Brazil, Russia, Germany, India, Turkey and Japan. We also have a lot of users from Eastern Europe and Scandinavia and see these regions as the top priority for future development. These regions have a lot in common in the cultural background and at the same time it is very important to respect local specifics and identify of each region. The key is adoption of apps to local languages. Nowadays our apps are the most international in the mobile appstores, as we support over 20 local languages. Moreover, we have open crowd-assistance tool for online translation so that any person can help us to improve translations to their languages and help to add more translations and even include translations to new languages. And of course all our translators are mentioned in the app.
FRUCT was started in the Nokia environment which in a couple of years went from market leader to barely existing. What lessons for further projects did you learn observing it from inside?

I cannot agree that Nokia is barely existing, as in fact the company become less visible after it quit mobile phones consumer market, but it is still huge and important player on another markets (primary B2B). I worked for Nokia for over 11 years and must say that it was the best experience in my life. Nowadays in FRUCT we are trying to maximum repeat the work culture as it was in Nokia. I don’t want to comment decision of Nokia on selected way of developing the company. When this decision was made, I made my own decision and end up where I’m now. But at the same time I know that Nokia is working on a lot of interesting and great projects, including project for eHealth. They are not public yet, but we might be surprised when will hear the corresponding announcements. I wouldn’t draw this picture in black and white, as it is more complicated, and remember, one Nokia already decided to go against majority and develop GSM-based communications, instead of NMT. As we know now this decision was a key for the further success.


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