Q&A: How one startup supports IBD patients

Web content editor Ian Bolland caught up with Roeland Pater, co-founder of Nori Health, a healthtech startup that uses an app-based AI-powered digital coach to support people with Inflammatory Bowel Disease (IBD). The company aims to run a second trial in a clinical environment this summer. 

How did Nori come about?

Nori’s journey started from my personal experience of living with a chronic disease. As a teenager I was diagnosed with Crohn’s Disease so know first hand how IBD affects people not only physically, but mentally – and the stigma they can face more generally. In fact, my three co-founders also all suffer some form of IBD and we came together to change the way patients are supported.

More than half of all adults now live with a chronic disease. This puts tremendous pressure on the global health systems. For patients this means that for the rest of their lives they have to live with a disease, which completely changes their state of mind and has massive repercussions for their lifestyles. At the moment doctors are the primary point of support but they provide only medical care for physical symptoms, they cannot act as psychologists or support groups in general. In fact, over 90% of chronic disease patients report a lack of support in between doctor’s appointments.

As well as a lack of emotional support, doctors often also don’t want to advise on wider lifestyle issues such as diet, exercising and social issues. People are left to figure these out on their own.

Our own experiences of this lack of support and personalised insight led us to create Nori to help sufferers to make better lifestyle choices and improve their quality of life. It’s a project born of passion, and one we think truly has the potential to better the lives of millions of IBD sufferers.

What kind of technology has gone into developing Nori?

Nori Health is a very special blend of AI (Artificial Intelligence) and human expertise. The chatbot Nori program, which consists of unlimited conversations in a six-week period, focuses on discovering and changing lifestyle factors that have a negative impact on quality of life and overall well being of sufferers.

The content of the program comes from scientific papers and discoveries in lifestyle improvement. We have built technology that feeds new study results into the program to help the community. This continuous extension of knowledge is important to help Nori decide which conversation is the most relevant for a specific user at a certain point. Deep personalisation is key.

We are currently testing an addition where a conversation is temporarily diverted to a team member to provide human support in case of errors, and after handling it giving the conversation back to Nori. Also human support is available in any case if people need that. We offer a live chat option on the platform that connects people to us directly.

Give us an idea as to what you mean about improved social life and better daily management of chronic conditions?

The outcomes of the program are important in terms of data. But the results of these outcomes are maybe even more valuable. If we improve managing a chronic condition on a daily basis, it means people can have a better social life. Missing social activities is one of the main issues for people with a digestive disorder. By improving practical factors like diet, hydration and stress levels – but also a more holistic approach to acceptance of the condition and being open about it – we see that people report less missed social activities and an overall improvement of their social life. Ultimately, that’s what counts.

For patients with chronic illnesses It can be very difficult to give a score to how they are feeling, either well or unwell. Nori, however uses a quality of life score as an indication of current quality of life based on both physical and mental well-being.

The quality of life score is based on the Health-related Quality of Life (HRQOL). This measures an individual’s or a group’s perceived physical and mental health over time. It is widely used in research studies and is generally considered a valid indicator. The concept has evolved since the 1980s to encompass those aspects of overall quality of life that can be clearly shown to affect health—either physical or mental.

Health is a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.

One of the cornerstones in the mission of Nori Health is to end the difference in quality of life between healthy people and people that live with a chronic condition. This starts with obtaining a healthy social life with positive relationships.

The trial data shows that more than half (56%) of the participants indicate that their social life has been improved, and that there were no missed social activities due to their condition – while this was the case in the two weeks prior to the program.

What kind of aspects does the digital coach side of the technology do that face-to-face doctor appointments don’t necessarily do?

Most people with IBD will see a doctor maybe twice a year for a maximum of 15 mins, to check their medication is working. Such infrequent, short appointments cannot possibly cover the many associated issues of IBD, nor offer sustained emotional support. Nori’s 6-week program provides a level of personalised, unlimited support that doctors unfortunately just don’t have the resources to offer.

Is this kind of technology something can help aid medical professionals in their treatment of patients?

Nori is definitely an extension to medical care, and can certainly aid medical professionals in their care of patients. For example, Nori empowers patients to track symptoms, mood, lifestyle and diet, potentially providing doctors with better information to tailor medical interventions. The support Nori can provide between medical visits means that patients can more easily access information and self-care, alongside medical interventions.

The most important thing to realise is that digital health is not out to replace traditional care. The two need to blend together. Digital can really make a big impact, we are already seeing self-care technologies like Nori take workload away from doctors, and help with early diagnosis.

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