digital cognitive therapy and brain monitoring for vulnerable groups

Ipsilon Test is a remotely operable, gamified brain monitoring and therapy app for neurodegenerative diseases using music to generate responses for analysis. It helps track cognitive status of vulnerable patients such as elderly and immuno-compromised at safety and comfort of home while mitigate risk of virus exposure by visiting clinics.

Yayoi Sakaki is the founder and CEO of Project Ipsilon. She is pianist by training and neurology and data science enthusiast by trade, has invented Ipsilon Test. 

During the health emergency such as Covid-19 pandemic, those who are old and/or immuno-compromised are at greater risk from the virus exposure impacting their health. We work with neurodegenerative disease patients with cognitive issues, such as dementia or multiple sclerosis, and offer at home selfcare with digital brain monitoring and therapy to ensure continuous access to healthcare for the vulnerable groups. Our Ipsilon Test is designed with music playing as gamification to generate responses which functions both therapeutic and monitoring of the therapeutic outcome from the logged data. Music playing is well-known for its role in multi-sensory processing and helps reinforce the connectivity among different brain regions.  As Donald Hebb's famous quote says, "neurons fire together, wire together." We help keep our users' brains active while they utilize our app on tablet at comfort and safety of their homes to supplement the therapy away from their clinics. While having ongoing therapy to maintain their cognitive wellness, clinicians can keep track of their patients' cognitive status of their patients. Our solution functions as risk mitigation while reserving hospital resources for acute care and to ensure the equality in healthcare access for all, especially the vulnerable population of elderly and immuno-compromised. 

We serve vulnerable population, such as elderly and neurodegenerative disease patients, and their physicians. We enable remotely operated digital therapy for the patients while tracking cognitive status of the patients and compile the report to the clinicians for the up-to-date cognitive data in case of the need of adjustments in the intervention.  We help shift the non-acute cognitive care of the patients to at home care as a part of risk mitigation from virus exposure while reducing hospital visits to help reserve the clinical resources for acute care.  We have already developed our solution and have been scheduled for pilot studies at a few clinical institutions. Even if the pandemic subsides earlier than expected, shifting some extent of non-acute care to home self-care with the clinician's observation seems to be in greater demand as patient-centric care approach. 

The use of music playing for cognitive assessment, potentially to detect dementia helps remove the stigma from cognitive decline or impairment. It also helps people take proactive stance to take active participation over their cognitive wellness management. The use of digital solution also helps to improve the equal access to healthcare among more vulnerable populations such as elderly and multiple sclerosis patients. 

Koo, B. M., & Vizer, L. M. (2019). Examining Mobile Technologies to Support Older Adults With Dementia Through the Lens of Personhood and Human Needs: Scoping Review. JMIR mHealth and uHealth, 7(11), e15122. https://doi-org.ezproxyberklee.flo.org/10.2196/15122

Marziniak, M., Brichetto, G., Feys, P., Meyding-Lamadé, U., Vernon, K., & Meuth, S. G. (2018). The Use of Digital and Remote Communication Technologies as a Tool for Multiple Sclerosis Management: Narrative Review. JMIR rehabilitation and assistive technologies, 5(1), e5. https://doi-org.ezproxyberklee.flo.org/10.2196/rehab....

We offer remotely operable cognitive training-monitoring app on executive functions for neurodegenerative diseases. From feasibility study with 10 Parkinson's patients aged between 46 and 82, our surveys showed that users seemed welcoming the solution feeling approachable with gamification with music playing and over 80% of them said they're willing to switch to digital cognitive therapy if they're homebound. Therapeutic outcome was observed among all except one patient with improvements in response time and response accuracy. It's critical to have access to therapies continuously to manage cognitive wellness among neurodegenerative diseases patients including dementia, and digitization is a way to circumvent the full-lockdown situation with no possible access to therapies. Some of our clinical partners in EU have already implemented telehealth consultation for non-acute care while cognitive therapy with monitoring capability is one of the last care domains that seems to be still yet to be implemented to serve elderly, especially neurodegenerative populations. Implementation is relatively easily coordinated with pre-installing the app at gadget store on wifi-capable tablet and have it delivered to patients directly. The same device can be also used for telehealth consultation to optimize investment on device. All patients receive de-identifying ID accessing service to comply with GDPR.

We envision that non-acute care for neurodegenerative disease patients would be fully shifted to remote care through digital health and telehealth, minimizing health access inequality. We also would see that the digital literacy among elderly would be improved significantly and the access discrepancy to internet and electronic devices would be also lessened. 

With the wealth of collected data, it may also help develop phase-identifying markers and also potentially digital surrogate biomarkers as diagnostic aid for those diseases which otherwise have lengthy and difficult diagnosis process. 

Digitization of care delivery has accelerated over the pandemic. If we can make it as "common understanding" that non-acute care for cognitive needs among the vulnerable population are all done through telehealth with digital health solution, that is a success. In order to measure it quantitatively, we can see the numbers of approved health insurance reimbursement for such services and also the numbers of healthcare providers offering such service. 

In our case, we have been receiving increasing numbers of inquiry and interests among clinical institutions and regional health systems to our services in past 6 months or so. From such inquiries, about handful clinical institutions are either in agreement or in discussion of pilot with us with the anticipation of service agreement upon successful pilot outcome. The demands are strong from Canada and northern Europe thus far, where universal healthcare, good internet infrastructure and high tablet device ownership among 65 and older seem to be the driving force. 

To apply for regulatory approval from each target market for each disease is lengthy and costly.  Also to work out the insurance reimbursement is difficult and lengthy process.  We are raising investment to be financially equipped to be able to complete those milestones and are in communication with industry leading consultants to overcome them.  We also are communicating and soliciting partnerships with the insurance companies to explore the effective deployment approach. 

Neuro SysMed Center at Haukeland University Hospital 

Baycrest

Dementia and neurodegenerative diseases are highly associated with aging societies. Especially in the UK, the interests for dementia and cognitive impairment are high and many world-leading research teams are actively studying the conditions. UK is also a world leader in music therapy and its implementation in actual clinical settings. In addition, epidemiology of Alzheimer's disease is high in the UK, the government has numerous R&D initiatives for innovations and the society seems to be more open to new solutions to combat the disease.  Thus, the generous prize funding and the culture to lead the new innovation with digital health, music as interventional tool and combat the cognitive impairing diseases, we believe our passion and goals are well-matched with the mission and the spirit of Trinity Challenge. 

We would like to work with Bill and Melinda Gates Foundation, which is already one of the global leader in Alzheimer's and other neurodegenerative disease research and funding.  We believe we can find the additional clinical,  AI-based technological partners and also interested regional health systems with less privileged countries can be matched by working through their network to serve our aim and mission.