Personal Health Coach + App for Chronic Rheumatic Diseases

Spondyloarthritis (SpA) has a global prevalence of 0.1%-1.9% with Axial SpA conditions being more prevalent. In the US, it affects 3.2mn adults. 

Our current healthcare infrastructure cannot deliver proven lifestyle interventions like regular exercise, quitting smoking, and dietary changes in an engaging fashion. 

This leads to a lack of adoption, cultivation & persistence of new lifestyle habits, which have the potential to improve quality of life and prevent disability. 

Our current healthcare systems lack the infrastructure to monitor disease-drug interactions necessary for rare disease management.  

This includes side effects. long-term health effects, and adverse events leading to issues with dosing and prescription adherence. In our survey (2021) of over 150 patients who take DMARDs, 43% are doctor diagnosed with IBS/IBD since taking up DMARDS, and another 29% experience symptoms of IBS.

Lastly, current apps offer self-directed education and tracking which lead to dwindling engagement rates by Month 2. 

They overlook core behavioral aspects of motivation and grit which are a function of our

• life goals
• perception of suffering from pain
• physical & social environment, 
• skills to implement healthy living habits, 
• health literacy, 
• interests, 
• personality type, 
• access and affordability

Anooka's behavior modification platform:

• Pairs a person with SpA with a health coach who has a background in motivational interviewing and is trained in Physical or Occupational therapy

• Periodically conduct our proprietary baseline assessment developed by Physicans, Allied health professionals and people living with Chronic pain to evaluate motivation, grit, and behaviors:
  • life goals
  • perception of suffering from pain
  • physical & social environment, 
  • skills to implement healthy living habits, 
  • health literacy, 
  • interests, 
  • personality type, 
  • access and affordability

• Offers access to our web-based app to identify a set of approaches that help them persist with their routine. Through the app they can: 
  • communicate asynchronously or synchronously with their coach,
  • perform activities or set up behavioral experiments, 
  • monitor progress, 
  • get educated about their condition, 
  • track effects from food, supplements and medication
  • journaling

Recommended participation time is from 6-12 months, early participation goals involve increasing physical activity and pain reduction.

Our solution serves people living with Spondyloarthritis

It is an inflammatory arthritic condition:

• Affects adults of working age 
• Frequently need to take up work that offers flexibility towards their doctor's appointments (65% of our survey participants had to change their profession or even stop working because of workplace requirements)
• Higher prevalence in regions having colder winters and in remote communities - low or no access to allied health services
• Severe shortage of Rheumatologists in the US and Canada - (4700 by 2030 v. 8249 required) means delays in diagnosis and therapeutic interventions
• Significant increase in doctor diagnosis of the condition due to availability of HLA-B27 gene test to catch at low to moderate severity of the disease

We help them incorporate exercise and methods to increase physical activity to relieve pain (before and after diagnosis) to prevent anxiety, depression, and further deterioration caused by the disease.

We help them identify patterns in symptoms, side effects & adverse events based on their food, medication, and supplements to be able to gain a better understanding of what causes their condition to improve or worsen.

Anooka is being built by a team of

• People with the condition (our pilot participants - >60% who finished 1 year with us)
• Human factors and behavioral neuroscience experts, 
• Home Occupational & physical therapists (from Alaska), 
• Physician and
• Pain psychologist

who shares a background in working with people living with Chronic Musculoskeletal, Kidney, or Cardiometabolic diseases and has joined forces to help build a behavior modification platform for people with Chronic Pain? 

With support from Veterans associations, Patient Advocacy groups and the Arthritis society, we interviewed over 150 individuals living with Joint OA, Rheumatoid Arthritis, Spondyloarthritis, and 40 individuals with Chronic Pelvic Pain or Endometriosis from across the US with the majority living in a rural or suburban setting and in 35 - 70 age group.

Our goal is to enable PCPs and Allied Health professionals to utilize remote therapy monitoring, chronic care management & health behavior modification reimbursement pathways more effectively by adopting Anooka into their practices.

To demonstrate clinical validity, we are planning to run a longitudinal study on a group of 20-25 individuals living with SpA over a period of 6 months to observe the quality of life improvements with follow-up at 12-month mark.

1. Maximizing motivators - based on behavioral neuroscience

2. Coach-led -> higher engagement (we observed 89% engagement to physical activity interventions over a span of 1 year in our pilot cohort)

3. Better engagement -> higher quality patient-generated data on the effectiveness of pharmacological and lifestyle interventions

4. Lastly, it helps us transition to a peer-to-peer model for those who finished 6 months with us to increase adoption and scale

In the next 1 year:

We are looking to launch a validated program focused on people with Axial SpA, alongside our existing Joint Osteoarthritis and Fibromyalgia programs.

Launch of our Mobile Application

In the next 5 years:

Anooka is an adjunctive digital therapeutic to drug-based management for >70mn adults who will be living with painful arthritic conditions by 2030. Our offering evolves into a behavioral modification operating system that allows allied health care professionals and health coaches to work with people who struggle with painful conditions without a cure.

By 2030, Primary or Specialty care are able to offer Anooka's behavior modification platform to those who suffer from pain from arthritis:

•  to improve their quality of life through lifestyle interventions 
•  to understand the efficacy of drug-based interventions (DMARDS, NSAIDS, and in some cases Opiates)

1. Better quality of life outcomes for people suffering from Chronic & Rare Rheumatic Diseases: Ankylosing Spondilytis, Inflammatory Arthritis, Systemic Vasculitis

2. Pharma: Developing new drug targets and a better understanding of commercially available drug performance

3. Additional revenue to allied health professionals & community health aides who perform chronic care management

Our web-based digital behavior modification platform:

1. Pairs with a qualified health coach who is also a licensed allied health practitioner (PT, OT, Nurse Practitioner), 
2. establishes baseline health and behaviors, 
3. Identify triggers and track performance of drugs, food, supplements and alternative remedies for adverse v. positive health outcomes
4. Helps define goals and activities to get to them
5. Educates about their condition and the science behind lifestyle modifications 
6. Generates SMS notifications for activities

Our approach is built on the following clinically-validated methods

1. Cognitive Behavioral Therapy for Pain and Insomnia (= Determining short-term experiments)
2. Virtual Exercise Therapy
3. Health Literacy Interventions
4. Behavioral Neuroscience - Motivation, Kohlers Effect

Diversity is key to the success of Anooka. Effective behavioral interventions are possible only if we understand the cultural, social and environmental differences along with a persons' health.

• Our early members
  • 55% above 55 years old
  • 60% from rural or small towns
• Coaches from BIPOC communities
• Our approach is specific to male or female biology

We have a B2B2C business model selling to:

Infrastructure as a service (Technology + Credentialed coach - optional)

• Allied Health Clinics (Pain Psychology, Physical and Occupational Therapy) with a per enrolled member per month fee model for using our technology
• Rheumatology & Orthopedic practices looking to tap into reimbursements for remote therapy monitoring & behavior modification through allied health staff affiliated to their clinics

For members/patients who want to have access after they engage with the clinic:

we are developing an annual membership fee that retains access to their data and all the core functionality of the app. When they want to engage with a coach again they can reach out to the person/clinic via the application

Near to mid Term

Enabling Allied, Home, and Community health clinics to deliver Chronic and Remote asynchronous care with the potential to make close to $25K per provider through current reimbursement frameworks.

Transitioning to Large Group practices & Managed Care Organizations for better management of their panels consisting of chronic rheumatic diseases.

Long Term

Getting through FDA Prescription Digital Therapeutic category to be offered as a prescription via practices and reimbursed for the duration a person utilizes the offering.

We have 4 OT practitioners from Alaska and Rural Michigan who are a part of our next pilot to evaluate clinical and health economics and are on track to adding more