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There’s an App for that: an interview with Anne Bruinvels, founder and CEO of PxHealthcare

Founder and CEO of PxHealth Anne Bruinvels joins OnFocus to discuss the launch of OWise Prostate, a digital app designed to support men with prostate cancer.

https://owise.uk/prostate/

Clare Delmar

Hello and welcome to On Focus brought to you by The Focal therapy clinic, where we connect you with issues facing men diagnosed with prostate cancer that are little known, less understood, often avoided or even ignored. Prostate cancer is now the most commonly diagnosed cancer in the UK. And with this sombre fact comes a multitude of challenges and opportunities. I’m Claire Delmar. Joining me today is Dr Anne Bruinvels, an expert in personalised medicine who founded PX Healthcare in 2012. During that time, she was also executive director at the European Personalised Medicine Association, where she realised that cancer patients’ experience following diagnosis is much poorer than it needs to be. And she founded PX to address this by correctly informing and supporting patients throughout treatment and recovery. Its first product was an app for breast cancer patients, which has been successfully rolled out in the NHS, leading the way for Owise Prostate. And Anne’s here to talk with me today about how this product will help men with prostate cancer. Anne, welcome. Thank you so much for joining me today.

Anne Bruinvels

Wonderful to be here, Clare, thanks very much for having me.

Clare Delmar

So let’s jump right in. Start with the basics. What is Owise Prostate and why should men use it?

Anne Bruinvels

Owise for prostate cancer is an app that’s been essentially co -designed and co-developed with men with prostate cancer who indicated they really needed support from day one of diagnosis with signposting and with essentially personalised information to support them through their whole disease pathway. So it is an app that people can download for free and then they can start using it by putting in a few profile details. And immediately they get back a tool that’s really helpful, which is a decision aid. And this was one of the things that several of the men demanded to have essentially, they said we really need something to help us have a better conversation with our doctor. And that’s exactly what we developed for them. And already they’ve responded by saying this really fills a great need for them. And then it’s essentially a tool that has lots of things in one place, and that includes a place to keep their treatments, to have things in their diary, to make secure audio recordings of their conversations with their doctors. And the security for us is really important, as is the privacy protection. And then the real feature that lots of men like is that people can track and trace how they respond to treatment. So people who have had treatment and for example, they’ve had issues with incontinence or with pain or with fatigue. All of those things can be very accurately monitored in the app. They can be reviewed back at any time, obviously by the users themselves, and then they can be shared in real time with their doctors, with their nurses or with any other trusted family members who they would like to inform about their wellbeing. So men say it’s essentially one thing that really keeps them on track and really supports them with their treatment.

Clare Delmar

Gosh, lots of questions popping up. But before I dig in, I know I spoke a little bit about your background in the intro, but can you tell us a little bit about what motivated you and inspired you to develop this?

Anne Bruinvels

Yes, absolutely. So my background is I’m a pharmacist and a biomedical scientist by training. I was very much doing research into genomics and genetics of human diseases. And while doing that, I became really passionate about the fact that lots of people who are affected by cancer get different treatments. So it’s very individualised and very personalised from that point of view. Having said that, very few people have access to personalised information and people always have to read a whole lot of things about things that don’t concern them about much more aggressive treatments, for example, or treatments or diagnostic tests that may not be appropriate to you. So I thought if it’s easy for me to find those things because I’m trained in this field, it’s very difficult for other people to find it. For me, it then became really important to make sure that people could have the right information at the right time and then also use these mobile tools, because this was sort of eight years ago when we started developing these things initially for breast cancer, as you said. And so we felt it was really important for people to also make sure it became their tool that they could populate with their data, they could review their data and if they want to share that data with others. And so then in the long run, we believe that that data in a fully anonymised way could be really supportive for both the patients, but also for medical research in general.

Clare Delmar

So, I mean, what are the lessons you’ve learnt thus far from the breast cancer app and its use?

Anne Bruinvels

What we learnt was actually really fascinating. First of all, we found out that by just having an app to support people with the tools that Owise has for both prostate and breast, and people feel much more at ease when they use it. They can actually have a conversation with their doctor in a better informed way, but also in a way that that makes them more relaxed because they can prepare better. Both apps, but also the prostate cancer app, contains a list of personalised questions that come up after you have filled in your profile. And when you change your profile, these questions change again. So in that way you can go into your consultation and your doctor’s visits being well prepared and at the same time, actually then in an easy way and listen back to that conversation back at home with family members and make much better decisions. So that’s one of the things we learnt, that people could have a better treatment discussion with their doctors and with their nurses. And then after that, we found out that people really like to manage their condition by monitoring their trends, how they feel. So we learnt from from patients who were being treated for advanced that is metastasised cancer. That actually by using the app, they could really much better gauge how the treatment was going and alert the nurses when things were going down, when things weren’t working well and also at the same time, use that same app to make sure that if they felt better, they could take on more. So we have people using the app to help them get back to work sooner, for example. So those are things we learnt on the go. And yes, we were have always been incredibly pleased with the really helpful feedback that we’ve had from users. So the app is continuously being updated with useful feedback from users.

Clare Delmar

I was going to ask you that. I mean, that’s that’s one of the sort of qualities, I suppose, about apps, is that you’re generating data all the time and you’re learning about your users all the time as well. So what are you learning about your users? I mean, is there a typical user? What are you learning about him?

Anne Bruinvels

Yeah, that is really interesting. Well, particularly for prostate cancer it was important for us that we made an app, which is, by the way, not just a mobile app, but it’s also what we call a web app that is a website where people can do the exact same things. And we found out that people really want to be informed in a very simple way. Everything has to be really clear and there shouldn’t be any ambiguity and that really these apps and websites should be there to take people along the way. So we make sure that everything is really easily indicated in the app, you know exactly where to click and no button is ambiguous, for example, it’s really well explained. And then the other thing is that we found out that men really wanted very specific things to monitor regarding their treatment. So, for example, with respect to prostate cancer, incontinence is a big issue. So we made sure that people could monitor the number of pads they’re using. Then the gentleman would also say, well, not every pad I exchange is the same. So we need to understand how much soaked it is. So we made trends. We made really easy tools and sliders to indicate also how soaked your pad was. So that way you always have a history, you know exactly what happened on which day. And you can really send that again to your doctors who may be interested to know how you’re doing and improve things for your own treatment, but also for the benefit of others in the future.

Clare Delmar

That’s really interesting, because one of the things I wanted to to ask about where the sort of non clinical aspects of prostate cancer itself and various treatments and of course, incontinence being one that men are very concerned about, sexual health being another one, and mental health being yet a third. Are there places to think about that, to address those issues on the app?

Anne Bruinvels

Well, absolutely. So we have the sexual health issues are also addressed in the app so people can can indicate their erectile function, changes to their sex life so they can monitor that as well. And then thirdly, or what you mentioned with respect to mental health, that’s really important, too. So there are also ways to monitor that within the app and to keep track of your mood, but also of the fears that people have. We know that cancer patients have a lot of fears about not just family related fears or financial issues, but also the fear of cancer recurring. So we’re actually collaborating, we’re very research driven at PX and working on Owise we’re always trying to make sure that everything is not just what we call medical evidence based, but that we contribute to research. So we’re working with researchers in Scotland on trying to understand how we can more quickly alert people when their fear of cancer recurrence becomes an issue and they may need to take action. So we’re really actively looking to develop that further. But it is already implemented in the app as it is.

Clare Delmar

That’s interesting because, of course, you’d be very familiar with one of the treatment options, or management options for men with particularly early stage or low risk prostate cancer is active surveillance. So I can imagine that the app might be of particular importance there. So another question I have is, like all diseases and cancer in particular here in the UK, I’m sure you’re aware that there’s quite a campaign right now to raise awareness about the so-called backlog of cancer patients that has been impacted because of covid-19. There’s a lot of fallout to this, not least of which is delayed diagnostics, delayed treatments. And I’m wondering if this has impacted any way on the app, if there’s any way that your app might help people maybe along the lines that you’ve been describing, what are you seeing as a result of the backlog?

Anne Bruinvels

Yes. So we started developing this app just before covid struck and then it struck and we essentially built it and it was released and launched last month. So it’s come just at a time when it can really start to support people. Well, I think what’s really important is to understand that actually it really feels a gap. So we have also urological surgeons who say. Well, really, they were trying to find a way to what they then call holistically support their patients with mobile technology, because people cannot always come into the hospital and Owise really fills that gap. So the patients, the users say the same thing. It really addresses needs that they have by having this tool now that addresses so many different things that are part of their their whole I don’t like to use the word, but it’s so easy to say the whole journey they have as a prostate cancer patient. So it really helps patients from day one, as you say, from actually diagnosis, even pre diagnosis all the way through their decision making that we call shared decision making process with their doctors. And then it goes all the way through even active space and then treatments. So it’s really this body that they can have on the way. And that’s the way that we try to design this, but really with the support of the patients themselves. And then for the clinicians, as mentioned, they say, well, this really fills a gap. We haven’t seen anything like this because you can bring it in really from the very first moment the patient comes into the clinic. And from that point of view it is really helpful all the way through to people going back to work and starting to play with their grandchildren again. And so it is yeah, we’re really pleased that this can fill the need that we’ve seen now. And in terms of backlog, I think we’re just at the right time to launch this, but also because men are now becoming much more able to use all sorts of mobile technology. We’re not saying they’re they didn’t do this before. But now, every man we encounter has a smartphone in their pockets and five years ago that wasn’t always the case.

Clare Delmar

No, you’re right. And I guess the epidemic is really accelerated that and using it for so many other aspects of your life. This is just yet another. So, yeah, I can see how that that comes in at the right time. I mean, that’s that’s wonderful. I mean, one final question is one of the things we noticed with a lot of our patients is how important the role of their partners is in supporting not only their treatment, but all other aspects of their journey, as you say. And I’m wondering if that comes in in any way, if partners can contribute or can share in any of this information?

Anne Bruinvels

Oh, that’s such a wonderful question, because the first thing we noticed when we started organising our workshops for cancer patients already, when we started early on, this was originated in the Netherlands, but we started working with lots of patients. Immediately we saw the carers come along and the partners come along to our workshops. And the same actually happened when we did last year or just before last year, we did our workshops with the prostate cancer patients and carers. All of them came along. And and that was really helpful because the partner often feels a little bit powerless, like they cannot really do that much. But with Owise we’ve make sure that there’s also a partner button that can be switched on. So that way it’s actually an app that can be used by the partner as well if the actual or carer in any way, because that way it can just be done as a collaborative tool. And that way the patient can actually delegate one of their close family members or friends, to really help them with this. So it’s really a tool for both.

Clare Delmar

I mean, I’m really looking forward to spending some more time on it. I’ve spent a little bit of time prior to this conversation, but now you’ve definitely inspired me to look a bit further and perhaps we’ll talk again with some more questions and maybe bring some of our patients into the conversation. So thank you so much for joining me today. It’s been a real pleasure. Something that I think we’ve all been interested in talking about. And I look forward to hopefully speaking with you again.

Anne Bruinvels

Well, that sounds amazing, Clare, I would love to have patients involved as well, because for them, that’s really the reason why we do it. So wonderful to chat. Any questions? Please, please don’t hesitate to get in touch. Just perhaps I might want say the website is https://owise.uk/prostate/ and you can find us on social media as well. But please, anyone with questions, feel free to contact us. We have a wonderful team supporting both the patients and also clinicians with questions. So feel free to get in touch.

Clare Delmar

Fabulous. Thanks again. Further information on Owise Prostate is available on our website, along with a transcript of this interview and additional interviews and stories about living with prostate cancer. Please visit www.thefocaltherapyclinic.co.uk. Thanks for listening and from me, Clare Delmar, see you next time.

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