Partnership in managing chronic conditions through technology: Collaborhythm, MIT Media Lab’s New Medicine Group

The doctor-patient relationship has been largely paternalistic. But with consumer empowerment,
changing patterns of disease, rising costs, and ubiquitous technology, this relationship needs
to change.

CollaboRhythm is a speech and touch-controlled collaborative interface where doctor and
patient make shared decisions. Patients engage with their data so that they can take action
in their lives, and self-manage in partnership with their doctors, who act more as coaches
and navigators.

Patients own their own data in CollaboRhythm: everything they see in the doctor’s
office is available at home, or when they visit another doctor, or when travelling. Equally, patients
can contribute data of their own – for example, their perceptions about social support, diet and
alternative therapies.

CollaboRhythm is not a tele-presence system – it doesn’t beam the doctor into the patient’s
life – but a system for tele-collaboration. The idea is that continuous monitoring helps patients
to live a healthier life, making them less likely to need more intensive therapy. An earlier model of
the innovation was used as a way to encourage and monitor medication adherence by people
with HIV infection.

The New Medicine Group at MIT is looking ahead to developments such as doctors’ sending out
medication reminders to patients’ bathroom mirrors or television sets. Patients can interact
with intelligent conversational agents before visiting doctors. Doctors can send patients
visualisations of their progress, presenting details in a form that is understandable and
actionable by the patient.

The underlying premise of Collaborhythm is that patients cannot be expected to adhere to a
medication schedule unless given reminders or encouragement. Patients and doctors make
a joint decision to schedule medication and reminders. Originally the schedule was managed
through a “Chumby” - an embedded computer device formerly made by Chumby Industries
Inc., which provided Internet access via WiFi - though other interfaces are now used, and which
reminds patients to take the medication and record it. Adherence data can be fed back to the
clinician in real-time. Clinicians can send short videoclips to patients to view on their device.
A pilot showed that patients were enthusiastic about the approach, and that most improved their
adherence to medication.

Enabling patients to be active, informed participants in their own care is surely a valuable way of
increasing quality, improving outcomes, and reducing cost.