Ampersand Health Provides a Consistent Community of Care for Some of UK’s Most At-Risk (and…

Ampersand Health Provides a Consistent Community of Care for Some of UK’s Most At-Risk (and Frequently Overlooked) Patients

Backed by clinical validation and empathy, a team of doctorpreneurs created an app to empower and enhance the wellbeing of chronic inflammatory disease sufferers – giving them the tools to manage their own care and minimize the physical and mental challenges caused by fluctuating relapse and remission.

Challenge

You cut your finger or scrape your knee, and your body sends inflammatory cells to heal the affected skin. This is an example of ‘acute inflammation.’

‘Chronic inflammation’ occurs when your immune system sends those same cells to various parts of your body even though no trauma or injury has necessarily triggered them. This form of inflammation can cause pain or discomfort and have a significant impact on your physical and mental health. It often presents in the form of “flare-ups,” where an individual experiences more distressing symptoms for a period of time followed by periods of “remission” when symptoms are non-existent or well-managed. This cycle of relapse and remission can be unpredictable, causing a great deal of stress for an individual and making them feel out of control at times. The unique bi-directional relationship between your mental and physical health is magnified during these episodes, because one can positively or negatively impact the other.

Crohn’s and ulcerative colitis, inflammatory arthritis, and eczema and psoriasis are examples of chronic inflammatory diseases. The uncertainty of when symptoms will arise can create anxiety. In addition, many patients find it hard to develop an understanding circle of care to support them through their condition journey out of fear of the physical and emotional burden these diseases can place on others as well as the stigma attached to them. The things patients do to stay one step ahead — i.e., track symptoms on their phone or in a notebook, chronicle eating and sleeping patterns, etc. — are frequently exhausting and overwhelming as they continue to wonder, “Will my body let me down when I need it most?”

The current apps meant to help patients are not clinically validated, making it difficult for attending physicians to trust they’re getting the right information to provide the best care. These digital solutions also don’t focus on helping patients self-manage both the physiological and emotional pain they face once away from a doctor’s care.

UK gastroenterologists, Dr. Bu Hayee and Dr. Gareth Parkes, recognized their patients’ ongoing challenges and feelings of powerlessness, and raised concerns about how those in their care were managing on their own. They began asking the questions: “How do we know you’re safe when you’re out of hospital? How can we be sure you’re not falling through the cracks, and if you have an episode of relapse, how are we making it easy for you to escalate yourself so we can see you when you need to be seen?”

Finally, they wondered, “How can we deliver not just a service but an optimum service for people living with these conditions?”

Ampersand Health offers an answer.

Origin Story

Dr. Bu Hayee, Consultant Gastroenterologist and Chief of Service for King’s College Hospital in the UK, and Dr. Gareth Parkes, Consultant Gastroenterologist and Clinical Lead for Gastroenterology at Royal London Hospital, were becoming increasingly aware of the physical and mental toll chronic inflammatory disease symptoms took on their patients. They each looked at the state of their own departments and wanted to provide patients with the best support to better self-manage their own disease to improve their lives, both physically and mentally.

The current slate of digital apps on the market — they researched more than 80 offerings — was not addressing the problem. Although they knew none were clinically validated, there was a bigger issue: chronic inflammatory disease affects a lot of people — in the UK alone, one in 123 people suffer from either ulcerative colitis or Crohn’s disease and approximately 10 million people have arthritis — but the umbrella term of “chronic inflammatory disease” covers 40 or 50 manifestations of the same thing in different parts of the body under different names. This means, these varied disorders do not have the same perceived scale as something like diabetes or heart disease, and the tools available are not as advanced and immersive as those for other ailments.

Drs Hayee and Parkes not only wanted to focus on the “disease” itself — regardless of the manifestation — but the way it presents by building a business plan around the common experience of relapse and remission that develops in chronic inflammatory diseases. They shared their idea with Nader Alaghband — who would become the third co-founder and CEO — and the trio realized that by developing a platform supporting long-term remission while empowering patients to manage their own wellbeing even during a relapse, they could enhance and improve their physical and emotional wellness.

The team immediately involved national charities and conducted patient and clinician focus groups to inform the experience before their first UX/UI exercise. They developed a basic data collection and messaging tool, and as things progressed, they realized what they built could support a business, and Ampersand Health was formed.

Under the Hood

“Monitor. Learn. Manage.” These are the three main tenets of the Ampersand Health app and website. They currently focus on two types of chronic inflammatory disease: IBD through the app “My IBD Care” and arthritis through the “My Arthritis” app. Ampersand’s dermatology-focused app is set to launch in 2023. Expert advice is provided to help patients “Monitor. Learn. Manage.” their care, helping patients at any step of their condition journey.

The app and site focus on two groups: clinicians and patients.

For clinicians: Hospitals use the platform to monitor and manage their patients’ care. Care plans are created to outline what patients are expected to do when they are not being seen by their doctor — for example blood tests, answering questionnaires, submitting data from other sources, etc. The platform hosts their care plan and makes it simple to assign patients to it. This teaches the system what that person needs to do at different times, which helps generate a to-do list for the clinician to virtually monitor progress and alert them when a patient is in need. The interface also integrates with several electronic patient records, allowing the clinical team to review how individuals are progressing from a mental vs. physiological perspective, for instance.

For patients: The goal of the app is to make it easy for them to adhere to their care plan and not feel overwhelmed by having to keep track of tasks themselves, because the clinician has set up prompts, reminders, and to-dos for them, which are all sent through the app. The app also provides various tools to help users learn more about self-management to feel more confident living with their condition. Patients also own their own record, so if they’re traveling and they need to alert their doctor, they can use the app to share data with whomever they want on their clinical team. A sense of community is created through virtual events hosted by Ampersand Health to alleviate the feelings of isolation, powerlessness, and stigma often attached to chronic inflammatory diseases like IBD and arthritis. An in-app newsfeed offers engaging and informative articles and stories, as well as registration links to the hosted events where patients can meet others and learn from clinicians and experts about their condition.

Ampersand Health also created their own behavioral science framework using 18–20 behavior change techniques from a behavior change wheel developed by the University of London. Expert-led courses are available in a variety of relevant subjects and when a patient begins a course, they receive a short video highlighting the key message and a series of small activities to help incorporate what they learn into their day-to-day life. Through these apps, patients have seen significant improvement in their life — including a 34% improvement in quality of life measured by disease control over a two-week period, and a 23% improvement in anxiety and depression.

Why We’re Proud to Invest

As mentioned, chronic inflammatory diseases affect many people around the world. The stigma often attached is significant — especially for those with IBD — managing the unpredictability of relapse and remission is physically and mentally draining, and those suffering from these different conditions often feel alone. This means those in need of care may suffer needlessly, and Ampersand Health has found a solution to that. Much of what the company is doing is helping people break down barriers with their doctors and their family members, so the people around them are more informed and able to be there when they need them most. Doing so provides a pathway for patients to take charge of their own care, leading to a better sense of wellbeing and a more fulfilling life.

StartUp Health is impressed by the work Ampersand Health is doing to break down those barriers to enhance and improve the wellness of the chronic inflammatory disease community and the steps they are taking to provide long-term remission for sufferers. We are also intrigued by the personal experiences the co-founders and staff draw from to continue to grow and build the business in support of the patients they serve. This was started to solve a tangible, living problem Drs Hayee and Parkes saw firsthand, and it has grown to support approximately 40,000 users and counting.

These aren’t just numbers on a spreadsheet, however. Members of Ampersand Health interact directly with the users of their apps, running a patient engagement program that includes different events that put faces to those they help. Knowing the people behind the tool they are using to manage their care are always working to better understand their experience and that they genuinely care about them reinforces that feeling of community and comfort for users.

“Our vision is that by focusing on these specializations and building a uniquely rich data set, we will be able to start to predict flare and personalized treatment for people with chronic inflammatory diseases in a way that should hopefully prolong remission in all patients to the point that we become part of the cure,” Alaghband explains. “That is a prediction and personalization challenge we’re up for and hope to be able to solve.”

Ampersand Health came at this not as a hypothetical mission or a business challenge, but as a real-life opportunity to make a difference in an area Drs Hayee and Parkes recognized needed deep support. Together with Alaghband, they built a company with others who cared just as deeply about the cause they stood for and gave patients more support around a significant part of their life they may have felt powerless against before. StartUp Health applauds that attention to personalized care and work to destigmatize and empower this frequently misunderstood community.

Join us in welcoming Ampersand Health to the StartUp Health family.

→ Learn more and connect with the Ampersand Health team.

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Ampersand Health Provides a Consistent Community of Care for Some of UK’s Most At-Risk (and… was originally published in StartUp Health on Medium, where people are continuing the conversation by highlighting and responding to this story.

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