Building a digital strategy for better health

At Eucalyptus, our mission is to empower patients and practitioners with technology. We’re building digital solutions to raise the standard of telehealth at a global scale. These solutions aim to drive efficiency and scale through well-time interactions, creating a high-touch experience for our patients. However, these ambitious goals aren’t met without significant challenges. 

Navigating obesity management in the digital health space requires an innovative approach. While our mobile app puts our patients' health journeys into their pockets, this isn’t enough to ensure results. Motivated to solve this challenge, our product and engineering teams have built the Patient Adherence Loop, or PAL for short. This is the architecture behind our digital platform that supports us in delivering the most effective and engaging patient experience possible. 

Understanding the Patient Adherence Loop (PAL)

The Patient Adherence Loop is the map of our patients’ journeys. It describes the dynamic closed loop of data-driven inputs and outputs that sets patients’ goals, tracks their progress and keeps them motivated to continue with their treatment program.
From each interaction a patient has on our app, to their communication with health coaches and medical support, the PAL works to optimise these touch-points and ensure they are both highly effective and engaging. Whatever actions patients complete, it pushes the PAL cycle along. 

How it works

1. Patients complete actions as part of their program. This includes any physical tracking activity like weight and waist tracking, quiz responses, and engaging with medical support or health coaching. 
2. These inputs are then turned into observations by our Health Coaching Trends Engine. Patient data is analysed in real time to categorise and flag certain behaviours. These behaviours could be anything from the lack of data (meaning a patient isn’t tracking consistently) to a plateau in patient progress. 
3. Patient trends are then defined. Our lifecycle communications team is looped into these trends and can trigger outreach to patients within specific segments, at scale.
4. Patients who demonstrate certain high-priority trends are flagged and funnelled into a triaged inbox for Health Coaches to have 1:1 communication with.
5. Patients are given direct actions and advice from their coach to support them in reaching their goals. 

Leveraging data to deliver a seamless patient experience

As the volume of our patient data grows, we have a responsibility to do something with this information. This means our tooling and level of personalisation must also grow. The PAL is effective because it enables our multidisciplinary care teams to deliver personalised support, at scale. 

Our practitioner dashboard makes it easy for coaches and practitioners to monitor patient progress and troubleshoot any issues directly with the patient. Patient trends and insights derived from this data are summarised to allow practitioners to jump straight into valuable conversations with their patients via in-app chat. This alleviates the need for coaches to complete complex analysis themselves. Displaying this level of detail via a dashboard was a complex product, design and frontend UI challenge to overcome. We also need to normalise data from numerous different sources. Like manual tracking, device integrations, third parties and diagnostic tests. This created an interesting scale data problem. 

However, it allowed us to use this diverse patient data to streamline multi-practitioner care, with our prescribers and non-prescribers able to communicate through notes and see a single unified view of a patient's journey. This presented another interesting engineering challenge to expose the right thing to the right person so that we ensure our multidisciplinary care experience is seamless.

This system works to solve one of the main problems that most weight programs face — adherence. Patients are supported at each touchpoint and program engagement is strongly encouraged, allowing for higher quality and more consistent intervention.

On our program:

• Over 1000 patients track their weight on Smart Scales, and an additional 1000 patients track their weight manually
• 1 in 3 patients use the app each day 
• 2 in 3 use the app each week
• 4 in 5 use the app each month

Levels, goals and actions: What are they and how do they work? 

Beyond practitioner interactions and the collection of data, the quality of the personalised program that we are offering patients needs to meet their expectations. Introducing Levels, Goals and Actions. 

When patients join the program, we get them to fill out a questionnaire that allows us to set their levels across three pillars, Fuel, Burn and Build. Based on this data, we assign patients to an appropriate level which should give them just the right amount of challenge. Patient data is collected from multiple sources to tailor the program to their level. 

We are currently working towards feeding all patient data into this process (as opposed to just self-evaluation) to allow for more informed level setting, including historical health tracking data from their smartwatch or phone. This would give each of our patients the highest chance to succeed in making progress. 

To progress through their levels, patients need to achieve goals by completing certain actions and milestones. Each level of the program introduces new goals with a set of daily or weekly actions. This allows patients to focus on the small steps that accumulate to create significant change. For the Milestone feature, our product designers worked hard to formulate a delightful experience to celebrate meaningful progress in smaller steps for the core patient biomarkers we track.

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As the program supports video, written and recipe content, we had to overcome a significant design and product challenge. It was our mission to create a multi-modal program that flowed seamlessly and shared just the right amount of info for patients to progress through their assigned goals. 

Delivering effective health solutions for complex conditions, such as obesity, is an immense technical challenge. The success of our PAL and LGA builds ultimately hinged on how well different functions of our business worked together. These were both deeply cross-functional projects, requiring input from engineering, clinical operations, health coaching and product. Thanks to the collaboration and innovation of every team within Euc, we’ve been able to make significant strides in raising the standards of telehealth at a global scale and delivering meaningful patient experiences. 

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