JOURNAL TRANSCRIPT

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Die Digitale Pille

Wie die Digitalisierung nicht nur Patienten, sondern auch das Gesundheitspersonal unterstützt Dr. Tobias Kowatsch, Scientific Director

Zürich | 27. Oktober 2017

CSS Health Lab

Health IS Lab

§ myStep / Ally § The empowered patient 1. Mobile Asthma Companion 2. Mobile Diabetes Companion

§ Alphastreams § SNF MCoach PersChange § Job Crafting IS § MobileCoach § SNF PathMate 1&2

§ § § § §

stressOUT / 2.0 KTI MOSS Privacy Paradox KTI CH Teamcoach SNF MCoach Diabetes

Tobias Kowatsch Scientific Director

Jan-Niklas Kramer Peter Tinschert PhD Student PhD Student

Filipe Barata PhD Student

Florian Künzler PhD Student

Further Bachelor & Master Students (1) (2) (3) (4) Valerio Signorelli Master Student

Matthias Heuberger Director CSS Health Lab

Dr. Ioannis Tarmanas Senior Researcher

Dr. Dirk Volland Senior Researcher

Andreas Filler PhD Student

David Köppel Lisa Rebmann Jael Denicola Giulia Göller

Michael Klemmer Master Student

Information

Slide 2 | Dr. Tobias Kowatsch | Zurich | October 27, 2017

Iris Shih PhD Student

Collaboration

Dominik Rüegger PhD Student

Marcia K. Nißen PhD Student

© University of St. Gallen & ETH Zurich & CSS

Anatomy of Digital Health Interventions Distal Outcome Practical Problem

Example relevant to Obesity (myStep 2.0), and / or (Pre-) Diabetes Management Interventions

Body Mass Index

Justificatory Knowledge

…

Proximal Outcome(s)

Physical Activity

Stress Management

Diet Behavior

Justificatory Knowledge

Prototype Research Topic Research Method

…

Just-in-time Adaptive Interventions State of Receptivity § Self-learning § Digital Biomarkers

State of Vulnerability & Opportunity § Self-learning § Digital Biomarkers

…

Digital Coaching § Working Alliance, Engagement § Self-learning

DSR, experiments, micro(RCT), inference statistics, ML, etc.

MobileCoach Reference Platform for Digital Health Interventions Slide 3 | Dr. Tobias Kowatsch | Zurich | October 27, 2017

© University of St. Gallen & ETH Zurich & CSS

The Digital Coach

Alexa, Ask American heart how to perform a reanimation!

+

https://www.amazon.com/dp/B06WP3HFCK

itskoko.com buoyhealth.com

relationalagents.com

Slide 4 | Dr. Tobias Kowatsch | Zurich | October 27, 2017

web.lark.com

mobile-coach.eu

getflorence.co.uk

sense.ly

© University of St. Gallen & ETH Zurich & CSS

Digital Coaching - Woebot Chairman Woebot

https://woebot.io

Fitzpatrick et al. 2017: The “analysis […] revealed a significant group difference on depression such that those in the Woebot group significantly reduced their symptoms […] while those in the information control group did not.” https://mental.jmir.org/2017/2/e19/ Slide 5 | Dr. Tobias Kowatsch | Zurich | October 27, 2017

© University of St. Gallen & ETH Zurich & CSS

Physical & Digital Coaching Car ...

Hospital

Family Doctor

Smartphone

…

PC Mouse Wearable Family

Hobby

Digital Coach

Work Pharmacy

Working Alliance Goals, Tasks, Emotional Bond

Health Professional Health Institution Slide 6 | Dr. Tobias Kowatsch | Zurich | October 27, 2017

Patient Everyday life of a Patient © University of St. Gallen & ETH Zurich & CSS

Scalability of Digital Coaching

Be You – Stress management Be Smart – Social skills Be Healthy – Drug abuse After 4 months, already 2300 subjects participate and 1 “real” coach handles them by only 2 x 15 minutes per day.

www.r4l.swiss Slide 7 | Dr. Tobias Kowatsch | Zurich | October 27, 2017

© University of St. Gallen & ETH Zurich & CSS

Overview of Digital Health Interventions Open Source Platform MobileCoach

Selected Interventions 1. ISGF Smoking Cessation 2. ISGF Problem Drinking 3. OKS Eating Disorders 4. Bosch Workplace Stress 5. Lungenliga Life Skills 6. SNF Childhood Obesity 7. SNF Personality Change 8. SNF Romantic Partner Support 9. CSS Physical Activity Coach Ally 10. CSS Mobile Asthma Coach 11. CSS Mobile Diabetes Coach

www.mobile-coach.eu

Slide 8 | Dr. Tobias Kowatsch | Zurich | October 27, 2017

12. BLV Mobile Diet Coach

IP belongs to the intervention author(s) © University of St. Gallen & ETH Zurich & CSS

MobileCoach

Childhood Obesity

PD Dr. med. Nathalie J. Farpour Prof. Dr. med. Dagmar l’Allemand Head, Obesity Care Program Paediatric Endocrinology / Diabetology Department of Community Medicine Children’s Hospital of Eastern Switzerland University of Geneva Zurich University

http://www.c4dhi.org/lab/projects/pathmate2/

Physical and Digital Coach

Physical Coach Digital Coach

Slide 10 | Dr. Tobias Kowatsch | Zurich | October 27, 2017

© University of St. Gallen & ETH Zurich & CSS

Childhood Obesity PathMate

Patient View

Day 120 1347

670

55%

Steps

Points

Challenges

1 PM

Lukas PathMate Team

Dashboard view with gamification elements Settings

Slide 11 | Dr. Tobias Kowatsch | Zurich | October 27, 2017

© University of St. Gallen & ETH Zurich & CSS

Childhood Obesity

Health Professional View

Digital Coach Physical Coach Slide 12 | Dr. Tobias Kowatsch | Zurich | October 27, 2017

© University of St. Gallen & ETH Zurich & CSS

Adherence to Digital Coaching Interventions 13 Obese Children between 12 and 17 Years

93% 89%

88%

82%

80%

76% 73%

71% 71% 74% 57%

64% 70% 56%

61% 60%

73%

70% 69%

67% 62%

68%

62%

64%

60%

60%

57% 61%

53% 52% 46%

48% 49%

51%

39%

% out of 13 patients with at least 4 conversational turns

Slide 14 | Dr. Tobias Kowatsch | Zurich | October 27, 2017

51%

45%

43% 43%

37% 38%

56% 48%

50% 40%

43%

% of daily goal achievements © University of St. Gallen & ETH Zurich & CSS

18064 Conversational Turns (CTs) during 5.5 Months & 13 Patients, i.e. 8.6 CTs per Day PathMate Team Channel 3,80%

Month1

96,20%

1,43%

Month2

Month3

Month4

Month5

Month6

Lukas/Anna Channel

98,57%

0,70% 99,30%

0,56% 99,44%

1,67% 98,33%

1,52% 98,48% 0%

Slide 15 | Dr. Tobias Kowatsch | Zurich | October 27, 2017

20%

40%

60%

80%

100%

© University of St. Gallen & ETH Zurich & CSS

MobileCoach

Health Literacy for Children with Asthma

http://www.c4dhi.org/lab/projects/asthma-project/

Digital Health Literacy Intervention Excerpt: Key Visuals for Clip 2 (“Wie atmen wir?”)

Slide 17 | Dr. Tobias Kowatsch | Zurich | October 27, 2017

© University of St. Gallen & ETH Zurich & CSS

Dr. Tobias Kowatsch Scientific Director Center for Digital Health Interventions, University of St. Gallen & ETH Zürich www.c4dhi.org | mobile-coach.eu | [email protected]

Advisory Board Prof. Dr. Elgar Fleisch Lisa Marsch, PhD Prof. Dr. Urte Scholz Prof. Dr. Florian von Wangenheim

Center Leadership Dr. Tobias Kowatsch Matthias Heuberger, M.A.

Slide 18 | Dr. Tobias Kowatsch | Zurich | October 27, 2017

Research Team Filipe Barata, M.Sc. Sigrid Beer-Borst Andreas Filler, M.Sc. Jan-Niklas Kramer, M.Sc. Florian Künzler, M.Sc. Sergei Liubich, M.Sc.

Marcia Katharina Nißen, M.Sc. Dominik Rüegger, M.Sc. Iris Shih, M.Sc. Dr. Ioannis Tarnanas Peter Tinschert, M.Sc. Dr. Dirk Volland

© University of St. Gallen & ETH Zurich & CSS