TriVox Health: improving care through shared online tracking

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Since we spoke with the founders of TriVox Health in 2014, their disease management program has taken off. The program began in Boston Children’s Hospital’s Division of Developmental Medicine as a way to more efficiently collect information on children’s ADHD symptoms from parents and teachers. It is now a user-friendly, web-based platform for tracking multiple conditions, incorporating medication confirmation, side effects reporting, disease symptom surveys and quality of life measures.

Vector sat down with founders Eric Fleegler, MD, MPH and Eugenia Chan, MD, MPH to learn about TriVox Health’s rapid growth over the past year, and what their plans are for the future.

How did TriVox Health branch out to other conditions beyond ADHD?

Chan: A lot of my colleagues started enrolling their kids with other disorders in order to get the quality of life measures. We quickly spread to other clinics within the hospital. Within the first year, we had enrolled 1,000 patients, including many without ADHD.

How many users do you currently have, and with what conditions?

Fleegler: TriVox Health is now being applied in nine clinics and across six conditions: ADHD, autism, anxiety, depression, epilepsy and asthma. To date, we’ve had 2.5 million questions answered from almost 5,000 patients and over 13,000 responders. We are working on expanding to other clinics within Surgery, Neonatology, Cardiology and Endocrinology. More conversations are always trickling up. We’re poised to go anywhere in the hospital.

What is the end goal for patients, and are you achieving it?

Fleegler: We are currently studying the platform to see if it makes a difference. Initially, we surveyed roughly 400 adolescents and parents to find out how they use technology and if they would feel comfortable communicating with their providers; the vast majority said yes. Within TriVox Health, we have enrolled over 900 families in a longitudinal cluster randomized controlled trial of the system. Just last week, we started to look at some of our enrollment data and we’re seeing a significant difference between those who use TriVox Health and those who are not.

We are still evaluating the data, but I think we’re going to demonstrate that patients and families are better engaged, their doctors know them better, communication improves and families feel greater satisfaction with their visit. Our long-term goal is to show that we truly affect care and health outcomes.

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Questions from a patient questionnaire. Click to enlarge.

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TriVox Health asthma
Provider’s view of a patient questionnaire. Click to enlarge.

What has been the biggest challenge in growing TriVox Health?

Fleegler: There are plenty of people who have a great idea but it’s another thing to know how to make it happen and take action. Part of the game — in a good way — is finding good people who you can work with, raising the money so that you can pay them, and then learning how to make your idea work.

Chan: When we branched out to other clinics, we found that while we can get clinicians to buy into the concept of what TriVox Health does — having more information by getting data from patients in between visits — but we have a challenge in making it work on a day-to-day level. They may say, “Yes, I really want to be able to monitor my patients much better and know what’s going on with them all the time.” But then we have to make it easy to incorporate into their workflow, in the context of an already busy schedule — that’s a huge challenge.

What’s on the horizon for TriVox Health?

Fleegler: We set up TriVox Health as a web-based system originally and now we’re launching a mobile app. Patients, parents and others who are filling out these questionnaires will be able to do so on both Android and iPhone iOS systems. Currently, while our teachers and parents are using it in the 50 to 70 percent range, our adolescent usage is in the range of 15 percent. Mobile has the potential to greatly improve adolescent usage.

We’re also trying to commercialize our product. In the fall of 2012, we received a $100,000 grant from TIDO (Boston Children’s Technology & Innovation Development Office) to make TriVox Health more widely available outside of Boston Children’s Hospital. We were able to successfully expand to two outside clinics: Pediatrics at Newton-Wellesley and Longwood Pediatrics. Now we are trying to figure out how to bring this to providers across the country.

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Provider’s view of data from multiple respondents and response to therapy. Click to enlarge.

Do you plan to expand outside of pediatrics?

Chan: The secret of our success so far is that we leveraged all of our personal and professional connections within Boston Children’s to move our product along. If we expand outside of the pediatric world, we don’t necessarily have those kinds of relationships.

Fleegler: That said, we think about it every day.

To learn more, visit the TriVox Health booth at the Global Pediatric Innovation Summit + Awards, November 9-10, at Boston’s Seaport World Trade Center.