Cognitant is a health technology company that creates ‘information prescriptions’, which aim to educate patients about their health. These clinically-led immersive experiences take the form of virtual reality (VR), augmented reality (AR) and interactive mobile content. The company aims to provide point-of-service health information in a format everyone can understand, with the motto “no medication without education”.
Here, Cognitant Group chief executive Dr Tim Ringrose discusses how the company’s platform is making patient information easier to digest.
Chloe Kent: What is the experience of using Cognitant for a patient?
Tim Ringrose: After a patient sees their doctor and discusses their treatment, they can choose whether they want to go to a little room next door to the consulting room and put on a VR headset like the Oculus Go to have a look at some information about their new treatment. The experience will explain a little bit about their disease, why the doctor is prescribing this new treatment, how to administer it and all sorts of practical tips and frequently asked questions.
If you want to watch the whole thing it will take about 20 minutes, but you can watch as little or as much as you want. Alternatively, you can choose not to look at it then and to go home and watch on a smartphone or iPad. If a patient’s smartphone is VR-enabled, which a lot of them are these days, they can use Google Cardboard or Google Daydream to look at it in VR.
We’re replacing information which would previously have been conveyed either by a consultation with a nurse at a later date, which sometimes takes place weeks or months in the future, or via printed leaflets or a web search – the latter of which can lead to finding material which actually isn't very accurate.
CK: So Cognitant is trying to get around the ‘WebMD effect’?
TR: Yes, patients often feel completely overwhelmed because there’s so much conflicting, concerning information online. If you’re starting a new drug, particularly a complicated drug like a biologic for rheumatoid arthritis, you’ll find all sorts of horror stories right alongside useful information if you type it into Google. What’s quite clear is very few patients would choose to have print information in this day and age, but what they’re looking for is still information endorsed by a healthcare professional.
We think that it's important to move away from print and to move into online, and to use visual tactics like VR and immersive content in 2D to empower people with virtually any educational background to understand their health. The average reading age in Britain is around 9 years old, so everything we produce we think, "Could this make sense to a 9 year old?" Then you have people with language issues or dyslexia which can mean that reading print information is hard for them.
Cognitant’s proposition is information prescriptions. Everybody is familiar with getting a prescription for a drug when they go to see a healthcare professional, and often it would be even more useful to have an information prescription. That way you can find out about your condition in a way that is relevant for you and answers the questions you have at that particular time that helps you make your own decisions and manage your health more effectively.
CK: What form do these information prescriptions take?
TR: We’ve developed Healthinote, a mobile phone app which accepts those information prescriptions. You can use it as a player and it receives the recommendations from the doctor as you see them. It means that the patient's got something on their phone that's recommended to them that they can look at whenever they have the time and the inclination.
Most of the time, doctors are giving out pieces of paper with a QR code on, which is scanned on the phone and recognises the content it needs to show the patient.
There's also something about VR that's very engaging but quickly we realised that having great content wasn't enough. We needed to provide tools to make it very, very easy for both sides: for doctors, nurses and pharmacists to recommend information, to make information prescriptions and for patients to be able to view them clearly and quickly.
CK: Which conditions is Cognitant VR currently able to explain?
TR: Our first programme is for primary care and it’s a VR/smartphone content experience for women looking to make the right choice for their contraception. It’s currently in the pilot stage before being rolled out to more UK GP practices in June and it’s a really interesting project.
GPs often aren’t able to fully explain the different options so the patient can decide what’s right for them due to time constraints, and Cognitant enables women to be able to look at the choices and rather than just simply going for the prescription of the oral contraceptive pill which GPs routinely prescribe.
The benefit for the patients is also a benefit for the GP, because it helps them give patients better information without taking extra time.
CK: As well as patients and doctors, how does Cognitant benefit the healthcare industry at large?
TR: The benefits for industry are around improving their credibility, raising their profile and getting some competitive advantage. Some industries, pharmaceutical most of all, still have a credibility issue. Businesses are looking for ways to provide added value, rather than simply to be producing tablets and other forms of medication. Plus, with biosimilar products coming into the market, they need to look for ways to be able to differentiate and raise the profile above the other producers of very similar chemicals.
We also believe that providing better patient education is a very important way to tackle the problem of medical non-adherence. Studies show that a lot of failures to adhere to medication as prescribed are intentional. People aren't convinced that they need to take it or don’t understand how they should take it. That's particularly the case with chronic diseases like diabetes where patients are often on many different regimens and they sometimes might not know why they're taking all these pills. If you've got five different tablets to take in a day there's a very high chance that you won't take them correctly or you might stop taking one because you're not really convinced that you need it.
Ultimately, that is good for patient experience but it's also good for the provider. If patients are using their medication correctly then the outcomes for those patients will be improved, meaning ultimately healthcare commissioners and providers will be more convinced that a product is effective.