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MONITORING IN THE WILD


Auckland Bioengineering Institute (ABI) senior research fellow Gonzalo Maso Talou refers to his work as developing “monitoring in the wild”. 


Together with Soul Machines, Maso Talou is leading a project to create a digital human platform powered by AI to support the treatment of chronic disease. “We want to provide behavioural coaching, literacy and personalised care management for people with chronic diseases such as Type 2 diabetes.” 


Soul Machines was founded in 2016 by Mark Sagar and  Greg Cross, and is built on a foundation of cutting-edge deep-tech research and a commitment to making AI accessible and ethical for all.  


“We want to revolutionise patient diagnosis and communicate the mechanistic understanding of the patient health to themselves using an AI-powered digital health navigator . In simpler terms – digital people who can communicate like a human,” says Maso Talou. It’s also about better and more targeted communication between the patient and the clinician. 


ABI Director Professor Merryn Tawhai is also working with Soul Machines, and an international consortium, to explore how their digital people could help patients with Type 2 diabetes and cardiovascular disease. Both conditions are intrinsically linked, treated in tandem and managed primarily at home by the patient with clinician advice and prescription medications. 


“But many patients struggle to understand their condition and how they should manage it, and very often don’t comply with treatment strategies recommended by their doctor,” says Tawhai. 


As Maso Talou says, “The patient feels fine without their meds and isn’t aware of any change – until they’re not fine and then it can be too late to do anything. We’re aiming to change lack of adherence and lack of communication by interfacing with that digital health navigator.” 


While there are other models on the market, Maso Talou says they’re constrained. “For example, referring people to an international resource means information won’t always be relevant to New Zealand. We need good New Zealand advice for patients, so we’re working with health providers and practitioners to curate that knowledge base.” 


This ties in with Tawhai’s development of a culturally appropriate digital health navigator. Linked with data from at-home and body-worn sensors, the navigator will read patient-specific information and talk to a patient in real-time to help them understand and manage their condition. 


"Rather than the episodic and reactive doctor-patient relationship typical in the real world, this would allow for continuous interaction that encourages and supports the management of chronic disease," says Tawhai. In other words, monitoring in the wild.  


Between them, Maso Talou and Tawhai aim to change the way patients and clinicians communicate to improve patient outcomes. “Often, a consultation is limited in time, information and decisions can be major. Patients may not be in the right state of mind to ask questions or take in the answers. They may not want to talk about their diagnosis. How can we help them? We can take that activity offline and into a calmer environment. The patient can ask questions and receive answers in their own time,” says Maso Talou. 


His platform would enable continuous monitoring from sensor devices such as smart watches and smart phones. Maso Talou says the patient often isn’t the best person to say what’s happening, nor are they going to analyse data like that. 


“Take someone with Type 2 diabetes. It’s critical the clinician has a 24-hour picture of the patient’s health, including their environment – a hypoglycaemic (low blood sugar) event at home is different to one in a clinical setting. Sensors will detect changes in stress and dizziness levels from the voice, heart rate and other biosignals, which can alert the clinician that the patient isn’t following the correct schedule.” 


“We can also record in the digital human platform  food and exercise diaries, and body measurements as part of that continuous monitoring to increase the information available to the clinician.  


“This technology already provides a communication channels between patient and clinician, providing disease and patient information in a natural language to the patient and clinically relevant sensor information to clinicians. The more we can facilitate information exchange via the platform, the more we can save time for the patient and clinician, offer robust advice from one source, and enable clinicians to focus on where they’re most needed.” 


Maso Talou and his team have been working with focus groups of clinicians, researchers, and end-users, including whanau to provide a useful and intuitive platform for both patients and clinicians. As a next step, they will pilot their platform with Type 2 diabetes patients. 

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