Folia: Because your knowledge matters

by Nell Meosky Luo

Chronic disease patients and their families make important observations every day. Folia captures these insights through easy multiple-choice questions, to enable the best care possible.
Cambridge, MA United States Patient Power Tools! Connected Health AMIA challenge

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About our project

The problem we solve: Precise treatment of chronic disease requires a lot of data about how different patients respond to available treatment plans. Right now, we rely on data captured at the clinic to make these decisions. It's not enough data, and it's not the right kind of information. To truly understand the outcomes of chronic disease treatment - and then to make sure each patient receives a treatment plan tailored precisely to her needs - we need to collect the insights that people have at home, every day, about how they or their loved ones are feeling. These observations, made by patients and their family members, are highly valuable, and should be part of the care conversation.

About our solution: At Folia, we call these insights Home-Reported Outcomes, and we're on a mission to harness the knowledge of families and patients - to make sure every patient receives the best care possible. Our platform, Folia, is designed to enable patients and their families to quickly capture the observations that they make every day – how the coughing was, whether treatments were completed, overall mood – using a set of personalized multiple-choice questions, defined by a combination of predictive analytics and user preferences. Over mere weeks of using Folia, which is available as an app both through the web and on iOS, users build a highly comprehensive database of what we call “home-reported outcomes,” or HROs. These HROs can then be communicated to the clinical care team through the Appointment Guide, a report that we have developed alongside our clinical collaborators to optimize its utility in the appointment setting.

Progress to date:

Please see the image below for a detailed timeline of our progress since we started work in 2016. Broad strokes: We completed our first full build of the platform in summer 2017, and started our first pilot program in cystic fibrosis at Maine Medical in Oct 2018. In spring 2018, after seeing very encouraging usage rates and feedback from our initial 90 user families, we expanded to an additional set of clinics, and started to test our distribution system in greater detail. In summer 2018, we debuted our iOS app, and we began work on an analytics engine to empower research with our data. Our focus for fall 2018 is securing our first research contract, and expanding to 500 families by Jan 1. 

About Our Team

Creator: Nell Meosky Luo

Location: Massachusetts

Education: Yale College

Bio: I'm the founder and CEO of Folia Health, where we're harnessing the power of the family caregiver to improve outcomes in health. Prior to joining the crazy world of startups, I worked as a management consultant for organizations in the healthcare, B2B software, and consumer goods sectors, among others. I went to college at Yale, where I focused on public health and biochemistry. My thesis examined how health reimbursement systems and best-practice protocols affect treatment for childhood obesity in the US, UK, and Italy. I'm a big public health nerd, excited about the promise that health tech holds for improvement of healthcare outcomes.

Title: Founder

About Team Members

Dan Toffling
Chief Software Architect, Bentley University
Biography: Dan has 15+ years of experience as a full-stack developer creating enterprise software. He studied comp sci and business at Bentley, and is the proud father of two children. His oldest has Down Syndrome, so he understands parent needs first-hand.
Title: Chief Software Architect
Advanced Degree(s): Bentley University
LinkedIn: https://www.linkedin.com/in/daniel-toffling-196756/

Peter Cerhan
Senior Mobile Engineer, B.S.
Biography: Peter grew up around medicine, with both parents working as doctors at the Mayo Clinic. He found an interest in computer science in college, and after spending 5 years developing apps and websites for clients through a consulting firm, made the jump from Minnesota to Boston to start a health tech career with Folia.
Title: Senior Mobile Engineer
Advanced Degree(s): B.S.

About Our Company

Folia Health, Inc.

Location: P.O. Box 398095
Cambridge, MA 02139

Founded: 2016

Website: http://www.foliahealth.com

Blog: http://www.foliahealth.com/caregiverchronicles

Twitter: @folia_health

Facebook: http://facebook.com/myfoliahealth

Other link: https://itunes.apple.com/us/app/folia-health/id1403862750?mt=8

Product Stage: In the Market

Employees: 3-5

How We Help Patients

Simply put - we help patients and family members to capture everything that's in your head, so that your observations and insights can be used by your care team to make sure that your treatment plan is the best fit for you. We hear from many of our Folia families and patients that the best reward for using Folia is the feeling of relieving a mental burden - it's hard to try to remember everything that you notice every day! Your insights are valuable, and we help you to make sure that they're heard.

How We Help Physicians

Care teams require a better evidence base in order to treat patients in the most efficient and effective manner possible. At Folia, we make it easier to do your job by giving you access to patient and family insights in a more organized and usable manner than ever before. With Folia's Appointment Guides, you'll be able to quickly understand the patient's use of treatments at home, and the outcomes that they are experiencing. We're currently working with our partner clinics to develop a pre-clinic planning solution that will allow you to walk into clinic fully-informed - so you can spend the valuable appointment time discussing and problem-solving, rather than simply collecting information.

How We Help Hospitals

We are excited to partner with hospitals in order to bring our clinic-level impact to a larger base of providers (see "How you help providers" section). We also partner with AMCs in order to improve the evidence base available for population-level research. 

How We Help Partners

We work with organizations that are looking to integrate continuous home-reported outcomes data into their understanding of conditions and treatment efficacy, with the ultimate goal of improving the targeting of treatments, our understanding of treatment value, and enabling the development of therapies that do even more to improve the lives of patients. For more information, reach out to nell@foliahealth.com.

Challenge Mission

Affiliation(s)

Our advisory board includes Irwin Birnbaum, RWJF Clinical Fellow at the Yale School of Medicine and former CFO, Yale-New Haven Hospital; Francisco Bonilla, MD, PhD – Former Program Director, Clinical Immunology, Boston Children’s Hospital; Mary Ellen Corrigan, APRN-PNP– Pediatric Nurse Practitioner in Pulmonology at Maine Medical Center; Margaret Grey, DrPH, RN, FAAN – Former Dean of the Yale School of Nursing and Anne Griffin Professor.

Key Milestones Achieved and Planned

We released Folia in a limited launch to the cystic fibrosis community in Oct 2017, and since that time have worked with nearly 250 CF families. Our monthly-usage rate has been high and has remained so over more than a year since launch, steady at 35% of all registered users. Our 250 families have answered more than 50,000 total Folia questions. Our next inflection point will be growth within the CF community; we are pushing to hit 500 families by the end of 2018. Looking forward, we are excited to launch in 2 additional conditions in 2019, and to start population-level research with our CF dataset.

Our Competitive Advantages

We have no direct competition in the condition-agnostic digital home-reported outcomes collection space. This is largely due to the significant technical requirements of building a condition-agnostic platform (see next section). Existing adjacent competition: Lifeguard, Caresync, Wellframe, Genia, and Healthjump are all chronic disease management platforms. Primary advantages: Simple, quick interface. Provider-agnostic, little time/no login req’d from hc providers. Targeting most motivated market – caregivers. Paying attention to growing needs of pediatrics. Patent-pending system for AI mgmt of questions.

Barriers to Entry

We enjoy both an early-mover position and unique IP that together establish a moat around our space. While we do expect that there will be other condition-agnostic digital home-reported outcomes platforms that emerge in the next several years, we are currently focused on moving quickly into multiple condition areas, in order to lock up distribution agreements with providers and disease communities, and to become the incumbent solution. Our unique IP is broad, given the lack of other solutions in the space, and we have plans to further invest in our IP strategy in the coming year.

Funding, Partners and Alliances To Date

We raised $270k from angel investors on a convertible note(mostly Northeast healthcare executives) in December 2017. We are currently raising a seed round of funding totaling $3M. This will likely be a priced round. We were members of the MassChallenge HealthTech (formerly Pulse) cohort in 2018, and we won one of 5 awards at the finale in June 2018. We have strategic alliances with Vertex Pharmaceuticals, AARP, and three provider partners.

Innovation Details

Intellectual Property Summary

We have filed a provisional patent and have plans to follow up with 3-4 patents in 2019. 

Clinical Information

We have no FDA approval requirements. For some studies, we will require IRB approval; we have started the process with collaborators at Dartmouth-Hitchcock. Our entire platform and back-end are HIPAA-compliant. 

Our data is primarily used at this point for improving the evidence base available at clinical appointments. We have an abstract that will be published in Pediatric Pulmonology in Nov 2018 that outlines our platform and the method of distribution through the clinic. We have not yet studied any impact of Folia upon patient/caregiver outcomes. 

Regulatory Status

We do not require FDA approval.

How we will use the funds raised

We are not raising crowdfunding at this time. We raised a round of angel funding in Dec 2017, and we are now looking for institutional (VC) investors for our seed round. Please inquire at nell@foliahealth.com. 

Thank You

At Folia, we believe that the patient and family have important insights that should be captured and made an integral part of the care conversation. If you agree with us, please reach out.

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Nell Meosky Luo
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Yale College

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