Health Radius

Dr. Joyce is a cardiothoracic surgeon in the Department of Surgery at the Medical College of Wisconsin. Throughout his career he has worked in opportunities to drive innovation for patients with cardiovascular diseases. As Director of Heart and Lung Transplant at MCW, he authored a number of peer reviewed articles on novel approaches to challenging diseases. He is the co-editor of “Mechanical Circulatory Support: Principles and Applications” which is now in its second edition. He has also served as a member of the board for Medical 21, a new venture that is pursuing artificial coronary artery bypass grafts. He developed a technology (soon to be incorporated under the name “Hoplon”) which can treat Left Ventricular Assist Device thrombosis through less invasive lytic therapy. His current work involves the use of a smartphone app (“Health Radius”) to identify locations where coronavirus transmission risk is elevated, as an alert system for communities.

For institutions of higher learning, the in-classroom exchange of ideas and networking opportunities represent one of the most significant benefits of pursuing a degree. Recent data showing a rise in COVID-19 transmission among college athletes suggest that safety concerns could jeopardize the coming school year. Health Radius is a smartphone app that tracks symptom and geolocation data to establish safety thresholds for classrooms. Using artificial intelligence to screen for transmission risk can improve the allocation of testing resources to those individuals who exhibit the potential for asymptomatic shedding of the coronavirus. With widespread adoption of this approach on a global scale, geolocation-based alerts could provide alerts to individuals when entering a location where active virus may be present. This strategy could facilitate relaxation of social distancing measures without jeopardizing the safety of individual users.

In the state of Wisconsin there are 71 colleges and universities enrolling 211,401 full time students. The current daily COVID-19 testing capacity for the state of Wisconsin is 15,508. Despite the fact that most schools are planning to resume classroom activities in the fall, there are no well outlined strategies to ensure the safety of teachers and students. On June 1, the NCAA lifted its moratorium on organized sports. However, as student athletes and athletic personnel returned to campus new cases were reported at Iowa State, Oklahoma State, Marshall, Mississippi, and Alabama.  In light of the limitations in testing capacity and the impracticality of testing all participants in the University setting on a routine basis, a data-driven approach is needed to establish screening parameters which can allocate testing resources in the most effective manner.

The Health Radius Smartphone App serves as a “COVID-Clear” passport for users through self-reporting of symptoms and geolocation history. Since the virus can remain active on various surfaces and individuals typically remain asymptomatic for an average of five days after infection, an individual could potentially pose a risk for transmission simply from traveling within the same location as recent active virus. Given that the Wisconsin Department of Health Services provides an application programming interface (API) which updates infection rates at the census tract level (locations with approximately 4,000 residents) on a daily basis, it is possible to identify individuals who have traveled to locations with active virus within the previous 5-7 days. By incorporating symptom and geolocation data into the screening process for entering the university setting, individuals with potential exposure risk can be tested to prevent unknowing exposure to other members of the classroom.

This solution serves the student population in Wisconsin’s institutions of higher learning. By facilitating an earlier return to the classroom, this technology has the potential to improve not only their educational prospects but also their ability to successfully enter the competitive job market after graduation.

This tech innovation carries the potential to unmask the location of active virus within a community. By driving increased awareness, mitigation efforts can be more effective in that social distancing and hygiene efforts can be expanded in geographies where high levels of vigilance are required. By functioning in a complementary fashion to test and trace efforts, this technology can allow for return to normal classroom activities without introducing unacceptable exposure risks.

Exposure to COVID-19 is a risk that the clinician members of our team face on a daily basis. Early in the pandemic it became clear that the inability to identify locations where the virus might be present made it impossible to introduce precautionary measures that were both effective and sustainable. The desire to gain more awareness surrounding exposure risk and the insights gained from transmission data suggested the potential for a technology solution that captures geolocation data from smartphone users in order to provide alerts when exposure risk is elevated. A team was formed that included expertise in testing strategies, supply chain management, artificial intelligence solutions, and clinical features of COVID-19.

Our team believes that technology can aid in addressing the COVID-19 pandemic.  We are a team of medical practitioners and university researchers in Wisconsin and we are currently dealing with this issue of getting patients back in the clinic and students back in the classroom. 
Many of our colleagues, friends and loved ones have been affected by the pandemic. The pandemic has devastated our Wisconsin communities, including our university participants. Learning has been disrupted in unprecedented ways. In order to return to a safe classroom environment it is important that we are able to assess the presence of the virus and facilitate the safety of participants. 
Our Wisconsin Universities are also concerned that some students will not re-enroll if they do not feel safe on campus or in the classroom. Given the importance of tuition dollars to keep the university functioning it is critical that students are able to return to campus in a safe manner. The Health Radius app can be an important tool to allow universities to open safely. 

The complexities associated with restarting economic (or educational) activities during a phase of the pandemic when daily case counts continue to rise require that a multi-specialty approach be implemented as part of the solution. In this case, deep expertise in technology (AI/ML, blockchain, big data, Mobile app development, etc), Medicine (epidemiology, virology, infectious disease, etc.), and economics (supply chain management, behavioral sciences, marketing, etc.) is required to implement a solution which can be effective in the short  term. The collaborative relationships of the various institutions represented in southeast Wisconsin serves as another asset in that a city of less than 1 million residents offers a geography that is small enough to establish feasibility but large enough to address scalability.

In the early days of the pandemic, our clinical team recognized that in patients with severe COVID-19, the mortality rate was unacceptably high. For patients who required a mechanical ventilator, the chances of surviving this disease were 50/50 at best. After surveying our experiences with mechanical circulatory support devices we recognized an opportunity to provide a novel approach with the potential to improve survival. By initiating early treatment to support both the heart and the lungs, our team has reduced the mortality rate to less than 10% in these high risk cases.

In our efforts to develop an app based approach which could facilitate safer reopening measures, we encountered challenges with coordinating our efforts with other developers and institutional leaders. By adopting a collaborative approach we have formed key partnerships that will serve to improve the likelihood of success.

In May of 2017, I joined the Medical College of Wisconsin as the Surgical Director for Cardiac Transplantation. At that time, the cardiac surgical team was in the process of rebuilding across multiple fronts with the goal of developing a world-class surgical program that could rival even the top institutions such as the Mayo Clinic (where I had previously served on the faculty). By setting ambitious yet achievable goals from the very beginning and working in a collaborative fashion with partners across multiple disciplines, I led the team in performing more transplants than had been achieved in the entirety of the hospital’s history and more ventricular assist devices than the Mayo Clinic during the same year. Our surgical outcomes were among the best in the nation and we pioneered several new innovations in the field. One of these innovations used a mobile phone app to improve the educational experience of surgical trainees and received the Community of Innovators Award.

COVID-19 mitigation efforts have largely focused on contact tracing approaches, with digital contact tracing via smartphone apps garnering a great deal of attention due to the privacy features which can be achieved through the exchange of encrypted Bluetooth signals. This strategy was first employed by the TraceTogether app in Singapore and has subsequently been adopted by the MIT Private Kits app as well as the Apple/Google API which was made available to public health agencies. However, all of these solutions require high adoption levels on the order of 60% and lack the necessary incentives to achieve this degree of engagement. By addressing the problem in a proactive fashion and linking participation with access to events in which social distancing is undesirable, the Health Radius app differs from other technology solutions in a fundamental way. The use of blockchain ledgers to enhance privacy protection serves as a further innovation which can improve the accuracy of the predictive models derived from the data collected through the app.

Activities
Symptom reporting

Outputs
Infection risk based on geolocation and symptom history

Short Term Outcomes
Increased awareness of exposure risk

Medium Term Outcomes
Improved social distancing and mitigation efforts

Long Term Outcomes
Lower transmission rates within a community
Earlier return to mass gatherings and normal economic activity

Current number: <10
One Year: 100,000
Five Years: 1,000,000

Establishing the safe return to classrooms in selected universities represents the immediate goal to be achieved within the next year. Between one and five years, the goal would be to further deploy this technology in various types of mass gatherings with the potential to return economic activity to pre-pandemic levels.

The primary barrier involves achieving high levels of adoption needed to optimize the artificial intelligence features of this approach. Beyond the current pandemic, retaining high user adoption will require the implementation of new features to deliver additional health benefits.

The challenge faced by universities, casinos, live sporting and entertainment events, and other businesses that require mass gatherings to ensure viability involves the reluctance of participants to voluntarily engage in a technology solution such as the Health Radius App. By focusing on the university system as a beachhead market, we propose an option where the “default” mode of education would be the continued use of videoconferencing. While this would ensure the safety of students and faculty, it would also hinder one of the primary value propositions associated with institutions of higher learning. By linking access to these mass gathering events to app participation, we hope to overcome the adoption challenge.

Clinical Translational Science Institute-Coordination of research efforts
Medical College of Wisconsin -Clinical trial/ IRB protocol; infectious disease support
University of Wisconsin-Milwaukee-Business expertise/supply chain management
Milwaukee School Of Engineering-Data science/Statistical support
89 Clouds-Data science, blockchain, coding 
Department of Health Services-Data management on COVID-19 cases via API

The product is geared towards businesses and has two pricing models available based on the usage. The
first model is geared towards businesses that may need one-time screening (Theme Parks, Airlines, or
Sporting Events). The second product is geared towards businesses with a recurrent user base (Property
managers). Concierge service that allows businesses to access customizable business intelligence reports
are also available.
 
Subscription Per person
Product 1 $10,000 annually $5 per person
Product 2 $5,000 annually $1 per person per month

An investment of $2.6 M is needed over the next two years. Piloting the app in Wisconsin will require a $500 K investment, which will be raised through seed funding. Scaling the app to a national user base will be achieved through Series A financing of $2 M within a year of starting operations.

No funding has been obtained to date.

We hope to achieve grant funding through the CTSA to pursue feasibility studies in the university setting. Upon implementation, we anticipate raising seed funding from investors to expand the use of the approach to other business entities (casinos, restaurants, etc.). At the point of scaling on a national level, we hope to partner with Major League Baseball to implement strategies to allow for fans to return to baseball stadiums.

While the technology solution to mitigation is relatively straightforward—notify individuals when they are at risk for exposure so they can take preventative measures—the implementation and end-user adoption challenges make this approach extremely complicated. Despite the diverse technology, health care, and business background of our team, an undertaking of this magnitude will require partnership with an even broader range of talents to achieve the levels of community engagement, marketing strategy, and behavioral incentives that are needed to achieve the high levels of adoption at which this approach can be the most effective.

The partnership goals for this project include personalized support, an audience of global leaders, innovative community, mentorship, strategic advice, technical expertise, and business and entrepreneurship training, funding, partnerships, and acceleration. To help us accelerate our work, validate our impact and business model, and scale our solution, we will need the partnership opportunities available through ELEVATE.

MIT Sloan School of Business
MIT Safe Paths Private Kit team