Lead Organization: AOK (Public health insurance organization)
Program Name: Multimodal Pain Therapy
Area of Care: Chronic pain
Healthcare Partners: StatConsult, Bavarian TelemedAllianz, Algesiologikum Munchen, Berlin Institute for Applied Health Services Research
Vendor: Kaia Health
Objectives
- Virtually deliver a technology-based fitness and health service to empower patients to self-manage their own health and pain-related symptoms
- Prevent unnecessary invasive treatments
- Prevent pain-related hospital admissions and readmissions
Model
Physicians and physiotherapists have developed over 300 exercises that can be accessed any time, anywhere via Kaia Health. Patients can be referred for enrolment by their clinician during check-ups and also self-enrol through the website. The app is downloaded by users onto their smartphones.
In the first three months of the program, patients are enrolled into a High Touchpoint Approach model, where they are instructed through the app and remote care coaches to build the healthy habit of exercising and practicing mindfulness. Patients are put on a tailored exercise plan and receive comprehensive back pain education. During this high touchpoint approach, patients get unlimited secure audio sessions with Kaia Health coaches, who are certified health care professionals. Patients are usually in contact with their coaches once a week, enabling the coach to personally motivate each patient to set and reach achievable goals.
After the first three months, patients are transitioned to a “maintenance mode” where they can access coaching services once a month. Other program offerings continue to be available (i.e. educational resources, exercise plan). Patients can access the coaching program at any time in the future and may request to move back to the High Touchpoint Approach if chronic pain symptoms and quality of life worsen.
Technology Type:
The Kaia app offers:
- Tailored exercise plans
- Augmented reality exercise adjustment AI
- Comprehensive educational back pain material
- Dedicated pain coach model
- Mindful pain reduction
Outcomes
At 12-week follow-up, the Kaia app group reported significantly lower pain intensity (M = 2.70 (SD = 1.51)) compared to the control group (M = 3.40 (SD = 1.63)). This program was especially useful early in the disease course for patients at high risk of developing chronic low back pain. This program allows family physicians to offer patients an effective low-cost treatment without delay.
Toelle, T. R., Utpadel-Fischler, D. A., Haas, K. K., & Priebe, J. A. (2019). App-based multidisciplinary back pain treatment versus combined physiotherapy plus online education: A randomized controlled trial. NPJ Digital Medicine, 2(1), 34.
Change Required to Support the Model
In an integrated care model, the change required to support this model came from how the patient was activated to manage their pain. Users who were activated through self-enrollment had a higher dropout rate than those activated by a clinician or case manager. Users enrolled by a trusted source are more likely to be engaged in the program, use the app for longer, and have better outcomes.
There were no staffing changes required to support program implementation, as Kaia Health offers its own certified coaches. Kaia also offers a coach-the-coach model, so that multidisciplinary clinics can incorporate the Kaia app into their own workflows.
Adoption Rate
As at October 2019, 300,000 people have actively used Kaia and 70,000 are active monthly.
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