Back to life - digital health coach improves quality of life for rheumatism patients

1.5 million people in Germany suffer from inflammatory rheumatic diseases, according to the German Society for Rheumatology (DGRh). 1.5 million people are limited in their quality of life every day by swollen, inflamed joints and extreme pain. And unfortunately, the rheumatism of these 1.5 million people is not curable. So how can we help these people? This is the question Christine Peine and Felix Lang asked themselves when they founded the startup Midaia. And they have found a solution: With their health app "Mida Rheuma", they pursue the vision of improving the well-being of rheumatism patients and reducing their disease activity by providing personalised health plans. In our joint interview, the two of the four founders talk about how a digital health coach can help rheumatism patients, what role lifestyle adjustments play in the disease history and what steps the startup has planned for the future. 

Health coaching for a higher quality of life

Midaia's solution focuses on non-drug therapies for inflammatory rheumatic diseases. The digital health coach Mida asks about various things from the patient's everyday life. Specifically, these are questions such as: How is the patient today? What pain does he have? How does he eat? After the requested data has been analysed, Mida develops individual health plans based on it. "The plans are quite short and contain concrete instructions on how the patient can improve various things in his lifestyle. Some of these are exercise instructions, recommendations on how to improve diet and eat anti-inflammatory food, or help on how to deal with depression and pain," explains Christine, one of the founders of Midaia. 

The Midaia team initially derived their recommendations from analyses of all the scientific and medical guidelines from Germany and Europe. As new studies are published, Midaia incorporates the results to provide patients with the latest scientific recommendations. "We keep improving this system over time so that it becomes even smarter and more personalised," says Christine. 

Lifestyle and health - two different pairs of shoes?

But how is a digital health coach supposed to help me if I cannot even be cured by medication and medical care? Many people and even patients are not aware that everything we do has an influence on the disease. This includes how we eat, how we exercise and even how one's attitude is towards one's disease. For this reason, Felix, also founder of Midaia, puts an emphasis on the importance of lifestyle adjustments within the disease story: "Lifestyle adjustments have a huge impact on health. Compared to medical care, which has a 10 to 20% impact on chronic disease, lifestyle adjustments are said to have a 30 to 50% impact. Lifestyle is one of the most crucial factors in these chronic diseases." In order to help patients in the best possible way, Midaia additionally shares the evaluated data with the rheumatologist in charge. "The doctor often lacks information between two treatment appointments. We provide him with this through an additional doctor's application so that he can also make better decisions in terms of medication," says Christine. Through the interaction of improved lifestyle and medical treatment, the patient should be able to live a largely unrestricted life. 

From the app to the medical device

The Mida Rheuma App is a medical digital application, which is why approval as a medical device is essential. To ensure that the benefit of such an application is greater than the risk of harm, there are laws in Europe that require this approval. The first step to certification is a risk assessment, as well as mitigation of the existing risks. "Through this step, we found and improved some points to make our product as safe as possible," says Christine. The second step is to prove the clinical efficacy of the application. Christine explains how Midaia has proceeded to do this: "We have shown that we reduce disease activity and improve patients' physical limitations. If the rheumatologist in charge also uses our doctor app, we can help optimise treatment so fewer appointments are needed." With success: Since 24 May 2021, the Mida Rheuma App has been approved as a class 1 medical device.

"Thank you Mida!" - from patients for patients

Mida has been used since March as part of a clinical trial. Since the end of May, the app has also been freely available to the public and free of charge for all those affected. Felix gives us an insight into how Mida has been received by the users so far: "In the meantime, some patients are using the app and are extremely happy to accompany us because they find the concept so great. They also see it as an opportunity to get involved themselves and pass on their own experiences to other sufferers. We have received very good ratings in the app stores so far."

One step ahead of the competition

Midaia also stands out in comparison to its competitors. In contrast to the competition, the health coach sets concrete tasks that are individually designed for each patient and his or her needs. For example, Midaia not only recommends that patients drink more water, but also gives them the specific task of putting a glass of water on their bedside table in the evening so that they can drink their first liquid in the morning. "In this point, we are far ahead of the competition. Many competitors only query the patient and may also pass on a vague recommendation, but after that the patient is left alone," Christine explains. Midaia is also a step ahead of the competition in terms of the spectrum of symptoms, as Felix knows: "There are many applications on the market that focus on specific symptoms, such as fatigue, depression or pain. We, on the other hand, offer a patient-centred, holistic application that combines all these symptoms, which often also occur in inflammatory rheumatic diseases, in one application."

Midaia's mission and how it was born

Midaia was founded in August 2020, but the vision of helping people with rheumatic diseases arose much earlier. Felix himself has witnessed within his family how severely affected patients are limited by the disease and the pain they have to fight. During his studies, he met Christine, who is studying healthcare and has been heavily involved with the topic of digital health in her professional career. The two quickly realised that there is a lot of potential in healthcare and its digitalisation, especially because it is still very analogue as of today. Already at the end of 2017, they jointly launched the Midaia project. They got the decisive boost in 2019 when two more team members joined and made it possible to develop the product, prepare the studies and make Midaia what it is today. "We are a diverse founding team of four from different countries and also very interdisciplinary. With a rheumatologist, an IT person, Christine as a health expert and me as a business expert, we cover all relevant areas of expertise," says Felix.

The next steps - this is to be Midas' future

As a certified medical device, Midaia is approved for specific indications, namely rheumatoid arthritis, spondyloarthritis and psoriatic arthritis. The startup's vision is to expand the application to many other chronic diseases. "Lifestyle adjustments not only help rheumatism patients, but also other sufferers such as diabethes or hypertension patients, whom we also want to help," says Christine. As a medical device, however, Midaia is not allowed to easily expand the application to include additional medical conditions, but has to be re-approved. That takes time. Felix explains what steps are planned in the near future: "The next disease patterns we are preparing for are more rheumatic diseases, such as osteoporosis and gout, as we can adapt these relatively easily."

"And then we would also like to expand into other countries, as these diseases affect not only German patients but the global population. We don't have any concrete plans for this yet, but we have good contacts in Ukraine and Spain and would like to orient ourselves in that direction for now," Christine adds.

Mida and 5-HT make common cause

By joining the 5-HT network, Midaia can see great added value in two different points: "The 5-HT network has very interesting partner companies that are extremely exciting for us as potential future cooperation partners. Here we would like 5-HT to serve as a platform to establish contacts there. Furthermore, we are also happy about the consulting services provided by 5-HT. Already in the first weeks after our admission to the network, we had an appointment with the 5-Hteam to receive free advice on our business model. This is truly an added value for us," says Felix. 

In addition, Midaia was one of eight selected startups to participate in the "Insuring Digital Health" event organised by 5-HT. As part of the event, the startups had the opportunity to engage in direct exchange with eight health insurance representatives. The result is potential partnerships, which will now be discussed in the coming weeks, and above all great learning effects. "What are the issues that move the health insurance funds? How can health economic improvements be achieved? Through the event, we were connected with exactly the right contacts and will now discuss together with the health insurance companies how care in rheumatology can be improved in a patient-centred and health-economic way through digital applications," Felix adds.

Feedback - the food for progress

Last but not least, Christine again clearly shows how much Midaia is oriented towards patients and the needs of stakeholders: "We actually live from feedback. The product we develop, we develop for the patients, for the doctors and for the stakeholders in the healthcare system. That's why we are always open to all kinds of feedback, no matter how critical. This helps us to get better all the time. We are always open if someone wants to contact us and we are very happy about it."