"We bring standardized diagnostics to the smallest practice"

To make the right diagnosis, to examine a patient's condition or to follow the course of therapy: Tests are important tools for doctors, psychotherapists or occupational therapists. Today, such assessments are usually carried out with pen and paper. A digital solution is finally needed for this, according to the founders of insight.out, a startup from Kaiserslautern that is part of the 5-HT network. That's why they have developed testbox, a platform for digitally performing test procedures including automatic real-time evaluation, which has recently been approved as a medical device. 

In this interview, Franca-A. Rupprecht and Andreas Schneider, two of the startup's three founders, about the advantages of conducting tests digitally - and how therapists can test their e-health platform for free.

 Andreas Schneider and Franca-A. Rupprecht, two of the startup's three founders

What's the problem with the fact that testing procedures in psychotherapy or occupational therapy are mostly done with pen and paper these days?

Andreas Schneider: Because the tests are used in paper form, the therapists first have to order them and wait for delivery. This means that the moment they realize during a consultation that they could use a certain test, they often don't have it in stock. In addition, prices are sometimes very high and often only larger order quantities are possible, so smaller practices in particular cannot necessarily afford to work with tests. In addition, some methods are very time-consuming to evaluate. All in all, this means that standardized assessments are often not carried out in practices, even though very good tests are actually available.

How does your testbox help to remedy this situation?

Franca-A. Rupprecht: The testbox is an online platform where therapists and physicians can purchase various test procedures directly, perform them digitally and have them evaluated automatically. If the therapist is unsure which procedure is suitable for diagnosis, examination or therapy tracking, he can enter various search terms to find out which tests can be used in the corresponding areas. Once he has decided on a procedure, he can assign the test to his patient, who can process it on any digital device. The assessment is then immediately evaluated automatically, so that the therapist receives a result within a few clicks, which he can use to guide his therapy.

A look inside the testbox

What types of tests can be performed in testbox digital?

Andreas Schneider: We are currently mainly targeting psychotherapists and occupational therapists. However, we are currently also expanding our range for speech therapists. In these areas, a wide variety of clinical pictures can be queried: Dementia, ADHS, motor disorders and many other abnormalities.

Franca-A. Rupprecht: The basic functionality is questionnaires, but in addition we also offer neurocognitive tests that can be used, for example, to record cognitive processes by measuring reaction times. This allows us to identify deficits or abnormalities that go far beyond what can be detected with the help of pure questionnaires.

Patients application on tablet

How did your startup get started?

Franca-A. Rupprecht: After my doctorate in human-computer interaction research, I worked as a research assistant at the TU Kaiserslautern together with Andreas on a project about Cognitive Load. In the course of this project, we realized that we needed a neurocognitive test procedure with which we could record the work processes in the brain that are behind Cognitive Load. We really needed this test procedure in digital form, so that we could use the computer to respond directly to the cognitive state of the person. But because the test didn't exist digitally at the time, we simply digitized it ourselves quickly. Then the Chair of Cognitive Science and the Chair of Psychology approached us and asked if they could also use this digital test. So we discovered a gap in the market quite by accident - because it turned out that it was not an isolated case that psychological test procedures were not available in digital form. Together with psychologist Jan Spilski, who was also involved in the research project, we therefore decided to found insight.out in January 2020.

What were the biggest challenges in developing the testbox?

Franca-A. Rupprecht: The most difficult thing was not the development of the platform itself, but the many regulations that had to be observed. Due to the DSGVO, we had to develop a strict security concept to protect the sensitive data of our users. Quality assurance was also a challenge for us: because we work with many different authors for the tests, we had to define quality criteria by which we judge whether or not to include a procedure in our platform. In addition, certification as a medical device was a very time-consuming process. 

Andreas Schneider: Now testbox meets all the prerequisites and requirements of the DSGVO and the Medical Device Regulation. Over 80 validated and high-quality test procedures are now waiting to be used in practice.

How does testbox differ from other solutions already on the market?

Andreas Schneider: With other products, the barriers to entry are often very high. For example, high license fees have to be paid or special hardware is required. In contrast, we have made it our goal to offer a model that is as low-threshold as possible: Our platform is web-based and works on any end device, so that tests can also be performed remotely from at home. In addition, because we offer a pay-per-test model, there are no fixed costs. All therapists who want to use our platform more intensively can also opt for an affordable licensing model.

Franca-A. Rupprecht: In addition, we offer a fully comprehensive range of products that is not yet available on the market. Other products also include digital questionnaires, but very few integrate procedures that actually examine the client, as is the case with our neurocognitive assessments. We also add additional value through the parameters we capture. For example, we can measure the user's eye movements, which provides important information for validating the testing procedure. For example, if we find that a child has not been looking at the screen the whole time, but at the air, then we know that the results are not valid. This increases the validity of the tests enormously.

How can therapists find out if using the testbox is right for them?

Franca-A. Rupprecht: Interested therapists can try out testbox without any obligation by registering for the free demo version. Although no real patient data can be collected here yet, most functions and many procedures are available to the therapist for testing completely free of charge.

You recently joined 5-HT. What do you hope to gain from being part of our network?

Andreas Schneider: It is always interesting for us to establish contacts in the medical industry and to exchange ideas with know-how carriers. We are sure that we can offer real added value with our solution, but there is always the potential to improve or rethink individual aspects. Soon we will also go into a round of financing, for which we are looking for investors.

Franca-A. Rupprecht: In addition, we are pleased to have contacts in health insurance companies and pharmaceutical companies. Even if there are other use cases here than with psychotherapists or occupational therapists, we also see great potential for digital testing procedures in these areas. Therefore, we welcome insights, ideas and information to find out if these markets make sense for us.

What is your vision for the future of insight.out?

Franca-A. Rupprecht: With our digital testing procedures, we want to improve the quality of diagnostics and thereby have a lasting impact on society.

Andreas Schneider: We bring professional, standardized diagnostics to the smallest practice!