The Boston Globe’s weekly Ocean State Innovators column features a Q&A with Rhode Island innovators who are starting new businesses and nonprofits, conducting groundbreaking research, and reshaping the state’s economy. Send tips and suggestions to reporter Alexa Gagosz at alexa.gagosz@globe.com.
The founders of a Swedish digital clinic are looking to treat Rhode Islanders for their knee and other chronic joint pain. Joint Academy, cofounded by Jakob Dahlberg in 2014 with his father Leif Dahlberg, has already seen more than 70,000 patients across the globe through its treatment program, which connects patients with a licensed physical therapist through chat and video calls with the company’s app.
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Dahlberg said Americans have a significant battle when trying to fight the chronic joint pain crisis. Joint Academy’s creation came on the heels of a 2014 study published in Arthritis & Rheumatology that showed more than one-third of knee replacements for arthritis may be unnecessary. And Dahlberg said it’s crucial to give patients the chance to try physical therapy-led treatment first, which is recommended by the Centers for Disease Control and Prevention.
Q: Why did you start Joint Academy?
Dahlberg: Six years ago, I was studying computer science and I was looking at my father’s research, which was very focused on osteoarthritis, which is the world’s most common chronic joint disease that affects the knee. He was trying to show that you should spend more time seeing a physical therapist, more time educating yourself about the chronic disease, exercising and other behavioral changes than taking medications or performing high-risk, expensive surgeries.
We started with a face-to-face intervention where you saw your physical therapist for three months at a primary care level, and it was successful. So I figured that we should digitize this treatment protocol, scale it to a global level, and make it even more cost-efficient while also having better outcomes. As a patient, you are able to connect with physical therapists and have your treatment covered by health plans.
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Q: Can you walk me through what it’s like from the patient’s perspective?
Dahlberg: After you download the app, you answer some fairly typical clinical questions. It’s mostly about symptoms: Which joint is most painful? Do they crack and are they swollen? After the questionnaire, they are connected in real time with a physical therapist directly through the app. They have a video call for an initial evaluation to make sure this patient is eligible for treatment. If they are, they start the treatment the day after and receive daily activities they need to perform. They will also receive exercise tips, educational material on the disease, quizzes; and tracking tools to see how their pain is progressing, their quality of life, and physical function.
Patients will also be connected with a peer community so they can meet other patients like themselves. It’s more of a holistic treatment.
Q: How often are these patients engaging with the app?
Dahlberg: I think that’s kind of the secret sauce. It’s five minutes a day. We’d rather see patients consistently put in five minutes of work versus seeing their physical therapist once or twice a week for an hour each visit. It’s actually better to just do it consistently, for five minutes, during two to three easy exercises. And we’ve proven that in nine clinical studies as well. Reduced pain usually comes after three months. We see even greater clinical outcomes at the six to 12 months benchmark.
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Q: Where are your physical therapists on the app based?
Dahlberg: We are live in 10 states in the US and every physical therapist is always operating under their license in that state. So when a Rhode Island patient logs into the app, they will be connected with a Rhode Island-based physical therapist.
Q: This is now covered by Blue Cross Blue Shield of Rhode Island. What does the service cost for those without insurance?
Dahlberg: We do have an out-of-pocket option at $89 a month with a one-week free trial and a 50 percent discount for the first month. And we are in contact with other local insurance companies.
Q: How would you say the issue of chronic joint pain in the US compares to the other countries, including Sweden, that you serve?
Dahlberg: In the US, around 17 to 18 percent of health care costs are tied to the GDP and in Sweden, that’s around 8 to 9 percent. In the US, joint pain is much more prevalent and much more costly because of lifestyle choices, obesity, nutrition, and exercise, but also because procedures and surgery costs are much more costly.
Alexa Gagosz can be reached at alexa.gagosz@globe.com. Follow her @alexagagosz and on Instagram @AlexaGagosz.