It’s been nearly two months since the beginning of our incubation partnership with TandemLaunch, and Backtrack has made some nice progress. We’re still partly in stealth mode as we work out some prototyping and regulatory details, and we’ll be making a bigger splash with a website/company launch within the coming months. But before that happens, I’d like to share a bit more background about back pain, why we think the medical community can do better, and where we see opportunity.
Let’s start out with the big problem: back pain.
It’s hard to overstate how enormous a problem low back pain has become for our health care system. As I’ve said before, back pain is the most common cause of work-related disability, the second greatest reason for doctor visits, and the leading cause of reduced physical function in Americans under age 45. Take a minute right now to think about everyone you know with back problems- it is hardly an exaggeration to suggest that everyone knows somebody suffering from back pain.
Over the last two decades, research has shown that most patients with ordinary back pain need to stay active, move around, and remain conscious of their pain in order to recover effectively. Physiotherapists have known this intuitively for quite some time, and most doctors now agree as well. However, when you tell patients to stay active, they’ll nod their heads in agreement (at the doctor’s office) yet continue to restrict their movement at home. This restriction is not due to laziness, but rather a powerful effect called fear-avoidance behavior: the reluctance to engage in any painful movement, ‘overdo it’, or take chances and risk re-injury that may lead to future consequences. When patients don’t consciously engage in any uncomfortable movement, they don’t gain any insight into the causes and effects of their pain, and don’t benefit as much from targeted rehabilitation with physiotherapists or other health care professionals. This is one of the main forces that reinforce back pain as a long-term, chronic, behaviourally driven disability- one of the most difficult classes of medical condition to manage.
Could there be a better way to approach back pain? For some insight, let’s consider a different condition: diabetes. Diabetes is a widespread, behaviourally driven, expensive and chronic condition that affects a sizable percentage of the population- just like back pain. However, the way we approach and treat these conditions has diverged in the last few years. Diabetes researchers and health care professionals have realized and embraced the idea that many patients can effectively manage their condition at home if you give them the proper tools to do so. In diabetes care, these tools are home glucose monitors– small, portable consumer electronic devices that patients can use to keep track of their blood glucose levels and learn how to manage their condition over time. Much like the quantified-self movement has helped create a consumer culture of measuring daily activity, step counts and sitting time, home glucose monitors allow diabetes patients to take control of their life through personal metrics. Better still, we’re about to witness an explosion of products and services that take advantage of this data, from personal apps like Glooko to Open APIs like ManageBGL.
We’re betting that the quantified-self approach will transform the way that back pain is managed and treated. Imagine if back pain patients had the right tools to monitor their movement and pain- what a difference that could make! We’re building Backtrack to be that tool.
Backtrack is built to tackle fear-avoidance behaviour head on. A small patch that you wear on your back, Backtrack communicates with your smartphone and keeps track of your movement- bending, reaching, sitting, walking- throughout the day. The user can communicate whenever they experience aggravation or alleviation of any discomfort they experience by tapping the device, and Backtrack keeps track of when that discomfort occurred in the context of your movement. Patients can learn about their pain on a day-to-day basis, gain insight into what kinds of movement hurt (and more importantly, which ones don’t hurt), and see where they’re making progress. They can also use the data together with their physiotherapists and other health care professionals, in order to evaluate their rehabilitation progress using data rather than recall and guessing.
In order to be successful, we think that the right set of tools to help bring the quantified-self revolution to back pain treatment will have the following characteristics:
1) They’ll be wearable. Not clunky-awkward medical device wearable, but sleek, intuitive, consumer electronics-grade wearable.
2) They’ll still be medical devices- with all the regulation and testing that goes along. While there are some great consumer electronics out there trying to help people’s backs (like Lumo Bodytech’s just-released LumoLift), we consider health care providers to be just as much our customers as their patients- and that means working within the health care system. The regulatory agencies that control medical devices (like Health Canada and the FDA) do very important work, and we’re going to take every opportunity to work with them and make a validated, quality product. Will that take time and effort? You bet. But we think it adds a lot of value as well.
3) They’ll be built on an API similar to ManageBGL, so that everyone can contribute and add value. One thing we’ve learned from the recent revolution in diabetes care is that when you open up a field to outside developers, they’ll build great things. Back pain is everyone’s problem- and it’ll take everyone’s help to solve.
Hopefully we’ll have early user insights to share with you soon! Like every startup, our ideas are based on a series of hypotheses that we’re eagerly testing. The truth lies outside the building– so that’s where we’re headed.