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August 14, 2015

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Hinge Health

15-08-06 Press Article ImageHinge Health is a digital health company that aims to cut costs and improve outcomes for musculoskeletal disorders through its 16-week digital health programme. SHP spoke to Daniel Perez, founder and CEO.


What is the burden of musculoskeletal disorders on employers?

Musculoskeletal disorders (MSDs) affect anywhere between 40-54 per cent of employees in a given year, with the main contributors being low back, knee, shoulder and neck. The costs are roughly evenly split between increased medical spend and lost productivity – and in the UK can cost £3,000-5,000 per employee each year.

But aside from being a healthcare cost, MSDs are also a significant safety issue. Simply put, healthy employees are safe employees. When you have a worker with chronic low back pain or knee arthritis going up and down a ladder, or working a factory floor you’re creating a significant safety issue for them and others. Indeed, up to third of all work-related injuries are related to an MSD.

Why is the delivery of best practice care so fragmented?

Unlike hypertension or high cholesterol, you can’t fit the treatment of MSDs into a convenient little pill. Best practice care for MSDs involves education, physiotherapy, weight loss, and social support. Unfortunately, to use education as an example, our health system just isn’t designed to allow a GP to deliver 8-16 hours of education to an employee to ensure they understand their condition and its treatment.

Moreover, while the current system might deliver two-three physiotherapy sessions – what these employees need are two-four sessions per week for the next 6-18 months. As such, the delivery of best practice care is too onerous, costly, and time consuming. That’s why less than one-in-five employees with an MSD will receive best practice care.

Can you describe Hinge Health’s technology and programme?

Hinge Health digitises the delivery of best practice care via a 16-week digital health programme. Essentially, we have taken evidence-based best practice and systemically digitised each component. For education, we’ve created an interactive and engaging curriculum where we track progress and assess comprehension. To digitise and scale physiotherapy we’ve developed two wearable bands with motion sensors that guide participants through clinically validated physiotherapy regimes.

Moreover, we combine digital weight tracking with the latest understanding of behavioural medicine to achieve meaningful habit changes and 5-10 per cent weight loss. Finally, because MSDs can be very isolating and have a chronic pain component, depression levels in this population can be 29-60 per cent. Each participant is assigned a dedicated health coach and put in a team of 12-18 people where they share progress and support. This camaraderie and accountability is remarkably effective.

How do you ensure employee engagement?

Currently, nearly 90 per cent of participants who start our programme finish it, and they do an average of four physiotherapy sessions per week. Our technology and programme is built to engage. We kick off with a one-on-one coaching session, track progress along the entire journey to keep participants accountable, have team goals, which instills camaraderie, and loop in behavioural medicine to instill lasting habit changes.

But perhaps the strongest factor is our engagement because delivering best practice care reduces pain and improves function. When our participants engage with Hinge Health, we believe that their condition improves, and that’s a powerful factor in engagement.

What are your results to date?

We’ll soon be publishing our results. But in our current cohort we reduced pain by 55 per cent and stiffness by 64 per cent in a trial focused on chronic knee pain/knee arthritis, while maintaining an 86 per cent engagement level.

Who’s behind Hinge Health?

We’re a team from Oxford, Cambridge and London with backgrounds in healthcare, behavioural medicine, engineering, and policy. Our passion is improving musculoskeletal health by using technology to better deliver care.

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