New Irish tech aims to cut last-minute chemo cancellations by 25%
cancer
patients.
eAltra is a web-based,
AI
-powered conversational platform that helps triage patients ahead of treatment, reducing the likelihood of their chemo session being cancelled due to a last-minute issue.
Its founder is Denis Roche, who is no stranger to the application of technology in medical settings. In 2011 Roche founded Vivartes, a web-based system to improve the quality of life for those in long-term care and in May last year, his second venture, eAltra, spun out of Trinity College Dublin.
Cancer treatment can be a long and arduous process and it's very upsetting if a chemotherapy session is postponed because an issue, such as an adverse reaction to medication. These unforeseen problems result in roughly 20 per cent of treatments being cancelled when the patient has already arrived at the hospital.
Key to improving the situation is good patient feedback, or what's known in medical circles as Patient-Reported Outcome Measures (Proms). Proms are crucial for understanding the impact of treatment on a patient. The better a patient can explain how they're feeling, the easier it is for clinicians to make an informed judgement about their fitness for their next treatment before they arrive for their appointment.
eAltra founder Denis Roche, Founder of eAltra One of the company's innovations is its conversational AI interface, which mimics nurse-led interviews using standardised questionnaires. Photograph: Tom Honan
Patients' ability to articulate their health status varies widely, as does their means of communicating with the hospital. As a result, specialist cancer nurses must juggle texts, calls and emails to get that information, often interpreting vague updates.
Making it easier to get more value from Proms has huge potential benefits because if patients are more engaged with their symptom management, their outcomes will be better, while a more comprehensive Prom gives the care team a deeper insight into how well a patient is coping.
'Current barriers to the more effective use of PROMs are a lack of understanding of their value amongst clinicians and patients, a lack of suitable IT infrastructure to deliver them and a lack of functionality and configurability to integrate them into existing workflows. Our system addresses all of these issues,' says Roche, who hasa background in art, music, IT, law and data analytics.
He originally studied for an MA in fine art/sculpture at the National College of Art & Design and also has an MA in cognitive computing from Goldsmith University in London and an advanced diploma in data protection law from King's Inns.
During his career he has worked as manager of the Creative Life Centre at Mercers Institute for Successful Ageing, set up Vivartes, spent time as the research lead for patient experience at the Chelsea & Westminster Hospital and more recently as a consultant in digital patient experience at the independent charitable hospital the London Clinic.
eAltra has been developed with input from clinical nurse specialists, consultants, surgeons, and radiotherapists in Ireland and the UK. 'The idea began with a collaboration with a lead cancer nurse specialist in the head and neck cancer service at the London Clinic, who was struggling to get patients to engage with information that could help them manage their symptoms,' Roche says.
'We have made the engagement process much more user-friendly with a first-of-its-kind conversational AI approach to patient-reported outcomes and needs assessments. This has been done by synthesising the dialogue from nurse-led interviews with standardised patient questionnaires.
'The second unique feature of our system is the conversational Patient Concerns Inventory (PCI), which helps patients to identify the key things about their treatment they want to discuss with clinicians during a consultation. It's easy to forget something at the time, and as these consultations are often short,t it's important for patients to make the most of them,' Roche adds.
Apart from improving the patient experience and reducing the repetitive administrative burden on staff, Roche says eAltra will have a positive impact on waiting lists by increasing patient throughput by up to 25 per cent. He also estimates the system will save an average of 2.5 hours of nursing time per day in a typical cancer service.
The company's web-enabled system, which allows interactions via smartphone, tablet or browser, works by sending patients a link 24 hours before their scheduled treatment. They complete their assessment and return it via a secure interface with no app or downloading required. Prompts are built into the system to ensure it's sent back in time.
Currently, it takes a clinician around seven minutes to conduct a review. With the eAltra system, this time is cut in half. In a busy cancer centre, treating 80 or more patients a day, this adds up to a meaningful time saving, Roche says.
eAltra is a Trinity campus company, working closely with St James's Hospital, Tallaght Hospital and the Health Innovation Hub Ireland to develop its platform. Potential customers are hospitals and health systems and the revenue model will be subscription-based.
eAltra is an Enterprise Ireland high potential start-up and has raised roughly €1.4 million between State assistance and angel investors.
A further fundraising round is planned for later this year. The company is one of a handful of companies chosen to participate in the Hill Oxford University Hospitals NHS market access accelerator in the UK and its system is currently being piloted in St James's Hospital in Dublin, with a further pilot to follow in the UK.
The NHS is a big potential customer and, in the longer term, the company is looking to enter the US market.
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RTÉ News
an hour ago
- RTÉ News
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RTÉ News
an hour ago
- RTÉ News
Healthcare workers stage Gaza protest march in Dublin
Healthcare workers led hundreds of demonstrators opposing the ongoing war in Gaza in a silent march through Dublin city centre. It was organised by Irish Healthcare Workers for Palestine, an informal group of more than 500 healthcare workers in Ireland. Dublin-based GP and Medical Director of Safetynet, Dr Angy Skuce, said it was their largest demonstration to date. She believes many were motivated to join today's silent protest, because people are now "watching the slow starvation of everybody in Gaza". "So for 20 months we have been watching our colleagues being bombed, shot at, abducted, killed, but now we are actually watching them in real time slowly starving to death," Dr Skuce said. "We're in regular contact with people over there, we're getting videos from doctors, nurses and ambulance staff over there, and over the last few months we've actually watched them get thinner and thinner and thinner," she added. "They are dying themselves and they are also trying to save people who are brought into their hospital, dying," Dr Skuce said. Among those leading the demonstration was Dr Ahmad Adjina, a GP in Templeogue in Dublin, who is originally from Gaza. "I have two cousins who are doctors, one is a surgeon in northern Gaza, another is in the south," Dr Adjina said, "whatever they can do, they do it". "If they had the equipment they would stay 24 hours working but they don't have that, and that's the issue," Dr Adjina said. "The other thing is they are moving from place to place to place to place, I don't know how they are surviving," he said. His wife Fatima Jabr is also from Gaza and she attended today's march along with their son. "It's getting worse and worse and worse every day," Ms Jabr said. "I just want to thank the Irish people, no words can say how grateful we are, honestly," Ms Jabr said, as she broke down in tears, "the support we have gotten from Irish people is beyond words". Demonstrators carried placards with the names and photos of some of Palestinian doctors that have been killed, while others highlighted the chronic shortages of basic medical supplies in Gaza, such as anesthetics and gauze. Medics also carried a stretcher with bandaged dolls through the streets, to represent the war's civilian child causalties. In silence, protesters began their march outside the Royal College of Surgeons of Ireland on St Stephen's Green and made their way slowly and solemnly through an otherwise busy Grafton Street. They were met with spontaneous applause as they turned onto South William Street before walking passed the Gaiety Theatre and St Stephen's Green Shopping Centre and returning to RSCI. There, Dr George Little, a consultant in emergency medicine, addressed the crowd. He told those gathered that healthcare workers had "a moral obligation, an ethical obligation and professional obligation to protect human rights". "In the last week we have begun to see the overt signs of starvation" in Gaza, Dr Little told RTÉ News. "I think that has a visceral response, particularly for Irish people, that's what it looks like, that's what forced starvation looks like."
Irish Times
14 hours ago
- Irish Times
How eating disorders are changing: ‘I'm not the stereotype. I'm a man, I'm plus-sized'
When William Dwyer Joyce was a teenager, skinny jeans and Indie bands were what was cool. To be slim was fashionable. As a someone who didn't fit into that stereotype, and who was always 'plus-sized', Dwyer Joyce turned to food as a coping mechanism. The now 32-year-old was diagnosed with binge-eating disorder when he was 21, though he says he struggled with mental health difficulties long before that diagnosis. 'For me, my binge eating was very secretive. It was going to the shop, getting large amounts of things like chocolate, crisps, cookies, whatever. And going home and secretly eating it to the point where I could not eat it any more,' he says. 'It created a coping mechanism that was quite harmful because my body image was very poor. It was about numbing. In a sense it was self-harm. If you eat to the point of pain, it's not a nice thing to go through.' READ MORE Compounding this difficulty, Dwyer Joyce also struggled with alcohol addiction and drug misuse issues. These challenges, he says, all came from the same place: a desire to be able to exert control. He is now five years sober. 'When I got sober, it was like I was in a house that was on fire. Sobriety put the fire out, but now I'm standing in rubble and I have to build the house again,' he was when he seriously sought help for his eating disorder. 'In April 2020 I got sober for the last time. A year after that, in 2021, I had a year of sobriety under my belt. My 30s were knocking on my door and I thought, I cannot live like this forever and the only person who can change this was me.' One difficulty he found when seeking help, he says, was the questioning attitude and scepticism he faced by some healthcare professionals because he doesn't fit the common eating-disorder stereotype: a young woman or teenager with anorexia. 'I am the opposite of the stereotype in that I'm a man, I'm plus-sized, I wasn't restricting food,' he adds. 'There is all this messaging around fatness or plus-sized people that if you're fat it's a moral failing or you're lazy or you don't care about how you look. But that's just not true.' William Dwyer Joyce: 'I am the opposite of the stereotype.' Photograph: Dara Mac Dónaill This stereotype is beginning to change, according to Laura Casey, director of services at Lois Bridges, an eating disorder treatment centre in Sutton, north Co Dublin. The number of young men seeking help at the centre has increased in recent years, she notes. Casey attributes this rise to the increasing gym culture seen online – in which men are constantly fed images of bodybuilders with very little body fat – combined with the masculine tendency of men to keep their feelings to themselves. 'But when they do go and reach out, they're not heard the same. Their voices can be dismissed a bit easier,' she says. Another changing trend is the prevalence of a condition known as avoidant/restrictive food intake disorder, or Arfid, which is often diagnosed among people who are neurodivergent. 'It's sometimes called the beige diet; they eat a lot of chicken nuggets and chips. But we're moving away now from language that describes these people as being a picky eater, and acknowledging in many cases they have a sensory aversion to something.' Laura Casey, director of services at Lois Bridges eating disorder treatment centre in Sutton, Dublin. Photograph: Dara Mac Dónaill According to Casey, Arfid can have a significant impact on an individual, particularly in a social setting. 'Sometimes a person's diet is so restrictive they won't eat. There is a lot of shame and stigma if all they are able to eat is a chicken fillet roll. So, nutritionally, they can be at the same risk as anorexia. It affects their vitamin intake and electrolytes,' she says. When it comes to certain foods, some people with this diagnosiscan have a panic attack or feel like they're choking. 'They can only eat yoghurts and drinks,' she adds. Awareness of eating disorders has increased since the Covid-19 pandemic, when there was a rise in the number of referrals for treatment to HSE eating-disorder teams, who provide specialist treatment. HSE data shows there were 894 referrals to such teams last year, a 33 per cent increase on 2023. There was also a 24 per cent rise in accepted referrals, where patients proceed to treatment after an initial consultation. A total of 562 patients were assessed last year, of which 90 per cent were female and 59 per cent were children under the age of 18. One-third were teenagers aged between 15 and 17. Still, the service also saw the number of adults accessing treatment increase by 51 per cent. You're either too sick for the psychiatric hospitals or you go into a general hospital and there's no help there for these things — 'Rebecca' Of those assessed, 503 had an eating disorder, 118 more diagnoses than in 2023. Some 63 per cent (318) presented with anorexia nervosa; 18 per cent (97) with an 'other specified feeding or eating disorder' (OSFED); 8 per cent (42) with bulimia nervosa; 3 per cent (16) with Arfid; and 2 per cent (10) with binge-eating disorder. Many eating disorders begin the teenage years. But disorders often don't end there. Rebecca, not her real name, was first brought to Child and Adolescent Mental Health Services ( Camhs ) at age 15. However, she believes this 'did a lot more harm than good'. Although she acknowledges there are many good people working in the service, she was unhappy with the attitudes she faced in relation to her anorexia. Then the coronavirus lockdown happened, shutting down vast swathes of regular life. 'Everything was gone, and I deteriorated very rapidly.' Following this, she underwent a 'string of hospital admissions and A&E presentations' to help with her diagnosis, but she says it was like a 'revolving door'. 'You're either too sick for the psychiatric hospitals or you go into a general hospital and there's no help there for these things. You're stuck between nothing that will help,' she says. 'When you go into a general hospital, it's really only for one thing: to be fed against your will. But it's so important to get to the root cause of it. It was very difficult to find help that suited me. And then when people do offer you that help, it's hard to accept it if you've had bad experiences. I'm still struggling a lot.' The almost 21-year-old makes a comparison to alcoholism: relapse can be a common challenge for people, and oftentimes the difficulties of the illness are persistent. 'But there's no AA meetings [for eating disorders] around the country that you can pop into. You're kind of just left alone,' she adds. Dr Art Malone, a consultant psychiatrist and chair of the eating disorder specialist interest group at the College of Psychiatrists, says one of the biggest challenges is that some areas of the State have inadequate access to the necessary specialist services. 'Not all areas that have a specialist service are fully resourced to deliver the sort of service they would need to do. The biggest one is probably the lack of higher-level care needed for severe cases, so the lack of inpatient treatment is something all teams have to contend with,' he says. Dr Malone says that for the 'very small minority of patients' who have very severe, acute illnesses there is 'no higher-level care available in the way that it should be'. 'What ends up happening is there can be funding sought in other places such as private places or abroad but there can often be fairly lengthy delays in arranging that and then even when it is arranged – because it's taking people out of their home environment – it can be quite tricky then to transfer their treatment back to their own home set-up,' he says. 'Body positivity was such a thing, but now we've gone back almost 20 years,' says Alicia Woods, clinical nurse specialist at Lois Bridges. Photograph: iStock Dr Malone says there's a big push to try to make early intervention a priority, as this can prevent people from needing inpatient care. He cites international research that found the relapse rate for people with severe illness who receive inpatient treatment is around 50 per cent in their first year. 'But it's important to note that services where they do exist are extremely hardworking. Things have come on such a huge distance in a very short time, but it's coming from such a low base in terms of service accessibility that there is still a way to go.' [ Eating disorders: 'I wouldn't speak to my worst enemy the way I talked to myself' Opens in new window ] In recent years, the Government has taken steps to improve eating-disorder services. Currently, 14 of the 16 specialist eating disorder teams recommended in its internal plans are funded. Minister of State for Mental Health Mary Butler says no patients have been treated abroad this year so far for specialist eating-disorder care. 'I'm very proud of the progress we are making in establishing a full suite of services to support people with eating disorders, from early intervention in the community to the development of specialist inpatient beds for acute care,' she says. However, things are far from perfect, those working in the sector say. Figures from the HSE show that one-third of funded posts at eating disorder regional specialists teams are currently unfilled. In the adult eating disorder team in the Sligo, Leitrim, South Donegal health area, there are more vacancies than people in post: 3.2 whole-time equivalent staff are in place, with seven unfilled posts in the area. Furthermore, there are only three adult specialist eating disorder beds in the country, all of which are in St Vincent's hospital, Dublin. The rules for these beds, which are for those who are acutely unwell, require patients to be within that hospital's catchment area to be treated there. As a result, people with eating disorders outside that area who go into public hospitals for treatment are typically referred to a general psychiatric unit. Often they are unable to access specialised care in such settings. However, The Irish Times understands a plan has been devised by the HSE to increase the number of public eating-disorder beds nationally. Minister of State for Mental Health Mary Butler says no patients have been treated abroad this year so far for specialist eating-disorder care. Photograph: Brian Lawless/PA Wire At least 20 new specialist beds will be established in the coming years, under proposals submitted by the HSE for Ms Butler's approval. The beds will be spread between Dublin and the rest of the country, but all of them will have a national catchment area. For some people, recovery feels impossible. Aoife, which is not her real name, developed eating disorder behaviours when she was 12, after she sought to lose weight for her Confirmation. 'My family weren't very nice about my body. But also society. You'd be in drama class and I was the biggest so I would have to try on the costume and if it didn't fit me then nobody would get it. Then there were things like the Special K diet, or Kate Moss's saying about skinny being better,' she says. The 32-year-old Cork woman says she was diagnosed with anorexia at the age of 15, and went into hospital when she was 16, which she describes as 'the worst point in my life ever'. 'I couldn't control anything. I had a tube in my nose, I wasn't allowed to walk anywhere. I basically just lay in bed. I soiled myself because it would expend too much energy to go to the bathroom. It was only about weight restoration, not about treating the eating disorder,' she says. She struggled through college but was determined to continue her studies. I've been told I'll never recover. I have chronic anorexia. So you ask yourself, what's the point in trying? — 'Aoife' After graduating as a teacher, she realised she needed to get better before she could work full-time. In 2016, she returned to inpatient care. She improved somewhat, she says, but was not in recovery. She was admitted again two years ago, but had to leave early due to panic attacks. For her, she says, a history of trauma is playing a role in her current condition: her sister died when she was very young. 'I overate when she died; that was soothing myself. My life felt out of control, I didn't know who would die next. Food was something I could control,' she says. But it is 20 years since the onset of those challenges. These days, she feels quite hopeless about her current trajectory. 'I've been told I'll never recover. I have chronic anorexia. So you ask yourself, what's the point in trying? Normal eating is no longer normal for me. This has become my normal and it's very hard to see outside of it,' she says. [ Eating disorders in later life: Some of my peers have had teenage weight levels for decades Opens in new window ] 'It's pointless to be here every day. I keep wondering, how did things come to this? I'd love for someone to tell me what to do because I just don't know where to go or what to do. I look inward wondering what I could do differently. What did I do to deserve this?' Trying to find somewhere to go is something many patients experience. Alicia Woods, clinical nurse specialist at Lois Bridges, says the centre is a private facility, but they receive 'phone calls everyday of the week from people who don't have private health insurance'. 'We treat a range of eating disorders. And in terms of age, we've treated from 18 up to people in their early 70s,' she says. 'The majority of older people with eating disorders have had it their whole life but they just haven't had the information, education or support to seek help. Some people do develop it later in life.' Though Woods says the reasons why individuals develop eating disorders are complex and nuanced, she believes social media is playing a role. 'Body positivity was such a thing, but now we've gone back almost 20 years. The videos on social media, encouraging people to obsessively run 5K a day, or the 'what I eat in a day' videos [and the food quantity] is not enough to feed a toddler,' she says. She is also concerned about the potential impact the widespread availability of weight loss jabs like Ozempic might have on vulnerable individuals. 'We know that people can put in fake weights and get these prescriptions. If someone already has a low [body mass index] ... the potential of that is frightening,' she adds. But even when people can access treatment, often recovery is not linear, according to 38-year-old Edel Higgins. She was diagnosed with an eating disorder when she was around 25. She didn't know much about such disorders at the time, but says she had 'always tried to change my physical appearance'. [ Families: the untapped superpower in eating disorder recovery Opens in new window ] It took four inpatient stays before she reached a point where she sees herself as being in recovery. She says: 'It doesn't just take one go. People often feel guilty when they have to go back. But it's such a complex illness.' The Tallaght woman is four years in 'proper recovery', but she says for her that doesn't mean the eating disorder is 'completely gone', but just now she has the 'resilience' to acknowledge and challenge those urges when they arise. She writes poetry to help her cope. She looks at inspirational quotes hung up on her wall. 'Sometimes I wish I could wake up, go about the day, not having all of these overwhelming feelings – the eating disorder and mental health [difficulties]. But it doesn't work that way. It can be frustrating. But it's about findings ways to deal with it.' Bodywhys (The Eating Disorders Association of Ireland) – – (01) 210 7906 – alex@
