When Varian acquired Helsinki-based Noona a year ago, it added a powerful tool for collecting patient reported outcomes (PROs) to its software portfolio. As part of Varian, Noona now has even greater resources to enhance and expand its impact on patient and care teams. In this article, co-founder Jani Ahonala explains the origins of the Noona® software application, and why patient engagement is so important in the fight against cancer.
Noona is a Korean word that means ‘older sister’. Noona team members at Varian want all patients to feel as if they have an older sister, or someone to take care of them during their cancer treatment journey. This ideal was at the core of why Noona was developed and the team believes that patients will embrace the use of digital tools when they feel them improving their lives and their care.
Electronic PRO solutions first gained market traction due to their usefulness in enabling clinical studies. The tools were developed primarily by pharmaceutical companies that really had little interest in extending the tools’ usefulness beyond their core focus.
“We founded Noona five years ago because it was clear pharmaceutical companies had little idea about the user experience outside the clinic, and cancer patients spend most of their time outside the clinic,” says Ahonala, who is now a senior director and global head of business development at Varian with ongoing responsibility for the Noona application. “Most other industries are focused on user experience at all points and Noona brings this approach to oncology.”
Now being rolled out by healthcare networks across the U.S. and Europe, the Noona platform enables clinical teams to be proactive rather than reactive once the cancer patient leaves their direct care. Via an app on their phones and tablets, patients can track their own well-being, ask and respond to questions, and alert their care teams when they experience complications.
“Many patients end up in emergency rooms because they don’t know how to manage their symptoms. With Noona, patients have a communication platform that can help them understand if their symptoms are normal or an indication that they need urgent care,” says Ahonala. “Clinicians can use Noona to better monitor patient symptoms and be proactive about adjusting therapies before minor symptoms become severe enough to warrant a visit to the emergency room. Noona then uses these patient-reported data to automate certain care team workflow processes, with the goal of making the care team more efficient and patient care more effective,” adds Ahonala.
Noona is also a valuable data gathering tool for finding new routes to drug discovery and for testing treatment protocols in a way that is not as cumbersome as formal clinical trials but still yields important insights.
“Digital innovation is the most important path forward to get beyond the current plateau of drug discovery and development and clinical trials, which need to be re-thought for the 21st century and enabled using digital tools,” adds Ahonala. “Technology such as ours gives companies the ability to think about patients as people. Technology and treatments need to fit into a patient’s lifestyle and give back to patients, or patients won’t use it.”
Ahonala recently participated in a patient engagement panel as part of a Regulatory Committee Innovation Day hosted in Washington D.C. by PhRMA, the largest trade association for the global biopharma industry. This meeting was the first conversation for the Regulatory Committee on Digital Health to prepare for the next round of negotiations with the Food and Drug Administration (FDA) about user fees.
At the meeting, Ahonala shared findings from early studies suggesting that digital PROs may improve survivorship for cancer patients. He also summarized a study from Stanford University demonstrating that patients are motivated to use Noona when they know their care team is responding to the information they are sharing through the app. In fact, some 90% of patients used Noona when they knew that their care team was interacting with the information they shared. This usage dropped to only 50% when it wasn’t clear to the patient that the care team was using the information being provided.
At Tennessee Oncology, some 400 healthcare professionals use Noona across the 32-site network to manage patient symptoms and capture a holistic view. As one of the nation’s largest community-based cancer care groups, Tennessee Oncology treats more cancer patients than any other group in the state, reaching approximately 25,000 patients per year. Over 20 percent of its residents reside in a rural setting where patients typically have more restricted access to quality care than their urban counterparts.
Noona was implemented at Tennessee Oncology to help elevate the voice of the patient and empower care teams with real-time patient reported data. It encourages patients to better communicate symptoms and other relevant clinical information to their care team, while eliminating common barriers to adoption—regardless of whether patients are three minutes away, in the heart of Nashville, or three hours away, in rural farming communities. According to Ahonala, the benefits of Noona are equally applicable to public networks in Europe.
“Many countries are investing heavily in cancer care. The good news is that treatments are getting better and better, even though some of the costs involved have been going up and up,” Ahonala points out. “We all want to help win the fight against cancer but, to do that better, we need to bring cancer care into line with other industries when it comes to enabling digital interaction between clinicians and patients. Noona was founded by a group of healthcare professionals who wanted to make a difference. Now, as part of Varian, I believe we are in a good position to achieve our common goals.”
Noona is headquartered in Helsinki, Finland, close to where another 200 Varian employees work on the Eclipse™ treatment planning software (TPS), radiotherapy’s most commonly used TPS. “Varian Finland has been an amazing success story and we hope Noona is able to replicate that success going forward,” Ahonala says.