For people with psoriasis and rheumatoid arthritis (RA), finding effective comprehensive treatment can be a lifelong battle. Medications are often expensive and inaccessible, appointments with specialists can take months, and lifestyle factors that may contribute to these diseases are often left out of the doctor-patient conversation.
Ohio-based healthcare company EndHealth believes this doesn’t have to be the case – and it’s inviting patients with such conditions to help prove it. Through its innovative study, called Project ImpactThe company’s goal is to demonstrate that addressing underlying causes (such as nutrition, stress, or sleep) alongside conventional treatments (such as biologic drugs) has the potential to stop or even reverse the progression of autoimmune conditions, including psoriasis and RA.
“Insurance doesn’t reimburse the time that’s spent talking to patients about how they can participate in their own care and how they can make lifestyle changes, even though the science is there,” says Dr. Miles Spar, EndHealth’s national medical director, who is board certified in both internal and integrative medicine.
But Project Impact’s model is different. Its whole-person specialty care approach looks at patients in the full context of their lives — including any social, physical or financial barriers they face to care — and connects them to coordinated, culturally competent primary and specialty care.
More specifically, Project Impact patients first meet with a provider virtually for about an hour. Soon after, they receive a personalized care plan developed by experts that may include specialists, dietitians, pharmacists, and health coaches. Depending on their health status, goals, and readiness for change, patients may also receive medications, lab tests, food deliveries, supplements, and wearable health tracking devices — all at no cost to them.
Unlike clinical trials, where subjects are randomly assigned to either an intervention or a placebo, this study is observational, meaning everyone gets the help they want and the way they want it. “We’re analyzing the overall availability of those treatment paths, not testing each path,” says Spar. “So signing up for the study doesn’t mean you’re signing up to do steps A, B and C — you’re signing up to have A, B and C as options, and then choose your own path.”
For example, people who want to work with a health coach can learn what lifestyle changes — whether it’s reducing sugar intake or adding a walk after dinner every day — might make the biggest difference in their symptoms. Then, they can contact their coach through the app to get support in implementing those new habits.
“The number of patient contacts we have each week is extraordinary, because even I wouldn’t bother my doctor about little things,” says Spar. “But if a health coach says, ‘I want you to bother me,’ patients are more likely to say, ‘I did a two-minute meditation today’ or ‘I bought running shoes’ or ‘I noticed I couldn’t eat breakfast while watching the news.’ So they see the coach as a true friend.”
Ultimately, the company is betting that when patients are provided with the right tools, team, and knowledge, they can help improve a condition that they’ve often been led to believe will only make things worse.
“When you are diagnosed with a disease that you didn’t choose, that takes away all of your control over your life, and that makes your life more limited, and then suddenly you are told, ‘But there is something you can do to get that control back,’ that is very empowering,” says Spar.
That’s what happened to Phyllis, 60, of Mansfield, Ohio, whose RA prevented her from doing most of the things she loved, whether it was visiting relatives and playing cards or going out to a place to dance two-step. “I lost interest in socializing with my friends and family because I was in pain most of the time,” she says. “Outside of church, I literally stayed in bed all day,” she says.
but through it Project ImpactPhyllis worked with a therapist who “really cared” and a health coach who helped her eat more fruits and vegetables and limit her sugar intake. Within a few weeks and even a few days, “I had more energy and less pain,” she says. “I felt refreshed.”
She felt valued, too. When Phyllis told her care team she didn’t have enough fuel in the car to get to the clinic for lab work, they were quick to help. “In traditional healthcare, if you can’t get there, you reschedule. And if you don’t reschedule, who cares?” she says. “With this team, if you can’t get there, they try to figure out why. Once they figure out why, they try to figure out how to resolve it. And once they figure out a solution, they resolve it.”
Are you interested in participating? Project IMPACT is currently enrolling adults age 21 and older in Ohio and Indiana who are taking certain medications for psoriasis or RA (or who have been advised by a physician to start medication). For more information or to see if you qualify, visit andhealth.com/impact or email impact@andhealth.com,
“The exciting thing is that … you’re helping to move this field forward, and you’re helping to add to the data that this whole-person specialist care approach works,” says Spar.
