DESTINY®
DESTINY® - bringing patients and doctors together
DESTINY | DatabasE-assiSted Therapy decIsioN support sYstem
NTD and NTC GmbH work together on linking medical, content and patient-oriented aspects, offering physicians and patients an integrated system that promotes networking and communication between physician and patient on the same level, involving the patient actively in the treatment process (DESTINY®).
DESTINY® helps to achieve a significant improvement and acceleration of treatment outcomes and optimises adherence and compliance. In turn, this can lead to significant cost reductions (fewer hospital admissions, physician visits and days of incapacity for work, lower medicine costs). Scientific knowledge is also acquired, enabling a better understanding of the disease and its effects. DESTINY® is also transferable to other indications.
DESTINY® on "Welt der Wunder (Pro7)"
On the 25th of October 2020 „Welt der Wunder“ uploaded a clip about the „Destiny Concept“ to YouTube. In addition to Dr. Bergmann, Ms. Lopez and Ms. Dr. Köchling also present an excellent example for the flying NTD team of how interactive patient care can be achieved with the use of NTD tools. It's an interesting 10 minutes that summarise our Destiny concept in a very clear and comprehensive way.
DESTINY® has already received multiple national and international awards as an innovative platform for personalised healthcare:
- ACQ5 Global Awards 2019- Germany, healthtech company of the year
- GHP- healthcare&pharmaceutical awards 2019
- German Medical Award 2019
- German Prize for Excellency 2018, 1st place, “Health” category
- Bavarian Innovation Prize Health Telematics (BIG) 2018, 1st place
- Stevie Award – International Business Award 2018, 1st place, “Health & Medical Information Solution”
NTD database
The core of DESTINY® is the web-based NTD registry database, which has received pseudonymised patient data in relation to diagnosis, treatment and quality of life, side effects and reasons for changes in treatment since 2008. This database was developed in conjunction with Ludwig Maximilians University in Munich and was inspected and approved by the Ethics Committee of the Bavarian State Chamber of Physicians in 2012. This approval was re-confirmed by the Ethics Committee of the North-Rhine State Chamber of Physicians in 2017.
Web-based since 2013, the registry database is a modular system containing basic documentation and a multitude of specialist modules (healthcare module, register module, study module, patient module, administration module etc.). All data collected is taken systematically at each participating practice and saved to the database. Statutory data protection requirements, in particular the German Federal Data Protection Act (BDSG) and the EU General Data Protection Regulation (GDPR), are ensured through an appropriate consent and encryption process. The healthcare and register modules have standard disease-specific basic documentation, whereas additional assessments for partial database collections are mapped in the study module. For the purposes of standardisation, medications are recorded according to current ATC (Anatomical Therapeutic Chemical) classification and diagnoses according to the current version of ICD (International Classification of Diseases). For the purposes of treatment monitoring and support, disease progression and treatment procedures are shown as a graphic display for each individual patient. The administration module manages system users, practice master data, studies and metadata. The patient module allows for active inclusion of patients in the treatment process via electronic surveys.
The appropriate technical and organisational measures are taken to ensure confidentiality, integrity, availability, authenticity, reviewability and transparency with regard to the registry database. For the purposes of data quality control, practice-oriented protocols and queries are displayed on the online registry database and processed by the practices.
The registry database is updated continuously, being adapted and expanded to meet clinical practice requirements. Due to its modular construction, the system can easily be extended to cover other indications and areas of application.
The following indications are currently available on the NTD database:
- Dementia
- Depression
- Epilepsy
- Migraine
- Multiple Sclerosis
- Parkinson’s and motor disorders
- Schizophrenia and Bipolar disorders
The modular nature of the registry database means that further indications from the fields of neurology and psychiatry may be added at any time.
PHREND
The predictive module PHREND makes it possible to locate the most suitable MS medication for an individual patient and predict disease progression under a specific treatment. Working with an experienced team of mathematicians and statisticians from PricewaterhouseCoopers (PwC) AG, Switzerland, a special algorithm was developed that can use past data from the NTD database to calculate how, in all likelihood, the disease will develop in a specific patient under the influence of various treatments.
To obtain this type of prognosis, the physician first enters the patient data, such as gender, month and year of birth, date of MS diagnosis, current treatment, any previous treatments, current EDSS value, date of the last relapse and the number of relapses in the previous twelve months. The software uses the data to create a graphic, showing the degree of probability of the patient remaining relapse- and progression-free under a certain medication for a set period of two to four years. Physician and patient therefore receive an independent qualified second opinion that they can discuss together.
In addition to the clinical data, important factors and preferences for the individual patient are taken into consideration in the treatment decision-making process:
- Pregnancy/childbearing preferences
- Application type
- Risk of side effects (to be expected)
- Frequency of control tests (e.g. laboratory tests)
Ideally, there will be up to two or three treatment options left, from which doctor and patient can choose a medication together. The physician also has the option of printing out the result or emailing it to the patient so that they can think about again quietly at home.
This makes the patient more strongly and actively involved in the treatment of their illness. This not only improves the relationship between physician and patient, but will also have an impact on the success of the chosen treatment. Adherence to treatment is increased on the one hand. On the other hand, it is a sure and certain thing that a medication works even better the more convinced the patient taking it is of that medication.
Test PHREND free for 3 weeks »
More information about PHREND:
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What is PHREND?
PHREND is a software developed by doctors to improve the care for people with multiple sclerosis. It is a decision support tool that helps to create a patient-specific treatment plan: based on a patient’s history, PHREND predicts what treatment options will be most effective and predicts the disease progression of the available therapies.
How does PHREND work?
PHREND makes predictions based on data about a patient’s medical situation.
- The physician fills out a simple questionnaire
- The physician and patient fill out preferences of treatment, such as:
- Pregnancy/childbearing preferences
- Application type
- Risk of side effects
- Frequency of tests - PHREND calculates the efficacy of different treatment options
- PHREND shows a graphic overview with the probability of relapse and progression for 2 and 4 years.
Screenshots:
Please click to enlarge
Why use PHREND?
We have several years of experience with PHREND, helping hundreds of patients per year. PHREND is the first application able to provide personalized predictions of the efficacy of treatment options for people suffering from Multiple Sclerosis. We are proud that we have won multiple awards with PHREND.
The pioneering PHREND concept has already received multiple national and international awards:
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Benefits for doctors & patients
Healthcare professionals
- Improved quality of care through personalized predictions
- Increased accuracy and cost reduction through automation
- Ranking of effectiveness and visual comparison of available therapies
- Contribution to peer-reviewed research
Patients
- Improved quality of care through personalized predictions
- Easy communication with doctor
- Ability to indicate therapy preferences
- Review of your own therapy and medication
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Try PHREND – for free
Sign up for the free trial version.
Check and optimize your patient‘s therapy.
3 weeks free.Only for doctors.
If you want to register for the 3-week trial version, please enter your contact details here.
You will then receive a confirmation by e-mail. This may take up to five minutes.
Please also check your spam folder.
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Integration of PHREND in DESTINY
PHREND is part of the modular patient management system DESTINY.
The additional benefits of DESTINY are:
- Therapy and diagnosis support
- Patient management platform
- Clinical course and statistics on population and patient level
- KPIs (Key Performance Indicators) for your own practice
- Benchmarking with other practices
DESTINY – your companion in everyday practice.
The "My NTC Health Guide" App
Another important module in DESTINY® is our “My NTC Health Guide” patient app, which significantly improves individual self-management and assists patients in adhering to their treatment regimen. The app provides the patient with an overview of his or her medication, upcoming appointments, and laboratory tests.
Generally, a patient and his/her doctor only see each other at planned appointments. Between these appointments, the doctor has no idea how the patient is coping with his/her illness. This is one of the key ideas behind the “My NTC Health Guide” app.
The patient is shown a graphical representation of the progression of his or her disease; immediate documentation of any events enables the patient to gain a better understanding of and assessment of his or her condition.
Through the app, the data entered by the patient can be transmitted in real time to his/her NTC doctor, if so wished. This gives the doctor a better insight into the patient’s day-to-day experience of the illness. The data are sent via an individual link to DESTINY. This considerably enhances the role of the patient, who is no longer just a passive recipient of information, but rather a co-creator.
The indications covered by the app include migraines,headaches, and multiple sclerosis. The user can navigate between the various indications, and a calendar shows when, for example, his/her next injection is due, or which questionnaires need to be completed for the surveys. The patient can do this independently via the app, before the doctor’s appointment.
QR codes to download the app:
Elispot biomarker test
The ELISPOT laboratory test differentiates whether an MS patient will respond better to treatment with interferon than treatment with the active substance glatiramer acetate (GA). The test was applied over 2 years at NTD practices as part of a validation study. The results are now being analysed.
If the evaluation shows positive results, the plan is to extend the test procedure to other B-cell mediated treatments. This would identify a suitable biomarker that can be assessed before a medication is administered to establish which treatment the patient responds to best.
Interaction Check – Powered by Pgxperts®
The “PGXperts® InteraktionsCheck" module from HMG Systems Engineering GmbH tells the physician whether a scheduled medication interacts with other medicines that the patient is taking. Within seconds, information is identified relating to interactions between medicines, active substances, food, lifestyle and genetic variations. The clear representation of genetically determined interaction risks quickly identifies patients who could benefit from a pharmacogenetic examination. This type of examination can be carried out under the collaboration between HMG Systems Engineering GmbH and the Institute for Human Genetics of the University Clinic Bonn. PGXperts® InteraktionsCheck helps physicians to optimise patient medication accurately, safely and efficiently.
Pharmacovigilance Module
When medications are adjusted and discontinued, reasons for discontinuation and adverse events are recorded in the database as standard. Until recently, the pharmacovigilance module has only been used in studies, but it has now been used in routine practice since March 2018. Where adverse events occur, they are recorded in a standardised, electronic report following the requirements of the Federal Institute for Drugs and Medical Devices (BfArM). Entries are stored centrally, followed up and emailed to the competent authorities. The standardised recording of adverse events in everyday practice is a major factor for making treatment even safer, identifying side effects earlier and making outpatient healthcare data more valid and meaningful.