Name

Project Rōnin

Location

San Mateo, California

Industry

Hospital & Healthcare Technology

About Project Rōnin

Project Rōnin is a cancer intelligence suite designed to revolutionize treatment and improve patient outcomes. Their product suite includes an oncologist dashboard, a triage dashboard for mid-level clinicians, and a mobile app for patients. These three digital channels capture key information from different points of care and combine that data with insight from research databases and Electronic Medical Records (EMR) systems. In addition to giving providers a wealth of data to inform care, their platform leverages predictive analytics to help oncologists contextualize information and compare treatment options.

Project ronin about

Innovations & Challenges in Cancer Treatment

The term cancer refers to over 100 different diseases, each of which has its own complexities, manifestations, and symptoms. As a result, each type of cancer requires highly specialized diagnosis and treatment.

In the last fifty years, there have been monumental advancements in cancer treatment. Some forms of cancer which were once universally terminal are now treatable, and the average death rate for cancer patients dropped over 31 percent in the United States in the last few decades.

Today, there are over 600 cancer drugs on the market and many more in development. There are also many more supportive medications available to mitigate chemotherapy side effects and support healthy immune function. Needless to say, treating cancer is an incredibly nuanced process that requires seamless communication and keen decision-making to determine the best treatment for each patient and disease.

Optimizing & Individualizing Patient Care

Alongside medical data, patient feedback is one of the most important factors that oncologists can use to optimize care. Understanding and tracking patient symptoms and side effects helps clinicians intervene to improve quality of life, mitigate risks, and make treatment decisions.

Although treatment options have advanced considerably, the technical infrastructure clinicians rely on to coordinate care is still behind the curve. The EMR systems used by most hospitals are intended for billing rather than decision-making purposes, and therefore don’t offer advanced symptom reporting capabilities. Furthermore, many of these EMR systems are siloed. If a patient visits an urgent care center, gets blood work drawn at an independent lab, and visits an out-of-state specialist, that information isn’t necessarily shared and updated between systems.

To help solve this challenge of disconnected data in the healthcare system, Project Rōnin built a mobile app to help patients track symptoms between visits and communicate with their care team.

Project ronin optimizing patient care

Choosing OneSignal

Project Rōnin knew they needed a messaging provider to encourage in-app symptom tracking and coordinate cross-channel communication between patients and clinicians. At first, they tried Pushwoosh and Mixpanel, but found both solutions to be unreliable. In the health tech industry where the margin for error is virtually nonexistent, reliability issues aren’t taken lightly. As Project Rōnin’s Product Manager Charlie Kottler puts it,

“When we experience outages from any third-party vendor, it can be a really serious health safety issue. Patients rely on notifications as part of their treatment experience, so reliability concerns are a huge deal breaker...we really have respect for providers like OneSignal that have higher reliability standards.”

Reliability was also paramount for their unique use case. Memory lapses, fatigue, and cognitive impairment are common side effects associated with chemotherapy and immunotherapy treatments. Finding a reliable push notification provider was, therefore, essential to ensure that patients remembered to report symptoms at regular intervals — and guarantee that their care team was acting on the most up-to-date information.

Charlie Kottler
“When we experience outages from any third-party vendor, it can be a really serious health safety issue. Patients rely on notifications as part of their treatment experience, so reliability concerns are a huge deal breaker...we really have respect for providers like OneSignal that have higher reliability standards.”
Charlie Kottler, Product Manager

As Project Rōnin’s product team looked for a more reliable messaging provider, there were other factors that informed their search. In order to comply with Health Insurance Portability and Accountability Act (HIPAA) standards, Personally Sensitive Information (PSI) cannot be sent through a third-party messaging dashboard. With that in mind, it was important to find a provider that offered a robust yet easy-to-use API and ample support resources to aid custom implementation. Additionally, they needed a solution that offered advanced segmentation and personalization capabilities in order to deliver personalized messages at scale to users in different treatment cohorts.

In OneSignal, they found the answer to all of these wish list items. Over a year later, they’ve continued to scale their messaging strategy and user base without any reliability issues. As Kottler reflects on the last year, he appreciates that OneSignal’s commitment to providing support extended well beyond the sales process.

“I’ve experienced a rocky implementation process with other tools. One of the main selling points with OneSignal was the ease of implementation and support — from working with sales to actually implementing the product.”

Project ronin choosing onesignal

Using Mobile Push Notifications to Encourage Regular Symptom Tracking

Currently, Project Rōnin uses mobile push notifications to remind cancer patients to report their symptoms between appointments. As Project Rōnin's Senior Product Marketing Manager Dustin Hoyman explains, the importance of these notifications is accentuated during treatment.

"Given the well-known 'chemo brain' effects of their therapy, push notifications are a welcome reminder for our patients. They enable them to report their symptoms on a regular basis without having to add another to-do to an already long and complicated list, at a time in their lives when complexity may feel particularly overwhelming," says Hoyman.

In addition to ensuring that patients share feedback at consistent intervals, notifications also give patients the opportunity to actively participate in their treatment and help to extend the provider-patient relationship beyond the bounds of a treatment center.

Because patients see the app and associated communication as a reflection of their care team, their push notifications earn reaction rates upwards of 40 percent — over 30 percent higher than average reaction rates.

By reminding patients when to track symptoms, push notifications also serve to encourage app retention and reinforce Project Rōnin’s primary mission to optimize treatment through data.

Project ronin using mobile push notifications

Dustin Hoyman
"Given the well-known 'chemo brain' effects of their therapy, push notifications are a welcome reminder for our patients. They enable them to report their symptoms on a regular basis without having to add another to-do to an already long and complicated list, at a time in their lives when complexity may feel particularly overwhelming."
Dustin Hoyman, Senior Product Marketing Manager

Using In-App Messaging to Triage Symptoms & Educate Patients

In addition to helping oncologists make informed treatment decisions, Project Rōnin also wants to reduce patient ER visits by improving patient education and facilitating communication.

Cancer treatment drugs are powerful by nature and severe side effects aren’t uncommon. Due to the variety of potential side effects and range of supportive medications involved in treatment, it can be difficult for patients to identify which symptoms are normal within the context of their treatment and which symptoms could be cause for concern. As a result, ER visits can occur unnecessarily due to a lack of information, or much too late, past the point when a less severe intervention might have limited suffering and prevented an emergency. As patients report their symptoms in the Project Rōnin app, self-reported symptoms are channeled into a triage dashboard.

Recently, the Project Rōnin team has begun working on an innovative solution to streamline clinician-patient communication and improve patient education. The solution they’re developing will use in-app messaging to send patients educational information about symptoms they’ve reported as well as instructions from their care team based on triaged results. Although the care team’s response to triaged symptoms will be provided on a case-by-case basis via the triage dashboard, the remaining message content and educational information will be personalized and automated using OneSignal’s data tags and tag substitution method. In addition to preventing emergencies, they hope that educating patients about their symptoms and providing symptom management tips will help to reduce fear and improve quality of life during treatment. It will also help them deliver a more personalized app experience that’s tailored to each patient, type of cancer, and treatment group.

Charlie Kottler
“I’ve experienced a rocky implementation process with other tools. One of the main selling points with OneSignal was the ease of implementation and support — from working with sales to actually implementing the product.”
Charlie Kottler, Product Manager

Using A/B Testing to Improve Patient Communication

Because push notifications and in-app messages can be seen as an extension of a patient’s care team, choosing the right words and tone of voice is important. Project Rōnin’s team took advantage of OneSignal’s A/B testing feature to figure out the best messaging to encourage symptom reporting. After trying out different messages, they found that messaging centered around “keeping your care team informed” resonated with patients because it emphasized the value of their participation in the context of their treatment.

Project ronin using ab testing 2

Building for the Future

As Project Rōnin continues to grow, they hope to personalize in-app messages and push notifications to an even greater degree to further optimize treatment and improve the patient experience. Kottler also sees the potential to use OneSignal’s in-app survey tool to ask more questions about patient's quality of life during treatment and compliment cancer research efforts.