An Interview with Lefteris Koumakis

Lefteris Koumakis is the technological coordinator for MyPal at the Foundation for Research and Technology – Hellas (FORTH) based in Heraklion, Greece.

He is responsible for overseeing the design and implementation of the software which underpins the MyPal system. In this article Lefteris explains his role on the project and what he hopes MyPal research will achieve.

Can you tell us a little bit about yourself and your background?

I am a collaborating researcher at the Computational BioMedicine Laboratory (CBML) of the Institute of Computer Science (ICS) at the foundation for Research and Technology – Hellas (FORTH), in Heraklion, Greece. I first joined ICS-FORTH in 2000 as an undergraduate student, and then from 2002 to 2004 studied as a postgraduate student. I have been working there as a software engineer since 2014.

My background falls in the areas of bioinformatics, data mining and personal health systems, while my research interests also include machine learning, clinical decision support systems, and natural language processing.

I have worked on more than 10 international EU-funded projects in these areas, including the iManageCancer project, which has very close links with the MyPal project.

What is your role on the project?

On the MyPal project, I am the leader of “Work Package 3” (WP3). Work packages refer to how European Union funded research projects, like MyPal, organise their work. My team at FORTH are responsible for the overall design and software architecture of the MyPal system.

Our aim is to ensure that all the different electronic Patient Reported Outcome (ePRO) measures for adult patients used in MyPal are successfully integrated within the system.

This means, for example, that when a patient completes an ePRO on their MyPal app, that information can be accurately sent and then used effectively by the healthcare professionals involved.

Along with making sure that this patient data is accurately captured and conveyed without any errors, we are also responsible for ensuring, as this is highly personal information, that it is extremely secure. When the system is finalised, we are in charge of overseeing its deployment across the different hospitals involved in the research studies and then its continual maintenance throughout the duration of the project.

How did you get involved in MyPal?

I was involved in the iManageCancer project as technical coordinator and leader of the team that developed the Personal Healthcare Record, which is the backbone of the iManageCancer system.

iManageCancer was an EU funded project designed to strengthen the ability of people living with cancer to manage aspects of their disease themselves through the use of specially designed mobile apps and games.

The design and the implementation of MyPal is based on extending and adapting some of the achievements of iManageCancer, such as the Personal Health Record for adults and the game developed for children. These tools have been adapted for the particular needs of MyPal patients and the active participation of the healthcare team.

What are the key ways that MyPal differs from iManageCancer?

In iManageCancer, we designed and developed one of the first self-management platforms for people with cancer, with the patient in the central role. However, as a self-management platform, iManageCancer didn’t actively require the involvement of the patient’s healthcare team.

MyPal goes one step further and provides a system where both the patient and healthcare professionals actively participate.

The data provided by patients through MyPal can be accessed by the healthcare team helping them to make more informed decisions about the care of the patient, something that was out of scope for iManageCancer.

There are also quite a few differences in terms of the technologies used on the two projects. For patients, MyPal is a mobile application (available for Android and iOS), whereas iManageCancer was purely web-based. MyPal also includes the use of wearables, such as the FitBit bracelet, and has specially developed algorithms for better timing of patient reminders and motivational messages.

What are the challenges that you and your team face when the trial is up and running?

Conducting multicentre clinical studies for a digital health intervention is difficult in itself, and within the MyPal clinical trial for adults with cancer, we are working in six hospitals across five European countries, which adds another level of complexity.

During the trial the main challenge will be to respond quickly if any errors arise.

Even though the MyPal software has been rigorously tested and validated, there is always the possibility that the user has problems or requests improvements. In such instances, we must be prepared to provide updates of our software quickly, seamlessly, and with the minimum of effort from the end user.

What are your hopes for the work you have done on MyPal?

In my view, the most interesting thing to come out of the project would be the acceptance by patients that such an app can help meet their health needs as well as giving them a sense of empowerment. I also hope that the healthcare professionals find the system, and the information it can provide about the patients’ physiological and psychological status, valuable in helping them improve the care they provide.

I will also be very pleased if the project improves the way a patient and the healthcare team, communicate with each other.