Developing Tortoise, a digital health platform to improve musculoskeletal health outcomes

Musculoskeletal (MSK) issues are a leading cause of morbidity. In the UK 30% of people live with an MSK issue and 20% of people see a doctor about one annually [1-UK Gov].

MSK conditions account for 20.8 million days lost in work [ONS] and significantly increase people s risk of inactivity, obesity and poor mental health [UK Gov]. NHS and private physiotherapy services are stretched.

Waiting times for physiotherapy services are long (NHS average 42 days in 2019) [2-Equipsme] which can exacerbate injury and impact mental health.

Non-adherence to home exercise programs is high, ranging from 50-75%, contributing to poor long-term outcomes and making assessment of treatment efficacy difficult for clinicians [3-Physiopedia]. Non-adherence causes are complex, involving physical, psychological, social, and environmental factors.

Our innovation, Tortoise, is a Tier C scalable digital health platform aiming to improve musculoskeletal and psychological health outcomes whilst reducing pressures on existing services.

The Tortoise app acts as a 24/7 holistic virtual coach for patients, boosting adherence to physical therapy programs and improving mental health through evidence-based interventions.

The Tortoise dashboard allows clinicians to remotely monitor adherence and key patient-reported progress indicators, enabling them to personalize programs and prioritize patients for follow-up.

Tortoise is being developed by an experienced multidisciplinary team including patients, specialist clinicians, behavioral scientists, product designers, software engineers, business development professionals, and project managers. The technology underlying the Tortoise platform is at TRL4.

We have validated the unmet need and innovation s potential benefits through qualitative research with 10 multidisciplinary healthcare professionals and 10 patients.

The insights from this patient and HCP co-development is shaping the Tortoise user requirement specification and feature selection for the minimum viable product.

This project will build on this proof-of-concept work through developing a minimum viable product suitable for launch by the end of 2023.