App Helps Cedars-Sinai Continuously Improve Parkinson’s Care

Rick Graham, who has Parkinson's disease, used to update his Cedars-Sinai care team about his speech, balance and the tremor in his jaw during his three-month checkups.

Now, thanks to a $5 million gift from the Elaine and Eduardo Saverin Foundation, Graham enters updates into an app on his phone every few days and his care team can view them in real time.

"I use it every other day, at different times of the day, and I hope that helps the care team have a better idea of how my medication is working," Graham said. "I enjoy it. It keeps me thinking about what I might be able to do better to help myself."

Cedars-Sinai is helping Graham and other patients by expanding its use of the app, called Kneu Health.

Doctors all over the world who care for patients with Parkinson's disease face the same dilemma, said Michele Tagliati, MD, vice chair of Neurology and director of the Movement Disorders Divisionat Cedars-Sinai.

"At each checkup you ask a patient who has a neurological disorder and may be in their 70s or 80s how they've been doing for the past three to six months," Tagliati said. "And you base your whole treatment plan on what they tell you."

The Kneu Health app, which Tagliati is testing with Graham and other patients, gives doctors more frequent updates. Every few days patients use the app to perform exercises-such as holding the phone in front of their face to check for tremor, walking so the phone's accelerometer can check their balance, or performing exercises that test their memory or reaction time.

Patients also can enter information about their sleep quality and other symptoms of the movement disorder, in which brain cells progressively deteriorate.

The information feeds directly into the Cedars-Sinai electronic medical record (EMR) and the app produces a summary for doctors to review. It also sends an alert if the data suggests a patient is at risk for falling or other serious issues.

"This allows us to intervene instead of waiting for the patient's next visit," Tagliati said. "Rather than unknowingly having a patient spend months on a medication that isn't working or having them end up in the emergency department because of a fall, we can change their medication or have them use a walker."

Graham was first diagnosed with Parkinson's disease in 2018. He takes daily medications, uses an online speech pathology program, practices yoga and Pilates, and sees Tagliati every three months for botulinum toxin injections to help control his involuntary spasms.

Graham said he finds the app intuitive and easy to use and likes the fact that he can check in whenever he wants-and choose what he would like to work on.

The Elaine and Eduardo Saverin Foundation's gift will fund the hiring of three physician assistants or nurse practitioners to help monitor the large population of patients with Parkinson's disease followed at Cedars-Sinai, which currently number more than 800.

"We're supporting Cedars-Sinai's Parkinson's disease program because it addresses a critical gap in care by ensuring that patients maintain their quality of care even in outpatient settings," said Elaine Saverin, chairwoman of the foundation. "Technological innovations like the Kneu Health app can have profound ripple effects for thousands living with Parkinson's."

The additional staff funded by the gift will also help patients with Parkinson's disease who are hospitalized for reasons unrelated to their condition, such as an infection or the need for emergency surgery.

"When a patient with Parkinson's disease is admitted to Cedars-Sinai, we want to make sure the neurology care team knows about it," Tagliati said. "These patients are at risk of prolonged hospital stays or other complications if their prescribed medications aren't given on time, or if they are prescribed medications that can be harmful when taken with Parkinson's medications."

Cedars-Sinai has created an electronic dashboard to track and improve the care of these patients. The additional dedicated staffing will mean a nurse practitioner or physician assistant is available to monitor the dashboard and ensure hospitalized patients with Parkinson's disease are receiving the best possible care.

Kneu Health participated in Cedars-Sinai's AcceleratorProgram in 2024, and the Cedars-Sinai Intellectual Property Company recently invested in the company.

"This innovative approach to treating people with Parkinson's disease is something that is done at only a few hospitals around the country," said Nirdesh Gupta, PhD, managing partner in the Cedars-Sinai Intellectual Property Company. "Thanks to the Elaine and Eduardo Saverin Foundation, the participation of our patients and advances in technology, we now have the opportunity to improve the standard of care for Parkinson's patients here at Cedars-Sinai and, ultimately, on a global scale."

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