The Longevity

New Brunswick Launches Canada’s First Innovation Hub to Support Tech Solutions for Aging

The Canadian province of New Brunswick recently launched the country's first innovation hub focused on tech solutions for the aging.

The New Brunswick Health Research Foundation (NBHRF), in collaboration with the AGE–WELL Network of Centres of Excellence (NCE), is launching Advancing Policies and Practices in Technology and Aging (APPTA), an innovation hub dedicated to building tech that supports healthy aging.

AGE-WELL NCE said the APPTA hub, which officially opened on May 16 in Fredericton, will focus mainly on developing technologies and solutions for policy, program, and service challenges in the field of technology and aging. The hub is meant to allow Canadians to benefit from emerging technologies that foster independent living and improve the quality of life for aging adults.

The goal is to help entrepreneurs get to market with their products and services designed to support healthy aging.

Lisa Harris, New Brunswick’s minister of seniors and long-term care [said], “We are delighted to be the host province for a hub that will be a national resource for policymakers, researchers, clinicians, and others working to implement novel technologies that will improve the health and wellbeing of older Canadians and their caregivers.”

The APPTA hub will help entrepreneurs take their ideas to market by connecting them to end users, policymakers, and service providers. AGE-WELL NCE said it will also bring training opportunities for graduate students and post-doctoral fellows from the field of technology and aging. AGE-WELL and NBHRF will jointly fund the salaries of four individuals annually.

“This hub will promote knowledge-sharing and effective transfer of needed technologies right across Canada," [said] Bruno Battistini, president, CEO, and scientific director of NBHRF and a co-sponsor of the hub.

Forbes Speculates on How People 50+ Will Live in the Future

PBS' Next Avenue, a service journalism project dedicated the 50+ consumer, recently turned five, and in honor of that birthday, they decided to look at the future of aging in America--and make some predictions. Contributing writer Shayla Stern's piece--posted by Forbes--focused on elements of "living" for the 50+. Not surprisingly, technology plays a large role in her vision.

The future of the way people 50 and older live and learn will be increasingly more connected and networked — social networks, cloud-based networks and actual real-live human networks.

For this article, we reached out to leaders and creative thinkers in areas covered in our Living & Learning channel to predict and imagine how we will live and learn in five years, 10 years and way, way down the road — the Jetsons prediction, as we've been calling it internally.

The Five Year Prediction: More Pervasive Home Automation

Scott Moody is the CEO and founder of K4Connect, a tech company that serves older adults and people with disabilities through software platforms that integrate devices, systems and applications into a single system that can work together and be managed as one form of application. Moody believes that in five years there will be a more seamless approach to accessing apps and managing household items — something we currently think about as the “Internet of Things” (IoT), or home automation.

“We’ve seen all these new ideas, products and applications coming out, but look: You can’t put 50,000 apps on your device and live a good life,” he said. "A lot of people talk about IoT and home automation, but it hasn’t really been successful.”

This is because the Internet of Things is not simple enough to use now. Companies like Moody's are working to overcome this.

So what does a "more ideal" smart home look like?

In a perfect IoT system, an older person could stand up in the middle of the night and a light would automatically turn on and potentially prevent a fall. Or if the person missed taking a medication, an alert would come over his or her in-house stereo system. Moody's company is working to assure that doorbells, door locks, motion sensors, streaming music, blood pressure monitors and pill reminders, as well as video chat and photo sharing, are automated through a central platform that can be controlled by a user’s smartphone or tablet.

Will this revolution really happen in the next five years?

[It] is “definitely coming,” [Moody] said, “but is it a few years? Is it five? It might be a little bit more” for a majority of older adults to be able to have such systems involved in their homes or retirement communities.

“It has to be an open system — a very open system, in my opinion — and not this monstrosity of individual things to make home automation really work,” Moody added. “New products and new ideas will have to be able to come out without a complete revamp of a whole system.”

However, Moody points out, we may see an important consideration with older adults in 10 years: income-level changes.

The Ten-Year Prediction: Tech That is Truly For an Aging Population

Americans in the next decade likely will retire with far less savings than their parents did. “The fact of the matter is the population we serve is, in fact, going to be very financially challenged in the future,” Moody said. “People today have pensions and insurance programs, but now people are retiring with maybe $25,000 in a 401(k). It’s going to be financially challenging for them.”

Because of this, tech-based systems for living will have to become not only more seamless, but also more affordable.

Will that affordable solution be lots of robots, to handle everything from housecleaning to caregiving? Moody doesn't think so.

[He says] the lack of humanity (and affordability) of robots makes him believe they will be less prevalent than some predict.

Additionally, Moody hopes that technological development will skew to being created with older adults in mind. “All these products are coming out every day and some of them are pretty neat. They’re all being designed for 25-year-olds, not the people we serve," he said. "Then someone slaps a bigger font on it and says they’ve adapted it for 90-year-olds."

More importantly, older adults do not all see themselves as ill, and even if they are, living in a fulfilling way means they want to address more than just their health issues.

In a recent essay posted on Next Avenue, Joseph F. Coughlin, director of the MIT AgeLab, warned against conflating growing older with health issues, which he said will be an especially important distinction to make for developers and inventors seeking to make innovations in the way we live as we age. "Older people, especially the oldest among us, are more likely to suffer from multiple chronic conditions and require significant care," Coughlin wrote. "But while this may be the story for some older adults, illness and older age are not equivalents. And even elderly patients managing chronic disease want to do things that do not involve their ‘conditions’."

Moody agreed, noting that as a boomer himself, he was especially sensitive to tech innovators treating older people like patients as they consider design.

“Too many people look at you when you turn 65 like you’re a patient and they want to tell you what to do,” he said. “At the end of the day, we all want purpose, and sometimes that purpose is the ability to take some level of care of myself. That whole idea of providing technology so I can live the life I want — that’s what I really want."

The Distant Future...Has Arrived

The piece finished up with a roundup of some more possibilities that may not be so far-fetched as they sound.

The Jetsons, you'll recall, lived in a flying saucer-like apartment building on the tallest stilts you’ve seen, accessible only by space car or jetpack, with a robotic maid and cool contraptions like smartwatches and 3D printers for food that actually exist today.

3D printed houses (that can be finished in 8 hours)

Homes with appliances that can look, speak and teach like humans

‘Smart threads’ that can allow fabric on your furniture to change color instantly and frequently

Homes equipped with virtual reality as a means of helping with dementia or distracting from pain

NY’s Governor Cuomo Launches Country’s First Aging Services Mobile App

With the launch of the Aging Services mobile app, announced on May 9th, the Governor of New York has high hopes for his state as a role model in serving older adults.

[It] is part of the Governor’s overall goal to make New York State the healthiest and the first age-friendly state in the nation, in accordance with the eight Age Friendly/Livable Community Domains outlined by the World Health Organization and AARP. Communities that are designed and designated as age-friendly are communities that promote healthy aging for older adults and individuals of any age.

[The] app [will] connect older adults with valuable resources and services in their communities. The New York State Office for the Aging’s Aging Services app will provide New York's more than 3.7 million older adults with easily accessible material about benefits, programs, and services, including information regarding health and wellness, housing, and transportation options. The app is compatible with both iOS and Android platforms.

A primary aim of the app is to help older adults locate the services already available in their neighborhood.

Using the app’s “Near Me” feature, an older adult or caregiver anywhere in New York can immediately obtain address and contact information for local offices for the aging, senior centers, farmers’ markets, caregiver services, Alzheimer’s Association chapters, and more, within the closest proximity to their exact location. 

The Aging Services app also links users with live information and assistance through NY Connects, the state’s “no wrong door” system for community-based long-term services and supports, which is designed to help older adults and those with disabilities remain healthy and independent. Additionally, the app provides timely news and updates about state and federal programs that directly impact the lives of older New Yorkers and their families.

Governor Cuomo's initiative is timely, given the changing technology habits of older adults and their widespread desire to age-in-place.

Older adults are increasingly using technological tools to connect to news and information, health and wellness resources, and social supports. Almost 75 percent of people over age 50 and almost 45 percent of people over age 65 now own a smartphone, and those numbers continue to grow.

Beth Finkel, AARP NY State Director said, “AARP is proud to partner with Governor Cuomo to make New York the first age friendly state. The launching of this app, specifically designed for older New Yorkers and their families, supports many of the principles of age friendly/livable communities. Today’s older adults are becoming increasingly connected to mobile technology via smartphones and other mobile devices, and this new age-friendly mobile app allows people to more easily link to community resources that help them age independently.”

Tom Kamber, Founder and Executive Director of Older Adults Technology Services, said, “We are experiencing a longevity revolution in this country and the role of technology to assist and support our daily activities is paramount. There is an increasing awareness of healthy living and social engagement among today’s older adults, and technology plays a key role in healthy aging. New York State’s new mobile Aging Services app helps older adults remain healthy, active, and engaged in their communities, which in turn leads to a stronger and smarter New York.”

The Aging Services app was developed by the New York State Office for the Aging in collaboration with the New York State Office of Information Technology Services. To explore more of New York State’s official mobile apps, visit www.ny.gov/mobileapps.

Might we Finally See a Digital Health Unicorn? Caremerge’s CTO Believes We Will

Co-Founder and CTO of Caremerge, Fahad Aziz, recently published a piece in Forbes on why he believes no digital health startup has yet achieved the "unicorn" status of a billion dollar valuation. Can it ever happen? Aziz believes it can, because some of the chronic limiting factors in the rapid adoption characteristic of unicorns is increasingly likely as the sector matures and offers ways to get around the limitations.

With Caremerge being one of the the fastest growing healthcare startups around, and one that has raised an impressive $20m in investment to date, his perspective is nuanced and insightful. (Please also check out The Longevity Network's own exclusive Entrepreneur of the Week interview with co-founder and CEO of Caremerge, Asif Khan).

Despite the fact that health is a basic need, not one digital health startup has attained unicorn status...There are several reasons as to why digital health startups have failed thus far to build multibillion-dollar businesses.

The First Difficulty: Securing Adequate Capital

No unicorn exists today that didn’t raise a crazy amount of cash in their first few years of growth. Digital health startups don’t have that luxury — which becomes a huge roadblock for them to grow exponentially.

Investors feel (and rightly so) that they don’t have enough leverage to assist a healthcare startup with growth. In addition to extensive government regulations, buyers (hospitals, physician offices, pharmacies or long-term care facilities) are often slow in buying technology. Investors are excited about the space because of the potential for demand but not enough to take on hundreds of millions of dollars of risk.

The bright spot: that investor confidence is growing.

In 2010, digital health companies received $1 billion in total investment, a drop in the bucket in comparison to others. Six years later, that number jumped 810% to $8.1 billion in 2016, as reported by Novahill Partners in their quarterly report (paywall). Part of this is due to entrepreneurs finding creative ways to generate revenue, lessening their dependence on providers.

The Second Difficulty: Costly Integration with Provider Systems

The fact that a digital health product cannot work in isolation and that it needs data from hospitals or physician offices adds complication and slows down innovation. By the time a startup creates those integrations, it has exhausted its funds and is likely dependent on this investment to work for them. And they usually don’t.

The bright spot: these integrations have become easier and less costly to perform

Major health systems offer out-of-the-box APIs and interfaces that make the integration process quick to build and test. There are also a number of third-party systems like Interfaceware and Mirth that provide built-in connectors to use and consultants who would do the integration for less, thus allowing startups to focus on their core business.

Third Difficulty: The Stakeholders Who Will Pay have Different Objectives Than the Ones Who Will Use

Healthcare regulations and large customers (like hospitals) often dictate the direction of a particular solution, and it becomes very difficult for a digital health startup to focus on optimizing its features to increase user tracking. New features take priority over A/B testing on existing features. Current unicorns in different markets have mastered the art of increasing traction by designing and redesigning the user experience, gamifying engagement, and sending smart notifications. This is only possible when you have one core offering.

The bright spot: many of the more successful startups are figuring out how to navigate this conflict.

More and more digital health startups are now trying to stay focused on their offerings. PatientPing, Amino, ZocDoc and Honor are several examples of digital health startups that have shown high growth while offering one core service.

The Fourth Difficulty: Many Digital Health Solutions Pull Provider Attention Away from Their Patients

Most healthcare technologies are used by care providers at hospitals, doctors’ offices, pharmacies and senior living communities. However, while technology has helped them become efficient, it takes their focus away from what they are trained to do. If you visit your primary doctor, you will notice that while they are talking to you, they are staring at a computer. It’s annoying, and they hate it too, but they have no choice.

This is the biggest challenge for digital health startups. They haven’t made applications that keep their users in mind.

The bright spot: there is a glimmer of hope in voice-activation, AI and other innovations.

Goodbye to clunky electronic medical records...Forward, a Silicon Valley startup, is determined to change that. By using voice recognition, artificial intelligence and connected EHR, they are letting physicians do what they do best: consult and let the technology assist them in a way that’s not a hindrance.

The Fifth Difficulty: B2B Does Not Utilize the Same Viral Consumer Adoption Model as Unicorns in Other Sectors

Most unicorns provide solutions to consumers. There are proven methodologies that allow to exponentially increase a consumer base via user engagement and virtuous loops (aka network effect). This is not as applicable in a B2B setting, but it’s not far-fetched either.

The bright spot: other sectors have demonstrated there is a version of rapid adoption that works in B2B growth

Palantir and Dropbox are two B2B companies that made it to unicorn status while providing solutions for other businesses. The business models were different, but they mastered the art of user engagement to retain and grow users in the system. Once users become the champions of their applications, it leaves decision makers and enterprises with no option to switch. Digital health startups now have these proven examples, and they need to employ them in their own businesses to generate the kind of growth that’s expected from a unicorn.

The Conclusion: any day now, the bright spots will win out over the entrenched difficulties in achieving the market scale of a unicorn in a digital health startup.

These are very exciting times for digital health startups. According to RockHealth, in the first quarter of 2017, there were 71 digital health deals totaling over $1 billion. Most of these investments were second and third rounds, which shows that startups have established traction and wowed their investors. Moreover, digital health startups are looking for creative ways to increase their revenue by signing up technology partners in addition to direct sales. And finally, more entrepreneurs from non-health startups are entering this space. For example, the founders of Vida, Honor, Forward and CloudMedx came from tech giants like Google, Facebook and Microsoft. Based on all of this, there is reason to believe that very soon we will see not just one but several digital health startups transform into unicorns.

Cleveland Clinic’s Commercialization Arm Gets Restructured, Adds Execs

Among the successes over the past two decades at Cleveland Clinic--many of which are in the news this week as Dr. Toby Cosgrove recently announced he will step down from his role as longtime CEO--is the development of its commercialization arm, Cleveland Clinic Innovations (CCI).

Last month, CCI announced it was restructuring the division to further expand and refine its ability to commercialize medical innovations and also attract talent to Cleveland.

The restructuring elevates the role of Cleveland Clinic Ventures, with the goal of putting added focus on spinning off companies and raising funds to get those companies launched.

[It] will align the commercialization process under two Cleveland Clinic departments. Brian Donley, M.D., chief of staff at Cleveland Clinic, will oversee CCI and Steven Glass, chief financial officer for Cleveland Clinic, will oversee Cleveland Clinic Ventures.

“This new structure will maintain appropriate separation and eliminate any conflicts of interest in the commercialization process,” said Glass in a prepared statement. “It will also better position Cleveland Clinic to take to market the breakthrough inventions of our caregivers into new medical products and companies that benefit patients.”

CCI has become a success story of commercializing innovative ideas to improve patient experience and outcomes by tapping into its practicing caregivers for ideas.

Founded in 2000, CCI has issued over 850 patents and executed more than 500 licenses on medical devices and techniques. Additionally, CCI has helped launch 77 companies, which have created over 1,200 jobs and raised more than $1 billion in follow-on funding, according to Cleveland Clinic.

Successful...spinoffs include Explorys, a data firm purchased by IBM, and Intellect, a neuroscience device-maker acquired by Boston Scientific. In June 2016, CCI executed a license with a national patient experience services company to distribute and implement Cleveland Clinic’s Communicate with H.E.A.R.T. program to hospitals looking to improve their patient experience. NaviGate performed a first in human transcatheter mitral valve replacement in April 2015. Cleveland Heart Labs has grown to over 200 employees.

A new director has also been named for each of the two newly restructured departments.

Peter O’Neill will serve as executive director of CCI. He has more than 10 years of experience with CCI, including serving as director of commercialization and chief executive of one of its spinoff companies, Custom Orthopaedic Solutions.

Jack Miner, former director of the Venture Center at the University of Michigan, will be managing director of Cleveland Clinic Ventures. In his new role, Miner oversees a team that focuses on the 77 spin-off companies in its portfolio. He also plays a lead role in spinning off new companies and raising the funds needed to not only get off the ground, but to get all the way to market. These plans will include funding strategies, technology road maps and business model development.

Q&A: Samsung Electronic America’s Chief Medical Officer Shares Priorities, Vision

Chief Medical Officer for Samsung Electronics America, Dr. David Rhew, will be a keynote speaker at the MedCity INVEST conference this month in Chicago, and this week he provided MedCity News with a written Q&A on Samsung's digital health priorities and on the many partnerships it is developing with providers and startups in the space.

This is a somewhat abridged version which aims to highlight topics relevant the the 50+ market of healthy living as well as caregiving tech.

What prompted you to move from working as a practicing physician to technology?

In addition to my work as a physician, I have a background in computer science and artificial intelligence so I have always been passionate about technology. As result, I spend a lot of time exploring how technology can improve health outcomes and reduce costs. I joined Samsung because there was strong alignment in tackling this industry challenge.

What are some examples of the digital health technologies Samsung is producing?

We apply technology to improve health outcomes, specifically access to care, quality of care, cost and efficiency, and the patient experience.  We focus on three areas: 

In-hospital, with a particular emphasis on improving efficiency of care and improving the patient and family in-facility experience;

In-health covers connected health and mHealth technologies such as remote patient monitoring, wearables, and telehealth; and

In-home This includes  Internet of Things technologies in the home or apartment are designed to meet the needs of seniors and those with disabilities.

What are some of the digital health technologies that excite you and why?

[I]magine a world where all types of healthcare, fitness, and wellness services were readily available on [a] digital health market place. This is precisely the vision for Samsung Health (formerly S Health).

Through a strategic partnership with American Well and leading healthcare organizations, Samsung has launched a direct-to-consumer telemedicine platform called Samsung Health. Samsung Health is currently available on all Samsung and Android mobile devices with the goal of expanding to other operating systems.

...Clinical research now demonstrates that virtual reality (VR) can reduce pain and potentially decrease narcotic usage for those with both acute and chronic pain.  Samsung is participating in a randomized controlled trial with Cedars-Sinai and Applied VR to evaluate the impact of VR in hospitalized patients with pain. We are also seeing very promising results with VR as a therapeutic tool for individuals with a variety of conditions including post-traumatic stress disorder, stroke, spinal cord injury, macular degeneration, and dementia to name a few.

Finally, digital health can help seniors, as well individuals with disabilities due to disease and/or accident, live longer, happier, and healthier lives. At the same time, it can improve the quality of life for the caregiver. One of the most common fears for seniors is being sent to a nursing home. The inability to care for oneself could potentially be addressed if the home and/or apartment were made safer and smarter. Imagine a home where the appliances were digitally connected to make everyday activities seamless; where sensors in the kitchen, bedroom, and bathrooms could enable early detection of falls; where wearables could help identify and proactively alert when an individual’s condition is worsening.

What have you learned from working with hospitals and care teams to implement digital health tools?

Increasing patient/consumer engagement in their health is one of the most important factors in improving outcomes. Digital technologies need to be seamless, easy, and secure. This means we need to think about the consumer “workflow”, motivation, and the internal needs that we are addressing with the solution. Data is only useful when it has been properly filtered, analyzed, and pushed out as actionable insights. Clinician involvement and when, how, and to whom the data are presented is a vital part of a successful digital health program.

How many startups are you collaborating with?

We work with a wide range of “startups”, from the very new to the more established. What unites them all is a commitment to innovation and using technology to solve specific healthcare problems – whether that’s senior isolation, medical treatment adherence or pain management.

What are some of the biggest challenges when collaborating with startups?

I would say the main challenge —no matter the size of the company – is that digital healthcare innovation is a relatively young sector. While we’ve come a long way in a short period of time, there are still many regulatory and structural considerations that need to be addressed.

What advice would you give to startups that want to collaborate with Samsung?

We want to hear from any organization that delivers technology solutions to improve the healthcare delivery process and patient outcomes. We are interested in startups that can provide a clear solution to a problem—or can show a specific barrier that they help patients or providers overcome.

In London: Courier & Caregiver Startups Partner to Provide OTC Meds On Demand

London's on-demand black cab service Gett is partnering with social care startup Cera to deliver over-the-counter medications and other essential items to seniors. One of the goals, says Cera, is to reduce the number of preventable emergency room visits.

15 per cent of [ER visits in the UK] are thought to be avoidable, according to Health Foundation research.

Cera, [which] uses technology to match up those needing care with an experienced carer at the right time and right place,...has also partnered with several NHS [National Health Service] trusts and hospitals.

Cera and Gett's partnership will mean a carer, or the patient themselves, can request everything from painkillers to rehydration sachets to cough syrup, and many other non-prescription products.

One of Gett's 100-strong fleet of couriers will then collect items from a central location and deliver them to the patient's door within an hour. Cera's carers and patients will also be able to use the Gett app to call for a wheelchair accessible black cab and trained driver.

According to Dr Ben Maruthappu, co-founder and president of Cera, the partnership is meeting a crucial need not only of patients and their carers but also of the NHS:

This partnership provides patients with access to rapid, responsive and on-demand services that have proved successful in other industries, while empowering our carer-workers.

The right medication at the right time can make the difference between an A&E admission, and an evening at home.

By partnering with innovative companies such as Gett we are building technology–enabled care solutions that benefit patients, families, carers and the NHS alike.

It follows a similar partnership announced between Cera and Uber last month, where Uber drivers will be trained to transport non-emergency patients around.

Entrepreneur of the Week: Dirk Soenksen, Ceresti Health

Earlier this month, ten caregiving health tech finalists competed in AARP’s Innovation@50+ LivePitch event in Mountain View, CA. (Click here for our wrap of the event). The Longevity Network is delighted to be featuring one finalist per week in our Entrepreneur of the Week segment for the next ten weeks.

This week we feature Ceresti Health. They offer a personalized digital health program aimed at the millions of unpaid family caregivers of someone with Alzheimer's or other dementias. The proprietary software comes with a tablet that serves as the gateway for education, support, care plans and coaching to improve care and reduce healthcare costs of this population. 

We spoke with Dirk Soenksen, co-founder and CEO, about the opportunities he sees in the 50+ market. 

Longevity Network: What does Ceresti, the company, do?

Dirk Soenksen: Ceresti is focused on reducing healthcare costs and improving care for the most expensive patients: those unable to self-manage their chronic conditions. Our digital health programs empower family caregivers to improve patient health.

Patients with Alzheimer’s Disease, stroke or a traumatic brain injury are unable to follow instructions or communicate symptoms, including pain. When these patients also have chronic conditions like diabetes or heart disease, their inability to self-manage increases costs for payers and magnifies care challenges for inexperienced and stressed caregivers.

LN: Can you tell us about your product and how it works?

DS: Our proprietary caregiver-centric 12-week program is delivered as a technology-enabled service. We provide the unpaid family caregiver with a dedicated tablet to be used in their home for the duration of our program. We deliver a highly personalized program that includes education, care plans, support and coaching.  For example, a caregiver might watch a video about the signs and symptoms of a urinary tract infection, or learn how to help someone with dementia brush their teeth, or enter a blood pressure reading. Caregivers acquire the knowledge, skills and confidence required for their specific situation.

LN: What opportunity did you see that you wanted to address with the creation of your product?

DS: Patients who are unable to self-manage their chronic conditions incur healthcare costs that are significantly higher per year than patients able to self-manage. Medicare spends more than $60 billion every year in incremental costs for 5.5 million U.S. patients who are unable to self-manage. The largest five Medicare Advantage plans spend an additional $14 billion every year on these patients, above and beyond what they spend for patients who are able to self-manage.

Peer reviewed studies show that engaging unpaid family caregivers improves care and reduces costs. Ceresti is the first company to integrate proven approaches for managing chronic conditions with best practices for Alzheimer’s care into a caregiver-centric personalized program.

We believe that our digital health programs can reduce incremental healthcare costs by 50% and save each of the largest five Medicare Advantage Plans more than $1 billion annually.

By creating a business that aligns the economic needs of payers with the medical and psychosocial needs of patients and their caregivers, we can dramatically improve families’ experience of living with Alzheimer’s—which is what we set out to do when we founded Ceresti.

LN: Who are your primary users? How will your product benefit the 50+ population?

DS: Our platform and in particular our dedicated tablets have been optimized for use by family caregivers, typically a spouse of the person unable to self-manage, or a baby-boomer child.  We also provide family members and friends access to our smartphone App to allow them to share pictures and send messages to the tablet.

An estimated 15 million Americans currently provide unpaid care for a loved one with Alzheimer’s. Almost 70% of these family caregivers are 50+. These numbers are expected to triple in the next 30 to 40 years.

Our programs will provide much-needed knowledge, skills, confidence and support to family caregivers as they struggle with caring for spouses or parents who are unable to self-manage their chronic conditions.

LN: How did you assemble your team?

DS: The three co-founders of Ceresti all worked together at a prior healthcare company (Aperio) also founded by me. Between the three co-founders, we cover strategy, vision, clinical, content, technology and scalability. We added a highly talented individual with a deep understanding of managed care to our leadership team.  We also benefitted greatly from the insights and suggestions of a diverse group of advisors.

LN: How has what happened with your company differed from what you envisioned would happen?

DS: Our prior experience of starting a company in the garage, raising venture capital, building a team, scaling operations and orchestrating a successful exit has prepared us well.

When we started Ceresti we recognized that we were likely the first ones to tackle the complex challenge of building a payer-focused business capable of improving care for millions living with Alzheimer’s Disease. We expected that some of our ideas would fail along the way and provide an opportunity for us to learn and pivot. That has happened a few times already. For example, we had truly spectacular results engaging patients living with dementia in a memory care facility with our digital psychosocial therapies. When we took these therapies into the home we had mixed results, which allowed us to understand the impact and importance of the family caregiver on the quality of patient care.  We quickly recognized that in order for us to be successful in the home, the family caregiver has to be central to our mission of improving patient care.

LN: What do you wish you had known before developing your product?

DS: It would have been wonderful if many of the insights we have made to date had been known to us.  We could have saved significant time and money.  However, the things we learned—such as the importance of the family caregiver in the home, as described above—were either unknowable or unknown by our team and by the significant group of advisors we assembled to help us.

LN: What most excites you about the aging/health technology market?

DS: In the U.S., 10,000 people turn 65 every day.  The demographics of the U.S. population highlight that the aging/health technology market represents a large and growing business opportunity. Digital health has yet to deliver on its promise, but I’m confident that it can and will. We believe that our approach of developing a holistic solution that includes a large and near-term economic benefit has the potential to create significant value for payers, while addressing the care needs of some of the most challenging patients.

LN: What is your best piece of advice for startups who want to include or target the aging / tech market?

DS: If your goal is to build a large digital health business, make sure that your product or service is capable of achieving a tangible economic benefit for someone who is willing and able to pay. Selling directly to consumers is expensive and inefficient.

LN: Where do you see your company five years from now?

DS: We expect that Ceresti will offer the leading solution deployed by payers and at-risk providers to reduce costs and improve care for patients unable to self-manage.  We expect that caregivers and families will benefit greatly from our program and seek out payers and providers who are prepared to underwrite our program as part of their suite of chronic care management tools.

LN: What health or wellness technology do you hope exists by the time you retire?

DS: I’m intrigued by the potential of non-human avatars to cost-effectively personalize caregiver or patient engagement in digital health. The current state of avatar technology isn’t quite where it needs to be, but this seems like something that could really be “game-changing” as an enhancement to a solution with a human touch.

LN: Is there anything else you’d like to share?

DS: In our view, personalization is the key to engagement, and engagement is the key to successful outcomes.  Ceresti has developed a proprietary “personalization engine” that operates “under the hood” of all of our digital health programs and adaptively and continually personalizes our programs to maximize engagement.  Every caregiver/patient dyad receives a unique program to address their specific and personal needs.  Our long-term differentiator will be the ability to achieve unprecedented personalization, using technology, at scale.

About the Author

Prior to co-founding Ceresti, Mr. Soenksen was founder and CEO of venture-backed Aperio. He started Aperio in his garage in 1999 and built a winning team that established Aperio as the recognized global leader in digital pathology. Aperio was acquired by Danaher in October 2012. 

In 2006, Mr. Soenksen founded the Digital Pathology Association (DPA), a non-profit organization comprising major vendors and leading pathologists, with the goal of establishing best practices and increasing awareness of digital pathology. Dirk served as President of the DPA from its inception until 2012, and as a board member of the DPA through the end of 2014. 

He has an undergraduate degree in Chemistry from Bowdoin College, and a graduate degree in electrical engineering from the University of Pennsylvania.  He also earned his MBA from Pepperdine University. 

To learn more about Ceresti, visit their website and follow them on twitter and Facebook.

The Longevity Network’s LivePitch Wrap

Day 1 of AARP’s Innovation@50+ wrapped up yesterday afternoon when the Judge’s Choice and Audience Choice Awards for best Caregiving Healthcare Tech companies were named! If you want to watch the full competition with fast pitches and questions from the judges, check out our videos below.

Round 1 of the pitch competition:

https://www.youtube.com/watch?v=rejIfXg84_c

Round 2 and the winners' annoucement:

https://www.youtube.com/watch?v=lAR-UkoK66U

Here’s a quick wrap on each of the pitches and the questions judges and audience members posed to the entrepreneurs, starting with the two winners.

Winner of the 2017 Judge’s Choice Award:  GoGoGrandparent

Justin Boogaard, co-founder of GoGoGrandparent, tells the audience that existing on-demand transportation services like Uber or Lyft would be perfect for older adults, except for two major problems: 1) 70% of users over 65 don’t have a smart phone, which is a prerequisite for using them 2) aging leads to certain kinds of slowing down, which means older users would miss certain changes and problems with using those prevalent transportation providers. GoGoGrandparent solves both these issues by coordinating access to their services using landline call-ins and by tracking and verifying all those changes that an older adult might miss—meaning that up to 25% of their users end up speaking to a real person on the other end of the GoGoGrandparent line.

An AARP member of the audience asked how the company planned to control for older adults having more and more access to smartphones. Answer: There are two major problems their app solves—one is access and it’s true that one is changing. But the other is declining capability of the elderly to adapt to unforeseen changes, such as a driver canceling a ride on Uber. And that will continue to be a need, said Boogaard “until we solve aging”).

Winner of the 2017 Audience Choice Award: Siren Care

Ran Ma, co founder and CEO of Siren Care, told listeners that their mission is to create smart textiles to empower people. Their first product is a smart sock to help diabetics prevent ulcers and amputation. If  Siren Care is right, “the only wearables you need are the clothes you wear everyday.” They started with a product for diabetics because there are over 400 people living with it, and because missing an injury leads to loss of independence and rising healthcare costs. The sensors are integrated into the fabric of the sock and the data is sent directly to the Siren app.

Judges asked about market differentiation. Answer: Many current socks for diabetics are compression socks, which only prevent edema. But research shows that only temperature monitoring reduces foot ulcers, and all other temperature sensors require behavior changes by the user, for example, using a thermometer to take the temperature of each individual foot and record readings throughout the day.

WINNERS-2-IMG_6081

Other finalists

Aegle Palette

Aegle Palette’s CEO and co-founder Yulin Li told the audience that their patented digital placemats use weights to determine and record nutritional info of meals for diabetics. Palette 1.0 captures primary data, like activity and stress levels, and correlates it with biomarkers, like blood glucose levels. This data is all stored in the Palette Vault, which is accessible to the medical team continuously. Palette 2.0 then analyzes that data and provides personalized recommendations to the patient, making it a B2B2C platform.

The judges wanted to know more about how the hardware in the placemat works.  Answer: Through photo recognition of food items and a scale to determine quantity of nutrients, calories, etc.).

AgeWell Global

AgeWell’s CEO and Founder Mitch Besser opened with a quote from the US surgeon general from 2016: “isolation is the greatest health crisis facing America”. Their solution? Employ able seniors to travel around their communities checking on less able seniors in their homes. Empowered with only a smartphone and a simple set of screening questions, these able seniors—known as AgeWells—can “be the eyes and ears of the healthcare system” to reduce hospital readmissions, ER visits and the need for institutionalized care.

Judges asked for specifics on what kind of information the AgeWells are collecting through the app. Answer: Behavioral data like whether they are falling or sleeping, or information about whether they have all their meds and food in the fridge.)

BrainCheck

BrainCheck’s COO, Wendy Fong, said it is the first evidence-based, self-administered test for measuring brain function. The company has already secured designation as a class 2 medical device and their “Sport” version has already been adopted by many schools and athletic teams to monitor head injuries for signs of concussion. They are hoping to “replicate the success of BrainCheck Sport in the memory market” by targeting mainly older adults and their caregivers.

Judges wanted to know what kind of tests are the current standard of care to assess memory and cognition in this population. Answer: There is typically a 6-8 month wait to see a specialist. In senior living centers where they use a pencil-and-paper screener, tests take 2+ hours and provide only a raw score without specifying memory vs. cognition scores.

Ceresti Health

CEO Dirk Soenksen of Ceresti Health says their target users are the unpaid caregivers for patients with Alzheimer’s Disease and Other Dementias (ADOD), stroke, and traumatic brain injury. This enormous market of patients, he says, are “unable to self-manage” because they can’t communicate or track their own behavior, medication, etc. Ceresti’s proprietary 12-week program proposes to solve a large part of this problem delivered as a tech-enabled solution for these unpaid caregivers that provides Education, Care Plans, Support, and Coaching

An AARP member of the audience posed a great question to Soenksen, wondering whether they were aiming to replace paid caregivers. Answer: Not necessarily. Their main target users are family members already providing unpaid care and who often cannot afford paid care. Cost savings come not from replacing paid caregivers but from reduced hospitalizations and ER visits.

iBeat

iBeat’s founder and CEO, Ryan Howard says they offer two emergency response products. The $249 iBeat Watch which has a button on the watch which acts like a life alert as well as proprietary cardiac sensors monitoring function for emergency incidents. Cellular connectivity is included. Second, it includes the free Heart Hero mobile app that teaches you CPR and tests your proficiency. As part of the Heart Hero network, you will be notified if someone is having a heart incident nearby, so you can be the good Samaritan by either providing CPR or locating the nearest defibrillators whose locations are provided by the app.

A savvy audience member in the audience asked whether there would be a way the watch could predict a heart incident and not simply react to one. Answer: The watch cannot yet provide this incredibly valuable service but it is already collecting large amounts of data about this population and it is the vision to utilize that data to add predictive capability to the watch.

Kinto, Inc.

Co-founder of Kinto, Jeet Singh, explains that Kinto is an app to help manage communications and coordinate care among family, paid caregivers, and the medical team. It also aims to provide caregivers with a community of support and practical tools to help them deal with their caregiving responsibilities, including financial planning, cost tracking, home care coordination, and safety and insurance recommendations. It is set up to provide the service direct to consumers or to large employers looking to provide valuable benefits to their many employees who provide unpaid caregiving to family members.

Judges inquired about their market differentiation in what is an increasingly crowded marketplace. Answer: Most of the competitors are provider-focused whereas Kinto begins with caregiver needs –many of which are not medical.

Marvee, LLC

Heidi Culbertson, CEO and founder, said Marvee provides a centralized portal for voice-activated caregiving solutions. It is currently integrated as a series of “skills” for Amazon’s Echo but is designed to be platform-agnostic so it could eventually integrate with any number of voice-activated home devices. Today, they have several services in market, including 1) “I’m ok” alerts; 2) engagement services like family news that Marvee can deliver when asked; 3) b2b services like turning paper into voice for answering ‘everyday questions’ in a senior living facility, where many residents cannot read paper handouts about what’s for lunch or what time today’s

An audience member asked for hard evidence on seniors’ willingness to adopt voice interface, given that voice-activated devices still malfunction. Answer: In the beta phase of testing Marvee, they saw a dramatic increase in usage at the 30-day mark, which shows the seniors were understanding the interface. They credit this adoption success at least in part to their “try this today” feature—which sends out, for example, a song from the era in which the user grew up. This feature builds an emotional connection to Marvee and improves adoption.

PillDrill, Inc.

PillDrill, says Founder and CEO Peter Havas, simplifies and modernizing medication taking. Specifically, it does 3 things: 1) reminds you to take meds 2) tracks what you take through a quick bottle scan; 3) notifies family members / care givers of medication adherence. Its strengths are simplicity because it doesn’t require a smart phone, flexibility because you can program it for any regimen of medication adherence, and dignity because “in order for a product to become part of a person’s life, it cannot just be needed; it has to be loved.”

After learning the device costs $199 with no additional monthly subscription, judges were curious how they had reached this particular price point. Answer: Research about this kind of device shows that it needs to be to be over $100 in order for users to trust it but less than $200 in order to be accessible to the largest number of users.

 

Richard Lui, Alex Drane Discuss the “Unmentionables” of Caregiving

This morning at LivePitch, MSNBC newscaster Richard Lui was joined by Alex Drane, 5-time startup founder as well as co-founder of the Eliza Corporation, for a candid, personal discussion on the impacts of caregiving.

Lui personally travels weekly from New York to San Francisco to support his mother in the care for his father, an Alzheimer’s patient. He is an Alzheimer’s Association Celebrity Champion who frequently addresses Fortune 500 firms as a thought leader in media, race and storytelling. Drane is also currently a caregiver for an aging family member.

THE STRESSOR SUPERSTORM

Drane and Lui began by finding the humor in their personal caregiving stories—and then turned to a discussion of the stressors that hit their lives when they became caregivers.

“I’ve come to think of caregiver stress as a superstorm of all the regular life stressors at one time,” said Drane, and she gave a shout out to AARP for putting together this event and specifically highlighting the unmentionable topics by including this caregiving panel. It’s a double jeopardy, she adds, because first of all, the act of caregiving can be very, very hard and then second of all, you think you are doing a terrible job so you feel really guilty and isolated. That's why it’s such a relief when you learn someone else is going through it too.

Lui couldn’t agree more but he points out that family caregiver is the most common job in the US, with 40 million Americans identifying as a family caregiver. The second most common job is retail sales, with only about 4 million doing working in this field. If I were a business person, I would see tremendous opportunity there, he added.

LESSONS FROM A WALMART CASHIER

Drane tell the audience that she’s often thought of caregiving as a disease, because it has a real impact on health. For example, as a caregiver, a person has twice the risk of coming down with an illness, twice the risk of experiencing social isolation, and twice the risk of dying.

But she has also just completed her 50th shift as a cashier at Walmart and wanted to contrast what she has learned from the many people who come through the line as Walmart shoppers who are also caregivers: their resiliency and their sense of purpose.

Lui added a note about his affiliation with Hidden Heroes, an organization that works with military caregivers. There are 5 million of these, he says, and he is “inspired every day by what folks are doing”.

There is a paradox here that Drane wanted to highlight: it is simultaneously true that caregivers experience compromised health from this work and a deep sense of fulfillment from it.

This is why, says Drane, if you are a caregiver, you want another caregiver on your own health team, because “we are finally extending the idea of who helps you with your health.” In other words, finding at least one other person who understands the paradox has health benefits for caregivers.

THE OPPORTUNITY: OWN THE ROLE AND TELL THE STORY

What Lui would like to see is people owning their work as caregivers. “Once people can say, ‘I am a caregiver. I don’t get paid but I have a job. I’m a caregiver,’ we will really be on our way.”

Caregivers sharing their story is a great gift, added Drane. It helps people feel less alone in hard situations. And by banding together in this way, we can really get things done.

Lui ended with an emphasis on the power of storytelling, a power he utilizes all the time as a newscaster. We need to get better at telling this story so people see it as an opportunity, he said. Because this is not simply a story of those who are aging. Caregivers are every age, and once we tell that story, investors and entrepreneurs can really see the incredible opportunity for innovation in aging for all.