The Longevity

Breg Enters the Increasingly Crowded Virtual Rehab Field

With providers moving toward bundled payments and "value-based system" in healthcare, costly post-surgical services like physical therapy are finding themselves on the chopping block. One consequence is an accelerated move toward virtual rehabilitation. And companies like Breg who have developing products to enable this remote care are set to capitalize on their foresight.  

 “We are actively moving toward online physical therapy programs and our goal is to eliminate physical therapy for hips, only use in knees when we need it …,” said Richard Iorio, a hip and knee surgeon at NYU Langone Medical Center, at a panel discussion on orthopedic bundled payments last week at AAOS.

At the recently-concluded annual meeting of the American Academy of Orthpaedic Surgeons (AAOS), Breg executives were showing off a new sensor-device [called Flex] connected to a mobile app that can guide patients through their daily exercise routine following orthopedic surgery.

This is the first time the company has forayed into the digital health, Internet of Things space, confirmed Brad Lee, president and CEO, in a booth interview [with MedCity News] last week where demos of the Breg Flex system were being presented. 

Breg's Flex is certainly not the only virtual rehab provider in the space. Differentiators among them are what device they require (smartphone vs. console), whether they offer clinical decision support and therefore require FDA clearance and how well they integrate with electronic health records.

[Flex includes a] chargeable Bluetooth wireless sensor, worn by patients to track progress with prescribed PT exercises with a companion mobile app.

The sensor and app work in concert to record range-of-motion that is key to better clinical outcomes. The data is also shared in real time with providers such that clinicians can tweak exercise protocols. The interactive patient app has a virtual avatar that guides patients through exercises. The system can also collect patient-reported outcomes that are key to getting reimbursed for certain orthopedic procedures such as joint replacement under bundled care programs.

...Flex also works with the electronic medical record of a practice or a hospital [and] is FDA-exempt because it simply monitors and tracks and does not offer clinical decision support.

Competitors include Reflexion Health's Vera and RespondWell, recently acquired by Zimmer-Biomet, an Indiana-based company that currently holds the largest market share of hip and knee replacements.

Reflexion Health’s Vera virtual rehab program...uses the Microsoft Kinect gaming console and the Vera avatar to guide patients through their at-home exercise regimen. The system received FDA clearance in 2015.

....RespondWell virtual rehab FDA-cleared.

...Jintronics and Reflexion Health use the Kinect platform thereby tying joint replacement patients to a console or a TV to do their daily rehab. All Breg Flex needs is a cell phone, or tablet and a sensor-device. In other words, patients can be out and about, and still get their rehab done.

[T]he virtual rehab space is getting crowded with several companies vying to win. But Breg’s CEO shrugged it off. “There is a huge market and there will be a lot of good players in the space,” he said.

Photo: Breg Inc.

Aerospace Scientists Turn Their Attention to Tech Gadgets for Caregivers

Among the dossier of caregiver products under development by the Advanced Space and Technology Research Labs, located in Shoreview, Minnesota, are a smartphone app to locate dentures equipped with special antennas, a hands-free car wash for your teeth and a robotic toenail trimmer.

The idea has received a grant of about $200,000 from the National Institute of Dental and Craniofacial Research, a division of the National Institutes of Health. And a University of Minnesota professor is helping out because the devices have the potential to solve some troublesome problems for the elderly, people with motor skill ailments and their caregivers.

As its name suggests, Advanced Space and Technology Research Labs was primarily involved in aerospace technologies.

[They] sell nanosatellite components for spacecraft the size of a Kleenex box and does research in spacecraft and aerospace vehicle navigation, working with government agencies such as NASA and the departments of Defense and Homeland Security. Suneel Sheikh, company founder, CEO and chief research scientist, is a specialist in GPS technology.

That GPS expertise led Suneel to explore other applications, what it calls "medical and terrestrial" projects involving personal navigation, and recently, lost dentures.

That has included designing devices that would help a firefighter find his or her way through a smoke-filled building or help track the location of dementia patients before they wander out of a health care facility.

ASTER Labs also is collaborating with Stephen Shuman, a professor and director of the Oral Health Service for Older Adults Program at the University of Minnesota's School of Dentistry

Dentures frequently go missing in long-term care facilities housing people with dementia, according to Shuman. The false teeth get wrapped up in napkins at meals and tossed in the trash, or they end up in the laundry or they mistakenly are taken by a patient wandering into the wrong room.

Replacing the dentures can cost upwards of $3,000 and result in tensions among staff, patients and family members over who's at fault. Yet it's proven a difficult problem to solve.

"This has been rolling around in my head for 30 years," Shuman said of the problem of lost dentures. "If you can find a satellite in outer space, you should be able to find a denture in a nursing home."

Some prior attempts to solve the problem involved embedding a radio ID chip into a denture, similar to the systems used to identify lost pets. But that technique requires bringing a detecting sensor fairly close to the denture to get a reading, which would not help if a denture was lost in a large building.

ASTER Lab's proposal is to embed a tiny antenna in the denture that would be tuned to respond to a specific frequency. The antenna would be passive and safe to the wearer, requiring no power inside the denture.

But if the denture got lost, the care facility would use a small, handheld detector wand that would be connected to a smartphone app. The detector would emit a low-frequency radio wave that would be reflected back from the antenna in a missing set of dentures. Then the smartphone application would guide the caregiver to the area in the building where the dentures are hiding.

A prototype is under development using the grant money. Next would be "a $1 million clinical trial of the device at the U's dental geriatrics teaching clinic directed by Shuman at the Walker Methodist senior housing campus in Minneapolis."

If everything goes smoothly, the system could be ready for production in two or three years, with the antenna adding a few dollars to the cost of dentures and the detectors costing a few hundred dollars.

A second grant will be devoted to difficulties the elderly or disabled can have with grasping a toothbrush.

The official name is the Automated Dental Care Device for Persons with Oral Hygiene Disabilities.

Shuman and ASTER Labs envision a hands-free mouthpiece that could be inserted into your mouth. A set of little brushes in the mouthpiece then would start moving, cleaning all of your teeth at once.

The mouthpiece could be attached to a station that could pump a fluoride solution or other agents in and out of the mouthpiece. Sensors would adjust the firmness and speed of the bristle motion and wirelessly transmit information to caregivers, including warnings about any problems. LED lights would indicate when your teeth are clean.

Shuman and Sheikh said the device could significantly reduce the effort required by caregivers in the difficult chore of manually brushing the teeth of disabled individuals.

"There's an autonomy issue," Shuman said. "No one likes to have other people doing things for them."

Shuman said there's a severe shortage of caregivers, so "anything we can do to make caregiving easier and more effective through technology is a blessing for everyone involved."

The last product under development at ASTER Labs is a a hands-free robotic toenail trimming system.

According to ASTER Labs, an estimated one-third of people older than 65 are physically unable to cut their own toenails because of problems with reduced flexibility, diminished eyesight and manual dexterity.

Older people who aren't able to take care of their feet and toenails experience a heightened "risk of injury, pain, infection and other complications," along with a reduction in mobility and greater chance of falling, according to ASTER Labs.

Even if patients can get their toenails trimmed at a podiatry clinic, many people don't like the experience of having their feet handled or are embarrassed undergoing the procedure, said Chuck Hisamoto, ASTER Labs research scientist.

"Nail-related Medicare coverage equates to an estimated $96.8 million each year, and frequent professional non-Medicare-covered nail cutting services become increasingly costly and inconvenient for seniors," according to the company.

ASTER Lab's proposed solution, which it is developing with a $200,000 grant from the National Institute on Aging, is a hands-free device that you could put your foot into.

Optical and infrared cameras and ultrasonic sensors then would guide a rotary burr to gradually pare away excess toenails.

The imaging technology would be an adaptation of work ASTER Labs is pursuing with collaborators to develop an automated system to measure the density of leaves and fruit clusters in vineyards to determine the best time for pruning. But instead of identifying grapes, the machine vision would be looking for toes.

There would be safety features in the toenail trimming device to immediately stop the machine if desired by the patient or if the person's toes moved.

If the high-tech toenail trimmer comes to market, it would cost a few hundred dollars, according to ASTER Labs.

The ASTER Labs scientists see it being used in elder care facilities, but they also think it could be bought by individuals who want to use it in their own homes.

"We try to take things in your daily life that can become difficult due to aging or disability and produce devices to help you become more independent," Sheikh said.

Wearable mHealth for Monitoring Cardiac Conditions is Quickly Gaining Ground

Two cardiac mHealth companies have had a big week--with announcements for both involving Mayo Clinic. The AliveCor and BioSig deals are indicative of the rapid adoption trend around cardiac wearable devices with integrated AI capabilities.

San Francisco-based company [AliveCor] announced a Series D funding round of $30 million, led by Omron Healthcare with participation from the Mayo Clinic.

AliveCor, whose Kardia Mobile was among the first ECG wearables on the market, has announced the release of Kardia Pro, a platform that adds artificial intelligence capabilities to help doctors and patients identify atrial fibrillation, the most common cardiac arrhythmia and an indicator of potential stroke.

Separately, the Mayo Clinic announced a 10-year partnership with BioSig Technologies, a Minneapolis-based medical device company looking to develop its PURE EP cardiac signal acquisition and display platform for commercial use.

BioSig has been working to create a digital health device that can help electrophysiologists diagnose and treat patients with abnormal heart rates and rhythms, including those suffering from atrial fibrillation and ventricular tachycardia.

These power of these wearable products is that they provide baseline measurements of cardiac patterns, coupled with the individualized tracking and learning of AI.

“During the first month of usage of Kardia Mobile, we learn about a user’s individualized heart profile,” says AliveCor’s CEO, Vic Gundotra. “Your personalized heart profile can be used for two benefits. First, it helps keep the data clean. If a doctor is monitoring your health using Kardia Pro, he or she can be more confident that the data he/she is reviewing is truly her patient’s and not someone else's. Second, and even more exciting, is that in the future, a heart profile may be able to find, and flag to your doctor, important changes in your ECG.”

"These are the kinds of tools that in the future no cardiologist will want to not practice with," Gundotra adds. "AI will supplement a cardiologist’s service, really being able to provide a higher level of service to the patient."

It's no surprise, then, that cardiac mHealth devices are front and center in the rapid shift toward patient-centric and consumer-centric care.

Artificial intelligence and machine learning are making their way quickly into the healthcare space, led by tech giants like Microsoft and IBM, whose Watson Health unit is partnering with health systems and mHealth companies across the globe.

“It’s (advancing) personalized healthcare,” says Kyu Rhee, MD, MPP, IBM Watson Health’s chief health officer. “The potential of mHealth in empowering individuals and promoting populations is enormous.”

Echo Health Ventures Aims to Fix Today’s “Broken” Digital Health Venture Model

The data is in: digital health funding saw its highest levels ever in 2016. The question is--what does it indicate? One possible interpretation is that 2016 marks the turning point when generalist tech investors see enough signs that consumers are ready for the digital health revolution that they are in turn ready and willing to put capital behind good--or potentially good--ideas.

But there’s another theory that lies behind the recent launch of Echo Health Ventures, formed in November 2016, as a strategic collaboration between Cambia Health Solutions and Mosaic Health Solutions.  Erica Garvin at HIT Consultant Media argues that, although the raw dollar numbers in digital health are indeed ramping up, the high failure rate of startups in this sector indicates that there is a fundamental flaw in the investment model.  

Today’s digital health venture model is broken. That statement seems bold and contradictory to the fervor and flourish of funding that has poured into the space recently. However, most health-tech startups are predicted to fail within the first two years of operation—why?

In 2014, venture funding in digital health smashed records surpassing $4.1 billion; equally impressive was 2015’s total of $4.5 billion. As the ball dropped on 2016, so did those numbers; however, the space still saw $4.3 billion by the year’s end. Even more telling is the $6.5 billion in investments projected for stand-out digital health organizations by 2017. It’s clear there is at least enthusiasm for digital tech in healthcare, so what’s tripping up the promising startup?

Startups in general are certainly risky--90 fail, according to Fortune. But Matthew Karls of Echo Health Ventures believes digital health is unique in that the real problem lies in the lack of long-term commitment and collaboration from investors. It's a flaw EHV hopes to solve.  

The top reason for [startup failure in general], according to 42 percent of startups polled by CB Insights, is a lack of market need for their product—but is that what’s happening in digital health?

“In healthcare, we often see early-stage companies struggle to convert pilots to commercial contracts and grow their top line, despite having secured an impressive base of early pilot partners and clients,” Karls said. “Many companies see rapid early growth, only to suddenly see the momentum stall and growth plateau, and it isn’t clear why…[At least part of the reason is that] this wave of funding has been driven by a herd of generalist and tech investors drawn by the extreme dysfunction in the healthcare system”.

The mantra for many of these generalist tech investors is quick return on investment, which can work in other sectors, but often fails in healthcare according to Karls, because of the complex “layers of process, regulations, and policies”.

Startups are stalling out before building their momentum because they need deeper insights from investors, which they don’t have—not when it comes to doing business in healthcare.

“Enthusiasm and optimism are always necessary for success, in all venture sectors,” said Karls. “What’s lacking is that kind of excitement with an accompanied appreciation for the complexity and magnitude of the current forces in digital health. To put it bluntly, healthcare is harder.”

Given this understanding of the market, Echo Health Ventures has adopted what it calls a “Stage-Agnostic Strategy”. 

Building new companies that leverage technological innovation to transform the health care system requires much more than sufficient capital. Over the years, specialized healthcare venture managers have brought patient risk capital and thoughtful, long-term strategic partnership with their portfolio companies. However, these venture capitalists are harder and harder to find.

Enter Echo Health Ventures, hoping to leverage the extensive resources from Cambia Health Solutions and Mosaic Health Solutions in order to magnify the impact it can create for new companies.

The company manages both companies’ existing portfolios as well as pursues new, stage-agnostic investments in healthcare innovation. 

“The Echo model is fundamentally a deeper, more engaging experience than most [accelerators] can provide given the level of long-term, not cohort-based, capital and resource commitment.”

Matthew Karls closes with some advice to startup entrepreneurs.

[Do] not be discouraged considerate and conscious about the importance of [your] moves. “Figure out what problems you can solve, understand everything that touches it, and build on your strengths. Find partners that will accelerate your growth or can provide the network and resources you need to succeed. Then, you can relentlessly focus on delivery,” he said.

What will separate the successful startups from those destined to fail is the willingness to disrupt healthcare; as we’ve heard before, creating solutions to fix broken processes is pointless. “Incumbents preach innovation but sit with dead weight to resist change,” said Karls. “Radically altering the system requires an understanding of it. Innovators must know how the gears work and build solutions that are far more than window dressing. Disruption in health care must happen from the inside out.”

Apple Lags Far Behind Amazon, Google in Smart-home Market


While Apple has been a market leader in smartphone sales for over a decade, they have yet to even offer a voice-controlled device specifically for the home that could compete with Amazon’s Alexa or Alphabet’s Google Home.

Consumer electronics giant Apple (AAPL) is "losing badly" in the nascent smart-home market, despite having arguably the best user experience with its HomeKit technology, Edison Investment Research analyst Richard Windsor said in a note Tuesday.

Apple is a "very distant third" in the smart-home market..., Windsor said. [They have] been rumored to be working on a home appliance that uses its Siri voice-response personal assistant. But so far Siri is mostly an application on Apple's iPhone smartphones.

Siri of course can be voice-activated, but research shows the power of the home devices is that a user can have both hands fully occupied with some other task and still activate it.

"Usage of both Alexa and Google Home show that over 60% of all usage is generated when the user's hands are busy with another task, [said Windsor.]  “This makes the use case of Siri on a device that needs to be removed from the pocket not as easy or as intuitive as Alexa or Google Home."

Still, Apple has made advances that neither of the other two tech giants have achieved.

Apple had done a better job of integrating home devices so users can give a single command when doing things like going to bed, leaving the home or returning home, Windsor said.

"This makes it easy to turn off all the lights, lock up, turn down the heating, and so on with a single button press, which is something that neither of the other two have come close to offering," Windsor said.

But consumer preference for the voice-activated home device may mean they miscalculated market priorities. If Apple is going to enter this burgeoning market, they are going to have a lot of catching up to do.

Amazon's Alexa grabbed 88% of the intelligent home speaker market in the fourth quarter, Strategy Analytics said Tuesday. Alphabet came in second with 10% market share after launching its Google Home speaker in November, the research firm said.

Some 4.2 million intelligent home speakers were shipped worldwide in the fourth quarter, up nearly 600% year over year, Strategy Analytics said.

"Amazon has had a near two-year head start over its rivals and has done an excellent job of building out an ecosystem of compatible devices and services or skills," Strategy Analytics analyst David Watkins said in a statement. "However, Google is hot on Amazon's heels and the search giant should be able to significantly cut Amazon's lead over the coming year thanks to its superior AI platform and well-established technology-licensing model, which has proved successful through its Chromecast built-in program."

In $15.3BN Deal, Intel Buys Israeli Self-Driving Tech Company, Mobileye 

After lagging behind in the smartphone revolution, news broke this morning that Intel is making a move to be a frontrunner in self-driving vehicles. The tech giant will acquire Mobileye, an Israeli tech company that specializes in computer vision, for around $15.3 billion.

First they partnered, and now comes the acquisition: the computing giant Intel has confirmed that it is acquiring Mobileye, a leader in autonomous driving technology, for $15.3 billion — the biggest-ever acquisition of an Israeli tech company.

Specifically, “Under the terms of the agreement, a subsidiary of Intel will commence a tender offer to acquire all of the issued and outstanding ordinary shares of Mobileye for $63.54 per share in cash, representing a fully-diluted equity value of approximately $15.3 billion and an enterprise value of $14.7 billion,” the company noted in a statement.

“This acquisition is a great step forward for our shareholders, the automotive industry and consumers,” said Brian Krzanich, Intel CEO, in a statement. “Intel provides critical foundational technologies for autonomous driving including plotting the car’s path and making real-time driving decisions. Mobileye brings the industry’s best automotive-grade computer vision and strong momentum with automakers and suppliers. Together, we can accelerate the future of autonomous driving with improved performance in a cloud-to-car solution at a lower cost for automakers.”

Mobileye co-founder and CEO, Ziv Aviram, says growth in autonomous vehicles will be “transformative”.

“It will provide consumers with safer, more flexible, and less costly transportation options, and provide incremental business model opportunities for our automaker customers...By pooling together our infrastructure and resources, we can enhance and accelerate our combined know-how in the areas of mapping, virtual driving, simulators, development tool chains, hardware, data centers and high-performance computing platforms. Together, we will provide an attractive value proposition for the automotive industry.”

Intel has plans to be a frontrunner in this transformation as well those in IoT and virtual and augmented reality.

Intel has been working officially with Mobileye since last year. Earlier this year, with BMW, the two started to test 40 self-driving cars equipped with the two companies’ technology. Mobileye was also an early partner of Tesla’s for its autonomous technology, although that relationship is ending amid some controversial undertones about safety measures at the carmaker.

Moving deeper into self-driving technology is part of Intel’s bigger strategy to build up its position in emerging areas of computing. Other verticals that Intel has focused on include connected “objects” (IoT) and virtual and augmented reality. It has been following through on this strategy with acquisitions as well as organic growth.

Intel has disclosed several other acquisitions in Israel to fill out that strategy, including buying a personal assistant platform from Ginger Software; Omek Interactive for gesture-based technologies; and Replay Technologies for 3D video.

Entrepreneur of the Week, Anupam Pathak, Liftware

Liftware currently offers two products that stabilize and level handles and attachments for people with hand tremor or limited hand and arm mobility. It was originally founded under the name Lift Labs with the help of a Small Business Innovation Research grant from NIH, and in 2014, was acquired by Google's Life Sciences (now Verily). By allowing users to maintain independence in everyday essential activities like eating, Liftware's products also allow users to retain dignity and confidence.

We spoke with Founder and CEO Anupam Pathak about Liftware, and the opportunities he sees in the 50+ market.

Longevity Network: What does Liftware, the company do?

Anupam Pathak: Liftware is a team of engineers, designers, and user specialists who are committed to supporting those with limited mobility live fully and independently. We believe that there is significant opportunity in our rapidly changing technological world to make profound impact on the quality of life of those currently struggling every day.

LN: Can you tell us about the Liftware and how it works?

AP: We currently have two hand-held technologies available -- Liftware Steady and Liftware Level

Liftware Steady is a device that was designed to help people with unintentional hand tremor.

These symptoms can be caused by conditions like Essential Tremor, Parkinson’s Disease, and other diseases like Multiple Sclerosis. The device uses a small microcontroller and a motion sensor to detect and differentiate unintentional tremor from intended movement. If tremor is detected, the device will physically move the attached implement (e.g. spoon) in the opposite direction to the tremor. For example, if the user shook right the device will move the utensil left by the same amount, thus cancelling the motion.

Liftware Level is a brand new device designed for people with limited upper-extremity mobility.

This can include people affected by cerebral palsy, stroke, spinal cord injury, huntington’s disease or other similar disorders. This device works to keep the attached implement level relative to the ground, no matter how the handle is turned or twisted. It similarly uses a variety of motion sensors, a controller, and motors to constantly adjust its position so that the user does not spill or lose control of their activity.

LN: What opportunity did you want to address with the development of your technology?

AP: First and foremost: the opportunity to help people. We worked closely with support groups and family members to understand the user’s needs and then develop something useful. We decided to start with eating since that was the most requested activity that people needed help with, though we are now exploring other areas of daily living.

LN: Who are your primary users? In what ways can your products benefit the 50+ population?

AP: Many of the conditions we are helping with are age-related. Essential tremor, Parkinson’s disease, and stroke, for example, mainly affect people over 60 years old. As a result, we’ve been very active in developing the concept of aging well.

LN: How did you assemble your team?

AP: The company was initially funded by the NIH through the small business program (SBIR). For about 3 years, we developed the core technology in collaboration with university hospitals. The core team consisted of extremely talented electromechanical engineers and designers. Once we started shipping product, we quickly had to assemble a customer service and operations team, who have been amazing.

LN: How has Liftware the company differed from what you envisioned it would be (if at all)?

AP: I didn’t expect how quickly things would move -- we went from a prototype to a real product that required support in a matter of months. We are also moving quickly to additional technologies faster than I had imagined.

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

AP: The amount of time, effort, and planning required in early design is substantial for hardware products. Most people (us included) tend to underestimate this. Thankfully we had access to mentors who made sure we avoided common pitfalls.

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

AP: I feel a sense of urgency more than excitement. The U.S. is going to experience a huge increase to the aging population. We need to challenge and even change the conventional, institutional approach to aging. We need to keep people independent and living at home longer, both for emotional benefit and because our society has limited resources. The thing that excites me is that I really believe technological advances will play a big role in providing solutions.

LN: What market is your best piece of advice for startups who want to include or target the 50+ market?

AP: Try to empathize with users as much as possible. People have been doing things a certain way for decades and getting them to change habits is extremely difficult. With that reality, the challenge is to design clever products that fit seamlessly into their lives and routines while simultaneously providing benefit.

LN: Where do you see Liftware five years from now?

AP: I think in 5-10 years we’ll start to rethink what it means to be “disabled” because so many technologies will be available to allow people to function easily in daily life regardless of their conditions. The Liftware group will play an important role in that transition.

An entrepreneur and innovator at heart, Anupam Pathak develops pioneering technology for people with various forms of disabilities. Recently, he founded Lift Labs, which launched two high-tech devices designed to stabilize itself for people with tremor due to diseases like Parkinson’s disease and well as general upper-extremity disability. Google (Alphabet) acquired the company into Verily, to allow the group to continue building new technologies to dramatically improve the lives of the millions of people suffering from disability or impairment.

To learn more about Liftware, visit their website and follow them on Facebook, LinkedIn and Twitter.

Entrepreneur of the Week: Emma Yang, Timeless

Timeless is a mobile app aimed at improving the lives of those suffering from Alzheimer's, like 13-year-old Emma Yang's grandmother who was her inspiration for designing the app. Timeless is currently a functional prototype but Emma has plans to crowdsource the funds to make it a fully functional app (see last question in the interview).

We spoke with Emma about Timeless and the opportunities she sees in the 50+ market.   

Longevity Network: What does the Timeless app do?

Emma Yang: Timeless is a simple and easy to use mobile app for Alzheimer’s patients to remember events, stay connected and engaged with friends and family, and to recognize people through automatic Artificial Intelligence based facial recognition technology.

LN: Can you tell us about the your platform/services and how it works?

EY: The key features of Timeless are: Updates (a stream of photos with the names and relationship of the people [e.g. Paul, Brother] tagged in the photo), Photos (a photo album where the pictures are grouped by person), and Identify (where a patient can take a picture of a person and the app identifies him/her by name and relationship in real time). The identification and relationship tagging of the persons are powered by Artificial Intelligence based facial recognition technology. The app also has functions for event reminders and assisted calling and texting. These functions help the patients to remember important events such as family or doctor visits, as well as make it easier for the patients to call friends yet avoid repeated callings as they might forget an earlier call.

Timeless helps Alzheimer’s patients remember and recognize family and friends, connect with loved ones, and cherish the timeless moments in life. The application provides a variety of research-backed solutions that address a wide range of problems caused by the disease that affect the day-to-day life of Alzheimer’s patients. Timeless is also designed to be simple and easy-to-use for patients.

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

EY: After doing extensive market research, I found out that none of the apps on the market related to Alzheimer’s disease are targeted for the patients themselves. The available apps only targeted caregivers seeking help or people who want to learn more about the disease. I wanted to leverage the power of artificial intelligence and mobile technology to help Alzheimer’s patients like my Grandma stay connected with friends and family. Hence, I took up the opportunity and developed an app to close this gap.

LN: Who are your primary users? How can/does Timeless benefit the 50+ population?

EY: The primary users of Timeless is the population with dementia and Alzheimer’s disease and their caregivers.

Alzheimer’s disease is a serious problem around the world. Alzheimer’s is a chronic neurodegenerative disease that affects 44 million people worldwide. In the US, one in three seniors dies with Alzheimer’s disease or another dementia. The disease is the 6th leading cause of death in the US, affecting more than 5 million Americans. Not only does the disease affect the patient, but also caregivers, including family, friends and care professionals. According to research, people with Alzheimer’s experience problems with forgetting appointments or important events, having difficulty remembering and recognizing people, and difficulty with familiar tasks.

With the functions and features mentioned above, Timeless can not only help the patients remember and connect with their loved ones, it also help them in their daily lives.

LN: How did you assemble your team?

EY: I work on Timeless myself as a single person team. I came up with the idea of Timeless myself, and I also created the feature set, and worked on the creation of the User Interface, user workflow, and did the development of the working prototype myself. However, I am very fortunately to be supported by two very kind experts in the field.

I consulted with Dr. Melissa Kramps, a specialist in the Alzheimer's Disease & Memory Disorders Program at the New York-Presbyterian Weill Cornell Medical Center on the functions and features of the app.

On the technical side, I also collaborated with Mr. Cole Calistra, the CTO (Chief Technology Officer) and his team at Kairos, a human analytics technology startup in Miami which developed the AI facial recognition platform which i am leveraging to implement the facial recognition aspect of the app.

LN: How has Timeless differed from what you envisioned it would be (if at all)?

EY: The design and development process of Timeless mostly fall into my expectation. The greatest challenge is testing and adoption of the app by the patients and their family and friends. In order to address this, I am reaching out to relevant organizations such as the Alzheimer’s Association to seek assistance to gain access to patients for testing. I am also developing plan to create awareness and encourage adoption through marketing campaigns, and raise awareness through organizations such as the Alzheimer’s Association.

LN: What do you wish you had known before developing Timeless?

EY: The challenge of getting access to patients and their family and friends who can provide help in testing and advice on feature set of the application.

The challenge of raising funds for an application which goal is for a social cause, rather than for profit.

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

EY: Mobile is an ubiquitous platform which changes everyone’s life. However, vast majority of the available applications are targeted at the younger user population. Seldom would there be applications that are designed with the need of the elderly in mind, let alone those with illness and purpose is to make their daily life easier. I hope Timeless can change that.

LN: What is your best piece of advice for startups who want to include or target the 50+ market?

EY: Spend the time and effort to thoroughly understand the patient’s need. Conduct research and talk to actual patients and observe their daily life to determine what will be useful for them.

LN: Do you have any other products in development?

EY: Timeless is the only product that I am working on now. I am focusing on taking it from a prototype to a real product. I’m working on further improving the User Interface and User Experience, consulting with my mentor (Mr. Cole Calistra) on implementing the backend infrastructure for the app for cloud based data storage interaction, and also working with Dr. Kramps on arranging for patients to test the app.

LN: Where do you see yourself and Timeless five years from now?

EY: Five years from now, I would like to see Timeless being used by Alzheimer’s patients around the world. I equally hope that by then we will have found a way to cure Alzheimer’s disease and Timeless will pivot to be a tool that help those who are in transition stage between diagnosis and treatment.  Personally I would like to study computer science, artificial intelligence, and machine learning by the time I go to college in 5 years. I am also especially interested in the intersection between health care, biology and computer science and would eventually like to explore and potentially pursue a career in that area.

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

EY: From observing the daily lives of my grandparents, I hope that there will be automated robotics or systems which can take care of the elderly’s daily life, 24 hours a day, 7 days a week. I noticed that getting customized, round the clock help for daily matters is the most challenging area where all elderly persons and their family routinely face.

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

EY: As mentioned earlier, I’m in the process of taking Timeless from a prototype to a real application. I’m planning to raise fund for the development through crowdfunding in a few months. The funds will be used for design improvement, hosting of infrastructure (such as databases) for Timeless, marketing and ongoing maintenance of the app.

I recently created a Timeless Facebook page for the sharing of Alzheimer’s and Dementia related information and innovation, and updates on the development of the app.

It’ll be great if you and any of your readers can “like” the page and share it with your community.

An 8th grader, 13-year-old Emma is passionate about science, computer science, and technology innovation. In 2015, Emma won first place in the US and second place globally in Technovation Challenge, a global technology entrepreneurship competition for girls, out of 400 teams from more than 60 countries. Emma believes that technology can be used to help solve problems and make the world a better place. She is a strong advocate for STEM and would like to encourage all girls to explore their interests in science and technology. In 2016, Emma was named one of New York’s 10 Under 20 Young Innovators to Watch and Crain’s New York’s 20 Under 20 2016

Emma excels academically and is a Davidson Young Scholar, a member of Johns Hopkins University Julian C. Stanley Study of Exceptional Talent (SET), and Wolfram Research’s youngest and first ever middle school mentee of the Wolfram Mentorship Program. Emma was the youngest participant of the White House’s Opportunity Project, representing Wolfram Research in bringing the power of the Wolfram Language to solve problems using Open Data.

Emma  was awarded the U.S. Space and Rocket Center Space Camp Scholarship, Stony Brook International Piano Festival Scholarship, and the Michael Perelstein Memorial Discover Your Passion Scholarship for her outstanding achievement in Music and STEM. Most recently, Emma was selected as one of 500 exceptional students globally to participate in the Junior Academy of the New York Academy of Sciences solving the world’s greatest challenges. Emma is also a member of the school Robotics team who will be participating in the FIRST Robotics Competition.

An enthusiastic coder, Emma’s proficient in MIT AppInventor, HTML/CSS, Java and Swift. Her goal is to develop apps that help solve the world’s challenges. She is working on ConcussionChecker – an app to help detect concussion early and Timeless – an app to help Alzheimer patients live better lives. She plans to publish these apps on the App Store to benefit the community and beyond.

Emma is also a young classical pianist and she has performed at Carnegie Hall twice. Winner of Hong Kong Music Festival, American Protégé International Music Talent Competition, Rondo Young Artist Vanguard Competition, and Crescendo International Music Competition, Emma is an active participant in school and local music events.

Born in Hong Kong and lived there for ten years, Emma comes from a family with diverse background from China, Hong Kong, Vietnam, and Indonesia. Among her favorite foods are Chinese dumplings, Vietnamese Pho, Hainanese chicken rice, and lasagna. Fluent in English, Cantonese, Mandarin and learning German and French, Emma’s goal is to speak as many languages as possible. In her free time, Emma enjoys coding, reading, biking, and going to movies with Dad.

Emma is an introvert and enjoys being one. Recently, Emma started writing for Quiet Revolution‘s Quiet Diaries, a space for young voices to post their perspectives on life.

Guest Voices: Dr. Shai Gozani of NeuroMetrix On Thinking Beyond a “one size fits all” Approach to Treating Chronic Pain

As it stands, more than 1.5 billion people worldwide suffer from chronic pain. And while the United States spends $600 billion annually on the direct and indirect costs of chronic pain, more than half of people with chronic pain report inadequate pain control. The numbers are alarming.

This is especially important to be aware of when thinking of older adults, where the prevalence of chronic pain is highest. Since the bulk of our national health care spending is on this age group, both the potential impact on lives and economy is massive.

I’d argue that one of the primary reasons for America’s struggle with treating pain is not any one component, it is the one-size-fits-all approach.

Chronic pain is a complex biopsychosocial condition, which means that it involves the interplay of biological (e.g., tissue damage, disease, genetics), psychological (e.g., anxiety, depression) and social (e.g., cultural, financial, access to care) factors. As such, chronic pain is a uniquely personal condition that affects each sufferer differently. For some, the primary issue is the direct experience of pain – the pain intensity. However, for most, the impact of chronic pain is felt through its deterioration of quality of life, such as sleep, activity, mood and general health.

Because of this, a one-size-fits-all approach (meaning a single treatment method often prescribed by a doctor) may be destined to fail. This method of treating patients, often in the form of prescription pain medications (e.g. opioids) does not address the unique and complex profile of the individual person, and often comes with undesirable side effects. Instead, treatments should be adjusted accordingly - especially for the 50+ population that is seeking to maintain a high quality of life with fewer medications.

To do this, health technology innovators will play a big role in changing how chronic pain is treated.

To start, a key piece to the puzzle is digital medicine. A good example of this is the growing approach of precision medicine, which is defined as “a medical model that proposes the customization of healthcare, with medical decisions, practices, and/or products being tailored to the individual patient.” Precision medicine has the ability to tailor the solution to the individual, incorporating conventional treatments that are appropriate for each patient.

In addition, we need to innovate and bring awareness to alternative and supplemental options so those with chronic pain - and their doctors - are not relying on a one-size-fits-all treatment. Take, for example, non-narcotic/non-pharmacological treatments, such as neurostimulation wearables like Quell, or cognitive behavioral therapy and physical therapy. Despite the prevalence of chronic pain, many people are unaware of the growing number of the options available to them.

Such drug-free options are especially critical in today’s regulatory landscape where it is becoming increasingly difficult for people living with chronic pain to gain access to prescription medications as well as for those in the 50+ age group who prefer fewer medications. While technologies like wearables might seem more targeted to younger people suffering from chronic pain, the older adult market is willing to explore technology solutions to help them maintain their desired lifestyle.

Moving forward, we need to start to think of chronic pain treatment as a combination of therapies to maximize relief for the older adult market where chronic pain is on the rise. In doing so, I encourage health technology innovators to think of ways to treat chronic pain, focusing on a “toolbox” approach that marries precision medicine with non-pharmacologic therapies.

From there, we can then break the vicious cycle of chronic pain, where pain is no longer in the driver’s seat. The end result? People with chronic pain can reclaim a higher quality of life.

About the Author

Dr. Gozani currently serves as Chairman of the board of directors and President and Chief Executive Officer of NeuroMetrix, Inc. NeuroMetrix is a commercial stage, innovation driven healthcare company combining bioelectrical and digital medicine to address chronic health conditions including chronic pain, sleep disorders, and diabetes. The company's lead product is Quell, an over-the-counter wearable therapeutic device for chronic pain. The company is located in Waltham, Massachusetts and was founded as a spinoff from the Harvard-MIT Division of Health Sciences and Technology in 1996.

For more information, please visit their website or follow them on twitter  or Facebook.

Nokia Announces IoT ‘Patient Care’ Platform and Rebranding of Withings’ Health Mate App, Products

The World Mobile Congress begins today in Barcelona, Spain where Consumer Internet of Things is one of seven highlighted themes. The power of Consumer IoT to disrupt the healthcare industry will be central to this afternoon’s session, entitled “The Future Of Health Is Digital”.

Just in time for this global Congress, Nokia announced it is launching its own IoT platform called Patient Care, which will integrate with several health and fitness-tracking products that were part of last year’s acquisition of Withings.

Less than one year after Nokia acquired Withings for $192.3 million, the telecommunications company will commit more forcefully to Nokia as a digital health company with a rebranding of Withings to Nokia early this summer, according to a company news release. The move was part of a series of new developments at the business, which will include a new connected device platform called Patient Care and a redesigned Health Mate application.

Patient Care is an Internet of Things platform used to support remote monitoring by clinicians. The platform syncs with the Health Mate app to share data gathered from the patient’s use of the company’s wireless blood pressure monitor and body cardio scale. Other devices that could be integrated into that platform include a wireless, FDA-cleared thermometer, and smartwatches and activity trackers currently branded as Withings.

Nokia is already promising to address the myriad ways its Patient Care platform and Health Mate app could be specifically adapted for the senior population.

Nokia’s digital health team is also collaborating with IBM for senior health, Cedric Hutchings, Nokia’s vice president of digital health, said in a phone interview. Nokia is working on ways to use cognitive computing such as integrating cognitive functionality into wearables and smart devices for home care. These voice-activated tools could use simple commands and offer reminders to take medication or turn off appliances.

With a trial in the UK underway and a few in US pending, the platform aims not only at at giving clinicians access to crucial patient data; through its redesigned Health Mate app, family members and caregivers will also be able to monitor information about loved ones.  

The platform is currently undergoing a series of clinical studies in the UK and U.S. The National Health Service in the UK currently uses Nokia’s platform in a 69,000 person clinical program to improve understanding of hypertension and how remote monitoring can be used to reduce hypertension rates. In the U.S., Fairview Health System and the University of Kentucky are also assessing the Patient Care platform.

The redesigned Health Mate app will improve user experiences by making it easier to add devices and share information with family members. The app will also include coaching tools to improve patient engagement.