Saturday, 25 May 2019

How devices are letting people take control of their own healthcare – The Australian Financial Review

Globally, nearly 28 million wearable devices were sold in the second quarter of 2018 – a 5.5 per cent increase on the previous year – according to the International Data Corporation. That’s $US4.8 billion ($6.7 billion) worth – an 8.3 per cent rise. The IQVIA Institute of Health Data Sciences says there are more than 310,000 health apps now available. The business of keeping well is booming. In October, the Global Wellness Institute reported that the wellness industry, covering everything from spas to apps, was worth $US4.2 trillion in 2017 – a growth of 12.8 per cent over two years which, it says, now represents more than 5 per cent of global output.

Instant genetic information

Diabetes is an area of intense activity in health tech. Between 1980 and 2014 the global population of diabetics nearly tripled to 422 million. For those with type 2 diabetes – the form of the disease that affects 90 per cent of diabetics – which a change of diet can fix the problem. If people can change their food buying behaviour it makes sticking to a healthful diet easier. That’s where entrepreneurs like Professor Chris Toumazou come in.

Not long before I met him, Professor Toumazou wanted a chocolate. “I’m not going to not have a chocolate,” he says. So at the shop counter, he waved his wristband over his two preferred options: a Snickers and a Mars bar.It flashed green on the Snickers. Based on his DNA, it had determined the bar to be the healthier option. (He has the hypertension gene, not the obesity one).

The wristband and analysis are developments from the Imperial College biomedical engineering professor’s company, DnaNudge. The London-based company has developed palm-sized micro-labs which do on-the-spot DNA analysis for key risk factors – including diabetes and hypertension. It also looks for genetic markers that reveal how well substances including carbohydrates, proteins, saturated fat, caffeine and sodium are metabolised. The data is encrypted and uploaded to the user’s app and wristband. They then scan or photograph foods to find out if an item is healthy for them.

Imagine a contact lens that continuously monitors diabetics’ blood glucose levels from their tear drops and transmits the data to an app.  Google

The object is to help people gradually change how they shop by being able to quickly tell which food options are best for them. For example, someone with a poor ability to break down fat will be guided away from foods high in fats.

In October, the company announced a year-long trial of the technology with a group of 1000 pre-diabetic customers of British supermarket chain Waitrose who will try to reduce their risk of developing the disease. Toumazou hopes to be rolling the technology out commercially in key global markets, including Australia, by the end of 2019.


There are a number of startups using DNA to direct eating behaviour but large companies are also getting in on the act. Nestle in Japan has a Wellness Ambassador programme. Subscribers to the programme upload pictures of their meals onto photo-sharing app Line, the food image is then analysed for its nutritional content. Users can also submit their DNA to a third party for analysis. On the basis of all this data, Nestle makes tailored diet and recipe recommendations. It also proposes particular supplements or kale and fruit smoothies for use in the Nestle Dolce Gusto machine.

DnaNudge says that when the technology is fully commercialised, the company will have booths in every supermarket where a shopper could swab their cheek and pick up a wristband complete with their genetic information 15 minutes later. The micro-lab cartridge with the DNA sample would be destroyed immediately afterwards. Toumazou is intent on making the technology affordable; he says the hardware will retail for tens of dollars and there will be a small subscription fee for the app – which could branch into monitoring inactivity levels, offering meal plans and building social networks of people with similar conditions.

Dr Harry Nespolon, president of the Royal College of Australian General Practitioners, says the role of the GP will evolve, and become more central.  RACGP

Toumazou says decades of healthy eating advice has failed to stem a global obesity epidemic. Something needs to disrupt that tide. “It’s got to be very simple so people make small changes, without really affecting their behaviour too much in the short term,” he says.

Chronic condition management

By taking a long-term approach, Australian tech start-up Perx is hoping to crack chronic condition management. According to the Australian Institute of Health and Welfare, half of the Australian adult population has one of eight chronic conditions arthritis, asthma, back pain, cancer, cardiovascular disease, chronic obstructive pulmonary disease, diabetes and mental health conditions – and 39 per cent of potentially preventable hospitalisations were due to these eight conditions.

Through a cluttered bookshop on Bourke Street, Surry Hills, in Sydney, and up a winding staircase, old high school friends Scott Taylor and Hugo Rourke have set up an office for Perx, an app that encourages people to stick to clinical treatments through gamification. The young co-founders are bright-eyed, wearing matching branded T-shirts, Apple Watches and physiques that suggest participation in amateur rowing or rugby union teams. They sit in their sparse, small meeting room, a blank white board against one wall.

Users of Perx have to upload evidence that they have taken their medication, a photo perhaps. They are then sent a simple game to play which offers the possibility of winning a prize such as movie tickets or a donation to their favourite charity.


The start-up is partnering with the NSW Health Sydney service, Diabetes NSW and ACT and Novartis, among others, which pay a licence fee for the technology; for the end user, the app is free. Data from the users is encrypted and aggreggated and general reports are sent to the participating organisations about the level of the groups’ adherence. They have several thousand users.

Perx began as a side project when Taylor was working in private banking and Rourke was a consultant across a number of consumer industries. Both men had family members struggling to manage different chronic conditions and they realised how few behavioural economics tactics were being used in the health sector. Two years after they started, the team now numbers seven (who are hard at work in a small room adjoining the meeting room) and a further three people are about to join the company.

“It’s pretty rapid growth given that this time last year it was three guys in a room in Bondi,” says Taylor. “We’re super excited about it.”

There is plenty of room to grow since 230,000 hospitalisations a year in Australia are because people fail to take their medications as prescribed. In Europe the problem is the cause of 190,000 avoidable deaths.

“Healthcare has traditionally suffered from top-down direction, not treating the patient as a person who can manage their own care,” says Rourke. “If we can empower people, health will be in a better place.”

The invisible doctor

At the Consumer Electronics Show conference in Las Vegas, run by the Consumer Technology Association, wellness and health technology formed a large part of this year’s new products. There were lots of cutting-edge devices making huge claims: E-vone smart shoes can detect a fall and call an emergency contact; a magnetic attachment for Motorola phones, which can measure respiratory rate, blood pressure, body temperature and blood oxygen levels; a Somnox robot pillow which glows and contracts as the user cuddles it in bed, all the while detecting carbon dioxide, sound and movement.

But in terms of the leading edge, few companies scrape it so closely