More products designed around actigraphy keep surfacing. aXbo is a ‘Sleep Phase Alarm Clock’ by an Austrian company. The basic idea is to differentiate sleep phases (light, deep, REM) using body movements that are detected via a motion-sensor worn on the wrist. The bedside clock unit has other features like power naps, auto sleep melody fade, use for two people, smart alarm etc. A desktop ‘research’ application downloads the data and helps analyze it. So the overall service is similar to Zeo or Fitbit, except it looks like aXbo was perhaps first-to-market (2006 press release discusses launch).

Remote motion-sensor based alarm clocks are probably a nerdy gizmo for now. But it does provide a good use case of how everyday appliances are getting smarter and generating volumes of data. It’ll be very interesting to see how such data can be leveraged to further sleep disorder research- as I wrote in my Zeo post.

Note that there are other products out there that offer the same functionality: FitBit, WakeMate, SleepTracker, and the somewhat unique Zeo.


Text4baby is  a service that delivers periodic text messages to expecting mothers reminding them of basic healthcare needs. It’s a free mobile information service designed to promote healthy pregnancy, and given that US that the second worst IMR of all developed countries, it makes sense. Women who sign up for the service by texting BABY to 511411 will receive free (i.e. not charged to the receiver’s account) SMS text messages each week, timed to their due date or baby’s date of birth.

It’s a public private partnership that provides this educational program. The list  is impressive: CTIAHMHB, Johnson & Johnson, WellPoint, Pfizer and CareFirst BCBS, BabyCenter, George Washington University and MTV Networks among others. U.S. government partners include the White House Office of Science and Technology Policy, the Department of Health and Human Services and the Department of Defense Military Health System. The mobile health platform is provided by Voxiva and fifteen U.S. carriers have agreed to carry the program’s text messages at no cost for two full years.

91% of US residents have a cellphone, compared to 22% that have internet connectivity. Educating pregnant women and new moms with information they need to take care of own and baby’s health is a powerful preventive measure. So there is reach and utility in this idea, no doubt.

Note: Found interesting background about Voxiva. They started in 1999 with the idea that mobile phones were going to play an important part in health going forward. They now have a technology platform and provide mobile health solutions in about 14 countries (mostly developing countries like India, Mexico, Rwanda, Peru). They market and sell to public health agencies and government providers usually, but are moving into pharma and provider networks now. An insightful interview with their founder here.

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I’ll admit right away that this post is more about the trend, and not the product itself. Withings is a french start-up that introduced a wi-fi enabled weight scale in late 2009. The device can send your data (weight, BMI, body fat, lean mass etc) wirelessly over the internet. So you can track it for free either online on website or through an iPhone app. It made some waves recently by announcing twitter integration. You can program it to tweet your weight and other info daily/weekly/monthly or every time you step on it.

Yes, I’m thinking the same thing. Why would you want to tweet something like that? And who the heck wants to be spammed by other peoples weight info?

Those obvious questions aside, its the trend that I find interesting. As the commodity devices that measure one or more of our vitals become web-enabled, ‘wellness’ goes beyond just being about purchase of a product. It gets transformed into a service. Withings is already compatible with a growing list of partners like DailyBurn, FitOrbit that provide fitness and personal training services. They also integrate with the big PHR platforms – Google Health and Microsoft Healthvault. So in theory, someone struggling with obesity could very well use the regular measurements from Withings device, social support from twitter followers, professional coaching through FitOrbit and health record from Google to try and achieve their ideal weight.

‘Connected Appliances’ are what Withings team envisions. They are not alone. I’ve written about several  analogous monitoring devices with some sort of web-integrated service (Read about Zeo, FitBit, Directlife, BodyMedia…). Although most of these focus on ‘wellness’ currently, they are setting an important precedent for managing ‘health’ conditions in a similar way. Consider the ‘how-does-work’ visual from the Withings website:

Now replace ‘weight’ with ‘Blood Pressure’ or ‘HbA1c‘ and you get the framework for managing health conditions (hypertension or diabetes, respectively). Take J&J’s spinoff, SymCare, for example. They are following the same framework for evolving the traditional glucometer. Lookout for more medical devices to move in the same direction.

January 2011 Update: Not that Withings team is reading Multiplyd for product strategy, but they just announced a Blood Pressure Monitor. I think that takes them one step closer to serious medical condition management tools company. Wellness is not going to be a sustainable product category for long, so this is a smart move.

August 2011 Update: Bought the Withings BP Monitor, using it to keep tabs on someone on the other side of the planet. It’s working very well so far. Very easy to use. The graphs and analysis functionality is not quite mature yet, but it works. I’ll definitely recommend it to others.

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I wrote about Proactive Sleep a while back and wondered how it would be to combine a sensor to automatically record sleep pattern. Well, Zeo gets one step closer to that.

Zeo system consists of a wearable headband that measure brain’s natural electrical activity. Although their blog has a high-level explanation of how it works, my understanding is that its a single-channel EEG, which seems to be a reasonable way to do sleep analysis in healthy individuals. That data is wirelessly transmitted to a bedside display and stored on an SD card.

Algorithms based on proprietary logic churn out a personal sleep score (called ZQ) to quantify the type of sleep you get. The display unit looks like a bedside alarm clock and shows current and past 2 weeks worth of sleep analysis. Also has some smart alarm clock features like SmartWake alarm that wakes you up at the most suitable time within half-hour of set time. You could upload the data to an online sleep journal through the SD card. The website gives graphs, trends and the ability log other supplementary lifestyle data that can affect your sleep. All that for $249. An additional $100 would get lifetime access to a personal sleep coaching program, which includes regular assessments, goal tracking, email tips etc.

There is no question that Sleep Science is a serious, mature field. Zeo can find its place as a useful adjunct for plenty of sleep-related disorders that affect people who are otherwise healthy. It’s not an FDA approved 11 channel medical grade polysomnogram, and it’d be a mistake to compare it to one. It’s perhaps a closer analog to Actigraphy where a wearable sensor measures overall motor activity during sleep. An actigraph unit is an accelerometer based device like the FitBit, WakeMate, SleepTracker or Axbo.

Accurate or not, Zeo is yet another proof that healthcare is slowly being transformed by sensor-based, portable devices that are capable of analyzing data in a consumer-oriented way to enable individual patient to manage their conditions better.

April ’10 Update: I ordered a Zeo from Amazon in March’10. Been using it for couple of weeks now. The hardware looks and performs well, but I have my complaints. The sensor in headband is bit bulky to sleep with, and I don’t think I’ll get used to the headband anytime soon. The fact that I need to replace the sensor pad every 90 days feels like a hidden cost (they are $24.95  for a pair without S&H) that was not disclosed completely in the marketing.

Software-wise, it’s bit less intuitive than I expected. I’m still wondering what the data tells me. I know Z-score is a overall indicator, but what about the breakdown? Are my 49 minutes of deep sleep enough?  The fact that I woke up 7 times – is that normal? In the end, I’m asking the question- what does this $250 device do for me…  Probably not much because I’m not the target audience for it. People suffering from sleep disorders would perhaps be more receptive.

May’10 Update: Returned it. Sorry Zeo.

June’10 Update: Learned about the Zeo API. Mobile fitness companies RunKeeper and Daily Burn are the first to integrate their services with Zeo. Neat strategy to promote it as a platform.

July’10 Update: Found out about NeuroVigil: another startup in the sleep-monitoring space. Their technology is also based on a single-channel EEG wireless sensor. They claim to be able to send the data (and its analysis) to any mobile device. NeuroVigil’s founder, Philip Low gave an interesting talk at TEDMED in 2009.

Nov’11 Update: Noticed that Zeo now has a cheaper, smartphone-based mobile ($99) solution and original clock has been re-packaged as bedside solution ($149). Smart move, since it makes them more relevant in comparison to other solutions like EASYWAKEme the market.

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Royal Philips International seems to be placing its bets on some innovative healthcare IT markets. Here are some that I’ve noticed in the past couple of years:

  • VISICU (a remote ICU monitoring technology company acquired in 2007)
  • Digital Pathology (commercial offering in 2009)
  • Motiva (Remote patient management and education delivered through television)
  • TeleStation (In-home hub for two-way communication between provider and patients with chronic diseases, integrated with wireless measurement devices)
  • LifeLine (focused on preventing falls and medication errors for seniors)

The list above is not comprehensive by any means, it’s just what I could recall right away. Without making this a post about Philips’ strategy, here is the latest addition to my personal list of innovative Philips Healthcare IT offerings- DirectLife activity monitor. It tracks your physical activity (through a triple axis accelerometer) to calculate calories burned. Results show up on a personal webpage (detailed) and on the device (simple indicator lights).

It’s like FitBit, but with some design differences – DirectLife is waterproof and needs USB-based sync (FitBit is wireless through a hub). Most importantly, DirectLife comes with a coach- a real person to provide inspiration and assistance to meet your target weight or activity level. The device (hardware) is $99, but coaching is a monthly subscription of $12.95 (first four months free).

The entry of Philips in this lifestyle-tracking arena makes the proposition more legit for mass adoption- now the HR departments of large enterprises  can think of offering it as a health benefit, maybe health insurance companies will pay attention too. FitBit is a great device in itself, but what’s needed is a “wellness service”, much like what DirectLife is starting to sound like. My prediction is that we’ll see proliferation of such services in the next few years- maybe even a lower premium option in your medical insurance if you choose an integrated activity tracking service.