Sandalbay Life

The personal wearable-sensor devices trickle that started with FitBit around 2008 is now starting to look like a flash flood. For every one offering that has got media love (like Basis), there are perhaps five other being incubated (like Node).

It’s an embryonic market, and one that is tackling complex health problems with commoditized sensor technology. Every smart inventor in a garage seems to be capable of doing something about it. So a few things are bound to start happening now:

  • Event Managers will take notice. Exhibit A: Quantified Self Conference
  • Doubts on where does this lead us or what we learn
  • Hardware and software platforms that unify the myriad devices start sprouting

Sandalbay Life exemplifies the last. It’s is a young startup (started last last year) at LA-based accelerator StartEngine. Not much information out there about details of the offering, but their aim is to provide a single software platform for manufacturers to leverage. Given the device and format proliferation, it makes sense that someone should try to manage the complexities of dealing with application and network security, cross-platform performance and reliability issues, etc.

“Providing the white-labeled consumer software for manufacturers to utilize”, as Sandalbay Life founder Neil Malhotra puts it in an interview, is smart, since so many of these offerings are from small players. But the big guys are noticing it too. Qualcomm’s 2net platform is going to be close competition. It too, is a cloud-based system designed to be universally-interoperable with different medical devices and applications and provide easy access to the aggregated data.

I’m also not sure how to align it with other platform approaches that are already out there. Biggest one being Microsoft Healthvault. Healthvault may not be white-labeled, but does provides a way for device manufacturers to contribute their data to a PHR. They do have API’s that let a developer get to the unified Healthvault data. Plus they have a fast-growing ecosystem of devices and apps that are integrated with it.

There are smaller, but committed players going at the aggregation value proposition from multiple angles: Digifit (cardio), WellDoc (disease management) for example. Open-source grassroots projects (OpenYou, Cosm, LockerProject, Sen.se) are surfacing too.

The play for sensor manufacturers to have a common platform for reducing their development cost is valid. Remaining value propositions (single app for consumers, unifying data from multiple devices, giving providers tools to create workflows and insights, etc.) all come with crushing competition. Plus the whole field of personal wellness tracking is too nascent – we need the devices to take a hold in the mass market before aggregating platforms truly become a viable business themselves.

2017 update: Sometime in the last few years, Sandalbay Life has recalibrated its offering to be more about wellness training programs. More about services than data aggregation.

Basis

The concept of sensor-based connected devices that help consumers manage a healthy lifestyle is certainly gaining traction. Consider FitBit, Zeo, DirectLife, miCoach, BodyMedia, GreenGoose as examples. It was only a matter of time before a startup in this space decided to go with a watch-like form factor.

I first heard about MyBasis during a talk given by Bharat Vasan (founder?) at Bay Area Quantified Self gathering in June 2010. He referred to it as PulseTracer back then, and described its use for pulse monitoring. Based on the current description on their website, the product concept seems to have matured. Similar to BodyMedia, it now has 4 Sensors: Pulse, Temperature, Accelerometer, Skin Conductance (i.e. moisture). It is USB and bluetooth enabled; and comes with integrated social functionality (gaming, sharing, rewards, etc.). There seem to be smartphone, iPad and online applications that help provide analysis and understanding of the collected data.

MyBasis certainly has the concept nailed: A smart device with multiple sensors and long battery life in a familiar form-factor + Always-on and connected to desktop, mobile and online dashboards that simplify analysis of the aggregated raw data + Integrated social features that help make it sticky and viral. If they play it right, this can be a hit. Mainstream competition from products (like the lackluster Polar offerings) is uninteresting and hardly addictive.

But critics can say that there are always technophile early-adopters (like me) who crave anything that is novel and web-enabled. So before we get over-optimistic about the impending success of such devices, consider two important caveats.

First, it’s not about sophisticated monitoring or granular data. Whether they realize it or not, the key value proposition for an average end-customer is the personalized insight that results from it. Gathering 24X7 data from multiple sensors is great, but it’s all pointless if the user doesn’t understand the ultimate picture that results from all that data. Most users are interested in revelations into their health and lifestyle, not numbers. So the way MyBasis handles analysis is going to be critical. I was disappointed with MyZeo and FitBit for the very same reason. An interesting approach that MyBasis seems to have is the creation of a virtual pet that gives a quick proxy of your overall status. It may sound silly, but abstractions like these have shown promise in encouraging self-monitoring and positive behavior change in users (e.g. see UbiFit project at University of Washington).

Second, the technology and device needs to be so well-integrated with a user’s lifestyle that they essentially ‘disappear’. If someone needs to put a headband one (like for Zeo) or remember to find a USB cable and synchronize every week to prevent data loss, you can be assured that it’s not going to work out long term. As a species, we humans have remarkable lack of discipline even when it comes to things/habits that are good for us. So the offering needs to add minimal extra work and be seamless with your daily life. Neil Versel at MobiHealthNews calls it “passivity”. Example: FitBit gets a better grade than Zeo in this regard. I clip it onto my belt (almost sub-consciously now) every day and plop it on to the USB hub (always connected to my desktop) once in a couple of weeks. That’s it.

MyBasis is still in early beta, so my impression is based on what their website claims and not actual usage. I’ve signed up for preorder and will update this review when I get my hands on one. Seems like the cost is a one-time $199 for now. It would make a lot of sense to have  a subscription-based model of some sort though. Also, it’d be great to see such solutions go beyond just wellness and be tailored for medical-grade serious conditions like diabetes, hypertension, etc. All clues indicate that such applications are not very far in the future.

Jitterbug Health Services

Jitterbug Wireless is a Mobile Virtual Network Operator (MVNO) founded in 2006. They offer simplified mobile hardware and service targeted towards baby boomers, with the value proposition being the opposite of a feature-rich phone. Few big, buttons and great customer service are it’s selling points for seniors who are looking for hassle-free wireless connectivity. Verizon Wireless is their main underlying network provider.

My interest piqued after I heard David L. Inns (Jitterbug CEO) speak at the Mobile Health 2010 event held in May 2010 at Stanford University. He described a sizable list of Health-related services available to Jitterbug customers. Here is the current list, and pertinent facts (from May 2010 time frame) from the presentation he gave at the event:

  • Check-in Calls: Automated calls to check-in on the user or a loved one. $5/month.
  • Medication Reminders: Automated calls at the right time to remind taking medication. Neat functionality includes a prescription refill reminders (with option to be connected to the pharmacy), personal dashboard that tracks medication adherence, and the ability to share it with others. In partnership with Meridian Health. $10/month.
  • LiveNurse: Unlimited 24-access to a registered nurse for health advice and information. Free on rate plan $29 and up, $4 month otherwise. 12,000 reported users in 6 months post-release and about 4000 calls handled per month. One-fifth of the callers end up seeking medical attention within 24 hours.
  • Daily Health Tips: Daily guidance and tips on living a heart-healthy lifestyle. Free. In partnership with the American Heart Association’s Go Red For Women Movement. Reported 4,000 users.
  • Wellness Calls: 5-minute per week motivational calls with tips and techniques related to topics like sleeplessness, stress, loneliness etc. Attracted 1,000 users in one month. Free with plans above $29. Content by Brian Alman who runs TruSage.
  • 5 Star Emergency Response: Personal emergency response service. Based on the offering by startup MobiWatch that they acquired late 2009. Supposed to be launching around Fall 2010.
  • D-Coach: A little-known, yet-to-be-launched diabetes management service in partnership with WellDoc. Incidentally, WellDoc’s Diabetes service recently got FDA clearance in August 2010.

None of these service concepts are unique per se, each has been attempted by other wireless (and non-wireless) companies. But two things make them highly viable within Jitterbug. First is their niche target market. It’s no secret that majority of healthcare costs are due to individuals age 65 and up. And that is Jitterbug’s target user too. A personal mobile device may provide the elusive ‘last-mile‘ access to such individuals. Second is the personalized, high-touch nature of Jitterbug’s service. Jitterbug users are already used to connecting with a human operator with one button-click and use them for pretty much everything – find a contact, dial the number, get weather info, etc.. Adding health-related services to that framework makes undeniable sense.

It’s not hard to imagine other services waiting to materialize- outpatient appointment scheduling and reminders, preventive services (flu shots, etc.) assistance, personal health record information access, to name a few. I bet we’ll see more wireless network operators move into the healthcare services vertical. For now, advantage Jitterbug.

MeYou Health

MeYou Health is a ‘well-being company’, in their own words. Their offerings help users engage in a healthy lifestyle, using their social network support. If you are like me, that doesn’t really tell you what they do. So I decided to find out more.

MeYou Health started in 2009, and is funded by Healthways, Inc. Healthways is a 30-year old, publicly traded health services company based in Franklin, TN. They main business is to provide disease management and wellness programs to managed care companies, self-insured employers, governments, and hospitals. MeYou Health seems to be a good extension to what they do.

The current ‘products’ being offered are all aimed at fostering behavior change and provide social support. The available lineup is:

  • Daily Challenge: Released September 2010. Sign up through a Facebook account, and you get daily emails encouraging one small ‘positive’ action like eat an apple, rearrange your desk. Points, badges and levels are achieved as actions are completed. There is added social functionality of peer-to-peer competition, benchmarking etc.
  • Community Clash: A web-based game that allows players to discover their communities’ health to other U.S. cities by choosing “cards” that represent health indicators such as obesity, smoking, diabetes, etc. The goal of this poker-like game is to bet on which city is more healthy. Underlying data for it is sourced from several databases that were promoted by the HHS led challenge, the Community Health Data Initiative (CHDI). This page lists those databases, and I found it to be a good bookmark of what open-databases are available around certain health-related topics like diabetes, uninsured etc.
  • Change Reaction: Another Facebook app that lets you record a small ‘positive action’ and pass it on to your friends. The idea is to create a growing chain of people who do it, and hopefully create a big trend.
  • EveryDRINK: A slick Adobe AIR desktop widget that lets you set a daily goal of drinking water, and then subtly reminds you to get a drink periodically.

They have some other under development, listed here. There is no doubt that behavior is a critical factor for healthy lifestyle. And changing behavior is about influencing the micro-choices we make hundreds of times every day (like taking the stairs instead of elevator or skipping soda for water). So there is a role for services that guide and encourage individuals making the right healthy micro-choice.

But such guidance source needs to be omnipresent in order to be effective. What if I end up ignoring my email or desktop alert after the first few times? Or don’t really care about Facebook? Intelligent mobile platforms, ubiquitous connectivity and sticky networks are promising trends that will eventually pave the way for viable solutions. Ones that consumers may even be willing to pay for.