Femtech hardware startup Elvie inks strategic partnership with UK’s NHS

Elvie, a femtech hardware startup whose first product is a sleek smart pelvic floor exerciser, has inked a strategic partnership with the UK’s National Health Service that will make the device available nationwide through the country’s free-at-the-point-of-use healthcare service so at no direct cost to the patient. It’s a major win for the startup that was […]

Elvie, a femtech hardware startup whose first product is a sleek smart pelvic floor exerciser, has inked a strategic partnership with the UK’s National Health Service that will make the device available nationwide through the country’s free-at-the-point-of-use healthcare service so at no direct cost to the patient.

It’s a major win for the startup that was co-founded in 2013 by CEO Tania Boler and Jawbone founder, Alexander Asseily, with the aim of building smart technology that focuses on women’s issues — an overlooked and underserved category in the gadget space.

Boler’s background before starting Elvie (née Chiaro) including working for the U.N. on global sex education curriculums. But her interest in pelvic floor health, and the inspiration for starting Elvie, began after she had a baby herself and found there was more support for women in France than the U.K. when it came to taking care of their bodies after giving birth.

With the NHS partnership, which is the startup’s first national reimbursement partnership (and therefore, as a spokeswoman puts it, has “the potential to be transformative” for the still young company), Elvie is emphasizing the opportunity for its connected tech to help reduce symptoms of urinary incontinence, including those suffered by new mums or in cases of stress-related urinary incontinence.

The Elvie kegel trainer is designed to make pelvic floor exercising fun and easy for women, with real-time feedback delivered via an app that also gamifies the activity, guiding users through exercises intended to strengthen their pelvic floor and thus help reduce urinary incontinence symptoms. The device can also alert users when they are contracting incorrectly.

Elvie cites research suggesting the NHS spends £233M annually on incontinence, claiming also that around a third of women and up to 70% of expectant and new mums currently suffer from urinary incontinence. In 70 per cent of stress urinary incontinence cases it suggests symptoms can be reduced or eliminated via pelvic floor muscle training.

And while there’s no absolute need for any device to perform the necessary muscle contractions to strengthen the pelvic floor, the challenge the Elvie Trainer is intended to help with is it can be difficult for women to know they are performing the exercises correctly or effectively.

Elvie cites a 2004 study that suggests around a third of women can’t exercise their pelvic floor correctly with written or verbal instruction alone. Whereas it says that biofeedback devices (generally, rather than the Elvie Trainer specifically) have been proven to increase success rates of pelvic floor training programmes by 10% — which it says other studies have suggested can lower surgery rates by 50% and reduce treatment costs by £424 per patient head within the first year.

“Until now, biofeedback pelvic floor training devices have only been available through the NHS for at-home use on loan from the patient’s hospital, with patient allocation dependent upon demand. Elvie Trainer will be the first at-home biofeedback device available on the NHS for patients to keep, which will support long-term motivation,” it adds.

Commenting in a statement, Clare Pacey, a specialist women’s health physiotherapist at Kings College Hospital, said: “I am delighted that Elvie Trainer is now available via the NHS. Apart from the fact that it is a sleek, discreet and beautiful product, the app is simple to use and immediate visual feedback directly to your phone screen can be extremely rewarding and motivating. It helps to make pelvic floor rehabilitation fun, which is essential in order to be maintained.”

Elvie is not disclosing commercial details of the NHS partnership but a spokeswoman told us the main objective for this strategic partnership is to broaden access to Elvie Trainer, adding: “The wholesale pricing reflects that.”

Discussing the structure of the supply arrangement, she said Elvie is working with Eurosurgical as its delivery partner — a distributor she said has “decades of experience supplying products to the NHS”.

“The approach will vary by Trust, regarding whether a unit is ordered for a particular patient or whether a small stock will be held so a unit may be provided to a patient within the session in which the need is established. This process will be monitored and reviewed to determine the most efficient and economic distribution method for the NHS Supply Chain,” she added.

Snap40 raises $8M for its AI-powered patient monitoring solution

Snap40, a Scottish startup that has developed an AI-enabled wearable device to help health professionals monitor patients either on the hospital ward or at home, has raised $8 million in seed funding. The round is led by ADV, with participation from MMC Ventures, and brings total funding to $10 million. Originally launched as a clinical […]

Snap40, a Scottish startup that has developed an AI-enabled wearable device to help health professionals monitor patients either on the hospital ward or at home, has raised $8 million in seed funding. The round is led by ADV, with participation from MMC Ventures, and brings total funding to $10 million.

Originally launched as a clinical pilot in August 2016, the Snap40 hardware and software platform initially set out to enable hospitals to monitor patients whose health is at risk of rapidly deteriorating while on ward, but has since expanded to increasingly focus on what happens after a patient is discharged, in addition to monitoring clinical trials.

Claiming to have the same accuracy as ICU monitoring, the wearable device captures oxygen saturation, respiration rate, pulse rate, temperature, movement and posture. In addition to onboard sensors, the Snap40 platform offers integrations with other devices e.g. a BP cuff, weighing scales, a glucose monitor. It then feeds this real-time data to the cloud where it is analysed by the company’s proprietary algorithms to identify if a patient’s health is at risk and alert a physician proactively.

In a call with Snap40 co-founder and CEO Christopher McCann he explained that where a patient has left hospital after an acute illness or has a long-term health condition, this can ultimately help to reduce hospital re-admission. In more extreme cases, it can also directly save lives.

Let’s take cardiac arrest, for example. McCann cites a report published by the U.K. National Confidential Enquiry into Patient Outcome and Death (NCEPOD) in 2012 that found physiological instability (e.g. elevation of respiration rate or a decrease in blood pressure) was present six hours prior to arrest in 62 percent of patients and twelve hours prior to arrest in 47 percent. Conversely, that instability had not been picked up on in 36 percent of cases where earlier recognition could have improved outcomes.

As another example, Sepsis, which McCann says is the number one cause of hospital readmission in the U.S., can be detected via an elevation in temperature, respiration rate or pulse rate and a drop in blood pressure or oxygen saturation. But in about 95 percent of patients in hospital, those measurements are only collected every 4 or 8 hours. And once the patient goes home, they are never collected.

“We give the physician access to both real-time and historical, trending data for the patient all on their mobile phone,” McCann says. “We wanted to create an experience where they could pull their phone out of their pocket and instantly pull up everything on a patient and allow them to see both acute changes e.g. now and long-term chronic changes over time”.

One interesting aspect of the Snap40 device is that it captures the rawest data possible (ie the actual waveforms), leaving the conversion of this data into tangible vital signs, such as respiration or pulse rate, to the company’s own software and machine learning models running in the cloud. This means that vital sign generation is easily upgradable as it is further refined and new correlations are derived from the large amount of historical data the company is amassing.

“We use non-invasive sensors to monitor the patient, transmitting the raw signal waveforms to our cloud platform, all of which we store for analysis,” says McCann. “We then use vital-sign specific machine learning models to generate each vital sign. Because we have the raw signal waveforms, this also means we can build and train new models and release new vital signs as software updates — this is quite like the Tesla model where they ship new software updates to their car that lets the car go faster”.

While Snap40’s use of machine learning/AI is currently limited to automating existing, repeatable well-defined tasks (e.g. the robust collection and generation of vital signs), moving forward the company wants to use AI to do things that aren’t humanly possible. For example, it is using historical data to build models that can predict patient deterioration based on what’s happened before across many thousands of patients.

McCann says the company is excited by the idea of being able to predict the likelihood of someone with lung disease developing an acute exacerbation of their condition. “If we can do this, with high sensitivity/specificity, then we can wrap this into a digital therapeutic, otherwise known as software as a drug… This is a whole new challenge, from a regulatory, technological and societal perspective”.

(A “digital therapeutic” is defined as software that is scientifically proven to provide some kind of positive change in someone’s health condition, either by seeking to modify the patient’s behaviour e.g. more exercise or more rest etc., or direct some other call to action, such as using a conventional device or drug in a specific way to elicit a measurable change.)

Meanwhile, Snap40 plans to use the new funding to more than double its headcount by the end of 2018, hiring in all areas of the business. The company has an office in New York and its headquarters are in Edinburgh, Scotland. Its target customer is mainly healthcare providers in the U.S., although the startup also works with NHS Trusts in England.

Drone development should focus on social good first, says UK report

A UK government backed drone innovation project that’s exploring how unmanned aerial vehicles could benefit cities — including for use-cases such as medical delivery, traffic incident response, fire response and construction and regeneration — has reported early learnings from the first phase of the project. Five city regions are being used as drone test-beds as […]

A UK government backed drone innovation project that’s exploring how unmanned aerial vehicles could benefit cities — including for use-cases such as medical delivery, traffic incident response, fire response and construction and regeneration — has reported early learnings from the first phase of the project.

Five city regions are being used as drone test-beds as part of Nesta’s Flying High Challenge — namely London, the West Midlands, Southampton, Preston and Bradford.

While five socially beneficial use-cases for drone technology have been analyzed as part of the project so far, including considering technical, social and economic implications of the tech.

The project has been ongoing since December.

Nesta, the innovation-focused charity behind the project and the report, wants the UK to become a global leader in shaping drone systems that place people’s needs first, and writes in the report that: “Cities must shape the future of drones: Drones must not shape the future of cities.”

In the report it outlines some of the challenges facing urban implementations of drone technology and also makes some policy recommendations.

It also says that socially beneficial use-cases have come out as an early winner over of cities to the potential of the tech — over and above “commercial or speculative” applications such as drone delivery or for carrying people in flying taxis.

The five use-cases explored thus far via the project are:

  • Medical delivery within London — a drone delivery network for carrying urgent medical products between NHS facilities, which would routinely carry products such as pathology samples, blood products and equipment over relatively short distances between hospitals in a network
  • Traffic incident response in the West Midlands — responding to traffic incidents in the West Midlands to support the emergency services prior to their arrival and while they are on-site, allowing them to allocate the right resources and respond more effectively
  • Fire response in Bradford — emergency response drones for West Yorkshire Fire and Rescue service. Drones would provide high-quality information to support emergency call handlers and fire ground commanders, arriving on the scene faster than is currently possible and helping staff plan an appropriate response for the seriousness of the incident
  • Construction and regeneration in Preston — drone services supporting construction work for urban projects. This would involve routine use of drones prior to and during construction, in order to survey sites and gather real-time information on the progress of works
  • Medical delivery across the Solent — linking Southampton across the Solent to the Isle of Wight using a delivery drone. Drones could carry light payloads of up to a few kilos over distances of around 20 miles, with medical deliveries of products being a key benefit

Flagging up technical and regulatory challenges to scaling the use of drones beyond a few interesting experiments, Nest writes: “In complex environments, flight beyond the operator’s visual line of sight, autonomy and precision flight are key, as is the development of an unmanned traffic management (UTM) system to safely manage airspace. In isolation these are close to being solved — but making these work at large scale in a complex urban environment is not.”

“While there is demand for all of the use cases that were investigated, the economics of the different use cases vary: Some bring clear cost savings; others bring broader social benefits. Alongside technological development, regulation needs to evolve to allow these use cases to operate. And infrastructure like communications networks and UTM systems will need to be built,” it adds.

The report also emphasizes the importance of public confidence, writing that: “Cities are excited about the possibilities that drones can bring, particularly in terms of critical public services, but are also wary of tech-led buzz that can gloss over concerns of privacy, safety and nuisance. Cities want to seize the opportunity behind drones but do it in a way that responds to what their citizens demand.”

And the charity makes an urgent call for the public to be brought into discussions about the future of drones.

“So far the general public has played very little role,” it warns. “There is support for the use of drones for public benefit such as for the emergency services. In the first instance, the focus on drone development should be on publicly beneficial use cases.”

Giving the combined (and intertwined) complexity of regulatory, technical and infrastructure challenges standing in the way of developing viable drone service implementations, Nesta is also recommending the creation of testbeds in which drone services can be developed with the “facilities and regulatory approvals to support them”.

“Regulation will also need to change: Routine granting of permission must be possible, blanket prohibitions in some types of airspace must be relaxed, and an automated system of permissions — linked to an unmanned traffic management system — needs to be put in place for all but the most challenging uses. And we will need a learning system to share progress on regulation and governance of the technology, within the UK and beyond, for instance with Eurocontrol,” it adds.

“Finally, the UK will need to invest in infrastructure, whether this is done by the public or private sector, to develop the communications and UTM infrastructure required for widespread drone operation.”

In conclusion Nesta argues there is “clear evidence that drones are an opportunity for the UK” — pointing to the “hundreds” of companies already operating in the sector; and to UK universities with research strengths in the area; as well as suggesting public authorities could save money or provide “new and better services thanks to drones”.

At the same time it warns that UK policy responses to drones are lagging those of “leading countries” — suggesting the country could squander the chance to properly develop some early promise.

“The US, EU, China, Switzerland and Singapore in particular have taken bigger steps towards reforming regulations, creating testbeds and supporting businesses with innovative ideas. The prize, if we get this right, is that we shape this new technology for good — and that Britain gets its share of the economic spoils.”

You can read the full report here.