Health management goes mobile – Medical Device Network


Diabetes and lifestyle-related diseases such as obesity-related conditions are huge medical issues that the world’s largest health organizations and insurers deal with on a daily basis. Diabetes affects 246 million people worldwide and is the fourth leading cause of disease-related death. But one medical device that can prove invaluable in helping to combat so-called “diabesity” disorders is one that most patients already have: the cell phone. By using sophisticated health management and monitoring software called Lifewatcher – designed to work through your mobile – many complications associated with diabetes and obesity can now be satisfactorily controlled.

Lifewatcher is the brainchild of Japanese-Canadian entrepreneur James Nakagowa. The idea was inspired by Nakagowa’s desire to help a friend deal with newly imposed dietary and lifestyle restrictions after being diagnosed with diabetes and undergoing quadruple bypass surgery.

“My friend was an oil executive who used to dine out most nights with clients and colleagues,” he explains. “After his operation he was so depressed he couldn’t go out because he was on a restricted diet and didn’t know what he could eat.”

“By using sophisticated health management and monitoring software called Lifewatcher, many complications associated with diabetes and obesity can now be controlled.”

In this case, and many others like it, doctors offer dietary advice, but it can often seem cryptic to the patient. For example, they may recommend “two to three units” of food per meal, but that doesn’t easily match available nutritional information for common foods. When Nakagawa researched the matter further, he had the opportunity to speak to a leading Japanese nutritionist. As she ate her morning bagel, he asked her if she knew how many “units” the meal contained and was greeted with a somewhat sheepish “no”.

Although the “unit” measurement proved difficult, Nakagawa – whose background is in financial software – was also surprised at how difficult it was to gather useful nutritional information on common foods such as a McDonald’s burger. “I said, isn’t there software for that?” He discovered that there were none, so the idea of ​​Lifewatcher was born.

Gather verticals

Nakagawa then spent an intensive period visiting and talking to medical researchers from different parts of the world. He spoke with doctors, diabetes experts, nutritionists and patients, and investigated public nutrition databases such as the one provided by the United States Department of Agriculture (USDA).

“On the side of doctors and users, people said that the conditions were not very well managed,” says Nakagawa. “From a diagnostic perspective, there was frustration that the focus seemed to be on testing – blood sugar, heart rate, etc. – but not managing adjustments to diet and diets. exercise and better education.

“You can display a graph of results such as blood sugar levels over a month or a year, but you cannot show Why [treatment] stops with testing and that’s not enough.”

Nakagawa’s background in financial trading software meant he was used to connecting parallel information flows and he had the idea that this could be done in health management. “I was in disbelief that healthcare around the world is split into such distinct verticals,” he explains. “Diagnoses don’t talk to nutritionists, who don’t talk to physiotherapists, who don’t talk to surgeons, who don’t talk to mental health experts and so on… I thought, how can you separate diet and nutrition of blood glucose monitoring when they have a direct relationship with each other?So I started building this [device] as a system of training and exchange in finance. I wanted to fit in horizontally.”

“How can you separate diet and nutrition from blood glucose monitoring when they have a direct relationship to each other?”

Nakagawa went back to doctors, experts and patients to ask what they would like from an ideal diabetes management system. The answer was something simple but effective. If patients could easily capture a record of the food they eat (by photographing it on their phone) and have the kilojoules/calories of the food compared to their blood sugar, blood pressure, heart rate, it would not only provide a much more accurate and useful picture of their overall condition, it would also be
further motivate patients to control their food and drug intake.

Starting from the idea that modern databases in other sectors can “think and be smart and learn to recommend”, Nakagowa thought it was time to apply it to healthcare. What followed was four to five years of continuous innovation as the Lifewatcher team built the program.

With constant updates and new features built in, the system is server-based and secure with privacy protected by permission-based access levels. Lifewatcher is based on a Linux platform and is
interoperable for Windows or any other software.

There was a level of complexity to make it work across all mobile platforms and as such the technology is open source and scalable. Besides the technical side, it was also about building relationships and gaining the trust of key members of the medical community, says Nakagawa.

But he is quick to point out that Lifewatcher is not a diagnostic tool: “We created a diagnostic feature, but we removed it. There are a lot of regulatory issues in this area.” However, the program can be configured to alert the patient, their doctor or even certain family members if information is not entered or if statistics show that the patient is approaching dangerous levels.

“The program can be configured to alert the patient, their doctor or even certain family members if information is not being entered or if statistics show that the patient is approaching dangerous levels.”

The cost of care

In Japan, a Lifewatcher subscription costs ¥315 per month. In other countries, the team may not release it on the subscription system and it will almost certainly come at a higher price. However, in terms of cost and return on investment, Nakagawa is confident that the Lifewatcher product, with its advanced features and ability for users to “plug and play”, is more affordable for companies to purchase than to develop their own. legacy systems.

There are other programs on the market that allow users to log nutritional intake and exercise, as well as systems where users can send photos of food to a centralized database for nutritional information, but Nakagawa claims it’s the only system to bring it all together. Additionally, patients’ vital statistics and other relevant medical information can be included and then viewed by both doctor and patient.

Nakagawa says Lifewatcher is in a “hyper-growth” phase and as such is open to partnership opportunities and inquiries from suitable companies or individuals.

In five to ten years, he would like to see Lifewatcher become the de facto standard global platform for disease self-management, wellness and prevention. “If we can create a care delivery paradigm and a standard platform, it can be integrated into all areas of healthcare – insurance plans, diagnostics, follow-up care, personalized medicine, prevention and general wellness. “, he concludes.

Next month we bring you an interview with Col. Dr. Robert Vigersky, US Army Walter Reed Medical Center, who is about to embark on Lifewatcher’s first US trial involving 150 US Army patients in the Washington area.


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