Interview: Davide Vigano, Founder, CEO, Heapsylon

This interview was originally featured on HIStalk. 

What does Heapsylon do?

Heapsylon is a company focused on wearable devices and quantified sales self technology for fitness sales and healthcare. The first product that we’re building is dedicated to the human foot. A couple years ago when we first looked at the wearable device landscape out there, we would have seen Google working on Glass and Apple and Samsung working on smart watches, but there was clearly a part of the human body that is both constantly under pressure and is also underserved by technology and innovation and that’s the human foot.

Our feet are a complex system. The contain lots of muscles and ligaments, and 25 percent of the bones of our whole body are in our feet. So we thought maybe somebody should be focusing on smart socks.

What computing goes in your socks?

We’ve created our own textile sensing technology that can detect pressure and force. By weaving sensors into a sock, you can get pressure and step activity monitoring data. We also connect those sensors to an anklet that snaps directly magnetically onto the sock. By doing that, we add to our own textile sensors an accelerometer, an altimeter, a temperature monitor, and storage, plus Bluetooth 4 technology that allows us to get all this data out of the smart sock and into your favorite mobile platform.

What kinds of insights can your sensors provide that Jawbone, Fitbit, or Nike+ Fuelband can’t?

The big difference is that we can detect both how far, how fast, and how well people walk or run. We can create a real-time gait analysis. Lots of patients use a walker. All of the devices you listed can’t detect accurate data since they are limited to their accelerometer’s capabilities and they need to be worn on wrists or on the chest.  You may have seen the recent Mayo Clinic study that was recently just published and covered by Forbes. 

It’s really crucial, as an example, for every cardiac patient to be able to track activity monitoring so that the doctors are able to understand how they’re doing in terms of remission recovery after surgery, as an example. The Mayo Clinic study refers to an elderly patients coming out of cardiac surgery that use a walker. They decided to position a FitBit device at the ankle level, because if you position a monitor in any other place on the body for that kind of patient, it’s not going to provide you with a lot of meaningful data.  Their strides are slow and short. The smart sock provides an extremely accurate data feed since we have the accelerometer positioned at the ankle and our textile sensors under the patient’s foot.

Are there any types of data that you capture that those other devices don’t?

Sure, let me give you an example. Let’s assume that now we want to go running and you just transitioned to a cool, minimalist new shoe. Between 60 percent and 80 percent of the runners out there get hurt within every one year primarily because of impact forces that we generate when we run and strike the ground with our heel. There is Harvard study that talks about this. Quantifying those impact forces today is impossible. Sensoria can provide the real-time gait analysis to the runner to inform him or her of where and how well he’s landing on his foot, in real time. Is it he landing on the heel, or on the ball of the foot, or to far on the forefoot? That would be bad too if the runner has Achilles problems as an example.

How about the battery?

There’s a battery in the anklet that is rechargeable and powers the textile sensors in the garments. The anklet can be changed swapped between garments and connected to a fresh pair of socks, and depending how often you use it, can last between two weeks and up to 18 days. The garments socks themselves are of course washable.

How does the anklet bend to one’s ankle?

It has flexible PCP electronics inside. My ankle size is probably different from my daughter’s. She can bend it and adjust it to her ankle size. You can just connect it and snap it through to the sock. It’s now linked to the sock, not touching it again. It’s magnetically connected to the sock. As soon as you connect it, it turns on. And as soon as you disconnect it, turns off.

How far along is the business?

We bootstrapped the company the company for the first year and then raised some funding through angel investors. Textronics just invested in Heapsylon. Textronics It is a large $24 billion electronics and engineering and manufacturing service company. We’ve also just completed a successful crowdfunding campaign to bring our product to market. We sold about over 750 pairs of Sensoria Fitness Smart Socks and 15 developer toolkits to people that want to build their own app on Sensoria. We raised pre-sold about over $1,1550,000 of smart socks and SDKs. That is what we needed to complete the first batch of production. The first fitness Sensoria socks product will come out in Q1 of 2014.

How much does each pair of socks cost?

We sell one anklet with sensors and electronics, one pair of Smart Socks, and the app for $199. People pre-ordering can get $50 off. Customers can order an additional three pairs of smart socks for $59 and use the anklet they previously bought. The full product with the ankle, is $199. Right now we offer $50 off for those that pre-order.

That’s a bit expensive. That means you have a very focused, targeted market.

The first version is for runners. Developers can now purchase the SDK for about $1,000, which includes APIs and a fully functional prototype to build apps. We are shipping the SDK to our first 15 developers today. We’re offering an SDK as well to help people get data out.

Are you planning to license your technology to clothing manufacturers?

Absolutely. We’d love to have implement a Gore-Tex type of approach where we license our sensor, electronics, and software technology in some areas. Everyone in the world should have the choice to buy dumb socks or smart socks. We can’t get there alone.

How big is the company?

We’re based in Redmond, Washington. We have six full-time employees. We have about 20 people working on Sensoria, very close vendors that work very close to us. It’s a complex system integration project. We have textile engineering, we have electronic engineering, and then we have software engineering. There’s a lot to do.

What’s your background? How did you get into all of this?

I’ve been in software engineering product management, marketing, sales, and engineering for a long time. I worked for Microsoft for a long time. I was in charge of the product management and marketing for HealthVault and Amalga at Microsoft. I spent many years there. I started working on MacWorks and PCWorks 1.0 in 1987 before the joint venture with GE – Caradigm — came along. I left the company about three years ago and started my own thing.

How about your co-founders?

We have a materials engineer that comes from the sports industry. Mario and Maurizio, my two co-founders and partners of the company, are both from the X-Box Kinect team. We have a pretty wide spectrum of skills sets that are over here. Although it’s a small company, we are very well represented in each one of the necessary skill sets.

Any FDA or other regulations to worry about?

Sensoria Fitness is not a medical device. In the future, we will evaluate options.No FDA. It’s really hard to hurt a patient with a 3 volt battery connected to a sock, so it shouldn’t be too hard from the FDA perspective. Reimbursement is a different story, of course. We are looking for the right partners in this space.

Are you looking to be prescribed through a platform like Happtique or HealthTap?

There is a lot going on in this space and we are following it very closely. For now, we’re just focusing in on delivering our fitness product. Through the right partnerships, we may be able to enter the medical device and healthcare market. But we won’t do that unless we have the right partnership in place.

Anything else?

We’re very, very keen on protecting the privacy of the patient. We will not sell patient data. We will sell socks, but we won’t sell data. That is something that is at the core of what we believe. Privacy is important to many of us. That’s something that is woven into our DNA.

I Don't Have Enough Priority

I regularly hear "I don't have a enough time for [X]" from friends, family, colleagues, and business associates. I'm sure you do too.

That saying is total bullshit.

You always have time. You don't have enough priority.

If you watch a single episode of TV, read a blog, play a game, or even eat, but you don't do [X], then you have implicitly stated that everything else is more important than [X].

That's fine. That's totally ok. Really.

Instead of saying that you don't have time, hold yourself to saying you don't have priority. It's 10x harder socially, but infinitely more honest.

I've been doing my best to hold myself to this. It's difficult. I'm nowhere near 100% compliance. But I find that thinking through this lens lends itself to holding more realistic perspectives of what I can and can't do. It also leads to better time management.

The Marginal Value of Google Glass, Continued, Continued

This post was originally featured on the Pristine Blog. 

Glass is just a computer. Nothing less, nothing more.

I previously identified four fundamental characteristics of Glass that make it unique. The only apps that will be successful on Glass will be those that take advantages of the new form factor.

1. Hands free

2. Heads up display

3. Friction free

4. First person camera

I just identified a 5th, and potentially a 6th unique characteristic of the Glass platform:

5. Head tracking. With the accelerometer and gyro, Glass understands head movements.

Although there aren't too many practical mainstream applications for head tracking, it presents interesting opportunities in robotics and robotic surgery. On Glass today, I find the value of head tracking to be limited, but head tracking will grow to be a far more powerful concept when coupled with larger eyeware screens. With larger screens, one can easily imagine intelligent data overlays that automatically adjust to what you see as you move your head. Although this is technically feasible with Glass today, it's just not practical given that Glass's screen doesn't obstruct the wearer's vision.

6. One-way audio. The bone conduction speakers allows for near-silent one way audio communications. In a perfectly quiet environment, 3rd parties can decipher inbound audio, but generally speaking, it's extremely difficult for non-wearers to hear what wearers are hearing. With one-way audio, Glass could be an interesting communications device in medicine in light of HIPAA regulations.

In addition to these two characteristics, I find the ambient light sensor to be intriguing. I consider it a subset of the 1st person camera. The 1st person ambient light sensor isn't compelling enough to be a fundamentally unique characteristic, but it's worth noting. I'm trying to envision the value of the light sensor in patient care environments, but I'm not coming up with much.

In retrospect, I should have identified all 6 of these when I wrote the original marginal value of Glass post in March. It's actually easy to systematically identify them: just look at the hardware sensors and human computer interaction elements. They define the marginal value of the platform.

A Shifting Basis of Competition

This post was originally featured on HIStalk. 

Software is eating the world. As a result, the basis of competition in almost every industry is changing. The venture capital (VC) industry in particular is undergoing substantial changes:

1) The JOBS act is making it easier for VCs to raise funds and for the common folk to invest in and take an equity stake in early stage companies. There will be more capital than ever to invest in early stage businesses. VCs are feeling competitive pressures from all sides.

2) Returns are concentrating among the top VC firms. The best VCs are attracting the top entrepreneurs, and vice versa.

As a result of these changes, VCs are working harder than ever to source deals. Per Tomasz Tungz, a partner at RedPoint Ventures, in order to compete, VCs must:

1) Create information asymmetries

2) Convince entrepreneurs that they’re the right partner

3) Deploy technologies that can help their portfolio companies in meaningful ways

Hospitals and health systems are remarkably similar to VCs. They employ swaths of highly specialized, highly trained people who make big important decisions that dramatically affect people’s lives. They offer what many consider to be a commodity (cash / health care services) in highly illiquid, opaque markets, with dramatic variances in price.

Hospitals and health systems could learn a thing or two from VCs:

1) Create information asymmetries. This doesn’t mean providers need to hide even more from patients (providers already do plenty of that without even trying). This means providers need to figure out how to employ analytics to make more intelligent decisions. With impending reimbursement changes in an ACO world, most analytics being deployed today are focused on identifying behaviors and processes that result in less-than-ideal, expensive outcomes. But there are a tremendous number of other data sets to explore: referring patients to clinical trials, public service campaigns that encourage patients to avoid getting sick (particularly during cold/flu seasons), and understanding the tremendous amounts of quantified self data that patients are collecting. The amount of health data to be understood is spectacularly large; the best care providers will be those that can make sense of it

2) Convince patients that they’re the right provider. The most common hospital marketing campaigns are those that say something along the lines of "Top 100 Wired / Best hospitals" or "come try this fancy new procedure." These campaigns and characterizations are superficial and highlight their complete lack of creativity, short-term, and myopic thinking. People buy stuff from people that they like. People respond to direct communication and being treated like real people, not boxes in a machine. Since everyone interacts with their local healthcare system, hospitals’ best marketing is word of mouth, and thus the best marketing strategies will be tied to improving the patient experience: transparency, communication, education, and outcomes. Marketing strategies in healthcare should be internally focused, not externally focused.

3) Deploy technologies that can help patients in meaningful ways. Obviously, hospitals have been doing this for decades, but as patients get increasingly involved in their own healthcare, the definition of "meaningful" improvements should incorporate the patients themselves. By extension, these meaningful technologies should also encourage medical practitioners to help patients make better decisions, not just treat them. Give a man a fish and he eats for a day; teach a man to fish and he eats for a lifetime. In light of #2 above, these technologies should foster a better patient experience, unlike the current cog-in-a-machine experience.

As software continues to eat the world, healthcare will oxymoronically evolve to be more people centric, not technology centric. We’ll rely on technology more than ever before, but only so that we can spend less time worrying about technology and more time delivering compelling services in ourservice economy.

PS: coincidentally, Fred Wilson from Union Square Ventures and James Kwak from The Baseline Scenario recently wrote analogies using the VC industry.

Healthcare IT Donuts

This post was originally featured on HIStalk.

There’s a famous Internet meme that explains each of the major social media networks through donuts.  

In light of National Health IT week, I thought it would be fun to look at the healthcare IT space through the donut hole:

EHR Companies

Epic: I make the most expensive donuts, I choose who I sell donuts to, and I don’t let my customers share donuts with anyone else.

Cerner: I make donuts using 85 different kinds of donut machines, but tell people it’s one big masterfully planned donut factory.

Meditech: I make donuts using a 1980s donut machine.

McKesson: I just threw out my old donut factory, and since the new one isn’t doing too well, I’m looking for a new donut factory to buy.

Siemens: I designed and manufactured every piece of equipment in my donut factory, even though most of those components are available as off-the-shelf commodities.

NextGen: I make literally every flavor of donut in existence, and none are particularly good; I wonder why I struggle to sell donuts.

GE: I make donuts, burgers, seafood, Indian food, Chinese food, and Italian food and sell them all at the same store.

Athena: I give donuts away for free, but charge people for actually eating them.

Greenway: I used to sell donuts by the dozen, but now I force people to buy a 12-month subscription to buy one donut per month.

Allscripts: I make donuts, then announce donut recalls.

eClinicalWorks: I don’t publicly talk about my donut business, but I sell lots of donuts anyway.

Practice Fusion: I give out donuts for free, and show weight-loss ads throughout the donut shop.

Startups

HealthTap: I provide a social network for people to share tips about the best and worse donut shops.

Catalyze: I help people build donut shops faster.

Pristine: I take pictures and videos of donuts and share them via Google Glass.

ePatientFinder: I match patients to weight loss clinics based on how many donuts they’ve eaten.

Simplee: I make it easier to pay for donuts.

Teladoc: / Ringadoc: I help people eat donuts over Skype.

RunKeeper: I ask people to record how many donuts they’ve eaten.

JawBone / FitBit: I automatically track how many donuts people eat using highly inaccurate algorithms.

MaxWell Health: I help people make sense of donut nutritional facts.

Kai Nexus: I provide tools to manage process improvement in donut manufacturing.

AdhereTech: I remind people to eat donuts on time.

CenterX: I make it easier and cheaper for doctors to prescribe donuts to their patients.

Ovuline: I remind women when they should eat donuts.

Miscellaneous

Merge: I like sharing pictures of donuts with all of my friends.

Mirth: I give away donuts for free, then charge customers when they ask how to open the donut box.

Medicity: I used to sell lean donuts, but now promise that my donuts aren’t influenced by my transfat parent company.

Orion: I sell kiwi donuts to most of Canada.

AirStrip: I provide solutions to watch and monitor donut-producing equipment.

ZocDoc: I help donut customers find donut shops.

WebMD / iTriage: I help people learn about different kinds of donuts.

Consulting Firms: I teach people how to eat donuts.

Every HIE: my customers promised me that they’d pay for donuts, but didn’t.

HIStalk: I write about all things donut.