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Aging in Place – A story of intelligent design and assistive technology
James Wyman, COO & co-founder, PILLO HEALTH (USA)
Friday, June 7, 2019 · 12:14 p.m. · 26m 48s
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oh
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hi everyone my name's james wyman amoco fonda ends yellow of below half
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we're a thirty five percent company at located in boston we
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also have offices in general uh just across the board in
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italy and we recently closed us use a funding uh eleven
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million dollar round from stanley benches and also send some digits
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so below half were half get technology company and our mission is to
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include the longevity and quality of life of patience managing the help at home
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we started the business in twenty fifteen on pretty personal reasons
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my cofounder manuel him see you can see here in the middle
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his father had recently passed away due to various have complications
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one of the biggest issues was him not taking is medications any manuel it was acting as the family caregiver
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going out a house on a regular basis trying to understand what
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was going on problem is the lack of visibility into the home
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means that really you don't understand until there is a catastrophic event some shape or form
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and so from an where there and the rest of the team this is
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a very personal mission to change lives and to build a better product that will
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and so to speak animation as i mentioned to improve the longevity in quality of life of patients managing the help at home
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uh one day in twenty fifteen the three of us sat down and we said what needed to change
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in health care in order to prevent instances like this from happening again to millions of people around the world
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that and we came up with one conclusion was what if they had been uh someone inside
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of the home twenty four hours a day dedicated to the health and wellness of his father
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what if i'm uh you know that's not an entirely new concept of course um we
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have home health agencies and home health care workers that can go out to the home but
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having a highly skilled healthcare worker at home twenty four hours
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a day isn't very cost effective and what practical for most people
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and unless they're very sick in which case they should probably be in an institutional
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setting like uh independent living assisted living with skilled nursing which of course is very expensive
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and and we know that ninety percent of older adults actually wanna h. independently in the
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comfort of their own homes often in the very same home that they grew up in
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and so we said well maybe we can look to technology to try
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and replicate that same idea of uh someone that could be inside the home
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and we see what we could build an artificially intelligent healthcare system
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for the home that could be there twenty four hours a day
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i could be dedicated entirely to health and wellness um and that
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could support our loved ones and can make a teams to the home
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now this may sound like a crazy idea but it's not entirely a new concept
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um this is a max from a disney movie big hero
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six is anybody familiar with this movie maybe just raise your hands
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okay a couple well uh it's about a robot you can see in the middle them in one it's
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in this robot sole purpose in life is to make sure that its own uh stay safe and stays healthy
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it's armed with all of the information of google half of all the key insights of an experience doctor and all
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of the scanning technology of the latest clinics and hospitals a
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packaged into that kind of cute cuddly uh why so approachable
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design and and that's actually quite an important point that i'll talk to a little bit later
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so that we can all founding principle building a someone inside
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of the home that could be dedicated purely to help them once
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for us the key to improving patient engagement and long term outcomes is defined
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that magical point at the intersection of cost effective technology and compassion and empathy interest
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and this is guided every decision that we've made from day one from the shape of the
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device from the features that we added on an even to the companies that we partner with today
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so let's talk a little bit about more up below the device and then later i'll show you some of the data that
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we've generated and we can talk about how popular half and could be could be used to shape the future of health care
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which for us means providing patients with access to better
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digital health solutions directly from the comfort of their own homes
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so from a device functionality standpoint staying true to our founding principle of creating this someone
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immediately meant that we ran into some product development challenges at this was
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in twenty fifteen and uh many people building mobile applications for digital half
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everywhere you looked software mobile uh was the craze and burn snatch at
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another billion dollar companies would be impounded at the time but we realise that
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if we wanted to make a difference in half came specifically if we
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wanted a proactive someone inside of the home we needed to go different route
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we needed a solution to be engaging we needed to be physically
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present inside of the home because we wanted it to dispense medications
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and we needed to be able to proactively engage with you beyond simply sending a notification to mobile phone
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most importantly if we were gonna find that intersection that boundary between technology and human like empathy
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or users we're gonna need to interact with the device viavoice just like that interact with another human
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now you have to remember this was in twenty fifteen like twenty fourteen we're using surrey
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was a horrible experience uh even alexia hadn't really started yet and we heard earlier from
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a google colleague about how much changed in the last couple years so i wanna highlight
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a few major trends across technology social demographics and and healthcare that have made below possible today
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so the first change as we heard really is this huge improvement
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in speech recognition and voice technology and simultaneous rise of these intelligent assistance
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speech recognition used to be horrible uh and in a few short years due to computing advances in the way
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we think about analysing speech it's actually become very very good and as we heard it's not better than humans
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as a result of this the sales of these intelligent devices the m.
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s. n. echoes the google homes is absolutely taken off i could show you
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dozens of slides um which show the growth of these devices i quite
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like this one because it shows that growth happening across multiple age groups
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so they're about seventy five million active uses of intelligent assistance in the us today
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and you can see that's pretty much the nails generation x. and even baby boomers and they're all growing
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i guess that's not to be surprising of course voice is one of the most natural
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things to human and with your five ninety five you generally know how to use your voice
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the second trained as we also heard about is this a gene population
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the slide shows the number of seniors the sixty five years and all that in the united states is what is the
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percentage of the population that they represent and you can see the green line going from thirteen percent to twenty one percent
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with your living in the united states asia europe and as we saw in switzerland these trains are generally the same
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and then the question becomes who's gonna provide care for older adults and how we can
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afford to actually pay for their health care and this is particularly worrisome in the united states
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i don't even need to explain the slide but basically the us is is the right bar and you can see the cross off the chart
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which brings us to the final major trade which is this focus on cost reduction efforts drop the whole system
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the us really stand seventeen percent of the g. d. p. on the help system
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last year that was three point seven trillion dollars next year
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that's gonna be four point four trillion dollars just on health care
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and so change has to happen and it has to start today
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so where are we today well one way to reduce health costs is
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to keep patients healthy uh through incentives in programs and by giving them
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the tools that they can better manage their own half of inside of
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their own homes muscle great example of that uh in this very last presentation
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another option is to focus on empowering and to do this every day in
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the comfort of their own homes rather than having human necessarily go to high
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cost locations like panic some hospitals in emergency rooms and that's exactly what we're
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trying to do with pillow so i'm gonna show you a short video and that
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but i think highlight some clothes functionality quite nicely matter now begins with two roommates room
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so much more than just
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no isn't it
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no return does
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ooh uh_huh
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so you saw a few different features the the first is that pillow was a voice interface
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what is a good interesting about that is that once you actually train someone how to use the voice to interact with technology
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and it becomes a far more intuitive experience then something like a mouse or a
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touch screen when you're constantly clicking with double clipping all swiping with your fingers and
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this is especially true for older adults this is something that we've seen in our research in focus groups over and over
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again it takes a moment to train someone how to use the voice once they've done that it's like riding a bike
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the second is that below isn't just about medications in our early surveys people
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told us that they needed help but they didn't wanna be reminded that they
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was sick all the time and so not only we design pillow to be
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friendly and engaging but we've also made experience about more than just two pools
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below fits into your daily routine and can help with basic costs like telling you what day
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or what time it is all checking whether or asking some simple questions around health and wellness
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and the serbs to build the bond between pillow and the user away from just medications
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we're also gonna be expanding this functionality so that part is like after provide is an
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insurance companies and even pharmaceutical companies can leverage our interface of trusted interface inside of the home
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to have people perform tasks on the behalf maybe prefer checking
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questions or even delivering educational video contents to individuals that need it
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and then of course you sold it below does stole and dispense medications undermines uses to take
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those pills the right time but we still twenty eight days with the pools inside the device and
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uh we do it in a very unique way we're not some clunky box that sits on the counter that beeps at you when
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it's time to take medications and i'm sure many of you have seen one of those before rather at the right time pillow wakes up
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looks into the room use facial recognition to identify you would proactively
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call you to the device and then dispense you make your your medications
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that facial recognition also security less we make sure that we're only dispensing pills or information to the right person
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and then we have a combination of senses inside of the device that ensure that you actually to couples
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and then finally pillow has the ability to connect uses to their families into the
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k. teams and you may have seen that at the very end of the video with
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the uh the the the doors are on screen and this is very important feature that
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patients possible by me cake is lost when when they provide isn't it doctor as possible
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something else you may have noticed in the video is the unique design
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of the device um when do testing concepts way back in twenty fifteen
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we showed uses dozens of different designs somewhat sleek and black and beautiful wood shop age
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is almost like an i. phone that dispenses bills um they didn't feel very friendly or approachable
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and actually when we did our surveys about seventy five
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percent of five hundred respondents when for this particular discipline design
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so staying true to a founding principle we attempted to get more personality to the design
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uh by using round a softer more anthropomorphic shapes shakes
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that resemble human features and that actually build trust over time
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we even made the ball decision of putting our lives on
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the device to reinforce the humanistic relationship and that humanistic feel
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um to to narrow that boundary ought to try and find that boundary between technology and human like interaction
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it's the same reason that you sort of a maximally of being this like cuddly friendly approachable robot
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you know the pilots um we saw that users were interacting in ways
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uh it in pillow with with with both ways that we never even experienced
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and now we see from our own data that these choices that we've
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made about trying to reinforce that relationship and build that trust really are working
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that sometimes uses with asp hello it was my new hey cut look like today do you like it
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well they would lip alone know that that was stepping outside and that they'd be back in
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five minutes and often they'd say below your tell me something funny uh i'm feeling lonely in this
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theme of loneliness which is actually incredibly important kept up over and over again in a lot of the data that we've seen and
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it's a bit of a double edged sword you know you wanna keep people inside of their homes for as long as possible but
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by keeping by actually doing that you increased a lot they get the chance of isolation and loneliness
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is about as well and is to make sure that the proper network and support structures in place
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and so it made us incredibly excited everytime pillow was able
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to engage with these individuals keep him company lighten up a day
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and and and these interactions me made us realise that we were on
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the right track people forming real emotional bonds without device and it's obvious
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that those ponds well below the more effective when it comes to real
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goal of improving the health and keeping them on track with the captains
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so here's another video it's about two minutes long these real uses of pillow devices and and it
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just gives you a sense of some of the bones that they formed with these devices in fact um
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with all three of these individuals after the pilot was so that they they didn't wanna give back the device and they still have them in there and say
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is automatic
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your your
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here
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ooh
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exactly as well
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probably
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now
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yeah
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re soundings they're away
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those rationale
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read a lot
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it also shows
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simon i have made i figure out
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we're more you're just out of your
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thing
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a lot
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yeah
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dawson i would recommend alone
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oh i yeah
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oh
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so they use all some of the bonds that people were forming with pillow and
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now the challenges to see with the um those ponds in those relationships translate into data
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since january we've run a pilot of about thirty to fifty uses in the early data does look very promising
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typically we know that the
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general population has medication adherence rates of around sixty to seventy percent
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and that goes low over time as you start to to get to go to the pharmacy to refill prescriptions and so on
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i'm only uses of the below devices are medications your grace actually above ninety percent
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which is a huge improvements in this is a train that's actually increasing month by month as people get familiar with the
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devices and seamlessly integrated into their routines in fact in may
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a week it was ninety eight percent daily adherence which means
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and drop once a mail order values is um ninety eight percent of the time
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to pain medication at least on the day that they were supposed to take it
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in terms of engagement which we measures the number of interactions per day that the
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user has with the device this was about four to five times per day on average
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the grey portion is medication dispensing event so this
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is when pillows gonna proactively wakeup understands you medications
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and you can see here that people are taking midst generally twice today once in the morning at once in light
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and in the blue portion is where the user actually proactively initiated the experience with the device
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and by saying that week would okay pillow and then asking the question was saying
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it come on and in terms of questions and come ons they generally look like this
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i'm not too dissimilar from the topics that people use to go home and and and
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the next uh for uh although we don't play music just yet that's coming later this yeah
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i do want to point out one part on this chart which is the grace section right at the top and
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that's where it uses a getting to know pillow we collect
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chit chat um it's by asking about personality asking for jokes
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and generally chatting with the device and it's quite interesting because this is the way of forming a bond with the device and and it's
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an excellent opportunity for pillow to provide positive reinforcement light hearted humour
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uh and to to really help them think positively about their health goals
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and so with that let's talk about the future
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i was recently at a conference on majoring where one of the speakers was focused very much on medication compliance and
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uh because mitigation is the key drive a up oscillations monks
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seniors and also a major barrier for older adults to stay in
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their homes longer and what he said was that compliance and engagement
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go hand in hand without one you generally cannot have the other
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someone's not engaged in the help them they're less likely to be compliant to that medication regimen and i couldn't
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agree more with that and that's exactly what we're trying to do a kilo uh solution is this unique combination of
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compliance because we still want dispense the medications engagement because
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we have this proactive intelligent assistant embed it into the device
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so here's an example of what i think the future okay good look
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like and and as you guessed most of it happens inside of the home
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you go to the doctor one day and you've been diagnosed with type two diabetes the doctor explains you
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that you have to take these new medications some with food someone into stomach you have to exercise more
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eat less major black because get some sleep already less et cetera et cetera
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naturally you forget ninety percent of that as you leave the doctor's office you get home you're alone you uncertain about what to do
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next well what if when you went home your doctor had prescribed
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you digital diabetes cage any delivered to you via your trusted intelligent assistant
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what if the assistant was able to how old are you medications and manager new medication schedule and to answer all
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the questions that you had a battle medications that you why they didn't have time all with to skate ask your doctor
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what if the assistant to deliver personalised educational content you like healthy
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eating types all recipes all short videos personalise to your specific needs
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what if this assistant to check in on you from time to time it could help by recording your
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blood pressure uh and you wait readings and if there was an issue potentially escalated to locate email your position
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so that's my vision of the future of health care and home and it's not that far off what you see here is real
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pilot that we did in the summer of last year uh with
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recently died diagnosed type two diabetics and over the course of the study
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we were able to increase patient compliance to medications improve patient understanding of the conditions
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and we increase the engagement in the half measured by the eating habits and exercise habits as well
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so i'll leave you with that will be launching with uh our product to consumers later this yeah probably
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in the fall uh in the united states in partnership with stanley back and they can result one's partner
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and with the sole purpose of imparting older adults stage independently at home and
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providing families via mobile application with the tool uh just open to do that
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we're very focused on bringing up product to europe and that will likely happen
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in twenty twenty and we actively looking for partners to help us do that so
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thank you very much one and one last thing i have a device outside so if you wanna learn more will have a demo we happy to give you one
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thank you
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your father present tradition
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any question yes just over there
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thanks for your presentation which was great i have a couple of questions the first one to use
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in your business you've been talking about the user drove or pillow your business model who is in
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charge here and the people we use it basically or browse their memory or part of their memory
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who is in charge of reviewing their system with one the right information
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and spectrum the writer abuse your in the box yeah i'm i'm there's
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second question is your business model again what happens when
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the people don't properly respond to what is expected bike bureau
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that's great so um the first question your right to the users of the device are
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generally older adults and and i would say the ranges anywhere from sixty to eighty years old
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in terms of who actually lows medications we found that the purchases of the device
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of family caregivers who so we that the sounds all the
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tortillas maybe the daughters of these uses so they would often come
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set it up inside the home and then help people a load
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medications inside of the device depending on how frequently you take medications
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you're really gonna be loading the device once every month or once every
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two weeks on average and so it's fits into your sort of daily
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or your weekly visits to the house where you can help unload the device we are working with a pharmacy
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partner in the us so that we have these disposable
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trays filled medications that can be shipped to you at home
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and you simply slide them into the back of the device and you get
00:23:32
to go so we're making the process easier show second question i forgotten it already
00:23:40
ah yes so right now uh if the person doesn't show up in front of
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the device uh and acknowledge that they actually taking the medication will take the minutes
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um after one hour uh we send a notification to pick
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a team who have downloaded the mobile application so they're able to
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get that alerts and then decide what they wanna do they can either either checking question
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which will go directly to the device and be spoken to that person by the device
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all you can actually video directly into the device from your mobile phone
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thank you one other question to do the right thing tape which is closer to what to do mobile sorry oh
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a sure i about their beginning of a new data
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i say oh what's your tools to ensure that that
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that our safety adaptation that's a great question probably above my pay grade um but i'll do my best shot
00:24:43
so um some of these other devices intelligence assistance that you know about the
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lex uh two homes and others were built with a very general use case
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from day one we decided that we were gonna focus on health and wellness and and
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and an essential owning or controlling people's health information so from day one
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we've architect of the system to be incredibly sick uh in the us
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we are hip uh compliant which is um one of the basic if
00:25:13
you work within the providers the insurance companies in the us you have
00:25:15
to go through these various uh thresholds and so that's where we are
00:25:19
right now obviously we we do all of the best security standards that
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you can imagine we have outside funds come in and consultant or the
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test as well and that's my that's my operations and finance guy and uh
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okay thank you
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maybe for the last one i'm sorry for the other with but
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we don't have enough time and i'll be in the barrack afterwards as well so you can you can come and asked me questions directly
00:25:49
yeah just one question uh did you already frank about working
00:25:53
together with hospitals so you could put below allows you oh
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has care assistance for example the patient go home have two mounds of remotes up you
00:26:02
know and then get back to the hospital and so the hospitals and the doctors can have
00:26:06
yep directly into the patients absolutely we're actually designing a pilot with the hospital
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system in new jersey around that use case right now so i'm nice discharged patients
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that had a c. h. f. congestive heart failure episode gonna get sent home with
00:26:20
the pillow device and they'll have that device in the home for part a month
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and and the main reason for that is in the us is we admission penalty penalties so that same patient goes back
00:26:30
to the emergency room within thirty days the possibilities penalise announced it cost more possible so absolutely we are thinking about that
00:26:38
okay you're thank you probably you you will have time during the lunchtime
Conference Program
Mots de bienvenue
Sébastien Mabillard, CEO | Swiss Digital Health
June 7, 2019 · 9:05 a.m.
140 views
Mots de bienvenue
Victor Fournier, Chef de Service de la santé publique | Canton du Valais
June 7, 2019 · 9:09 a.m.
151 views
Mots de bienvenue
Laurent Sciboz , Directeur des instituts informatiques
June 7, 2019 · 9:14 a.m.
155 views
Vidéo avec Nao
June 7, 2019 · 9:23 a.m.
Soutenir le parcours du patient à l'ère du numérique
Frédéric Ehrler, R&D chef de groupe Interaction homme-machine et capteurs, HUG (Suisse)
June 7, 2019 · 9:28 a.m.
191 views
La santé à l'ère des assistants numériques
Yariv Adan, Chef produits Google Assistant, GOOGLE (Suisse)
June 7, 2019 · 9:56 a.m.
149 views
Preventive medicine at home allows health costs reduction
Guillaume Dupasquier, CEO, Domosafety
June 7, 2019 · 10:29 a.m.
Introduction de la 2ème partie, Assistants @ Home
Sébastien Mabillard, CEO | Swiss Digital Health
June 7, 2019 · 11:22 a.m.
How humanoid robot can be an assistant to the healthcare personnel
Thierry Perronnet, General Manager, Avatarion Technology (Switzerland)
June 7, 2019 · 11:24 a.m.
Physical Therapy made Digital ? The new standard of care for the next 50 years
André Eiras Dos Santos, COO, General Manager EMEA & APAC, SWORD HEALTH (Portugal)
June 7, 2019 · 11:54 a.m.
209 views
Aging in Place – A story of intelligent design and assistive technology
James Wyman, COO & co-founder, PILLO HEALTH (USA)
June 7, 2019 · 12:14 p.m.
The Power of Clinical Curiosity
Benjamin Errett, Senior Director of Brand, FIGURE 1 (Canada)
June 7, 2019 · 12:43 p.m.
Introduction à la 3ème partie: Seeds of innovation and pre-arranged meetings
Sébastien Mabillard, CEO | Swiss Digital Health
June 7, 2019 · 2:04 p.m.
A conversational robot doubles the success rate of quitting smoking
Roland Savioz and Michael Schumacher, OBEEONE / HES-SO Valais-Wallis (Switzerland)
June 7, 2019 · 2:07 p.m.
124 views
What are the challenges facing the health system in the face of the digitalization of family life?
Maddalena Di Meo, CEO & founder, BABY & KIDS CARE (Switzerland)
June 7, 2019 · 2:29 p.m.
622 views
How do health companions change our daily lives?
Giovanni Joerger, Marketing & sales director, OFAC (Switzerland)
June 7, 2019 · 2:47 p.m.
113 views
Soignez-Moi.ch: your doctor without delay
Romain Boichat, COO & co-founder, SOIGNEZ-MOI.CH (Switzerland)
June 7, 2019 · 3:10 p.m.
504 views
