Continuous health monitoring: How vital data can lead to preventative care

Matthias Puls

CEO & Managing Director of Kenkou

Continuous health monitoring: How vital data can lead to preventative care

15 June 2022 | 10min

Quick Takes

  • Digital health technologies and vital data capturing has the potential to bring continuous health monitoring to patients, enable proactive care and personalized patient journeys

  • Individuals are seeking to use their health data to take more control over their well-being, disease management, and prevention

  • There are three key strategies that digital healthcare startups can incorporate for successful development of their apps

As healthcare technologies continue to grow exponentially, individuals are looking for ways to take their well-being into their own hands through digital solutions that can provide continuous health monitoring. We are already witnessing the revolution of the digital age, with the rapid delivery of vital data, like heart rate, to both the individual and physician, ensuring that care shifts from a “reactive” response toward a “proactive” response. Various stakeholders, including startups, big tech companies, and policy-makers, are crucial in moving digital health forward.

To discuss how the field is moving towards data-driven personalized care, Healthcare Transformers sat down with Matthias Puls, CEO & Managing Director of Kenkou, a Berlin-based company developing a software development kit (SDK) for point-in-time measurement of major vital signs, including heart rate variability and heart rate.

The digital health market

HT: Could you tell us a bit about the history of Kenkou and what unmet need in healthcare it aims to solve? What was the driving force behind the strategic shift from an app provider to a software development kit (SDK) provider?

Matthias Puls: Kenkou was founded in late 2014 with the original goal to make stress measurable through specific hardware. Imagine getting up in the morning, placing your hand on a sensor, and directly receiving feedback about how much energy you had for the day.

We later realized the opportunity software had without wearables (hardware) so we decided to develop an app in the area of stress and burnout prevention using the smartphone camera as the main sensor. You only had to place your finger on the camera for one minute, and we were measuring the pulse wave and analyzing biomarkers such as heart rate and heart rate variability. 

With the digital health market rocketing during the COVID19 pandemic, we decided to start enabling other digital health applications with our scalable technology. Since then we have been developing and implementing a so-called software development kit (SDK) that can seamlessly be integrated into other health applications within just a few hours. 

Preventative care with data: now and for the future

HT: We are currently experiencing a shift from “sick care” to “preventive care.” How do you see digital solutions contributing to this transformation at the current moment, and in the next 5 to 10 years? 

Matthias Puls: Digital solutions support the transformation to preventive care and are actually an enabler of this shift.

We all know – and it has been the subject of many scientific papers and studies – that behavioral factors play a significant role in disease prevention. However, over the past decades, we have also learned that health promotion programs targeting selected risk groups or populations have significant limitations: they do not address individual needs.

Each individual has a different lifestyle, lives in a different ecosystem, and is exposed to different determinants of health. Therefore, it is crucial to understand the initial state of health, observe health parameters over time, and get insights from everyday life. We speak about “closing the feedback loop”. With such a knowledge base, we can design preventative plans analogous to today’s treatment plans. However, we need vital data and biomarkers available for individuals and physicians to make it happen.

I am convinced that with such an approach, we will make the long-awaited shift from treatment to prevention. Today we lack a 360-degree view of individuals’ state of health – physicians have limited access to knowledge about individuals’ health. For example, a chronically-ill patient may visit a physician only a few times a year, receiving laboratory tests from time to time. 

This sporadic patient journey leads to data fragmentation where health is measured in a narrow timeframe or point-of-time, not continuously. Yet, in analog healthcare, this was the only option. As a result, chronic patients are “under care” occasionally and 99% of the time – when at home – they are outside the health system. Furthermore, healthy people have no tools to manage their health; they can only react when the first symptoms appear. 

Thanks to modern digital health technologies and data capturing, we can repair this dysfunctional approach and begin switching toward continuous health monitoring. 

Evidence-based medicine through data

HT: You recently said, “Relevant vital data is becoming the key differentiator for effective digital health solutions on their way to individualize offerings.” Can you please elaborate on this and explain why you believe this is true? 

Matthias Puls: Most advances in medicine are achieved when physicians gain more and more insight into an individual’s health. Think about the stethoscope helping to assess the health of the heart and lungs or modern medical imaging technologies and laboratory tests. Based on the results – images, calculations, signals, or data – physicians can make an accurate diagnosis and choose a course of treatment. Thus, medicine is becoming more and more evidence-based and precise. With access to data, physicians can proactively spot negative health trends in advance.

Today, continuous health monitoring devices collect an individual’s real-time data, completing this array of diagnostic tools. On the one hand, data can be used to improve disease monitoring and management; and on the other hand, it can be used for early disease detection and prevention. For example, many studies show the relationship between patient outcomes and the stage at which the disease is diagnosed. But early diagnosis is not possible without continuous health monitoring. This is only one example showing the power of data.

Vital data and biomarkers are a true wealth of knowledge, and we cannot afford to waste it. Data is the magnifying glass to understanding the processes occurring in the body over weeks, months, or even years. Almost everybody uses Google maps to get from point A to point B, without even thinking about the broad range of data involved in this process. So why don’t we use vital signs to develop individual journeys to a healthier future “me”?

Data-enabled patient empowerment is the key to prevention

There is also another aspect of data – the contribution to patient engagement and empowerment. Information can be gathered from wearables or smartphones, and then presented to individuals in the form of understandable summaries or guidelines, which have been generated by algorithms. The results can motivate them to change their behavior and incorporate more healthy lifestyles. I call it replacing “guessing” with “knowing.”

Of course, when we talk about collecting vital data through continuous health monitoring, we are also talking about AI systems that preliminarily analyze this data. Through this approach, the doctor receives only information about alarming signals or can gain a “full picture” of health through a detailed summary.

I do not doubt that data will become the most precious asset in treatment and prevention. This unlocked power has already been recognized in many healthcare systems. For example, the European Commission has recently presented the proposal on the European Health Data Space (EHDS) legislation. EHDS aims to facilitate the collecting and exchange of health data for primary and secondary purposes.1 Everybody will benefit from data-driven healthcare.

Challenges and opportunities within data integration

HT: As the number of health apps that individuals use increases, so does the amount of data generated. What main business challenges and opportunities do you see as a result of this?

Matthias Puls: The main problem is that the data from healthcare applications remains locked in data silos. Thus, some data is stored in an electronic health record (EHR), some in fitness apps integrated with wearable devices, and some in yet another platform – for example, telemedicine. Why? 

There are two main reasons: the lack of interoperability between systems and devices, and a culture of working in silos. Recently, we have seen significant progress in technical and semantic interoperability – when data has a single format, it can flow freely between different systems and devices.

However, there is a lot of work to be done to integrate data from different sources. For example, patient-generated vital data is not commonly included in EHRs. In addition, digital health vendors and developers are reluctant to share data for various reasons like legislation, data privacy regulations, or simply protecting data as a valuable business asset.

At Kenkou, we aspire to become a bridge between patient data and the health system. We not only enable the capturing of (cardiovascular) biomarkers via the smartphone camera but aim to break down barriers to data integration and sharing. This is our contribution to creating a coherent data-driven healthcare ecosystem.

Individuals are also a major factor that will help foster the shift towards better health through improved access to data. In my view, individuals will realize over time the value of vital data for their well-being, disease management, or prevention. Many citizens go to their physicians and present the vital data collected through continuous health monitoring. Soon they will expect that this data will be included in their EHR because they want to take more control over their health. They want to be engaged, informed, and better understood. 

The wearables and smart sensors market is snowballing. According to the latest IDC report, 533.6 million wearables were shipped in 2021. It is a 20% increase over 2020, and the trend is accelerating.2 With the expansion of the range of captured vital data, the patient will soon be the primary source of their own health data. I can’t imagine that individually captured data will remain outside the health system. Moreover, we will see more smartphone sensors, and thus, fewer wearables and external sensors.

How big tech companies are influencing digital health 

HT: Tech giants such as Apple, Google, and Microsoft, are all making moves into digital health. How do you think this will impact the digital health space?

Matthias Puls: Their impact on the health sector will be huge. Big tech companies have tremendous experience delivering perfectly designed and personalized digital services and products. They have the know-how, technology, and financial resources to scale new solutions addressing unsolved problems.

We should stop seeing big tech as a threat to healthcare. Instead, we have to start actively co-shaping their role in the healthcare ecosystem.

Matthias Puls

There is nothing wrong with Apple or Google’s health-oriented offerings, as long as these companies share the same values as individuals and the healthcare market. 

If they follow ethical principles, comply with data protection rules, and share data with other stakeholders, these tech companies can contribute to individuals’ health and sustainable health systems. Thus, we all have to learn how to play on one team since healthcare faces many challenges, from the rising prevalence of non-communicable diseases to workforce shortages. They can be tackled only in joint public-private partnerships between innovative companies, academia, policy-makers, and other stakeholders.

Big tech has developed many exciting technologies that healthcare could apply. Smartphones enable us to see a physician from anywhere and at any time. Thanks to advanced integrated sensors and mobile apps, we can even individually observe trends in our own well-being. These technologies translate raw data into knowledge, increasing health literacy and the role of prevention. But to fully realize this potential, we must work on data integration.

Additionally, it is homework for policy-makers to set smart goals so that solutions developed by big tech will also contribute to citizens’ health. Instead of fearing that tech companies will disrupt healthcare, healthcare systems should wisely use their power to achieve goals like better prevention, chronic disease monitoring, and patient engagement, among others. It is a matter of reframing the perspective.

Key strategies to help healthcare app companies succeed in product development

HT: What advice would you give to the founders/leaders of a startup in the healthcare app development space?

Matthias Puls: This is a tricky question and requires extensive discussion. To keep it short and sweet, here are three key strategies for healthcare executives who are developing healthcare apps.

1 Look out for a complimentary leadership team with strong healthcare knowledge
2 Understand reimbursement and regulatory structures as this can be highly complex
3 Be aware that this journey will be a rollercoaster with many ups and downs, but it is worth it. Embrace the process as you learn so much about the industry, leadership, people, and yourself

Matthias Puls is an innovation-focused leader in digital healthcare and a passionate catalyst who enjoys supporting people and organizations to grow and succeed in a fast-changing environment. He is inspired by how digital business models disrupt the status quo and curious about behavioral and motivation psychology as well as neuroscience. Before joining Kenkou and moving to Berlin - Europe’s heart of digital health - Matthias has been working as a management consultant for over a decade. In his spare time he enjoys different kinds of active sports and tries to make sense of vital signs.

References

  1. European Commission. (2022). Article available from https://ec.europa.eu/health/ehealth-digital-health-and-care/european-health-data-space_en [Accessed May 2022]
  2. IDC. (2022). Article available from https://www.idc.com/getdoc.jsp?containerId=prUS48935722 [Accessed May 2022]