Nestor

Imagine a future where technology could help predict and prevent cardio pulmonary conditions, respiratory issues and other sudden onset medical conditions, and could help manage associated symptoms. We believe that the future is now. It has been widely shown in studies that changes in physiological conditions among individuals which manifest themselves through vital signs are good indicators for general health of an individual. Vital health metrics for patients both in hospitals (except some ICUs) and home are currently rarely monitored in real-time. Most products on the market currently measure patient specific metrics which are aggregated hourly at best and there is no way to integrate feedback from health care providers for better health management. Our mission is to change that. Nestor is an affordable, real-time and local independent wearable sensor providing an integrated end-to-end cloud solution for reliable and meaningful access to patient health data, equipped with analytics and notifications. 

We have all seen videos and articles on the web about how healthcare systems in major developed and developing nations fell face-first in the wake of the COVID-19 pandemic. Overworked healthcare workers, neglected primary healthcare needs of patients in several communities are the theme of news related to the pandemic.

All the so-called "smart" health tracking devices such as Fitbit and Apple Watches have failed to deliver. Telemedicine is on the rise but there is no way for doctors to have physiological data from the patient from far away, and the pandemic has made physical visits a rare ordeal and something to be avoided.

However, we do have the technology to slightly alter our perspective and use the age old physiological indicators, the vital signs, to provide some glimpse into the state of an individuals mind and body in order to provide better management within our communities. 

People with underlying health conditions and the ones affected by the viral infections during the pandemic need continuous healthcare in order to better manage their symptoms and pave their way to recovery. In order to do this healthcare providers need reliable remote access to patient data with minimum overhead. Nestor solves this! 

Nestor consists of three major technological components, 1) a smart finger-based wearable sensor for collection of vital signs data; 2) a smartphone app that connects to the sensor and acts as a data relay between the device and the cloud; and 3) a cloud based real-time back-end system for storing and relaying data with dashboards for healthcare providers and other stakeholders for the individual patient.

The finger based wearable sensor is completely wireless and uses data from an embedded photoplethysmogram and human body temperature sensor, to extract vital signs data (heart rate, SpO2, blood pressure, temperature and respiration rate) of the patient. Note that this more accurate than the wrist-based counterparts.

The accompanying mobile app provides an intuitive insight into the real-time data from the sensor for the patient. It will also be used for GPS data for contact tracing within the community. The app will also relay the data for storage onto the cloud for the back-end system, and will be the primary interface for providing feedback and alerts to the user on an ongoing basis. 

The back-end system will store data in a real-time database and provide a dashboard interface for the associated stakeholders for the individual patient. 

Two major stakeholders for this project are the individual/patients within a community and their healthcare providers and loved ones. Our target users are individuals with already diagnosed acute illnesses, who have an elevated risk of health deterioration due to underlying medical conditions. Such individuals are also at a high-risk for bacterial and viral infections especially during pandemics like COVID-19. Our secondary users would be the healthcare providers and loved ones of such individuals, who are directly responsible and emotionally-dependent on the well-being of such individuals.

By providing a simple wearable device and an intuitive mobile interface we aim at providing the ultimate peace of mind to our end-users, without major disruptions to their daily lives. We aim at making our sensor system affordable and widely available so that it can be used in diverse communities around the globe. 

Our cloud-based dashboard and back-end system would provide high-fidelity health data to healthcare-providers and loved ones so that they are always in the loop and can provide feedback and take preventive actions in the case of any emergencies. The focus here is to provide an easy to use interface for dealing with multiple patients at a time.

Remote health monitoring and access to health facilities and personnel is highly restricted during pandemics, as we have seen with COVID-19. Also, such situations put a high burden on our health systems and workers, who end being overworked. Our sensor system and analytics platform provides a remote low-cost diagnostic and monitoring tool, it provides for reliable access to raw patient health data for better decision-making, it is a tool which supports and protects health workers, and provides affordable primary healthcare access within communities. It can also used for better disease surveillance and management during pandemics. 

Note that most health trackers currently on the market (like Fitbit, Apple Watch, other wrist based solutions) use PPG from the wrist which is not a strong indicator and has a higher signal to noise ratio which makes it harder to extract much meaningful data apart from the heart rate and maybe the blood oxygen saturation. Other finger based solutions like Oura also do not provide any other meaningful data, however technology exists to provide other important vital signs data such as blood pressure and the respiration rate as well. Also note that all of these solutions also are not really suitable for use in mass community based deployments since they do not have a focus on providing access to the raw data to healthcare providers and relevant stakeholders for the patient's health management. 

Nestor is based on PPG from finger and hence is inherently more accurate, and we would be the first wearable to include indicators for all the vital signs used by medical professional in all situations. Also our cloud based infrastructure and analytics platform would make large-scale management of community deployments possible with little burden on healthcare workers. 

The core technology that powers our solution is based on the advances in non-invasive human body sensing especially PPG, which uses optical inference from blood volume changes in human capillaries to estimate the associated physiological signs.

The wearable sensor itself involves a lot of hardware innovations and advancements that have happened in the last few years with smaller SoC for lower power wireless connectivity and even IoT based LTE and GPS connectivity. 

We merely are combining all these technologies into our product which could be used in a multitude of possible scenarios such as in a pandemic like COVID-19. 

On the software side we are heavily reliant on real-time cloud base messaging and storage technologies for dealing with vast amounts of data with utmost integrity and privacy in our minds. With the cost of cloud computing and storage going down we think now is the time to put that technology to use where it really matters.

Our subscription based business model where the user will always have basic access to their vitals signs without paying is perfect for situations where low cost deployments are necessary.

Finger based PPG is a widely known technology which is already used in off-the-shelf pulse oximeters. 

Also the hardware technologies being used are already a norm in the IoT sector, with low cost SoCs from major manufacturer like TI, STM etc being pushed towards the wearable market.

On the software side cloud computing is synonymous with AWS, GCP and Azure on the daily.

We believe based on our initial survey of doctors and nurses that such a device could be highly useful for telemedicine purposes, even in scenarios without a pandemic especially with the elderly and critically ill population. Hence we believe that with the rise of telmedicine the need for some kind of physiological data from the patient would be a very helpful indicator for the healthcare providers. 

Also, the current solutions clearly do not provide sufficient ease of use for healthcare providers to adopt since there is not end-to-end solutions on the market even with Fitbits and Apple watches being at the forefront of the wearable medical device market.

We aim to beta launch in about a year and half or so time. So we currently do not have any users but at beta launch we hope to have signed up 100 users as our initial adopters with partnerships with at least 5 healthcare organizations in BC. In five years we aim to reach the nationwide health services in Canada with coverage of at least 25% of elderly population in assisted care. 

The goal within the next year is to get an initial MVP ready and get the pilot testing done before launch. We then plan to scale the manufacturing and get the design ready for the appropriate regulatory approval. In the meantime further testing would be done with the help of local health agencies in BC and the NRC to get the product to scale and ready for market. We plan to commercially launch in about 2-3 years time frame with the appropriate approvals and measures in place for the utmost impact.

The short-term barriers right now are mostly financial since we are looking for pre-seed funding for the development of our MVP based on our initial proof-of-concept prototyping. We will need the funding to get some contract design work done and also to provide basic salaries to the employees, also the funding will cover all the R&D operational cost along with the business operational cost for the next 6 months. This should get us to a stage where we are eligible for other local funding for our pilot stage.

The major hurdle after the pilot testing would be that of regulatory approvals especially the FDA medical device approval which is a tough process to get by. We will need to prove the accuracy of the data that we gather and will have to prove that we are still a class II device at most. Since the diagnosis in our case will still be always coming from a medical health professional.

For the short-term we are seeking pre-seed grant funding from multiple avenues. Hopefully we will get that covered by the end of September so that we will be able to continue our MVP development and get ready for the pilot at the end of the year.

For the approval processes we are seeking guidance from industry experts and multitude of wearable companies that have gone through the process before so that we can have an idea of what to expect.

Full-time: 2

This project requires exposure to various different technical stacks such as embedded system design and programming, real-time messaging and persistence, real-time databases and networking, and real-time web front-ends. Along side this, the project also requires insights into the workings of healthcare facilities and an understanding of the work of healthcare workers. Our team consists of an engineer and a nurse who have a wide network of access to diverse skill-sets and perspectives within the respective fields. We have a working prototype as a proof-of-concept and with some support we aim to create a MVP (design work is already under progress!) in the current development cycle. We believe that if it is not us this problem would not be solved at all! 

We are in negotiation with the BC Health Agency, CIHR, NRC and Mitacs for possible partnerships. 

The major products and revenue stream for our business would be:

1) smart wearable sensor (one-time, individual patient purchase or renting via the health care facility for short-term usage) - this will provide real-time insight into the state of their health

2) accessories associated with the sensor (one-time, individual patient purchase) - for preference based visual customizations

3) additional smart analytics features in the user mobile app (subscription, individual patient purchase) - for feedback and notifications from healthcare providers and experts on the go

4) analytics and notification services for healthcare institutions and providers (subscription, institutional purchase and individual licenses for loved ones) - to connect to their patients and provide them better health management and feedback

5) access to anonymized patient data with user permission for machine learning applications (subscription, ML researchers and institutions) - for the development of predictive and preventive machine learning models

We have used personal funds to get a simple proof-of-concept prototype working in the last 4 weeks.

We plan to develop our MVP for pilot testing at the end of this year (~6 months total) by using grant funding mechanisms for COVID-19 related initiatives. 

For pilot testing we plan to use Innovate BC's Fast Pilot Program (https://innovatebc.ca/what-we-offer/get-funding/bc-fast-pilot-program/). We expect 6 months - 1 year for this process.

Within a year and half or so with successful pilot testing we plan to raise seed capital from VC firms based in Vancouver and Silicon Valley, to fund our growth and manufacturing at scale. At this point we expect to have some revenue from initial paying customers as well.

Based on our revenue at the time we will most probably decide to have a couple more VC funding rounds to develop further revenue streams and customer base.

With sufficient customer base we should have a continuous revenue from the sale of the individual sensors and subscription revenue from our analytics and notification services for individuals, and healthcare institutions. This should be the major source of funds being used for both cost covering and further R&D in about 5-10 years time-frame.

We are currently looking for grant funding for the development of our MVP. We have a basic proof-of-concept prototype which needs to be miniaturized and some additional functionalities added for it to get to a stage for pilot testing at which point we have government funding support lined up for field testing in BC.

Hence, we are mainly seeking pre-seed funding from the Solve program, mentorship and guidance from health experts for medical devices would also be very useful.

This funding will mainly go toward the R&D cost of the project and if we win a bigger prize it will also fund the employee salaries and some contract work needed for the app and back-end development.

Any help with FDA approval processes, recruiting and marketing would also be very helpful since those are the areas where we are least skilled.   

We are looking for partnerships which can help us raise some pre-seed funding to get us to market launch. Before that happens we need to develop our MVP, do initial pilot testing and get regulatory approvals. During this process we need guidance with recruiting, marketing, management, legal and regulatory requirements.

We would like to partner with Solve program members working on medical wearable devices and technologies which need FDA approvals. Also faculty and members associated with medical device companies in general would be very helpful in learning about how to structure the business and refine our initial business plan. During this time we would also like to partner with NRC Canada since they would be providing the bulk of funding after the pilot testing is done. 

We plan to use the health data from our patients fully anonymized and with permissions from the users to accelerate the development of AI solutions for predictive and preventive health analytics through machine learning and advances in computation that has become pervasive over the last decade. 

For any such application high fidelity and reliable data is needed and we are going to provide just that!

We will be using this funding for our machine learning and analytics initiative right after our pilot program when we plan to get some initial customers to work with. This funding will be supporting a team of ML researchers and the associated costs in developing the core of the predictive and preventive analytics needed for better health management of the wider population in our communities.

We are already currently planning to do a crowdfunding round right after we get some pre-seed funding for our MVP development to get our selves some buffer resources to accelerate our development and to get us in a position for our pilot. 

We have already had interest from people about crowdfunding and this is a solution that directly impacts our communities and the long term health of the wider population. 

And the solution also falls under the UN Sustainable Goal # 3: Good health and well-being.

We would be using this funding to develop our beta version for regulatory approval after our successful pilot. Note that bulk of this cost would go towards R&D and development specifically on the hardware and software aspects of the project.