SiA™ (Systematic Intervention Agent) AI First Platform

Problem - Rare Lung Diseases - In terms of numbers:

Individual rare lung diseases affect only a limited number of people. But they have a large total impact. Altogether, rare pulmonary diseases affect about 1.2 million to 2.5 million people in North America alone. 

These rare Lung Diseases primarily include various types of ILDs (Interstitial Lung Diseases).

Worldwide, the incidence of ILD ranges from 1 to 31.5 per 100,000 person-years and prevalence ranged from 6.3 to 71 per 100,000 people.

In 2019, in the USA, there was an estimated 654 841 cases of ILDs, 429 786  DALYs and 21 505 deaths from ILDs. 

In Denmark (where I live and work) the incidence of ILD is 4.1 per 100,000 person-years. In India (where I belong and work) the specific incidence of ILD is not known but estimated to be on high side. 

In India the incidence of Occupational ILD (Asbestosis is an occupational ILD) is estimated to be one of the highest with respect to other countries especially due to issues related to Asbestos use - India uses an estimated 350,000 tons of asbestos annually.

Amongst ILDs, IPF (Idiopathic Pulmonary Fibrosis) is characterised by poor survival. IPF can be considered, in its prognostic features, to be a malignant, cancer-like disease. Until the last few years there were no effective treatments, so IPF was also considered an orphan lung disease.

Worldwide, IPF affects 13 to 20 out of every 100,000 people.

According to the National Institutes of Health (NIH), about 100,000 people in the United States have IPF with approximately 30,000 to 40,000 new cases are diagnosed each year. 

In Denmark (where I live and work) the incidence of IPF is 1.3 per 100,000 person-years. In India, the specific numbers are not known.

(Amongst other types of ILDs and Pulmonary Fibrosis, a recent scare was during Covid19 - multiple recent studies have shown about 20% to 40% of COVID-19 survivors appear to have developed Covid19 induced pulmonary fibrosis.)

Problem - Rare Lung Diseases - In terms of Health Related Quality Of Life (HRQOL) :

HRQOL is significantly impaired in patients with ILD. The type of
ILD, immunosuppressant medication, and lung function all influence HRQOL.

Studies have shown that, around a third of ILD patients experienced a clinically relevant HRQOL deterioration in a 12-month period, which was associated with baseline lung function values. As lung function values are time-dependent variables with possible improvements, in contrast to age and ILD subtype, it, thus, seems important to improve lung function and prevent its decline in order to maintain HRQL on the possibly highest level.

While the numbers of patients affected with ILDs worldwide (a major rare lung disease) is significantly large, focus on improvement of lung function and preventing it's decline in outpatients is missing. 

For improving lung function and preventing it's decline amongst outpatient ILD patients, research studies have listed following challenges:

1. Many physicians have no detailed knowledge of ILD and therefore miss using it during the line of treatment and for improving patient's quality of life

2. Patients do not have enough training and information about Self Care

3. Patients do not have easy to use tools for measuring and recording lung function

4. Patients and families do not always have access to Medical Care and Home Health Support System which disproportionately affects disinvested communities and historically underrepresented identity groups

5. Patients and families do not have a platform to be used as community support from fellow patients and families

As a result, patients with ILDs continue to suffer with a very poor health related quality of life.

Source References: 

https://ugeskriftet.dk/files/scientific_article_files/2018-11/b5069.pdf 

https://pure.au.dk/portal/en/persons/charlotte-hyldgaard(2422d2b1-a56b-4924-a424-97abc55f3fa0).html

https://erj.ersjournals.com/content/54/suppl_63/PA4723 

https://hqlo.biomedcentral.com/articles/10.1186/s12955-020-01570-2 

Solution: 

SiA™ (Systematic Intervention Agent) is an AI First platform that helps doctors, healthcare professionals, families and patients with rare lung disease to build collaborative partnerships with each other to facilitate systematic, regular and personalised interventions. 

SiA™ follows a holistic approach - regular lung function measurement, medicine compliance, exercise, diet and emotional wellbeing for improving lung function. 

SiA™ uses AI and Data Science to assist doctors with Clinical Decision Support System software for early and precise diagnosis of ILD. SiA™ uses power of No Contact Artificial Intelligence (AI) and Natural Language Processing (NLP) to improve timing and efficiency of human interventions in Patient Support. SiA™ uses Machine Learning to analyse multi-source data to give personalised notifications for improving adherence to medicine, diet, exercise and positive habits.

SiA™ platform has 2 main modules: Clinical Decision Support System (CDSS) for Doctors and Patient Engagement platform for Patients, Families and Holistic Health ILD Specialty Coaches

1. SiA™ as CDSS for Doctors treating ILD Patients

SiA™ Automates workflow for diagnosis of ILD and assists doctors with standards, expert guidelines, knowledge-base for an early and precise screening and diagnosis. SiA™ also helps doctors in creating the Treatment Plan with a Holistic Approach - medicine, diet, exercise, emotional health etc. and allows doctors provide a curated and personalised patient education material.

2. SiA™ as Patient Engagement platform for Patients, Families and Holistic Health ILD Specialty Coaches

SiA™ as Patient Engagement Platform has 3 main components:

1) SiA™ Home Kit

SiA™ Home Kit includes SiA™ Mobile App for patients, a handheld digital spirometer - SpiroPRO™, a smart inhaler cap - InhalerPRO™, a mechanical lung exerciser - BreathPRO™ and a mucus extract device - UltraBreathPRO™ .

SpiroPRO™ the handheld digital spirometer, has a patient centric design and uses real time feedback mechanism to allow patient perform a quality lung function assessment with ease.

SiA™ then uses Machine Learning algorithms to help doctors in interpretation of SpiroPRO™ generated Spirometry reports. 

SiA™ has also made the communication related to lung function between doctor and patient simpler. The complex lung function language is converted to an easy to understand 10 point scale - LHI™ (Lung Health Index) with Red-Amber-Orange-Yellow-Green colour bands.

SiA™ Mobile App for patients act as an intelligent but virtual Systematic Intervention Agent whose service is augmented by human SiA™ coaches. 

Important Note: SiA™ is a hardware agnostic platform - while it's fully integrated with Briota's proprietary hardware it's designed in a way to enable patients select from a wide range of home care hardware devices available in the market.

2) Self Care Patient Support Network

SiA™ Platform allows doctors to build a personalised Holistic Care Plan with Self Care options for patients -

3) SiA™ Holistic Care Community for connecting ILD Patients with other patients, families and Holistic Care Specialty Coaches - Diet, Exercise, Emotional Health, Behavioural Changes

This is a virtual social platform connecting patients, qualified holistic health coaches referred as SiA™ Coaches, Carers and Families. Patients can share their experiences, celebrate their successes with exercise, positive habits like smoking cessation etc and also have friendly Leaderboards to cheer each other. Families can connect with each other to learn on how best they can help their patients. Volunteers with required qualification can join as SiA™ Coach from providing voluntary services. 

SiA™ Coaches have a "Coach" version of SiA™ App to allow them to help ILD patients.

We have used SiA™ platform to help 40 thousand people manage their Covid19 related Lung Health during Covid19 pandemic in India. The services of SiA™ coaches (which included Field workers, Nurses, Doctors, Yoga experts, Dieticians, Emotional Health coaches) was provided for underprivileged sections of Mumbai - Chunabhatti Zone in Mumbai Municipal Corporation in India and also to workers and families in labour colonies in Industry Zones in the state of Orissa.

We also ran a special 12 Week Lung Health Improvement Program run by SiA™ Coaches for Covid recovered, ILD, Asthma, COPD patients. 

Currently we are working on a Government of India project under Nidhi4Covid to help 1200 patients improve their lung health in India with the help of SiA™ platform and SiA™ coaches.

Note: The SiA Platform for patient is fully integrated with Briota's Clinical Decision Support System (CDSS) software used by Doctors. Currently our CDSS Software helps standardise the screening and diagnosis of Asthma and COPD. We are working on including the rare lung diseases such as ILDs in our CDSS software. The CDSS for ILDs will also provide a content repository for doctors to have an easy access of relevant publications of latest research, case studies, guidelines and recommendations from experts around treatment and management of ILDs.

Clinical Validation and Patents

Our SiA™ platform and related technology to help patients with Lung Diseases such as ILD, Asthma, COPD, Post Covid Lung Complications etc. is clinically validated in various studies in India.  We are currently working on finalising the prototype of a multi country, multi center user study of how SiA™ platform helps Lung Health patients improve self care. This study on clinical side will be lead by Aarhus University Research Hospital Lung Health Department.

We have applied for 5 patents for various components of our technology and SiA™ Platform with unique technology. 

Our technology is developed to help patients with any chronic lung condition such as COPD, Asthma, ILD, Post Covid Fibrosis etc. 

SiA™ platform and our solution under this MIT Solver application is focused on providing an innovative and holistic platform to patients, families, carers and healthcare staff dealing with Rare Lung Diseases - which include ILDs primarily (Interstitial Lung Disease). Our target geographies are first India and Denmark (where we already have operations). The SiA™ platform's community features are designed in such a way that it could be opened for global launch with local coaches joining the platform.

ILD Patients are currently underserved for following reasons:

1. Health System structured around Lung Health is under huge stress to provide personalised and holistic service to ILD patients - especially post Covid scenario infrastructure even in developed countries are under stress in dealing with Lung Health patients

2. The situation is worse especially in developing and underdeveloped world. Many ILD patients get diagnosis which is generally delayed but do not have access to post diagnostic health care

3. ILD is a complex condition - while there is some good research around Idiopathic Pulmonary Fibrosis (one type of very severe form of ILDs) - there is still not much research completed around other types of ILDs. Even the research is known and available for clinical discussions and learnings especially in Europe and the USA. In absence of sufficient research, even specialists find it difficult 

4. On the same lines - use of the latest technology to help ILD patients especially on Self Care is almost not available

As a team lead for this project, I (Gajanan Sakhare) have a personal reason to get involved into using technology for solving Lung Health issues.

I have seen the difficulties a chronic lung health patient and her family goes through. My mother is a severe Asthma patient for last 3 decades and being her carer, I have realised that a holistic approach has a huge potential to improve quality of life of lung health patients. Our solution has already served more than 40 thousand patients improve their lung health during Covid pandemic in India. We have helped patients, carers, healthcare staff related to various lung conditions such as ILD, Covid19 Fibrosis, COPD and Asthma. Unfortunately India though having a very large number of ILD patients - does not have a registry for ILD patients.

On invitation of Denmark Government, I recently moved to Denmark. Denmark provides us an opportunity to understand the research and successful initiatives to improve ILD patient care. 

In Denmark we have a Danish Interstitial Lung Disease Registry (DANILDA). 

I am privileged to have a subject matter expert who was responsible for developing this DANILDA - Prof. Elisabeth Bendstrup.

Elisabeth is the Head of the Centre for Rare Lung Diseases at the Aarhus University Hospital, Denmark.

Elisabeth's Research areas are: 

Interstitial lung diseases:

• Epidemiology: Development of the Danish Interstitial Lung Disease Registry (DANILDA).
• Aetiology and biomarkers of lung fibrosis: Collaboration with Danish and other Nordic ILD centres.
• Quality of life, rehabilitation, palliation and comorbidities: Collaboration with Danish and foreign centres.
• Interstitial lung disease related to connective tissue diseases: Collaboration with Danish community and university hospitals.

Sarcoidosis:

Epidemiology and biomarkers

Pulmonary hypertension in interstitial lung disease:

Epidemiology, biomarkers and treatment

Including Elisabeth as subject matter expert allows our team in Denmark to understand what specific challenges specialists, healthcare staff, patients and families with respect to ILDs are facing on ground.

In India we closely work with Prof Meenakshi Bhakre as a knowledge partner and subject matter expert. Meenakshi is the In-charge Head of The Department, Respiratory Medicine Department, Symbiosis Medical College for Women, Symbiosis International University Pune. Meenakshi in her practice at the University's hospital comes across various ILD patients especially coming from the underprivileged and underserved sections of the society. Having Meenkashi as subject matter expert helps us understand the difficulties faced by ILD patients in India coming from difficult socio-economic backgrounds. 

Apart from the research team's support we also have mentoring and collaboration support from Bayer Pharmaceuticals.

Our Solution - SiA™ (Systematic Intervention Agent) is for various chronic lung health conditions. This solution is Growth stage for Asthma, COPD, and Post Covid Lung Rehabilitation. For Rare Lung Diseases specially ILD (Interstitial Lung Disease) our solution is at Pilot Stage. We have an excellent team with research background in ILD in Denmark and India. However Denmark has a very small number of ILD patients and India does not have a structured approach or registry of ILD patients yet.

North America has more research work completed around ILD and also has a large number of patients taking treatment for ILD.

This Horizon Challenge will allow us to connect with Healthcare, Scientific and Pharmaceutical research community working on ILD at global level - especially in the USA. With Horizon we can expand our network and contacts and learn from any other relevant research and technology successes in other rare disease areas. The prize money will also help us complete the ILD specific User Experience (UI/UX) and Mobile Application improvements and also help us initiate and complete a user study for our SiA™ platform with 30 ILD patients in Denmark.

We also understand that Horizon Therapeutics is working on developing medicines (HZN-825) to treat people with IPF, the most common interstitial lung disease. 

Getting recognition (and possible mentoring support) from a specialised BioPharma company (Horizon Therapeutics)  focused only on rare diseases will help Briota generate good interest from Doctors and Patients who may be interested in Briota's holistic approach in managing rare lung diseases. This may help us address current market barriers for scaling our solution and offerings.

Finally as part of our solution we will be working on creating a SiA™ Holistic Care Community and Market Place for connecting ILD Patients with other patients, families and Holistic Care Coaches - Diet, Exercise, Emotional Health, Behavioural Change

SiA™ (Systematic Intervention Agent) is technology platform that specialises in helping patients with rare lung disease on improving self care. Our platform is already battlefield tested and proven. We have helped more than 40 thousand people and saved 3800 Hospital Beds during Covid19 pandemic. Our SiA™ Platform and Services have helped patients in India manage and improve lung health with better self care, holistic approach, remote doctor and holistic health coach support.

To achieve better self care at home settings, we use power of No Contact AI and IoT for regular lung function measurement at home. SiA™ mobile app gives appropriate auto-suggestions and auto-notifications based on multiple data sources such as weather, patient's daily diary, adherence data, communication with SiA™ coaches etc.

SiA™ uses Natural Language Processing (NLP) to improve timing and efficiency of human interventions when required to complement the auto-suggestions and notifications.

SiA™ uses AI and Machine Learning to help doctors get recommendations on personalising lifestyle and behavioural changes plan for patient including Diet, Exercise, Emotional health, smoking cessation etc. 

There are many technology solutions available in the market related to improving lung health. But they only address a particular part of the problem and generally are built with a design "One Size Fits All". Rarely technology companies take a holistic approach. With SiA™ solution's patient centric, holistic and personalised approach, we believe that other technology companies will also start working on providing a more holistic and personalised solution. We are confident that SiA™ will act as a catalytic agent for other innovative and impactful solutions in Lung Health space.

For ILD Specific Solution implementation of SiA™, we aim to achieve following impact goals next year:

1. Conduct a pilot study for 30 ILD patients using  SiA™ solution in Denmark and India 

For ILD Specific Solution implementation of SiA™, we aim to achieve following impact goals in the next 5 years:

- Provide SiA™ technology platform, SiA™ Coach and SiA™ Community services in various forms to help over 50 thousand ILD patients, healthcare professionals and families globally.

- With our solution, we hope to improve Health Related Quality of Life (HRQOL) of the patients suffering with ILD or other rare lung diseases.

For the 1 year goal, we are already initiated various activities both in India and Denmark.

Here are the goals we are aiming for:

Across all Lung Health chronic conditions - Asthma, COPD, Long Covid, ILD  - 

• By 2030, help 1 million patients suffering from some Lung Health condition
• By 2030, bring in over 10000 specialised, certified and qualified SiA™ Holistic Coaches, Volunteers and Experts on SiA™ Community Platform to help patients in different geographies - India, Europe, USA, Japan

Only related to Chronic Rare Lung Health diseases such as ILD -

• By 2030, touch lives of 100 thousand patients suffering from ILD
• By 2030 help 100 thousand patients improve their Health Related Quality of Life (HRQOL)
• By 2030, make SiA™ community platform an active community platform for sharing knowledge and resources for improving Self Care of ILD patients

Here are the indicators we use to measure our progress on our Goals for SiA™ Solution specially designed for ILD patients - 

• Health Related Quality of Life (HRQOL) values measured with standard tools such as K-BILD, ATAQ-IPF, or L-IPF/L-PF
• Improvement or reduction in the decline rate of Lung Function measured with Spirometry
• Mean survival from the time of diagnosis

We use No Contact AI, Natural Language Processing (NLP), Data Science, Machine Learning, IOT and Mobile Application development technologies in our solution. Our software solution is hardware agnostic which means it works with our own proprietary hardware and also with 3rd party hardware available in the open market. We have applied for 5 patents to protect various elements of our technology. 

We are building a proprietary technology to make self care for ILD patients more personalised. Our technology uses Descriptive, Predictive and Prescriptive data analytics to provide regular, timely and personalised interventions for building positive habits to help improve health related quality of life of ILD patients. Currently we are analysing over 40 different data points to provide Systematic Interventions and we continue adding more and more data points.

We are currently building SDK and API for our software to allow other companies and startups build a wider range of applications with Briota's algorithms for improving Self Care of patients suffering with various chronic conditions - and not just lung disease.

Our team includes members from 2 countries - Denmark and India. We have more than 60% of our team represented by women. Our extended SiA™ Coach Network setup for Covid19 pandemic support project consisted of 90% women.  We have a startup team culture where all team members are treated equal at Founder level.

We are a for profit impact venture. Our revenue streams include following:

1. Direct sales to Government, Organisations, Hospitals, NGOs etc 

2. Collaboration projects with Pharma companies

3. Soft money for R&D

4. Private Investment - Angels, VCs

For ILD specific operations we will also be offering paid services directly to patients. 

Any certified and qualified SiA™ Coach offering a paid service to a patient through our community platform is required to pay a service fee to SiA™ platform.

We have received Government of India research and development related grants and subsidies totalling USD 120K and a sanction of grant and loan (not availed for strategic reasons) for USD 250K. We have already done 3 paid projects with Municipality of Mumbai and Hindalco Industries.

We have signed collaboration agreements with 2 large Pharma companies - one in India and one in Europe and are in discussions with a Pharma giant in Japan for collaboration.