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Extending independence with dignity for the vulnerable

with Jean Anne Booth, CEO & Founder at UnaliWear

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The number one fear people have of growing older is losing control over their own lives.

Personal Emergency Response Systems (P.E.R.S.) are monitoring systems like bracelets and pendants that exist in the market today to help keep vulnerable people safe. Yet most of them can seem rather stigmatising or their use is limited to the home only unless they’re tethered to a smartphone, which can be a frustrating experience for those who aren’t digitally savvy.

When Jean Anne Booth tried to get her 80-year-old mom to use one of these devices, she got a resounding, “No”. So, she took it upon herself to start UnaliWear and design the Kanega watch. This stylish device, which doesn’t resemble a medical device in the slightest, is a self-contained voice-controlled watch that offers emergency assistance, guide-me-home assistance, medication reminders, and fall detection. It helps senior people lead independent, active and safe lifestyles.

On this episode of HealthRedesigned, we speak to Jean Anne, who’s also the CEO of UnaliWear about how her mother inspired her to create the watch. She also describes how they’re extending the fundamental capabilities of the Kanega watch to assist not just seniors, but everyone who’s independent-but-vulnerable, helping them feel more empowered about making day-to-day decisions while making sure they stay safe.

Improving digital solutions on the market

What inspired you to start UnaliWear?

As my mother was turning 80, she didn’t want to wear any of the emergency alert products on the market today, but she’s medically frail. She was a model all of her life, that means she’s very slender. As she aged, she went from being slender to small. We had a conversation about how she was going to maintain her independence but also still be safe. We’ve looked at everything in the market and she looked at me and she said, “Don’t you get that for me. I’m not wearing it.”

A couple of weeks later, I went back to my mom and said, “Okay, how about if I made you a watch? It talks to you, you talk to it and it looks good so nobody knows that it’s a medical device. It can also help you with medication reminders and if you have a senior moment, it can help you get home.”

That was kind of the genesis of UnaliWear. The bottom line was, the products that were on the market today and back then are limited to use in the home unless they’re tethered to a smartphone, and my mom didn’t have a smartphone—more importantly, she didn’t want one. That big button is socially-stigmatizing, which, my mother, is never going to use. That’s where we came from.

Delivering independence with dignity in style

What does the Kanega watch look like and how does it work?

The focus groups first called our Kanega watch a ‘wearable OnStar for people’. Time magazine called it a ‘Smartwatch for Grandma’. We provide discreet support for falls, medication reminders and a guard against wandering. Our guide-me-home assistance uses an easy speech interface, plus there’s no smartphone required because it’s built into the watch.

Inside that watch, we combine cellular, Wi-Fi, GPS, Bluetooth Low Energy for hearing aids and telemedicine devices, an accelerometer for automatic fall detection, and of course, that continuous speech along with artificial intelligence in the cloud that learns the wearer’s lifestyle. This is how we guard against wandering—it’s basically a 24/7 wellness check.

It’s a purpose-built smartwatch without a platform. You can’t build an app for the Kanega watch–it’s a vertical solution. We’ve created the embedded software, the embedded hardware, and the cloud software. We control all of that so that we can deliver independence with dignity to the wearer.

We’ve also got a patent pending on the battery system in the band. You get a charger, two batteries in the charger and two batteries on the watch. When your Kanega watch tells you to change the batteries, you just change them out by swapping the ones in the band for the ones on the charger. Since you never take it off, you don’t forget to put it back on.

Personalising the experience for each user

How do people control when they want the watch to speak?

You can speak to your Kanega watch at any time—there’s a small command set that it knows on the watch, and a larger command set when it connects to the cloud.

If the watch wants to speak, it’ll vibrate on your wrist like a cell phone on silent, asking for permission. You can give it permission out loud or you can press the crown button once. If you give it permission out loud, it’ll speak to you and tell you what’s on the display. If you only press the crown button, it’ll tell you on the display.

Do family members get updates about the user and what other information can the watch communicate?

For the person who wears the watch, that independence with dignity actually means that they’re in charge of how their Kanega watch behaves. Even if I buy a Kanega watch for my mother, she decides whether or not I get notified when emergency services are activated on her behalf or when she skips her medication. This is really important because it’s one of the fundamental things that we do differently than other solutions that are in the marketplace today.

If my mom chooses not to take her medication, it’s her choice, because she’s independent. But if she does make that choice, she’s going to get in trouble eventually, and having made that choice, when she gets in trouble, the Kanega watch can keep her safe. You can have many interactions with your Kanega watch like asking it what time is it, what day it is, asking it to get you help, to call the operator, to list your medications or for directions home.

How is the Kanega watch experience unique for each user?

Part of what we do is learn that wearer’s lifestyle. We take your activity and location information and then we process it non-real time in the cloud. Basically, build up that knowledge base of who you are, where you go, what kind of times that you tend to be active, what times you tend to be quiescent. That allows us to get a better idea of who you are and what kind of things might be important to you. In the personalization and activity going forward, we can take that information when we’ve got a larger set of it, and use it to be more predictive, which is more helpful than anything that’s available today.

Falls are the single, most correlated predictor, of future hospitalization. To do an actual gait analysis, you need sensors on the leg. But since your arms are attached to your body which is attached to your legs, you can actually approximate changes in motion patterns through changes in gait, through an analysis of your motion. Each person has a particular way that they tend to swing their arms when they walk. If there’s an issue that indicates that there could be a change in gait, it’s gonna change the way that you swing your arms.

We’re always checking to make sure that the user tends to move the same way that they’ve been moving before, with the same kind of motion patterns. If it changes, we simply alert them that we’ve seen a change in motion patterns and they should probably check in with their doctor. The goal is to actually get in front of that likelihood of future hospitalization.

Giving control back to the user

Up to which point, is somebody in the family able to get involved and help the person wearing it make a decision that could impact their life or health?

In the United States, less than 12% of the independent-but-vulnerable population above the age of 75 uses a P.E.R.S. product. 88% are like my mom and they choose to wear nothing rather than be tattle-tailed on or to wear something stigmatizing. I feel very strongly about the fact that, as a child, and especially as the alpha female making the healthcare decisions for the extended family—just because you want to know doesn’t mean you get to know. It’s all about the person who’s wearing the watch; their choice, their life, their independence. If you have a medical power of attorney, then you can set up the watch, and if you don’t have a medical power of attorney, you don’t get information without the wearer’s permission.

Extending independence with dignity to all

You were beta testing with people as young as 23 years old. Were they wearers of the watch or relatives of people who would wear the watch?

They were wearing the watch. In 2015, I ran a Kickstarter campaign and raised some money to bring the product to market. The real purpose behind the Kickstarter campaign was because I knew that the Kanega watch was gonna be valuable for the older population, but I also believed that it would be valuable for other populations—the thing is, I didn’t really know who those populations were. It was a way of doing a market test.

Because of the Kickstarter campaign and the user-experience test, we decided on the broad age range because there were people, of course, seniors, but also people with multiple sclerosis, Lou Gehrig’s disease, Parkinson’s, epilepsy, down syndrome, blind people and disabled veterans.

The fundamental capabilities of the Kanega watch worked for all of these independent-but-vulnerable demographics. There are a couple of special things that we do for the blind demographic. But other than that, everybody else gets to extend their independence with dignity, utilising the Kanega watch the way that we built it for my mom.

Discoveries that helped shape the design of the Kanega watch

What do you think has been your biggest learning to date?

I can’t tell you how many focus groups we did over some of the fundamental pieces, especially the battery system in the band. Getting that trade-off between a battery that stays on the band and a battery that is easy to remove. If you’re 97 or have Parkinson’s or other central tremors or you just don’t have strength because you had a stroke, which was seriously challenging.

One of the early learnings that we’ve had in the focus groups was the way the band and the battery system were going to fit on people’s wrists and how it would look. Just to make the appearance look right, we didn’t actually build the full watch. There was the shell of the watch, and then the battery system, and the band.

We started off with the watch as a hunk of metal and used a CNC machine to cut it out, which made it significantly heavier than the real watch. We actually didn’t get any data from the focus group that we ran because all anybody could talk about was how heavy it was.

That was an interesting lesson. We realised that even though we had something that didn’t have the right pieces in it, we would always make sure it weighed the right amount. This meant that we could focus on the things that were important, especially from a mechanical, visual and style point of view.

UnaliWear’s Kanega Watch is now in production and just about to launch in the U.S. pending a final FCC approval. If you are international and would like to see a Kanega watch in your country, feel free to get in touch with UnaliWear through their website.

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