Huma wants to bring the hospital to your home
“Technically speaking,” says Dan Vahdat, the 36 year-old, Iranian-born, London-based medtech entrepreneur, “no one should die of heart attack.”
Such crises, he explains softly, are the consequence not principally of ill health but of poor medicine — a failure to intervene months, if not years before the attack.
“If we had continuous diagnostics, we should be able to predict a lot of people will get certain diseases a lot earlier. And as a result they won’t have the complications. And if you don’t have the complications, the tragic things won’t happen.”
Vahdat’s company, Huma, is in the business of providing precisely such diagnostics, transforming your smartwatch or phone into tools to replace the expensive kit in hospitals. Known as remote patient monitoring (RPM), such systems can keep track of a raft of vital signs all the time, rather than just when you visit a doctor.
Bringing the hospital to your home
Many smart watches already boast blood oxygen and heart rate trackers. But Huma has also invested in tech to track mood or deliver standard tests for Parkinson’s, expanding the range of conditions which it wants to assess at a distance. Its app can then relay that information back to doctors, notifying them if things take a turn for the worse.
Understandably, given the pandemic, the NHS has been keen to roll out RPM, shielding GPs from infection and, hopefully, admitting patients to hospital only when truly needed.
Last April, Huma helped set up a number of “remote Covid wards” in a small NHS trial. The result, according to an NHS assessment published at the end of last year, was fewer GP appointments made, fewer patient hospital admissions and re-admissions, as well as doctors’ time and money saved.
Now the company (valued at around £160m of which Vahdat owns a quarter), is set to announce a series of new deals to help the NHS deal with the backlog of cases that Covid has caused with other conditions. Swollen waiting lists, missed scans, operations and delayed treatments are certain to be responsible for a secondary toll, hidden by the current pandemic.
Macmillan has estimated that around 50,000 cases of cancer are now undiagnosed as a result of patients who would have had lumps checked in normal times, staying away from GP surgeries.
In the upcoming trial, the entire waiting list for hip and knee operations at seven NHS trusts will be asked to download a Huma app which records symptoms and movement ability — information that will then be used in real-time by doctors to triage for those who are the most needy yet also well enough to undergo the procedure.
A pilot of the scheme, in two private clinics, found it led to fewer operations cancelled at the last minute — a frequent blight on resources. Huma is already running a similar scheme for the cardiac surgery list at the Royal Brompton and Harefield NHS Trust, “then the plan is to roll it out for other areas and illnesses”.
Dan Vahdat, the founder of Huma
Credit: Huma
In that way, explains Vahdat, a tall, languid figure whose accent hints at both his Iranian upbringing and American education (at Johns Hopkins University), Covid has enforced technological transformation in the delivery of healthcare.
“It’s the kind of disease that really is suited for [RPM]. The patient, if they’re [mildly] sick shouldn’t go to the hospital. The doctors… can’t get sick, because if you have all your doctors sick, then you have no healthcare.” And now that Covid has helped us get used to the idea, there is no reason, Vahdat says, not to roll it out to a host of other conditions. Covid is, he says, “a really interesting moment… which has led to a lot of pain.”
Ultimately, though, he thinks it will be positive for medicine. “Looking back we’ll have this bit of a smile around it. It changed us.” RPM has a specific trio of benefits, he says.
First is the continuous risk profiling — identifying patients trending towards chronic sickness who would benefit from “delightful moments of behavior change to, say, decrease their chances of diabetes in 10 years by 50pc.” Then there are the diagnostic advantages, picking up the early warning signs of heart attack. And finally therapeutics — not pills, but the precise dietary or exercise regimens to improve health before sickness strikes.
‘We can be the most impactful company in the world’
The combination, he says, will lead to the NHS provision of personalised preventive healthcare, “almost like a Spotify that you subscribe to, always on 24/7 in your pocket. And hospitals looking after you, as soon as they see something that might go wrong in 10 years from now, they start nudging you…” Virtual Covid wards, with their patients at home, feeding data through wearable devices to doctors is, he says, an early example of such predictive care.
“You’re looking at your patients, you’re picking them before they get to those complicated situations” which might require ventilation and the rapid deterioration for which the disease is notorious. It is a vision that, by preserving the well, reverses the traditional medical formula of curing the sick. And by that measure it is certainly a field which could propel Vahdat to his ambition.
“I think we can be the most impactful company in the world,” he says, somehow managing to sound humble at the same time. With that, he admits, would come massive scale. The problem is that the web’s existing giants — including both Google and Apple — have also identified health as an extraordinary opportunity for growth.
“There are alligators,” admits Vahdat, “And it will take a long time until we can be one of the alligators ourselves.”
In the meantime Huma has been trying to partner with the big beasts rather than compete with them. The result has been distribution agreements with Amazon, and App store fast-tracking coordinated with Apple. One of the reasons there is so much interest is, naturally, data.
Personal data has become the currency of the internet age, and no data is more personal than health data. The kind of predictive insights that Vahdat describes will require huge quantities of the stuff, using the experiences of countless patients to help inform and treat others.
Securing such undoubted advances while respecting privacy concerns is of the great balancing acts of the healthtech field and has already tripped up, among others, Google (as well as the NHS itself).
Vahdat is relaxed on the issue, noting that while Huma “keeps data secure”, millions of people already share intimate information on messaging services or email. “The way I look at it, between my medical data versus my messages, my WhatsApp conversation, or my email, if one of them should be public, I prefer my medical data. And I think most people are in that camp.”
The project has already had to overcome the doubts of its most important sceptic. Vahdat’s father is an Iranian cardiologist who, like many doctors, hoped and expected that his son would follow in his footsteps.
When Vahdat dropped out of his medical PhD to found Huma “my father was really disappointed. And I told him, ‘You look at patients, maybe at best you can see 100 per day. We will get at some point to a place that we will see 10,000 patients in one day. We can have unlimited impact, almost. So that is cool.”
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