F103 How are smart garments making remote patient monitoring comfortable? (Laurent Vandebrouck, Chronolife)

”If you get certified in France you can sell everywhere else,” says the CEO of Chronolife Laurent Vandebrouck about the rigor of the French regulation and certification processes.

“The procedure for medical devices to be certified are the same throughout Europe. You need to get the CE marking. However, at the level of the way you are allowed to manage, collect and store medical data and patient data is different from country to country. In other words, there are European directives, but countries are free to adapt their directives and strengthen the rules and regulation as far as data security is concerned. And this is exactly what happened in France. The constraints and the regulation regarding data security are very, very strict,” explains Laurent Vandebrouck.

With a higher than European average spending of 11.5% of GDP on healthcare and good health outcomes, France has been regularly lauded for the high quality of healthcare provided. Yet, as written on the Health Advances Blog, the country has often been perceived as a laggard in the digitalization of the healthcare system. At the forefront of all initiatives is the long-awaited ‘Dossier Medical Partagé’ [DMP], a fully interoperable Electronic Medical Record for all French residents covered by health insurance. After several setbacks, the nationwide DMP roll-out has officially been ongoing since 2018.

For digital health startups, France is a challenging country because there are many small insurance companies one needs to negotiate with in order to reach scale. That is a stark contrast compared to the USA, where you immediately get access to tens of millions of users when signing a contract with an insurance company. “It's very important for startups to go on the international market and commercialize their solutions and services in many different European countries,” mentions Laurent Vandebrouck.

What are smart garments?

Chronolife is a French company innovating in the space of smart garments for remote patient monitoring. Clothes are not the main innovation of the company, their secret sauce is a patented neuromorphic (bio-mimetic) algorithm, HOTS (Hierarchy Of event-based Time-Surfaces). The algorithm detects and predicts deterioration in patients’ state of health and alerts caregivers to allow earlier intervention and avoid costly hospitalizations. While the company uses the algorithm in its smart garments, it could be used by providers of other wearable solutions.

Chronolife operates mostly in countries that have in place laws and regulations regarding remote patient monitoring. In Europe, those are France, Germany, Scandinavian countries .

The company’s mission is to enable healthcare professionals to have timely information for earlier intervention and to ensure a continuum of care that fills the existing gaps from hospital to home.

In 2019 the company launched Nexkin, a washable smart t-shirt that monitors six key physiological parameters, including heart rate, breathing, temperature, and activity. The company invested a lot in creating a usable T-shirt.

It can be washed as a standard garment without the need to remove electronics. “This has been a really huge investment on our side. If we want remote patient monitoring to be a success and really improve the quality of life of the patient and improve the patient outcome, the key element to achieve adherence is to make remote monitoring so seamless that the patient forgets about it. Medical devices or wearables need to be comfortable but also used as a standard T shirt otherwise, you will immediately face issues of adherence of the patients to the remote patient monitoring service,” explains Laurent Vandebrouck.

Can you destroy a smart shirt?

Chronolife T-shirts are washable 40 times. “And in fact, the issue of the wash is not really with the electronics fully integrated into the T-shirts. It got more to do with the textile that we use; the more you wash it, the more the elasticity of the T-shirt is affected and the sensors are not completely on the skin anymore. This results in more and more noise and a decrease in the quality of the measurements. But we guarantee 30 to 40 washes, which is pretty good,” says Laurent Vandebrouck.

Tune in for the full discussion:

Some questions addressed:

How would you describe/ assess the digital health status of France at the moment? You are the CEO of Connected Health Development which supports Medtech, Pharma, and Insurers to define, develop and launch their connected and digital health service offering for RPM (Remote Patient Monitoring), prevention, and/or therapeutic efficiency programs.

You worked for Qualcomm for eight years since 2001 and 2009, while this is over a decade ago. Can you make any reflections about the French vs. the US healthcare system? What would you say are the positives in France from the viewpoint of an individual to the viewpoint of a CEO of a startup?

How has COVID impacted digitalization these efforts and how does the national digitalization relate to Chronolife specifically?

Chronolife, a French AI company specializing in HealthTech. In 2019 you launched Nexkin, a washable smart t-shirt that monitors six key physiological parameters, including heart rate, breathing, temperature, and activity. Let’s start with the basics. How durable are clothing with sensors, how demanding is the care for them?

Do you ever come across potential customers that would worry they would destroy the clothing unintentionally?

The Keesense t-shirt enables healthcare providers to continuously monitor six physiological parameters - ECG, physical activity, abdominal and thoracic breathing, skin temperature, and pulmonary impedance to detect edemas. Are these t-shirts only used on prescription? Are they covered by insurance? Do you have any B2C customers and in which cases do people decide on such a purchase?

In July this year, you announced a partnership to accelerate the deployment of a non-invasive telemonitoring solution that aims to facilitate remote monitoring of chronic patients during the COVID-19 pandemic. After two months in this project, is there anything that you can share?

You are working on several chronic conditions and use-cases such as heart failure, sleep apnea as well as postoperative follow-up in order to bring to these patients the benefits of real-world continuous remote monitoring. How would you describe your position in contrast to other wearable solutions?

In 2015 an investor said to me in an interview that wearables are not interesting to investors anymore, because they are much more interested in other kinds of sensors such as ingestibles, imbeddables etc. I assume you disagree?
How do you see the future where there is an expectation that data will be acquired at a distance with no contact with our body or skin?