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Innovation in Israel - IoT

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Paying Full Attention to the Body

You think we're close to our smartphones? Wearable devices enable the human body and those of our pets to reliably, objectively and continuously communicate with sophisticated smart systems. 

Wearable devices (wearables) are computerized accessories that can be worn or attached to the body. The IoT enables these accessories to gather information and communicate with computerized systems or with other accessories, and even gain far-reaching insights – among others, through use of big-data, machine learning and artificial intelligence.   

Wearable technology allows us to embed things such as sensors, cameras and screens in items of clothing and gadgets that we use on a daily basis such as clothes, glasses, shoes, watches and others. Applications of the computerized accessories are extremely varied – from entertainment and fashion to security, communications and fitness. Two of the products sold in this field are Google's smart glasses and Apple's smart watch.

"The Innovation Authority supports a wide range of companies developing groundbreaking technology", says Tzachi Schnarch, Director of the International Collaboration Division at the Innovation Authority. "The companies in the field of wearables that are supported by the Authority are, among others, also developing solutions that integrate artificial intelligence (AI), for example, smart-bands and smart watches that are designed to help users implement their fitness training program or accurately monitor physiological indicators for referral to their doctor. The accumulated data assists development of advanced methods for predicting disease, and of innovative treatment methods."

As we will see, with the help of the following two Israeli technologies, one of the areas in which wearables are causing a real revolution is the monitoring of both the human body and that of dogs and cats, which enables a greater degree of knowledge than can be expressed in words, and utilization of the data in order to preserve our health.


A Finger on the Pulse 

At first glance, 'Oxitone' looks like a sophisticated digital watch, one of many such watches that have become commonplace in recent years. But appearances can certainly be misleading, because this is actually a medical band aimed at allowing a significant shortening of treatment duration, continuous monitoring of vital signs and, in practice, to save lives.

Dr. Leon Eisen, a physicist and graduate of the Weizmann Institute, worked as a physicist and engineer in several companies until he realized that it was in the medical field that he could make a real breakthrough. Dr. Eisen founded 'Oxitone' in 2010 following a personal experience that ignited his imagination: he realized that sick people need continuous monitoring and not only while they are hooked up to medical devices in hospital. The Innovation Authority's incubator in Ashkelon gave their support and initial backing for R&D and continues to do so today.

"The idea behind the R&D was that the body can actually transmit vital signs to a device that will be capable of monitoring them continuously and comfortably." After surveying various solutions in the field of wearable technology, Dr. Eisen chose to develop a watch-like medical band.

"We are all familiar with the oximeter – a pincer-like device that is the most common means for measuring the level of oxygen in the blood. Patients are given it in the hospital ER and remain connected to it throughout their stay in the hospital", Dr. Eisen explains. "However as soon as the patient is discharged and he returns home, the measuring and monitoring stop. This is not easy for someone who has just undergone surgery or illness from which he is still recuperating and is also one of the reasons that, for example, 21% of the patients who are discharged from the Pulmonary Department are re-admitted to hospital within a month."

"Although there are already devices and stickers that measure different indices related to heartbeat, what we are doing is completely new", Dr. Eisen explains. "What makes our product different is the ability to measure the level of oxygen in the blood as well as the pulse and skin temperature – all with a digital wireless band worn on the wrist, just like a watch." Oxiton is the first company in the world to receive FDA approval for a wearable medical wristband that measures medical signs on a clinical level.

The Oxiton device doesn't just make do with measuring medical signs but is also connected to an application that helps the medical team, the patient's family and the patient himself provide him with real-time treatment. The platform combines artificial intelligence which enables hospital-level ambulatory diagnosis even when the patient is in a home environment or other location far from his medical team. Artificial intelligence even enables to predict what to expect over the next few days, if complications are expected and if there is a need for hospitalization. 

Hospitals today have many programs aimed at reducing the number of returning patients, but for whom all the supervision is done manually: the nurses call the patient every day to ask how he is doing. It's not only an expensive solution, it's also lacks real effectiveness – the patient doesn't have any real data on his vital medical signs and his response is based solely on how he feels. 

"By contrast", says Dr. Eisen, "our platform performs the monitoring both automatically and continuously: a patient is discharged from hospital and continues receiving the same monitory level of treatment in his home as he did in hospital. If his condition worsens, the system alerts the medical team and informs the patient what to do."

"We know that many patients with irregular signs become pressured and don't press the button for help even if they have one. Oxitone issues a warning about their condition even if they themselves are passive – and can thereby save their lives. It is interesting to note that our system also assists in the opposite direction, by preventing 'false alarms' of the patients or their families which would have involved an unnecessary trip to the hospital."

"The platform provides a response for the three most important values in the world of healthcare: it enables an earlier release of patients to home supervision, it facilitates high-quality medical treatment in the home, and it enables the lowering of treatment costs. A shorter stay in hospital reduces the risk of exposure to disease, alleviates the congestion in hospitals and enables individual care in comfortable home surroundings, which themselves contribute to recuperation."

"We recently completed the approvals stage and will beginning selling the platform in the US during the next few weeks", says Dr. Eisen. "There is a lot of interest in our system and a genuine desire to adopt the technology. We are undertaking all the tests and improvements required in order to launch the product onto the health market."

"Today, patients who are discharged from hospital receive the device for 30 days – and are extremely reluctant to return it. I noticed that many of the health suppliers approaching us are interested in the device because, among other reasons, they want to be able to treat their parents and see what is happening with them in real-time."

Oxitone is presently intended for patients and not for healthy people. "We are only marketing the platform to people who really need it, not just anyone who wants to feel safe", Dr. Eisen explains. "We are not engaged in 'wellness', but with saving lives."

Among the intended patients are those suffering from lung disease and at risk of incurring brain damage due to lack of oxygen. It is important to supply these patients with exactly the amount of oxygen they require and to ensure that they receive it. Today, such patients receive a home oxygen device and need to operate it themselves. "They do so without any indication as to the amount of oxygen they are receiving and how it affects them. By contrast, when the device is connected to our platform, it is activated automatically via biological feedback", Dr. Eisen explains. 

Despite Oxitone's groundbreaking technological sophistication, the company is proud of the device's simple and easy use – an attribute that encourages the patients to respond and makes the medical team's work easier. The advanced solution is protected by four patents in the US. At the same time, development and design work on the device continue unabated as Dr. Eisen explains: "In the coming weeks we will launch an even more sophisticated device which is smaller than Apple's watch."

"I currently have an even bigger vision", Dr. Eisen summarizes, "I understand that if it's possible to continuously receive all these signs from the body, I can also build learning tools that will help explain to the body to use bio-feedback in order to treat itself."


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Let the Animals Say What Hurts 

PetPace is showing just how creative and far the field of wearable technology can go. Avi Menkes, the company's CEO and one of its founders, comes with a background of decades in computer science and a wealth of experience in the field of remote sensory systems. "We live in a world of sensors", says Menkes. "You just attach a sensor to something and it starts transmitting data. It's usually information about electricity, valves, etc. but we have taken it in a completely different direction. We thought how to take remote sensing technology and apply it somewhere there is a real need – like animal health."

"67% of dog and cat owners regard them as a close member of the family. Unlike humans, animals cannot speak. They can't tell us when something is bothering them physically or if they have a medical problem. Moreover, when a problem exists, their animal survival instinct is to conceal it. Sensors, on the other hand, can enable the animals' body to tell us what is happening to them and to decide on intervention when required."

"The concept of a 'connected pet' belongs to the world of IoT in which almost everything can be connected to the internet, enabling us to follow it and connect it to activation of other products. For example, a smart collar can tell us when a dog's temperature starts rising and then activate the air-conditioning at home."

People can be connected to sensors that use oximetry technology - non-invasive monitoring devices that sit on the finger or hand. However, as Mr. Menkes explains, these solutions don't work with animals because of their fur. "We believed we could find a solution. We started working on this idea in 2012. We were three founders: the veterinarian Dr. Asaf Dagan, Avner Schneur and myself. During the initial years of the product's development and assimilation into the veterinary market, PetPace received several projects from the Innovation Authority."

"Following a lengthy and difficult process of development, we invented a collar with non-invasive sensors that sits on the neck of the dog or cat and monitors all its medical signs. These include temperature, pulse, respiration and HRV – a heartbeat-related index that tells us if the animal is suffering from pain, stress or other medical conditions. We can also calculate the animal's level of activity and how many calories it expends and to receive a report on all its body positions. The system not only monitors the data but, using a range of various mathematical models, can also identify if a problem arises. Upon identification of a problem, it sends a warning to the pet's owner or the veterinarian. The system has several international patents regarding its mechanism and innovative algorithms, for example the ability to evaluate temperature in an accurate yet non-invasive manner."



"In practice, the system is capable of a Bio-Response analysis of what is happening to the animal. It is also capable of identifying the influence of things like diet and medications on the animal, and the significance of these influences. Using Artificial Intelligence, the system learns a great deal about animal-related issues and problems. For example, the system can identify pain with an index that no other wearable has – HRV (Heart Rate Variability) – with which we can identify pain and stress without even seeing the dog, simply by analyzing the data that its body continuously transmits."

"The system has been validated by experts at universities such us UPenn and NCSU in the United States and at the Bio-Medical Engineering Department at Tel Aviv University, and was found to be very accurate. Apart from the obvious technological achievement, this device also allows us to protect our beloved pets' health and to provide their owners with peace of mind that should something happen, they will be aware of it at an early stage, while it is still possible to treat or prevent further deterioration."

"There were cases where we genuinely saved the lives of dogs and cats. One such example is of a cat that appeared perfectly healthy to its owner, but whose HRV was low. The owner decided to listen to the system and took the cat to the veterinarian who ran some blood tests and discovered that it had a disease called Hyperthyroidism. Without the correct treatment, the cat's condition would have deteriorated, even resulting in its death."

"We are working on specially designed applications for guide dogs for the blind and dogs which work in drug identification etc. For example, we checked dogs used by the US government along the border with Mexico. We found that these dogs are at a constant level of high distress and therefore more vulnerable health-wise. We also saw which activities help reduce the stress, such as taking the dog home at the end of the day instead of leaving him in an enclosure." 

"Taking a dog from the moment it is born and transforming it into a skilled work dog is a process that takes around 2 years and an investment of between USD 30,000-50,000. There is great importance to protecting the health of such a dog. Although we haven't done it yet, we believe that using advanced analyses of their biometrics, we will be able to predict which dogs will complete the course and succeed in action, thus optimizing the selection process."

Another important aspect is the ability to monitor the health of a blind person's guide dog. Its owner is reliant upon the dog but has difficulty in visually identifying if it has a physical problem. The goal is to make this technology accessible to the blind so that the system will report to them whenever a problem arises with the dog."

The final PetPace product is made up of two elements: the physical collar and the monitoring service. The collar weighs a little more than 40 grams and comes in three sizes that are suitable for cats and dogs weighing 3.5-80 kgs. These collars were released for sale to the general public in 2015, mainly to the US market. The product recently arrived in Israel with the price of the collar and service ranging between NIS 500-1,000 a year.

"Because thousands of dog collars have already been sold, we have accumulated a vast amount of big-data", explains Menkes. "We are close to a billion points of big-data – the largest database in the world in this field. Consequently, pharmaceutical companies have expressed significant interest in our development and diagnostics. Our data enables us to observe diseases like epilepsy and understand what seizures look like."

"Our vision is to improve the preventative healthcare of dogs and cats worldwide; to give them a voice so that we can intervene at an early stage and help them avoid suffering."


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