Charles Bark, founder and CEO of HiNounou, the first insurTech offer for elderly people in China, talked to H&TI about the specificities of his home care system and his ambitions for the coming years.
The innovator also shared his vision of AI and silver tech market, believing that China could lead these areas because of its proactive approach, unlike France, which is lagging behind in focusing on philosophical reflections instead of acting, according to him.
HiNounou pack is entirely focused on prevention
How did you come up with the idea of creating an insurTech pack for the elderly people?
There is an expression in China which says that the beautiful lotus flower comes from the mud. I think that the most beautiful inventions arise from the solving of a problem. And that’s exactly what happened with the creation of our company.
Five years ago, I called my mother and she told me that everything was fine. Then my brother contacted me to tell me that she had fallen. I was shocked and realized I had no way to have visibility on her health. Then I thought of weather applications that allow us to know exactly what the weather is in this or that city. I told myself that it would be interesting to set up this kind of system in order to better monitor our loved ones’ conditions and ideally to foresee their health problems. That’s how HiNounou adventure began. The company was established in 2016 in Hong Kong and we opened offices in Shanghai last year.
Your idea is to focus on prevention.
I am convinced that if we focus on prevention, outcomes will be better. Currently, care services for the elderly are generally oriented « post accident ». Artificial intelligence (AI) and connected objects allow us to change the way we care to focus more on preventive than curative services. As the French says: « prevention is better than cure ». This is HiNounou’s strategy!
What do you offer exactly?
Our solution allows to set up a follow-up at home done by the patient himself. In HiNounou package, there is a smartphone, a sphygmomanometer, an oximeter, a DNA test and an Axa health insurance contract.
The user just need five minutes per day to collect his health data. Smartphone icons are large and there are pictures to clearly explain to consumers how to use the different tools of the package. When the person uses the oximeter for example, he just has to open the app and put the device on his finger. Data is automatically transmitted to the application and the user can see thanks to a gauge if his/her results are good (green area), worrying (orange area) or bad (red area). He can also see the average of results over thirty days.
If there is a problem, our system can alert the person(s) connected to the application and the user can also call Axa for 24/7 assistance. We also work with Ping An, which offers accidental and death insurance.
The first insurTech offer in China
Your package includes health insurance for people over 65 years old. This is a first in China. Why don’t insurers have offers for seniors?
No insurance or mutual insurance want to bet on seniors insurance because they consider them too fragile. According to the World Health Organization (WHO), Healthy life expectancy at birth is 68.5 years in China, while life expectancy is 76 years (2015 figures). The period after 68 years is therefore critical.
How did you manage to convince Axa and Ping An to work with you?
What was perceived as a risky situation isn’t any more thanks to our innovation which makes it possible to reduce the risks of cardiac problems, making the average duration of hospitalizations from thirty to ten days and limiting the costs. With our offer, the rules of the game have changed. This attracted insurers!
Are you really the only one to offer this kind of solution in China?
At the moment and to my knowledge, yes we are. We managed to launch this insurTech solution because of the innovation that we brought. In order to offer the most relevant and effective device, we conducted four years of R&D in France in cardiology because the biggest health problems of the elderly are noncommunicable diseases, including heart failures. According to the WHO, of 56.4 million deaths worldwide in 2015, 17.5 million were due to cardiovascular disease, the leading cause of death worldwide.
The research work we carried out in partnership with the UTBM (université de technologie de Belfort-Montbéliard) and the CHU de Strasbourg through the program « e-care« , which was tested on 8,000 people, have made it possible to develop a system capable of detecting cardiac arrest six days in advance.
An integrated offer
HiNounou also signed an agreement with Chinese phone manufacturer ZTE. What is the purpose of this partnership?
ZTE thinks we are very innovative in the health insurance sector. Through a two-year contract, we agreed that HiNounou app would be pre-installed on some of their smartphones. For the time being, our app is on 20,000 phones, out of a total of approximately 1.2 million terminals sold by the manufacturer. We have a very good potential in terms of visibility.
What is your business model?
We buy medical devices at a price agreed with our partners Axa and Ping An. We put our brand on all these products and then we sell our package to consumers. Our asset is that we offer an integrated device.
Usually, manufacturers of e-tools or DNA tests sell their products independently. They do not about the results and consumers health. When I created HiNounou, I was thinking of a device for my mother. As she is a doctor, I had to propose a quality solution.
Our idea is to propose a set of devices that is neither product-oriented nor service-oriented but that combines both to enable the elderly to lead a healthy life. Our goal is to identify the genetic risks inherited by his parents. Once these risks have been identified, we act on prevention (follow-up equipment), and then we offer home assistance if needed.
Do you only target the Chinese market?
We are in talks with several players from other countries. We met South Korean Axa delegations, we also talked with Sodexo’s « elderly care » division to consider a deployment in the US but also with Swissray (a Swiss group that develops medical imaging equipment), with the French mutual group VYV and other insurers.
DNA tests: « Europeans are asking themselves too many existential questions »
You would like to launch HiNounou package in France but the country doesn’t allow the sale of DNA testing kits, like many other European countries. How do you plan to overcome this obstacle?
Our offer is modular so it can be adapted to any markets. If the country does not accept DNA test, we will simply remove it from the package. We can also build other partnerships with local insurers to fit the particularities of each market.
DNA testing is already considered in other countries as a medical equipment, like urine or blood test. This is the case in the United States and China, for example. The problem with Europeans is that they are asking themselves too many existential questions in my opinion. When all these countries will wake up and realize that DNA testing has become a reference from a medical point of view, they will be lagging behind.
I explained to President Macron (met during his official visit to China) that HiNounou was exactly the kind of start-up that showed the way. We import French innovation into China, we adapt it to the Chinese market with major local companies like Ping an and ZTE but also with French companies like Axa, then we add to all this a Chinese innovation, here DNA testing, and when we will have a customer database of one million people, let’s imagine the type of research we will be able to conduct to move forward and innovate more!
This will allow us to show positive feedback to France. When the country will be really interested in the silver tech market and DNA testing, we will be able to highlight the experience we get with Chinese and US consumers. We are already starting to show off in France. Our team was mandated in December 2017 by La Mutuelle générale de l’Éducation nationale (MGEN) to conduct a study in China on AI-based insurTech in order to know what can be done in France in that area. It’s a whole loop! The idea starts from France, we adapt and boost the solution throughout the Chinese market, we add a local innovation on top of it and then the product comes back to France with added value.
You were born in Neuilly and lived in France for many years. You could have launched HiNounou in France. Did you choose to set up your company in China primarily for these regulatory reasons you mentioned earlier?
Exactly. In the field of eHealth, we noticed that in France it was almost impossible to evolve because of these legal restrictions. You can’t even take a picture of someone without the risk of getting into trouble! Of course privacy protection is important, and it’s a good thing there are rules, but the law mustn’t prevent the development of research.
In China the government has understood that DNA analysis is the future of medicine because it will help advance the level of precision medicine. If pharmaceutical and insurance companies do not show an interest in this sector in the coming years, they will become the next Kodak. They will be out of the market!
« Health data privatization doesn’t exist in China »
In France, and more generally in Europe, consumers are quite wary of sharing their health data. Are Asian consumers really much more open about this or is it a cliché?
Everything is a question of culture. In China, the perception of privacy is completely different than in France. For example, all care is done in hospital. When the doctor talks to a patient, the next patient is waiting just behind and he is listening to the conversation, the door is wide open. Health data privatization doesn’t exist in China, there is no privacy in terms of care!
And, let’s be honest, in France, when a patient performs medical tests, who knows exactly who has access to his results? It’s important to make every effort from the technological point of view to protect health data, but we have to stop believing that access to this information is completely restricted.
According to Mr Bark, China will lead the AI and silver tech markets
Do you think China can become a leader in the global health tech market, especially in the areas of artificial intelligence and home care?
Of course. AI is based on big data analysis. The more data you get, the more powerful artificial intelligence and algorithms you will have. China is much more proactive than France, for example, because they consider it’s more interesting to launch the innovation first to perceive its potential rather than starting with the introduction of laws. The idea is to collect as much data as possible and then weigh the pros and cons.
Besides, one of China’s great assets is its big population. This allows us to launch our product on a large scale in a single market and to draw conclusions quickly. China and the United States are both at the forefront of artificial intelligence, but China is ahead of the United States regarding the number of potential consumers. In addition, the government is much more flexible at the legislative level and Asian consumers, especially the elderly people, are more receptive to high tech than US consumers.
In your opinion, could China also dominate the global silver tech market ?
We conducted pilot tests on seniors. When we asked them if they thought they will have trouble using a smartphone, they didn’t understand why we were asking that question. And that was also the case for people over 80 years old. Here, elderly people play with their smartphones in the subway, they go on WeChat (mobile application of Tencent), etc. All insurTech devices have much more potential in countries where digitization is already part of lifestyle.
Moreover, in China, of 230.8 million people over 60 (2016 figures), tens of millions live alone. Previously, children, and especially women, cared for their parents, but this model is dying because women are more and more active and they don’t want to be confined to a domestic role anymore. The children of these isolated elderly people will therefore be more inclined to buy home care devices for their parents in the coming years.
Besides, in 2050, almost one in two people will be over 60 years old in China (44%), said the UN. In France, it took 150 years to double the proportion of people aged 65 years or over. In China, India and Brazil, this evolution will take place in twenty years. The Chinese elderly population is already important in terms of number so if it doubles, the possibilities in the silver tech sector are going to be huge.
« Do not demonize artificial intelligence »
You are developing a companion robot to overcome social isolation. Do you think robots could become the future « friends » of the elderly people?
The opposition IA versus human doesn’t make sense. All our devices are meant to increase human power and palliate the lack of human presence. The idea is not to replace human contact but on the contrary to strengthen the link between elderly people and their loved ones. For example, the user can ask the HiNounou robot to call his son and he can chat live with him as if they were both in the same room thanks to our facial recognition system (three camera follows the user when moving) to achieve 360-degree vision.
Let’s be a little more imaginative. I am currently working with cognitive science researchers to develop a system that allows the robot to detect the user’s emotions. If the user is anxious or depressed, for example, one of the main problems of elderly people living alone, the robot can offer him to call his daughter or to put a song he likes. It could be the same for physical health aspects. If the robot notices that the person hasn’t moved so much during the day and the weather is sunny, it may encourage him to go for a walk by proposing a walk in a park near his home. The robot can become a nice companion to ensure the well-being of its user.
However, some scientists fear that AI will eventually become a danger to humans.
AI should not be demonized as it should not be deified either. AI is not about killing people. The biggest enemy of human is human. Robots just do what their manufacturers want them to do. If we think big and beautiful, we will get something that is beautiful.
When do you plan to launch the HiNounou robot?
We are currently improving our prototype and we are planning to launch the final product on the market in late 2018 or early 2019. We already offer the robot as a premium offer. Our idea is to make a name with our current mobile application-based package and then evolve it.
Our goal is to become the reference in the field of elderly home monitoring. When you talk about connected vehicles, you think of Tesla; when it comes to innovation in the mobile phone sector, you immediately think of Apple; I would like than when someone speaks about silver tech, everyone instantly think of HiNounou.
To a collaboration with the CNRS (France)
You talked with French President Emmanuel Macron during his official visit to China in January. Did you feel he was interested in your product?
I wanted to make him understand that what we set up with HiNounou on a small scale, we would like to develop it in big ways with high tech French players. With HiNounou, we aim to create an innovation hub in the silver economy because solving problems in this area requires a lot of synergy. The idea is to interconnect different multi-sectoral players so that everyone can bring their solutions. We have already launched this model at our level but we want to develop it on a larger scale. This will help to change the trade balance in China with innovation, because the country will be able to focus more on exports, here on export of devices focusing on elderly care services.
Emmanuel Macron said our solution was a very good idea and he put me in touch with Frédérique Vidal, French Minister of Higher Education, Research and Innovation, who was at his sides in China. Then she introduced me to Antoine Petit, president of the CNRS, and we began to consider a collaboration. He told me that he was ready to help us if we needed support in terms of innovation. This is a very good news for us because France is very good in innovation. The country has excellent engineers and researchers. To think very early on ethical issues doesn’t have only negative effects because in analytics, for example, researchers are struggling hard to find the best solution. It is also important to take all of these beautiful innovations out of French research centers and convert it into a business, to adapt it to different markets.