Articles

Diabetic Society of Singaporenull

« We want to reach out to 3 to 5% of the diabetic population in the next three years » through the mobile app Glycol Leap, says to H&TI Nawal Roy, founder and CEO of Holmusk. This society recently launched the mobile app Glycol Leap whose goal is to help people with diabetes to adapt their diet and physical activity to control their disease better. Health coaches deliver daily personalized advice to the patients in order to help them achieve their goal.

Since April 2016, the Ministry of Health of Singapore has declared « war on diabetes. »

Partnerships between the public sector and private companies specialized in health tech are emerging to offer innovative solutions. Holmusk is one of these firms.

Nasal Roy present Glyco Leap, this new innovative app, but also exposes his projects and his vision of the eHealth market in Singapore and more generally in Asia. He believes the city-State will become a leader in the global fight against diabetes.

Fight against diabetes, « We’ll be very kind to work with the Government of Singapore » (Nawal Roy, CEO, Holmusk)

You launched Glyco Leap in 2015…

We have been doing beta testing since last year. Since July 2016, we have officially set up our B2C strategy and open our app to subscriptions.

One of your plan offers users daily, expert guidance on diet and activity from your personal dietician coach. Who are these experts? How do you choose them?

They are all certified dieticians. We have in our health team a doctor, a group of dieticians, a fitness scientist and a psychologist. This is a very complete team.

What we believe, with diabetes, is that a big part of change is related to diet. With our application, users learn about their physical condition, the type of food they eat and how it really influences the intensity of the disease.

We go after only people with diabetes, people who have been diagnosed and all the pre-diabetics, because we strongly believe that if you control in the earliest state your diabetes, so if you do early intervention, you effectively curb the disease’s effects.

One problem you may encounter throughout your service is the lack of users motivation. The more the months and the years pass, the more they may get discouraged.

This problem of motivation is always there. So, the key part is to know how much does the user know and care about his disease. Hence, my idea is that we can be focused on that portion of the population which is more motivated to do things and is looking for a platform to help them. That is what we offer.

What are the user feedback so far?

Very good. Basically, among the people that we have signed up, the early data that we have seen on their evolution are very positive. Most of the users have been able to achieve their goal and even beyond.

What is your final objectives with this app?

We want to reach out 3 to 5% of the diabetic population in the next three years through Glyco Leap. In Singapore, it will represent almost a million people. In the US, nearly 20 million people are concerned.

The Six-months Core Programme is chargeable at S$69 (€45,6) per month, which can be quite expensive for some people. Isn’t there a risk that digital health devices be used only by the well-off ?

Not really. We are launching a new version at $ 20 (€ 13) per month. I don’t think that technologies related to e-health are reserved to a certain part of the population. Look at any diabetic person, most of them spend more than $ 1 200 (€ 790) per month on that disease. And even after doing it, they continuously spend more money as the disease gets worth and worth.

Thanks to scientific advances, we can help patients reduce their spending over the long term by encouraging them to change their lifestyle. By changing the lifestyle or by managing the disease properly, you can positively influence the evolution of the disease.

Hence, I think the service we are offering doesn’t cost so much compared to the money people with diabetes spend monthly on their disease. It would be much easier for patients if the costs related to the use of our application were reimbursed by insurance companies or the MOH.

This would be the best possible options.

If you get sick, you go to the hospital, and the expenses will be covered in part by the government, but if you want to be proactive, if you want to use a service like ours to stay healthier, the money will come only from your pocket. That is why we hope that things will change at the policy level to encourage people to stay healthy and not waiting until they get sick to help them financially.

How people with diabetes get to know your app ?

We target employers, insurance companies and clinics and we try to work with clinics and some hospitals.

Do you work with the Singapore government?

Not yet but we would like to. When we launched the project Glyco Leap, the war against diabetes had not yet been declared by the Singapore government. Now that is the case, it is much easier to work with the public sector on this subject so we initiated several projects with them on several fronts. We have not yet announced a formal partnership but we would be happy to work with the government.

Holmusk is a data analytics company. What’s your data privacy policy?

We collect and use personal data only for the needs of users and for nothing else. We will never compromise the confidentiality of such information, for any cost.

Your main priority right now is the fight against diabetes but you recently said to e27.com that your “intent is to eventually focus on every chronic disease”. Have you already some projects in your mind for the coming years?

We are already looking closely at issues related to mental health. We work with some hospitals on cardiovascular patient data as well. We want to look at all kinds of chronic diseases, from asthma to smoking-related health problems. The fight against diabetes is just a starting point.

How does your company try to make a difference, compared from its competitors and big internet companies like Alibaba?

• I think right now our team is the biggest in this specific sector. We have set up one of the best best technology data team and, on top of that, it’s a highly comprehensive team.Look at the competition, they are usually doing one thing at a small scale, whereas we aim to grow nationally and globally.
• We also create our company on a solid foundation, through reputable advisors and investors, a very important point.
• We are also working with very credible partners, such as SingHealth, renowned universities, etc.
• Finally, another of our strengths is our speed. Our executive skills are very strong.

Hence, I think all these factors make the difference compared to other companies in the market.

What aspects of your service would you like to improve?

We try to improve our tool continuously. Currently, we are focused on the early diabetic and the pre-diabetic market but we would like to extend our service to chronic diabetic market, to type 1 diabetes.

We would potentially even think of how we can include medication through our application. There is still much to do!

You are working with SingHealth to analyze a whole repository of cardiovascular data but you are also working with universities and hospitals. Do you believe partnerships between private expert companies like Holmusk and the public sector are essential in the eHealth market?

Absolutely. The public sector is about to become a key partner in the healthcare market.

You have already acquired a company, MindLinc (an electronic medical record focused on mental health), in the United States and you have opened an office in Malaysia. You also said that you would launch Glyco Leap across the Atlantic and elsewhere in Asia.

We are on the process to launch our app in Hong Kong and in Malaysia next year. We are launching it in the US as well. We are also considering right now to launch a web version of Glyco Leap.

There are many companies specializing in eHealth which have recently set up based in Singapore or which want to. How do you explain this interest in the city-State?

First, it’s easier to start a business here compared to other countries in terms of aid and taxes but I think Singapore is also attracting entrepreneurs because there is a high concentration of capital, of talent and an easy access to other Asian markets. Hence, Singapore is a good starting point.

What is your vision of digital health in Singapore and more generally in Asia?

Digital health is emerging at a very first phase in Asia and elsewhere. Stakeholders of this market are trying to solve many problems. One of the main challenges is to try to solve the inefficiency of the current healthcare system but most of them are mainly working to overcome the challenges related to access to care offerings. Right now, access to hospitals, to medicine, to health in general seems to be a privilege. We must think of solutions in this area from a macroeconomic point of view.

Do you believe Singapore can become the main leader in the fight against diabetes through health tech solutions in the coming years?

Without a doubt. Diabetes is a global problem. There is no other country in the world which has declared a war against that disease. That shows a high degree of leadership. This will, and because I know how the Singapore government is working – very effectively -, give me faith in this country. Singapore will become the world leader in this fight against diabetes.

Singapore : a state initiative to declare « War on diabetes »

In April 2016, the Ministry of Health of Singapore has declared the « war on diabetes. » This is the first time that a country pays as much attention to the fight against this chronic disease.

« The WHO recently announced that the global number of adults living with diabetes has quadrupled since 1980 to over 400 million in 2014, Mr. Gan Kim Yong, the Singapore Ministry of Health, said in April 2016. And of these 400 million, 400,000 are in Singapore – they are Singaporeans. Among Singaporeans, about 400,000 have diabetes, and one in three Singaporeans have a lifetime risk in developing diabetes; a 30% lifetime risk. »

« Of those who have diabetes, one in three Singaporeans have not been diagnosed. And among those diagnosed, one in three have poor control of their condition. »

According to official predictions, more than one million of Singaporean residents will be affected by diabetes by 2050 if no new health measures are established.

The Minister emphasized the consequences of undetected diabetes, such as:

• the development of heart disease;
• stroke;
• kidney failure;
• blindness;
• amputations …

Diabetes costs more than $ 1 billion annually in Singapore

A study published in April 2016 by the Saw Swee Hock School of Public Health (Singapore) and the University of Southern California, estimated the total economic burden of diabetes for working-age adults at more than a billion dollars a year (€ 959 million) in Singapore (2010). This amount could exceed $ 2.5 billion (€ 2.4 billion) by 2050.

« However, the long-term costs of diabetes, taking into account the psycho-social burden, is far more than this, notes Mr. Gan Kim Yong. We need to tackle the Diabetes challenge. Therefore, I am declaring War on Diabetes. We want to help Singaporeans live lives free from diabetes, and for those with the disease, to help them control their condition to prevent deterioration ».

Six-Month Long Public Engagement to Seek Suggestions on « War on Diabetes »

The Diabetes Prevention and Care Taskforce, headed by the Minister for Health Mr Gan Kim Yong and Acting Minister for Education Mr Ng Chee Meng, has launched a major public engagement exercise to gather views of Singaporeans on the issue. The proposals and relevant comments will contribute to the Diabetes Action Plan that the MOH will roll out progressively in 2017.

The campaign is divided into two stages:

• From September to December 2016: the attention has been focused « on identifying the barriers, gaps and issues hindering Singaporeans from adopting a healthy lifestyle ». The department has collected the best suggestions to promote the benefits of a healthy diet and regular physical activity, but also to encourage Singaporeans to carry out regular monitoring and follow their doctor’s recommendations.
• From January to February 2017: the objective is to « focus on eliciting views on specific measures and initiatives proposed during the first phase ». To encourage as many citizens to join the debate, an online public consultation will be launched. Each participant will give its opinion on the ideas presented in the first phase of the campaign and will explain how this or that initiative seems to be more effective than another one.

After February, the Taskforce « will study the feedback gathered, and evaluate the feasibility of incorporating the proposed measures into the Diabetes Action Plan ».

War on diabetes: the first assessment is encouraging

In November 2016, the Ministry of Health of Singapore presented the first results of the campaign. Over 1600 responses had been collected so far. « We have received good ideas on how we can encourage Singaporeans to adopt healthy lifestyles to fight diabetes », the minister said, such as « focusing on making healthier food and drink options more easily available, while others who responded proposed expanding fitness programmes in the community to make exercise more accessible and convenient ».

• A mobile bus clinic

« We will continue to engage and work with key stakeholders, including the patient and caregiver community, Mr Gan Kim Yong said. I am happy to note that DSS has been an important partner in diabetes management. For example, DSS has a mobile bus clinic that accepts referrals from general practitioners (GPs) for foot and eye screenings. These support services enable GPs to provide more holistic care, which is integral to good diabetes management. DSS and its partners also provide financial assistance to low-income families for medical products and educational programmes ».

• Outreach programs

The DSS has also been active in raising awareness and prevention. In particular, it has launched outreach programs « disseminated through nurse educators, talks, forums and workshops ».

• Lifestyle modification pilots in community centers to coach high risk individuals

Furthermore, in partnership with public healthcare institutions and grassroots organizations, the Takesforce has launched community-based pilot interventions to help high risk people to modify their lifestyles by setting goals and coaching health programs. For example, a lifestyle modification pilot has been initiated within the Community Club Toa Payoh West to learn residents how to eat healthier. Personal goals have been set for each of them to encourage them to adopt a healthier lifestyle and thus better manage their diabetes.