A test lab in your smartphone

Healthy.io and the slow revolution in healthcare

Since shortly after the smartphone revolution began, I’ve been told that these devices packed with sensors are going to transform healthcare. All sorts of innovations have been promised, from heart monitors to skin disease trackers, but few have yet to be deployed at scale on the clinical frontline.

So I was intrigued to hear about an Israeli business called Healthy.io which has won big contracts with the NHS for services that allow tests normally done in a lab to be carried out on a smartphone.

The company was founded in 2013 by Yonatan Adiri after a career which at 26 had seen him appointed Israel’s chief technology officer by Prime Minister Shimon Peres. When I went to meet the company’s London-based Chief Commercial Officer Katherine Ward she told me that Adiri’s lightbulb moment had been about the sophistication of the smartphone camera as a collector and inspector of data:

“He realised that the biggest investment in technology is actually into the smartphone camera because of the billions of selfies uploaded to the cloud every day. And if you think about 2013, it was right on the cusp of the Kardashian selfie revolution.”

Much of Healthy.io’s success is about getting people to take pictures of something rather less glamorous, a dipstick dipped in a urine sample. Urine tests are the second most common diagnostic tests that the NHS undertakes, after blood. Until now they have involved either coming in to the GP surgery or hospital to have a test, or somehow getting a urine sample to the lab.

Now, the patient can do it at home. After the dipstick has been removed from the sample, it’s placed on a colour chart, and then the Healthy.io app uses the smartphone camera to examine it.

“That image of the dipstick on the colour board goes back to our UK-based cloud, the algorithm runs through it, and it translates the image into clinical grade results,” Katherine Ward explains. Years of painstaking research have gone in to making this work: “We've essentially taken 15 million images over the last eight years to train an algorithm to allow the camera to identify change in colour, in arbitrary light conditions with arbitrary phones.”

One example where the home testing kits have made a difference is with kidney transplant patients. If they get a urinary tract infection when they are sent home after an operation that can be both dangerous and costly - they may end up needing another kidney.

Usually they are sent home with strict instructions to call the doctor about a test if they have the slightest symptom of a UTI. That can mean a gap of five to six days between symptoms and treatment by the time it has been arranged for the patient to visit the hospital and the results of the test have come through

“We've got it down to three to four hours because immediately it became ‘Okay, good, we've got the result, let's get going’.”

Another version of the kit is being sold in chemists, aimed at women suffering from cystitis. They can then take the results direct to a pharmacist and get a prescription for antibiotics. At the moment this is a private service but the first NHS rollout is underway in Lincolnshire and the hope is that it can take some of the pressure off GP surgeries.

Now, the first great innovator in diagnostic testing appeared to be the “blood test from a finger prick” company Theranos, whose founder Elizabeth Holmes was convicted of fraud last year. The collapse of the once feted Silicon Valley startup has cast a shadow over all medtech startups - “it has gone from ‘why can’t you be more like Theranos’ to ‘you aren’t like Theranos, are you?’ one entrepreneur told me.

Hopefully, ambitious young startups have learned the lesson that the “fail fast and iterate’ philosophy that works for a gaming or social media app is not appropriate when it comes to health.

After years of clearing regulatory hurdles, including having its app approved as a medical device, Healthy.io appears to understand that and is beginning to make a contribution to boosting NHS productivity. Finally, the smartphone revolution, which has changed the way we shop, travel, bank and even date, is beginning to change the delivery of healthcare.