John Fletcher CA, CFO at MySense, explains how AI is set to transform elderly care
By CA magazine
28 April 2022
MySense is an innovative AI-powered solution designed to transform elderly care. CFO John Fletcher CA tells Christian Koch about tech-savvy pensioners, easing the strain on the NHS and the ethics of bathroom sensors
When Margaret, a 93-year-old grandmother living alone in a one-bedroom Stirling flat, wakes up at 7.15am, the first thing she does is boil the kettle to make a cup of tea. It’s the first of four hot drinks over a day that also sees her make seven visits to the fridge, sit in her armchair for six hours 46 minutes and use the bathroom five times. By the time she falls asleep at 10pm, a staggering 15,000 data points have been collected on her comings and goings via web-connected sensors dotted around her home, plus a Fitbit-style smartwatch on her wrist: information that immediately pings its way to her caregiver, as well as her daughter in Toronto.
So far, so Orwellian, you might think. But the data gleaned from Margaret’s travels around her home has tangible health values that could see the pensioner live at home for longer. The sensor on her fridge door? It provides insight into her nutritional habits, letting her caregiver and daughter know she’s eating regularly. The device attached to her kettle and taps? She’s staying hydrated. The smartwatch monitors her heart rate, while a belt wrapped around her mattress looks for changes in sleep patterns. And a sensor on the toilet lid can identify possible health issues by the number of bathroom breaks.
It’s all part of a service provided by MySense, one of a growing number of AI-led “age-tech” firms set to transform elderly care. As CFO John Fletcher CA explains: “MySense builds a digital portrait of [an individual’s] health that in some cases is able to give clinicians weeks of advance warning [about illnesses] based on tracking the data.”
In doing so, the technology can help seniors enjoy more time living in the comfort of their own home – around six months extra independence for each patient, according to MySense research. “To be able to say to those with dementia, or the frail and elderly, that you can stay in your own home for longer because the data shows you’ve been looking after yourself can be a massive event in their lives,” says Fletcher.
As such, it provides peace of mind for families, particularly those reluctant to place parents in a nursing home. “People have told us they feel reassured when checking their phones in the morning and seeing that their mum has got out of bed, made a cup of tea and visited the fridge. It means they don’t have to worry about them so much at that point in time,” says Fletcher. For those patients with dementia, tracking daily activity can show “whether somebody has left the house and not come back”.
Allowing worried relatives to keep tabs on their older family members isn’t the only way MySense can help. By reducing the need for round-the-clock supervision, it could lead to a fall in demand for caregivers, of whom there is a shortage in many western economies. The platform may ease the strain on health services by reducing the number of emergency calls and medical appointments, while the data gives doctors the opportunity to refer patients for tests earlier. One NHS/MySense study of dementia patients using the sensors found that unnecessary emergency hospital admissions and GP visits fell by 43% and 62% respectively, resulting in savings of £13,742 per patient.
Ups and downs
MySense was founded in 2016 by Lucie Glenday, a digital strategist and self-confessed data geek, who felt compelled to create a healthcare solution after her 23-year-old sister died of a rare form of motor neurone disease. At present, the firm operates a B2B model, selling to the NHS, care homes and assisted living facilities. It has also set its sights on selling direct to consumers: Fletcher estimates its eight sensors, plus smartwatch and home hub, could retail as a £400 package.
Conditions seem ripe for the company’s mainstream appeal. First, there’s the demand for wellbeing apps and health-tracking wearables such as Fitbit and Apple Watch, which soared during the pandemic. The second is the sheer scale of the elderly market: the number of people aged 85 and over is projected to double from 1.6 million in 2016 to 3.2 million by 2041. Around 3.6 million older people live alone in the UK, while the combined annual savings of those in retirement, in 2015, was estimated at around £49bn by ILC-UK and Prudential. These older cohorts are also more tech-literate than were their predecessors; baby boomers set to enter their seventies and eighties this decade are no longer “the generation that tech forgot”, but au fait with iPads, Instagram and IP addresses.
Theirs is a demographic that is increasingly likely to have their care catered via algorithms. If a retiree takes a tumble in their residential home, then fall-detection technology can alert their caregiver straight away. And the ever-present spectre of elderly loneliness – as damaging as smoking 15 cigarettes a day according to one study – may be eased by robots such as ElliQ, Pepper and GenieConnect, which are currently spinning around some UK nursing homes. These mechanical helpers use AI to hold simple conversations, host trivia games and play residents’ favourite music (particularly helpful for dementia patients), as well as reminding them to take their medicine.
As ever with AI, alongside the benefits, there are questions about potential harm, not least privacy concerns. “Ethics went into the brickwork of MySense from day one,” says Fletcher. The company, which recently established an internal data ethics committee, stresses that it doesn’t monetise or sell the data that it gathers on its users. “We could have integrated with Alexa or included a webcam in sensors, but our approach has always been to leave data ownership to the end user and make them feel in control… We’re striving to use AI for good.”
Issues around gender, racial and cultural bias have been observed in other AI healthcare tech, such as apps used for diagnosing skin cancers, which could be less accurate for users with dark skin according to University of Oxford research. Fletcher says MySense spends “a lot of time building anti-bias mechanisms into our algorithms. For example, we know and account for the fact that diabetes presents itself differently across different ethnicities.”
AI health- and age-tech could also encounter challenges with insurers if they feel the AI has over-promised. “If a healthtech provider says, ‘there’s no chance you’ll get a heart attack or develop gallstones or arthritis based on the data we’ve collected with your genome or medical history’, that could be profoundly pernicious,” says Fletcher. He also raises his concerns that “as with all new technology, it may not be available to the poorest people”.
In principle
Fletcher is well equipped to deal with the business challenges of advancing technology. The CA began working in telecoms in the 1990s, a time when “everybody thought mobiles were glamorous and exotic”. His career in the sector included nine years as director at KPMG, where he helped nations such as Iran, Iraq and the Bahamas build mobile networks and phone licences. Before joining MySense last year, he spent three years as a consultant, helping Malaysia switch its mobile network to 5G.
Throughout this, Fletcher says he has been steered by the “ethical commitment” that comes with qualifying as a CA. This principles-based approach to business not only helps him navigate the moral maze that comes with marrying AI and health, but also provides “discipline and focus on finances… investors and clients will always favour talking to the visionary entrepreneur over the CFO, but they want confidence this vision is [backed up by] properly controlled finances and rigorously tested projections that aren’t just a back-of-a-fag-packet calculations”.
The pandemic has presented challenges for MySense. The severity of the crisis meant the NHS and care providers “only had one thing on their mind for two years”. The social care system similarly struggled to adapt. But this is precisely where AI-based solutions have an opportunity to relieve the cost and staffing pressures affecting the sector. And, in turn, the opportunities for MySense look bright.
“I think as people become more demanding [about healthcare] and families more concerned about elderly relatives, MySense is in a good place,” he says. “We can’t stop chronic debilitating diseases – that’s not what we’re trying to do. But what we can do is allow data to enhance the quality of life of so many elderly and frail people, or those with dementia. To know they can live independently for longer is great news.”
