

Amulyte (YC S13) is Building a Better Lifeline For Seniors on the Move - jacalulu
http://techcrunch.com/2013/08/16/yc-backed-amulyte-is-building-a-better-lifeline-for-seniors-on-the-move/

======
kyro
I'm super-impressed and really happy to see this recent batch of YC companies
tackling some very underserved and unsexy problems.

While Amulyte is not a new idea, I do think their product is a much-needed
improvement on what's existed for some time. But will that improvement be
enough for it to be a widely adopted product? I don't think so. Products
offering similar solutions have been around with moderate levels of success,
and neither seniors nor their caretakers are technologically savvy enough to
see an accelerometer or self-quantification as selling points. And while
selling to nursing homes might seem a good idea, they're already relatively
well-monitored settings that account for only 20% of deaths due to falls in
people ages 65yo+ [0].

I think this is mostly a marketing issue, and an interesting one. This is a
morbid product. Buying it acknowledges to some degree that you're old, and on
your way out. It's not like life insurance where you buy it once and don't
think about it. Nor is it like taking medications that are _contributing_ to
your health. A product like this serves as a constant reminder of your
fragility while not providing any immediately obvious benefit. Imagine putting
it around your neck every day. Beyond the inherent psychological barriers that
a product of this nature can create, marketing for this type of solution just
hasn't seemed to help. Life Alert, a wear-around-your-neck monitor for the
elderly that's been around for a long time, has been known for its "I've
fallen and I can't get up!" campaign [1]. What elderly person or caregiver
would ever want to relate to someone in that commercial?

I don't know what the answer to that problem is yet. How do you get people to
acknowledge the eventual death of their beloved elderly and push them to be
proactive in taking preventative measures without using scare tactics? I'm not
sure, but coincidentally, I finally got to reading the article _Slow Ideas_ by
Atul Gawande [2] this morning that touches on similar problems -- problems
that are insidious and have no immediate solution. He seems to strengthen PG's
points on doing things that don't scale [3]. In particular, he talks about how
marketing efforts, efforts that scaled, in India to combat cholera were
unsuccessful, and how opting for the door-to-door method resulted in
significant drops in mortality. The message of the article was that these
problems require more than just slick ads and pamphlets. They require changing
the norms, changing the way people perceive these problems. And from his
experience, the most efficient and successful way of doing that is to do
things that do not scale. Maybe that's the answer.

A product like this isn't just a shiny new toy someone orders from Amazon, or
backs on Kickstarter. This touches on some very deep problems in our society
and its views on preventative health, mostly that we don't take it seriously.
I think a company like Amulyte should really focus its efforts on creating an
effective marketing strategy. They may have the most advanced monitor in the
world, but that won't tear down many of the barriers that exist for this type
of product. And if they can crack that marketing problem, then there's a lot
more success out there to be had. Some food for thought, Amulyte guys. Good
luck! I'll definitely be watching closely.

[0]
[http://www.cdc.gov/HomeandRecreationalSafety/Falls/nursing.h...](http://www.cdc.gov/HomeandRecreationalSafety/Falls/nursing.html)

[1]
[http://www.youtube.com/watch?v=bQlpDiXPZHQ](http://www.youtube.com/watch?v=bQlpDiXPZHQ)

[2]
[http://www.newyorker.com/reporting/2013/07/29/130729fa_fact_...](http://www.newyorker.com/reporting/2013/07/29/130729fa_fact_gawande)

[3] [http://paulgraham.com/ds.html](http://paulgraham.com/ds.html)

~~~
jacalulu
Thanks for the feedback and input, you bring up some great points. We are
currently working on a few ideas to make this device more senior friendly by
adding features that would make it more than an alert pendant for them. We
feel that the best way to get it right is to actually run a pilot program and
get real user feedback. Right now we are focusing on solving a pain point,
which for our target user is the fear of falling outside while alone. Once we
have perfected this, we will be playing around with a few ideas during our
pilot program. You can expect to see some new iterations and ideas emerge down
the road that we are hoping will make this more than a simple help pendant.

As for selling to nursing homes, the stats might seem like a reassuring thing,
but you might also be missing the underlying story. We have spoken with
several retirement homes, and they have told us multiple stories about how
staff (not necessarily at their home) have wanted to stop residents from
leaving the grounds because they are worried that if something happens they
won't be able to get help - and in some cases they do actually stop them from
leaving. Point being, sometimes stats look good, because the rules and
guidelines put in place to keep them looking good actually have a negative
impact on a persons overall happiness and well being. So although the stats
look nice, the bigger picture could still reveal that something is broken.

You are very right that this will be a marketing challenge, but I have hope.
In my own case, my grandmother lives alone and my family wants her to continue
doing so, but we also worry. Rather than having to ask her to move to a
retirement home one day, it would be great if we could use a system like this
to allow her to keep her freedom and independence while still having peace of
mind that she will be ok. Our goal is to try to make a device like this feel
empowering, rather than morbid, but we acknowledge that it will take some
time. I have faith that something can be done in this space though because
when you take a look at it, you can see how obviously broken it is ("I've
fallen and I can't get up" is the perfect example of just how broken it is).

I actually read the article Slow Ideas last week and found it to be a great
read. I agree that ads and pamphlets will not solve this problem, but doesn't
mean we should shy away from trying to fix this broken industry. At YC we are
constantly told to do things that do not scale at first, it's a strategy that
has proven to work, and I'm all for trying it in this scenario.

Thanks again for your feedback, definitely some great food for thought :)

~~~
mattzito
If I can make a suggestion from my limited experience dealing with the older
folks in my family - there's a number of older folks who see the current
situation as you age as basically a binary choice: A) you stay home and
maintain independence at the risk of having something bad happen to you or b)
you go into a assisted living facility and give up your life and independence
in exchange for better safety.

It's interesting to watch how assisted living facilities have been trying to
mitigate b). A number of facilities I've seen recently are structured more as
apartments where nurses, doctors, and additional care are on call _when
needed_. Residents get to design their rooms when they move in, bring in their
own furnishings, etc. It's trying to straddle a middle ground between a and b.

Similarly, I think amulyte can be marketed to families as peace of mind and
care - and to the older folks as independence. This little button lets you do
what you want without worrying about how someone will get to you if there's an
issue.

------
callmeed
Seems like a smart move considering 10,000 baby boomers turn 65 _every day_.
Hopefully they're in it for the long haul.

It will be interesting to see what the marketing strategy will be.

------
elmarschraml
This is the best kind of startup - targeting an important problem whose
current solutions are outdated and not very good.

There are LOTS of seniors already using such a product (usually ordered by
their concerned family), and a low monthly fee is not an issue when your loved
ones's life is at stake.

The existing solutions are basically a DECT cordless phone with a one-button
911 call. Marketing something like amulyte should be a slam-dunk. Of course
you're not gonna sell "it has GPS and an accelerometer" \- you market "it will
notice when you fall, it will automatically call for help, even if should be
unconscious, and even tell people where exactly you are".

~~~
jacalulu
Great point - the marketing for this device is going to sound quite a bit
different based on the audience that we are reaching out to. For the
TechCrunch crowd, we can say things like "a micro-controller to keep all those
bits running in harmony"...definitely not something we would be telling our
end-user :)

------
idank
It's marketed as a device for the elderly but another segment that could
benefit from this are disabled people living alone.

When I left my parents house, I looked for something like this to use in case
of an emergency. One option was to pay a monthly fee for a similar device,
that upon activation makes someone call you and if you don't pick up they send
an ambulance or call someone.

In the end I went for a wrist-watch like device that hooks itself to the house
alarm and dials a predefined number when you press it. It obviously only works
when I'm at home but that was enough for me and it doesn't include a monthly
fee.

~~~
jacalulu
The option to expand into other markets is something that we are always
considering. We've chosen to target seniors right now, but we definitely have
other markets in mind for which this device might be useful (individuals with
cognitive impairments is one of them).

------
jzwinck
$30/month is too much for this to get Wal-Mart traction (which is what it
needs, because not even the daughters of seniors buy FitBits online). Seniors
often live on what they call "fixed income" which is a euphemism for
government aid, pensions (which are diminishing), etc. A new expense cannot be
covered by working harder or smarter. A $30/month new expense is exactly why
lots of seniors do not have smartphones (ironic then that Amulyte folks say
they considered making a phone app but not enough of the audience have
smartphones, then made a device that costs the same as a smartphone data
plan).

Consider that the Kindle 3G comes with free cellular service. The hardware is
in the same price ballpark, so why does Kindle let me download entire books
for free, but Amulyte charges me $30/month to publish tiny updates that I hope
I don't need?

Also consider the SPOT satellite messenger. It costs $150 plus $150 per year,
which is much cheaper than Amulyte. The main downside for this application is
that it does not work indoors--but the SPOT folks could add GSM capability and
then their device seems almost universally better (the one exception being
ergonomics for seniors).

Finally, ergonomics. Amulyte can't be too large, or it will be a constant
dangling reminder of dying. And it obviously shouldn't be black in color--if
not because black implies death then because new little black electronic
widgets are really confusing and scary to old people. Round and light-colored
would make a difference for some of the target audience.

~~~
jacalulu
Thanks for the feedback, you bring up some valid points that we have
definitely thought through.

First, the expense associated with the device is comparable to what is
currently on the market (in some cases it is actually less expensive than the
competition). We realize that not everyone will be able to afford devices like
this, which is why we also want to explore ways to get this subsidized. We
believe that a device like this can allow seniors to live independently for
longer, thus allowing them to remain in their own homes longer, and saving
them on the cost of retirement and nursing homes (not to mention studies show
that 90%+ of seniors want to remain living in their own homes for as long as
possible). Down the road we may even explore offering a less expensive version
of this if that becomes possible on our end (we still need to cover
manufacturing costs and overhead).

You bring up a few other examples, but none of them are exactly comparable.
First, the Kindle makes its profits off the books you do buy (they may offer
some for free, but the profit comes from the business model in which users do
still pay for books on their device). Second, you bring up SPOT then add that
it doesn't actually work the way we do. The added functionality does come at
an additional cost on our end. We are also spending more on getting a smaller
form factor (this means a lot more work on the hardware engineering side), and
we are creating a custom dock so that the pendant can be easily recharged
without needing to fidget with a micro USB.

In terms of ergonomics, the device will measure approximately 40mm x 40mm,
which is comparable to current devices on the market with a limited set of
features. We are continuously trying to engineer the device to be smaller, and
over time we will be able to, but this does incur larger upfront costs and a
longer period of time. So right now, we are focusing on making the best device
possible, and will continue to iterate and improve on it as components get
better and better :) As for the black - it tested rather well with males
(although my preference, and that of a lot of the female seniors we showed the
designs to, did prefer the lighter coloured device).

------
jusben1369
Firstly it's just great to see someone from YC targeting anyone over 24 :) Ok,
snarky joke is over.

I think this is a great idea. I see 3 challenges. i) Seniors tend to be more
frugal than the younger generation so $30 per month might be a dealbreaker.
Having said that children would probably pay that to know their parent is safe
so maybe that's the better angle. ii) Superseded by a smart phone based app.
No need for $99 for the device and $30 in a subscription. Will someone do 85%
of this for an iPhone/Android device at $5 per month?

~~~
jacalulu
Great points, both of which we have put much thought into: i) our target
customer is actually the daughter or daughter-in-law of the device user. They
are almost always the ones who make decisions to get a system similar to
Amulyte, and they are the ones that typically end up covering the cost for
their elder relative. ii) we considered coming out with an app, but after
talking to a lot of industry experts we verified what we had suspected -
seniors simply don't use smartphones. There definitely are some that do, but
the majority of them do not. Even those who have one rarely use it (it isn't
uncommon for them to turn it off when they aren't using it or leave it
somewhere, unused, for extended periods of time). Getting the right form
factor is an important implementation consideration, and a cell phone isn't
suited for this user.

~~~
jusben1369
Got it. I figured you guys would have done deeper research. the flip side of
your wireless device research is there might be a partnership opportunity with
wireless manufacturers or networks as I agree you'd drive more adoption and
usage of their devices.

------
wesley
Sounded good, until I heard about the monthly fee.

I don't think this will go very far, as there are probably other companies
going after this market without any extra fees.

Also, the battery life needs to be at least a month.

------
davmar
I really like what these guys are building. Real market, real need, real
customers. Great approach to solving the problem too.

I'd definitely bet on this type of product being the future of senior
monitoring.

------
robg
I worry about the battery life here. Other devices can last much longer by
using those base stations. And in this population, what happens if they forget
to charge once a week?

~~~
dataminer
To get around this issue they can build an alarm which starts sounding when
the battery is getting low. Another feature would be to send a notification to
the care giver to charge the battery. The third fail safe would be to alert
care giver if there is no communication with the device.

~~~
jacalulu
Couldn't have said this better myself, this is exactly what we are doing :) We
are also conscious of making sure that charging the device becomes part of a
seniors daily routine to help ensure that it remains charged. We are also
using induction charging to make charging the device as simple as placing it
on its holder (no micro USB to fiddle around with)

~~~
MartinCron
The daily routine is probably key, you'll get better compliance with something
that is done daily than something that can (in theory) be done weekly, even if
the batteries _could_ last that long.

~~~
robg
We take this approach with our biowatch, but it's a different demographic that
also charges a smartphone every night. With seniors, I worry that it comes off
to charge it may not go back on. And the loss of faculties related falls
starts to correlate with loss of memory and further dementia.

That said, they are honing in on the user experience at nursing homes.
Independent living facilities offer a slightly different demographic and
likely closer to their goal. Worst case, the device is sending low battery
pings, and that itself is an opportunity for children to check in.

------
gngeal
Sound almost like A. C. Clarke's CORA
([http://www.e-book2u.org/sf/Clarke08/30298.html](http://www.e-book2u.org/sf/Clarke08/30298.html)):

 _" THIS IS A CORA ALERT. WILL ANYONE WITHIN RANGE OF MY VOICE PLEASE COME
IMMEDIATELY. THIS IS A CORA ALERT. WILL ANYONE WITHIN RANGE OF MY VOICE PLEASE
COME IMMEDIATELY."_

Another piece of past future come true?

------
tghw
It would seem a much simpler solution would be feasible. A small GSM device
that is essentially powered off until it is needed, at which time it would be
booted up and begin sending GPS coordinates via SMS. If you wanted higher
reliability, you could look into the FM-based system that LoJack uses, but
either way, constant communication seems unnecessary.

~~~
jacalulu
Great points, this is something that we have given a lot of thought towards.
We are going to be pinging the device at certain points (when someone logs
into the portal for example), and the device will also send data at set
intervals (we can adjust how often we send data to save battery life, and
based on a few other things). When the device is not actively sending data or
establishing a connected we do sleep the device.

We opted not to send GPS location via SMS because it is a lot less secure. We
are also sending more than just GPS data, all of which we would have to
interpret on the server side anyways thus complicating the implementation. We
looked into this and for a variety of reasons it made more sense to use data
to transmit information from the device.

~~~
tghw
Doesn't that place a pretty large assumption on good data coverage? I live in
Denver, which generally has good coverage, but my last place was in a total
dead zone and I had to get a microcell device to be able to use the phone
indoors. SMS almost always got through, OTOH.

------
micahroberson
What are the dimensions? Although this product isn't intended to make a
fashion statement, the elderly may still be averse to carrying/wearing around
something rather bulky. Especially if they're having trouble admitting to
their fragile state.

~~~
jacalulu
Size is definitely something we are incredibly conscious of. This device will
be 40mm x 40m x 17mm, but we are always working on trying to get it to be
smaller. We want this device to look great, and we are approaching it as if it
almost were a fashion statement, or at least an accessory that a senior will
wear.

------
opminion
In some European countries panic buttons for the elderly are provided by
public health organisations.

Perhaps Amulyte could target those organisations, aside from marketing to
individuals.

