“AI helps to focus more on the people and thus allows medical staff more time to actually concentrate on establishing interpersonal contact.“

Often older people face dramatic consequences to their health if they fall and many cases are definitely avoidable. The former Microsoft manager, Diana Heinrichs, founded her company Lindera in 2017 just for this reason: her AI-supported moveability app is similar to a clinical analysis from the gait laboratory. The CEO discussed with #ki_berlin what the medical world will look like in future and why approvals for digital care applications are already standard in France.

Cross your heart: Have you met people yet that use your product? Did that make you proud?

Yes! Since I founded Lindera I had the privilege to meet many people where our technology has sustainably changed their life. This includes carers who have told me that they now have distinctly more time to look after the older people and to focus specifically on maintaining their mobility; but also older people who were able to largely preserve their quality of life due to the fall prophylaxis. To receive such feedbacks on one’s own product does make me feel rather proud. Especially since I experienced in my own family in what way age can be restricted and what it means to support specialised carers to remain in their trained job for longer. This experience was important to me and spurred me on and was finally also one of the reasons why Lindera exists today.

Where do you see the greatest potential for your fall-prevention app? And how das AI come into this?

The Lindera SturzApp has the potential to offer a solution for the core problem of our society getting older and older. Falls are the most common cause for injuries and are a serious problem in respect of health and society. With the age group of the above 65-year-olds, about every third person falls at least once a year. Many of these older people have problems to regain their earlier mobility or not even at all. At the same time falls do not only affect the injured person and their families but also the health system. Falls at an old age cause costs amounting to billions and cannot be cured by simply vaccinating or giving tablets. Our Fall-App reduces verifiably the risk of older people and those with restricted mobility from falling. Additionally it relieves carers in their everyday work.

In order to analyse the risk of falling by smart phone camera and app – and that without any additional hardware or special sensors – we work with artificial intelligence. Our patented 3-D algorithm records movement parameters down to a millimetre, transfers these subsequently into a precise digital 3-D picture and establishes the probability of a fall by that person. Apart from a detailed gait analysis, our Fall-App also provides a catalogue of measures for a fall prophylaxis tailored to this specific older person.

What does the current Lindera range of products offer?

Our product range grows continuously. Last year we promoted our solution to be integrated into the stationary care process in cooperation with partners such as DAN Produkte, Medifox or even myneva.heimbas.

In the meantime our offer goes way beyond that already. Our AI is the Swiss knife of mobility analysis – and can be used in care homes as well as in clinics or reconvalescence institutes. We offer our 3-D technology as software development kit for example also to developers of fitness apps. One example is the application Skill Yoga that builds on our AI.

Is it conducive for the developments in the e-health sector that within the standard care, processes by the Ministry for Health are accelerated due to the coming into effect of the Digitale-Versorgung-Gesetzes (DVG) [Digital Supply Act] and the decision for digital health applications (DiGA)?

Absolutely, an acceleration is urgently needed. The WHO is warning rather loud and based on facts that the EU lacks specialised personnel. We want to develop innovations within Germany and Europe, to provide a contemporary as well as patient-friendly health care for everyone and also to make the profession of carers more attractive again. But this will only succeed, provided the framework conditions are right and necessary structures and prerequisites are created. But to start with the approval process is difficult. As early as January, for example, the Health Minister promoted an app with the DiPA [Digital Care Applications] cabinet resolution with which falls can be prevented. But the truth is that approvals for digital care applications (DiPA) are dragging on until now. It is a slow process - no dynamics in sight. Also, residents as well as specialised carers in stationary care homes are explicitly excluded from the DiPA. This prevents new ways of working in care homes to soften the notorious lack of a specialised work force and to establish a new way of working in a team. During my time at Microsoft, I promoted the Modern Workplace in the office, turning away from a time clock towards an intelligent team work. We also need this change in the care sector – instead of short-term contract workers and extensive manual documentation.

How much do you benefit from the demographic developments of the past decades – is it a challenge or rather a blessing?

The demographic change and the increasingly aging society encourages our work at Lindera essentially. Our core motivation is to promote individual physical mobility of people by using Artificial Intelligence and to prevent falls in this way. We also want to rethink mobility in old age: It is our intention to further a health care that focuses on prevention and enables as many people as possible to maintain their agility and mobility – and that in every phase of their life. As Amazon has found out that it cannot only sell digital books, we have realised that our 3-D technology does not only prevent falls in old age but distinctly promotes mobility in every phase of our lives.

Not only Germany’s society is aging, populations in other countries are also aging faster. How far do you, or rather Lindera look ahead beyond national borders?

We want to use our technology to set standards worldwide in the section of a medical mobility analysis. The largest service provider in France already uses our solution in the private care sector. It basically applies: the challenges are similar in many countries, only the prerequisites are often different – that is the national regulations within the health sector, approval processes and ways of financing. We view this as a challenge but by no means as an obstacle, as we have strong partners actively working internationally. KORIAN, the European care service provider, one of our largest customers, operates for example the retirement home Castel Voltaire, west of Paris. This institution is considered to be an excellent example for integrating technological solutions in care homes. This is a good basis by which also other health-tech enterprises abroad can convince with their products. 

I presume that you also discuss this intensively with physicians of various different fields. Do you meet with approval or rather rejection regarding the application of Artificial Intelligence in the e-Health sector?

We experience approval and work together with physicians of various different fields: We developed our technology coming straight from practical experiences and during the development phase we worked together with the Geriatrics research group of the Berlin Charité, psychologists as well as trained nursing personnel right from the start. The AI potential in the medical and care sector is generally huge. Physicians are also very much aware of this. And AI does not only take over administrative and organisational tasks but has also supported prevention, diagnosis and therapy for a long time. The benefit and the advantages of AI are only too clear to see and go from more precise diagnoses and more individual ways of therapy, via relieving care personnel right up to sustainably reducing costs.

You may be very outright: In your opinion – what will medicine look like tomorrow? Will we still have human doctors? How do you argue with people who are afraid of AI in the health sector?

One of the large misunderstandings is that AI should replace or could replace medical staff, no matter whether doctors or nursing personnel. But the contrary would be correct. Using AI helps to focus again more on the human and gives medical staff more time to look after and care for the patients. A future vision for medicine and care of tomorrow is an individualised, patient- and prevention-oriented health care. Until now we only visit a physician once it may already be too late. Over the past few years we have started to count our steps, take our pulse or record our sports activities per app – these are only just bits of a puzzle on the way to a sustainable digital health care. In future we are equipped with a personal 3-D avatar on our smart-phone that informs us continuously about our health and suggests what to do in real time.  

And what do you think about the start-up situation regarding the medical sector in Berlin – after all we do have the Charité, an important international campus?

There a lots of advantages for innovative health enterprises being close to institutions with an international standing such as the Charité in Berlin. In this respect we, at Lindera, have cooperated with researchers and physicians of the university clinic in the most varied ways and will continue to do so also in future. Dr. Anika Heimann-Steinert and Oskar Stamm, for example, from the Geriatrics Research Group have scientifically evaluated and confirmed the high precision of our AI. Altogether Berlin already offers a wide range of portfolios of research centres, clinics, IT-enterprises, service providers and established networks that are growing continuously and around which increasingly more health-start-ups are establishing themselves. But still, from what I have seen, the start-up scene in the medical sector in Berlin is by far not as strongly represented as we know from other segments.