Q&A: Developing an app to ease basic needs for people with neurological conditions

Many patients with neurological injuries or conditions suffer from neurogenic bladder, or bladder-control, problems that stem from brain, spinal cord or nerve issues. 

Some patients may need to continuously use a catheter and urine collection bag, but that can be time consuming or hard to use in public spaces. Augment Health cofounders Jared Meyers and Stephen Kalinsky aim to add another option for patients with their device that monitors bladder filling and alerts users on a smartphone app.

CEO Meyers and CTO Kalinsky sat down with MobiHealthNews to discuss how their system works, what they learned when talking to patients and providers, and what’s next for their startup. 

MobiHealthNews: Can you give me some background on how the device and the app work?

Stephen Kalinsky: We’re helping people with neurological conditions to know when their bladder is full.

At the end of the catheter, where usually they’d have a bag, instead our device connects and monitors their filling. It notifies them on their phone when their bladder is full, and then they can open this valve when they have to go to the bathroom, and it will void their bladder. And so it makes it more of a natural process where someone’s storing urine in their body again, instead of offloading that to a bag.

There are physiological benefits that come with that, and then there’s also a peace of mind where you don’t necessarily have to worry about people seeing the bag and staring or potentially having leaks.

MHN: What was the impetus behind designing this kind of system? 

Jared Meyers: The project started while Stephen and I were at Georgia Tech going through their biomedical engineering program. We were each working a couple of different roles with startups the previous summer; we were coming back looking for where we could really make an impact and start something of our own. 

It was honestly a conversation I had on a plane with a urologist. From there, we started talking to more and more people. As we made this transition from talking with predominantly urologists to also hearing stories from people with spinal cord injuries, people with multiple sclerosis who deal with these problems every day. That was when it really transitioned from an interesting space to a problem that we knew we had to solve right away. It was really this research, this understanding of the patient journey and the patient experience.

MHN: What did you hear from patients and providers when you were kind of discussing that patient journey and experience? 

Meyers: Initially, we were hearing a lot about infections from the clinician side. Catheter-associated urinary tract infections are a major and very notable issue within the space, and there’s been a lot of work done on those. But then, as we continued talking to patients, what we started hearing was that, in a lot of cases, it can take someone a really long time to be able to use the bathroom. Some people were hesitant to go outside for a week or more after starting to use these urine collection bags because they were embarrassed.

In other cases, someone had their pet cat jump on their bag, causing the bag to burst. From other people who maybe had the condition for a little bit longer or had done a little more research, they were really voicing these concerns around, “Wait, if I’m using a bag instead of my bladder, what’s happening to my bladder health?”

For a clinician, they might see this patient once a month, but for his patients and people dealing with the conditions, this is an everyday – potentially even every four hours – kind of thing.

MHN: How did you develop the app to work with the device? 

Kalinsky: It came from those user interviews, where they were identifying the needs and how someone would interact with it. Before we knew we needed an app, one way we were looking at things was if there was a modality where the device could notify someone. But if you think about if you ever have something in your pocket, you might not necessarily hear it. And if you don’t have sensation below the waist, you’re not going to feel any haptic signals there. Obviously, if it’s covered up by clothing, you’re not going to see a light. 

So sending information to the phone was actually one of the easiest ways to access patients. You have a lot more computing power on your phone than we could fit in a device that we wanted to scale down.

There’s this synergistic effect where we were able to get the device smaller and reduce how much weight would have to go into a battery and other processing, and then also do more sophisticated processing and generate reports if the patient needs to show this to their doctor.

MHN: What are your next steps for the business? 

Meyers: What we’re looking toward next is hyper-focusing on the two core elements of the business, the tech development and then the commercialization pathway. At a slightly more detailed level, we have that prototype complete, but just making sure we can make it as usable as possible for people who maybe have limited dexterity because of some of these injuries and diseases. 

Once we’ve done that and gone through the regulatory process, we’re ready to get this in people’s hands as quickly as possible. So in that regard, it’s identifying who those initial adopter clinics will be, really interfacing with the neurologists and other stakeholders within the industry.