Prevention is better than cure but in Australia and New Zealand, just 1.3 per cent of the health budget is spent on preventing disease. Meanwhile, about one third of chronic diseases are preventable.
This is a problem that Dr Noel Duncan set his mind to addressing. He’s the founder and managing director of SiSU Health, a company that has developed simple, easy-to-use technology that is free and accessible as well as applicable to every demographic.
THE ROAD TO A HEALTHY LIFE
Headquartered in Australia, the SiSU team combines an online health platform with physical ‘health stations’ located in all states of Australia, UK, Ireland and Germany to help improve corporate and public health.
‘It’s very difficult to live a healthy life and you need constant support and guidance,’ Duncan says. ‘A one-week intervention plan isn’t going to create long-term sustainable behaviour change.
‘Online health platforms and apps aren’t enough to engage males and blue-collar workers, who are a particularly significant focus for SiSU Health.
‘We know from our research that men will engage with a physical health station and we hypothesise that this is because they feel there is no one actually making a judgement call on them.
‘Forty-six per cent of the 3.2 million health checks we have completed in the last 24 months are from men. By comparison, online only health platforms achieve significantly smaller levels of engagement.’
Duncan adds that historically, the best thing you could do for your health was to be wealthy.
‘We’ve got some really great data to show that we have engagement across the entire Socio-Economic Indexes for Areas (SEIFA) spectrum.
'We will continue to make sure that the use of our health stations continues to be free to the end user (customer) so there is no financial barrier to use our products and services.’
FIVE-MINUTE HEALTH CHECK
Standing about 2.5 metres tall and one metre wide and deep, SiSU health stations seamlessly guide a person through a five-minute health check using proprietary software which measures height, weight, body mass index (BMI), body fat, blood pressure and resting heart rate.
‘We’ve also recently added total muscle mass, body water and an electrocardiogram (ECG) trace, which measures heart abnormalities,’ Duncan says. ‘The tests also assess a person’s heart age, risk of diabetes and cardiovascular disease.’
Currently, SiSU Health stations are situated within supporting retailer partners such as Priceline and Bunnings and corporate partners such as AMP, Crown, Simplot, Transdev and the Commonwealth Bank.
Duncan says his ultimate vision is to ensure there is a free health station within five kilometres of every person living in Australia, New Zealand and Europe by 2025.
TRIAGE AND PERSONALISED INTERVENTION
Data collected from health checks using SiSU Health stations is General Data Protection Regulation (EU) aligned, meaning it is owned by the customer. Data security and integrity is a key and defining value of the business.
‘If a customer’s health results warrant it, we might encourage them to patriciate in a health behaviour change program such as one of the government’s diabetes prevention programs,’ Duncan says.
‘However, customers are only encouraged to participate in a third-party program if they have given their explicit and informed consent.’
SiSU Health has also developed its own meal plans and physical activity programs.
‘We aim to personalise the intervention and encourage them to come back to use the health station every couple of months so they can track their improvements over time.’
Ideally, users would return to the health station about six times a year.
‘What we’re trying to do is to set up a platform and infrastructure for individuals to own their health,’ Duncan says. ‘Using the health stations, we can look after the general public as well as the staff within any organisation.’
UNDERSTANDING THE CUSTOMER
For our retail and corporate partners, who sponsor a SiSU Health station, the benefit lies in the aggregation of deidentified data, which offers insights about the health and wellbeing of their customers.
‘We hold the largest dataset in Australia when it comes to the health (not disease) of the population,’ Duncan says. ‘We’re not there yet, but over time, we plan to add predictive modelling within the health and life insurance environment.
‘This will deliver a tangible, financial difference based on positive behavioural changes promoted by SiSU Health stations and interventions.’
With over 3.2 million health checks completed, Duncan says it will soon be possible to see datasets that predict, for example, a specific group of 40-year-old males who are at risk of Type 2 Diabetes or cardiovascular disease in their 50s.
‘If we can intervene when these males are in their 30s, 40s and 50s we might be able to make a significant difference to their health, wellbeing and quality of life in their 60s and 70s,’ he says.
REWARDING GOOD BEHAVIOUR
SiSU Health is also building a camera into its health stations, so that people having regular health checks can authenticate themselves with facial recognition.
‘This will potentially provide life insurers with the opportunity to reward customers for their good health behaviour by keeping their premiums at a particular rate.
‘If life insurance customers are living a healthier life, then there are real financial implications not just for insurers but for the wider population.’
Duncan says SiSU is currently profiling the tested populations in Australia by postcode, gender and age demographics.
‘We’re working through our three million plus health checks undertaken to date, looking for pockets of risk, with a focus on diabetes, obesity and smoking,’ he says.
‘We’re also looking at what interventions can be made in those populations based on limited budgets.’
FOR THE LOVE OF SPORT
A Melbourne boy by birth, Duncan says he loved sport as a kid but wasn’t very good at it.
‘I had the passion, but I knew I had to get in by academia or in a support role,’ he says.
With a PhD in exercise physiology and a post-doctoral fellowship from the Pennsylvania State University, Duncan began his career designing training programs to optimise the performance of elite athletes.
Having worked for the Collingwood and Richmond Football clubs as well as the Victoria Bushrangers Cricket team, Duncan and a couple of former university friends decided to start a business that would scale their expertise in fitness, nutrition and health.
‘We built some software in the early 2000s that allowed an individual to do a health check online and be triaged into behaviour change programs such as a weight loss, healthy eating or aging, or diabetes prevention and you could follow that program online,’ he says.
PASSION FOR DISEASE PREVENTION
With clients such as Medibank Private, NRMA, banks and financial institutions, the business grew in rapidly in Australia and in 2006, Duncan moved to the UK to scale it overseas.
‘In 2009 we sold the business to McKesson Asia Pacific and then McKesson on-sold it to Medibank Private,’ Duncan tells.
‘So, for three years I was a Medibank employee, but in 2012 it was time to consider the next phase of my career.’
The SiSU Health business was the result of Duncan’s determination to continue working in public health and disease prevention. His goal was to come up with a model that was scalable and could reach as many people as possible in a high-touch manner.
SiSU Health began in the UK in 2013 and later moved to Australia where it is now headquartered.
‘Australia is not in terrific state as a country health-wise — we’re in the top third of OECD countries for obesity and the rates of diabetes and cardiovascular disease are rising,’ Duncan says.
‘We see that there is a need for preventative strategies at scale to attenuate the decline in health that is occurring and SiSU is one of a handful organisations concentrating on this at scale.
OWNING YOUR OWN HEALTH
Duncan says the company is observing that when individuals regain ownership of their own health, their engagement with the technology and supporting programs improves.
‘We have seen positive behaviour changes just by identifying an individual’s health results and then encouraging them,’ Duncan says.
‘Working with individuals on their health results as well as being there to offer support is the key to getting them to keep tracking and improving their results over time.’
Duncan is also conscious of the need to strike the right balance between how much an individual wants to track themselves versus feeding an insatiable corporate desire for data.
‘We need to be there to support individuals when they’re ready, not when we’re ready and that’s one of the reasons we need to personalise the technology as much as we possibly can,’ he says.
‘A message that we send a 25-year-old healthy female has to be different to the message we send a 55-year-old male who, potentially, is not as healthy as he was.
‘Our messages need to be inspiring and achievable, they need to be relevant and affordable, because a lot of people are prepared to spend money on their car but they’re not so enthusiastic about spending money on their health until it becomes a serious issue.’
THE DATASET OPPORTUNITY
For the highly active users who love tracking themselves every day, Duncan says the company is building a mini station that can be used in the home and smaller corporate organisations.
SiSU is also working on expanding the range of tests an individual can take at the station.
‘For example, a user will be able to consult a GP and will only get triaged off to allied health support when there’s an issue.’
At the 2019 Life Insurance Breakfast, Duncan will motivate participants with the opportunity presented by delving into the data SiSU has been collecting.
‘The future will be to provide financial incentives for an individual to maintain their life insurance policy at a particular premium,’ he says.
‘A simple and cost-effective way to do this would be for customers to use a physical health station in a public facility four to six times a year.
‘If they don’t access the health station, then potentially their premiums will go up, so it makes them accountable to live a healthier life while providing the life insurance partner with tangible, real-time data that will allow them to be more sophisticated in their commercial modelling.’
ENHANCING THE HEALTH SYSTEM
For Duncan, health data is as valuable as financial data. For this reason, the SiSU business spent two years working through compliance standards and ultimately achieved ISO standard 13485.
This means the health stations are classified as Class IIA Medical Devices. SiSU also has ISO 9001, 27001 and 45001 compliance standards.
The company is currently one of a few worldwide and the only one in Australia to offer health stations classed with medical device certification.
‘We need to ensure that the data coming from our stations is highly accurate and trusted,’ Duncan says.
‘Completing all these compliance processes and certifications means that we can work very closely with allied health professionals, GPs and pharmacists as well as government support groups.’
He adds that SiSU sees itself augmenting the existing health system not replacing it.
‘We’ve triaged over 510,000 people into the GP network using the health stations so we’re not here to take work from GPs were here to support them’ Duncan says.
‘The goal is to provide more data to allow the GP to spend time with the individuals who are really unwell rather than individuals who are on the cusp and who potentially might be able to look after themselves.’
Hear Noel Duncan speak at the 2019 Life Insurance Breakfast.