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Syndo Health NV Telemonitoring and coaching at the service of health

As a start-up created in June 2018, Syndo offers patients an easy way to follow the evolution of their health and puts them in contact with a personal health coach to support and motivate them, which enables behavior change, reduces anxiety and promotes self-care.

Heart failure affects approximately 230,000 Belgians. Every year, about 15,000 new cases are diagnosed. By 2040, this number will double again, which means a total of more than 400,000 patients. 25% of these patients will be hospitalized again in the month following the first admission. After six months, this percentage will reach 50% and one in three will die within one year 1 . These figures are all the more alarming as 75% of patients do not understand what heart failure is 2 . Although many cardiac doctors and nurses often spend quite some time educating patients about medication, dietary restrictions, symptoms, a lot of this information is forgotten when the patient is back home. As a consequence many patients don’t always follow up the advice they get with the high readmission and death rates as a consequence.

In such a context, the Syndo project started in 2016 within the healthcare investment fund Carevolution. The goal was to bring an innovation to market to support people suffering from chronic diseases since this has a big impact on the society: indeed, the costs associated with the management of these diseases are very high for health insurance. Heart failure and post-acute coronary syndrome (ACS) were chosen as first pathologies because many people suffer from these pathologies. Furthermore the Syndo solution was co-developed with the cardiologist team from the hospital OLVZ Aalst. And a successful proof of concept (POC) with real patients in Flanders clearly showed the positive effects of the Syndo telemonitoring and digital therapeutics in a reasonably short term since hospitalisation and death rates are very high in the first year. Thanks to this first success the company Syndo was founded to further develop and commercialize the idea.

The Syndo solution has three pillars. The first one is dedicated to telemonitoring via 3 top quality devices. The start-up provides the patient with a scale, a blood pressure monitor and a physical activity tracker to use at home. Taking measurements is very simple because the devices will synchronize automatically with the Syndo application. With these updated results, the patient and / or his doctor will have a real-time view of the situation. Alerts are triggered when a measure is out of the ordinary. The Syndo nurse validates the alert before it is sent to the treating doctor. The feeling of being followed reduces greatly the patient’s anxiety.

The second pillar deals with continued education and coaching via the Syndo application.In due course, the Syndo app sends the patient a message reminding him which medications he needs to take. The treatment will have been previously encoded

in the application. The patient will not have to worry about forgetting to take the medicine. Then, every day, he will receive brief and helpful tips, validated by international experts, to help him change his habits as his cardiologist has recommended. It will be information on different topics: nutrition, physical activity, stress reduction, how to recognize his symptoms, etc.

The third pillar consists of an accompaniment by a personal coach. Indeed a coach will contact the patient regularly (about 15 minutes once a week) to answer his questions and support him when he finds it difficult to change risky practices such as sedentary lifestyle, overweight, alcohol and tobacco use, a diet too salty... The patient will have the reins in hand to integrate these changes into his life and set new goals for a healthier lifestyle, one small step at a time. By restoring a structure to the patient's life, this program will significantly reduce his stress level and will avoid a possible depression. The personal coach also has a preventive part to play: if a measurement is abnormal, he will have the patient do it again and will direct him to his cardiologist if necessary. He may also help identify associated symptoms that can lead to complications, as is the case with edema.

After 8 months on the market Syndo could already boast 150 patients using its services. 57% of them suffered a heart attack while 43% have heart failure. This number also includes patients with hypertension and overweight. Their average age is 67 years old. Moreover 80% of them adhere to the telemonitoring and medication. Furthermore, the drop-out rate is less than 5% which is extremely low for such types of programs.

1 Sources: « L’usage efficace des médicaments en ambulatoire dans l’insuffisance cardiaque. Rapport du jury. Bruxelles : INAMI, 2008. Selon les chiffres de l’étude réalisée par la VUB et publiée dans De Standaard, le 15 février 2010 ». White paper “Heart Failure: Preventing disease and death worldwide”, 15 May 2014.

With this solution, Syndo is positioned in the field of prevention, monitoring and patient support. The start-up provides valuable help to doctors and patients alike. As regards doctors, patients often don’t follow their advice: they don’t take their medication strictly, they have trouble limiting salt and fluid consumption, … And even though many hospitals do a great effort in educating patients right before they are sent home, a lot of this information is forgotten along the way and what's left of it is not always easy to apply. The situation is radically different with the Syndo solution: the doctor has access to an interface for monitoring the vital signals of his patient. He receives real-time information and can thus check if his advice is strictly followed or not. With Syndo, doctors can now not only prescribe medication, but also a healthier behavior to their patients.

The same is true for patients once they have come home: they are away from the ‘safe’ hospital environment and very often feel anxious and stressed. They fear that a new event will take place and cannot enjoy life anymore. Patients are also overwhelmed by the 101 things they need to suddenly take into account and don’t know where to begin to change their lifestyle.

This is why Syndo believes that one of the keys to healthy patients is to activate them. According to many scientific research works, four levels have been identified to show the skills and confidence that equip patients to become actively engaged in self-care: level 1 (disengaged and overwhelmed), level 2 (becoming aware, but still struggling), level 3 (taking action), and level 4 (maintaining behaviors and pushing further). The aim is therefore to increase the level of patients’ activation in order to reduce the readmission rate in the year and therefore raise their chances of survival beyond one year.

that telemonitoring alone is not enough: there is a true need for education and coaching to facilitate behavioral change and improve self-care. This is where the Syndo app comes into play: its users are more activated, they turn into empowered patients, which leads to better health outcomes thanks to continued patient education at home and personal coaching of patient to a more healthy life. On top of that it generates less anxiety for patients since the telemonitoring of the patients brings vital signs and follow-up of alerts.

In November 2019 Syndo started to monitor people with hypertension and overweight. The start-up also wished to commit itself even more in the field of primary prevention. Indeed the demands of the elderly abound and cardiac monitoring is very interesting to avoid possible infarction. And Syndo will not stop there since it is now doing a POC with two mutualities in Belgium. In a longer term it is also considering to extend the number of monitored pathologies to include diabetes and the chronic obstructive pulmonary disease (COPD), two pathologies which can be greatly impacted by adopting healthier behaviors (e.g. tobacco). Likewise Syndo foresees to start operations in neighboring countries: France, the Netherlands, Germany and the United Kingdom. With Syndo help is more than ever at your fingertips!

Syndo Health NV Chaussée de Gand 1434 - B-1082 Berchem-Sainte-Agathe Tel.: +32 (0)4 86 76 21 60 Email: info@syndo.be - https://syndo.be