Our smartphones are essentially super computers. So why not put them to work to help track our health? That's what Israeli-based OneStep is doing. The company uses smartphones to provide gait analysis for patients, who simply need to walk with their phone in their pocket. To learn more about OneStep's technology and a recent addition to the company's capabilities, we chatted with Alaina Victoria, OneStep's Clinical Content Manager. Tune into our conversation to find out more about this technology and its applications in the healthcare space.
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Frank Jaskulke01:19
Good morning, good afternoon, good evening to everyone out there in Medical Alley. Thank you for joining us on another episode of the Medical Alley podcast. This time we're going a little international and hearing from a really fascinating company that takes advantage of some consumer technology advancements. Some of you may know, some of you may not that in your pocket, you probably have a supercomputer. Might be an iPhone, might be an Android. But you have this incredibly powerful computer with sensors, with data collection, with internet connection. And that has opened up a whole bunch of new possibilities in healthcare. We can ask questions, we can test things, we can do things that even a few years ago, we might not have thought possible. And one of Medical Alley's members, OneStep, is taking advantage of this technological advances to develop a better way of diagnosing certain common healthcare conditions and then better managing their treatment. So today, I'm joined by Alaina Victoria from OneStep. And Alaina, maybe if you would start just by telling us a little bit about yourself and your work, and then introduce OneStep to the listeners.
Alaina Victoria02:31
Sure, thanks so much for having me. So I am the clinical content manager on our marketing team at OneStep. I am also a doctor of physical therapy in my education. And part of my role is to ensure that our materials and our efforts are clinically accurate and relevant. And I offer feedback based on my experience as a clinician. So it's a very unique role. And it's a lot of fun, and I'm enjoying it very much. And to introduce OneStep, we like to describe ourselves as a digital physical therapy platform that's made up of both a patient app and a clinician portal. Our solution is based on our unique science that turns any smartphone to a gait and motion analysis lab. And we're able to do that without any wearables or additional equipment needed. I think that part to me, at least, was the most interesting that it's tools I already have. It's not adding one more thing to the repertoire. And I'll sort of say your background, that's pretty cool having, you're in physical therapy, you know, the clinical side. And now in the marketing, I know in this industry, right, we need to be creative, we need to get our message across, but it needs to be clinically accurate. Really cool. And kudos to OneStep for bringing those two together. Yeah, it's a very exciting role. And there are other physical therapists in non clinical roles in the OneStep team as well, in sales, and also as our clinic managers. So it's a very diverse mix. And it's great.
Frank Jaskulke04:08
Wonderful, wonderful. Well, I know, you kind of alluded to this a little bit about the motion detection, using algorithms, using your smartphone to be able to do that. Can you talk a little bit about functional movement and gait analysis and what OneStep is doing? As I understand it, this is something that is commonly done, but the way it's done traditionally is much more involved a lot less convenient for the patient. What is it that you're doing that's a bit different?
Alaina Victoria04:39
Yeah, so to give you some context on functional movement, or sometimes called functional mobility, we're referencing real world movement patterns and how a person is able to perform specific activities in their everyday life. So in the clinic, a physical therapist might have a patient perform a functional movement assessment in a few different ways. One quick, simple way is to have them perform a squat, or reach down and bend and pick something up from the ground, reach over their head. So in these instances, they're assessing the quality of the patient's movement, and their ability to perform that specific task, which is where it gets that word of functional. And at OneStep, we are looking at functional movement in a few different ways. So I guess you would say our most notable way is using the phone to assess gait. And the way that's done is all the patient has to do is download the OneStep app, put the phone in their pocket, or simply hold the phone against their thigh, take about a 30 to 45 second walk, and we're able to capture over 40 gait parameters, all from the sensors within the phone. So that's one aspect of movement that we're looking at.
Frank Jaskulke05:48
Oh, wow, that that's pretty incredible. And so you're building the algorithms, the software, but you don't have to go and develop hardware, because you can just leverage what we probably already have.
Alaina Victoria05:59
Exactly. And that's what makes our solution pretty unique. The fact that we don't use wearables or need extra equipment. So patients, they don't have to have any additional expenses. It's something that is always on them and at their disposal.
Frank Jaskulke06:14
Alright, so then I've downloaded the app, I'm running the test, what happens with it? Or how, how does it, say, integrate with the clinical community so that they can serve the patient?
Alaina Victoria06:26
Yeah, that's a great question. So the information that's recorded on the app is transmitted to the, we call it the clinician portal or the dashboard. And the provider or the physical therapist is able to go in and see their entire patient roster, and then also click on specific patients and dive deeper into the information that they want to look at. Because we don't just look at gait, we also allow the patient to do functional movement assessments within the app. So common ones that we would use in the clinic would be a timed up and go test, or a TUG, or a sit to stand test. And these are ways to look at different types of movement, as opposed to just gait parameters. So it's a very holistic picture of how the patient is moving in their environment. And then that information is right in the portal for the clinicians to review.
Frank Jaskulke07:13
And I have to think, in many ways, it's probably more productive for the clinician as well than that they can gather that information, they can do their assessment, but it doesn't necessarily require that the patient come in, take up clinic time to do that.
Alaina Victoria07:31
Right. It is a very effective use of time. And it also gives that insight of the patient in their natural environment because when they come into a clinic setting, they they know that they're being assessed, and it's not their everyday circumstances. So they're able to do these assessments where they spend the bulk of their time.
Frank Jaskulke07:49
A little bit of white coat syndrome, but this time in physical therapy. Yeah. Oh, very interesting. As I understand it, the product also is being used, not just with the clinical community, but also with say, medical device firms or other technology companies that might be working in adjacent spaces. We have a ton of medical device companies in Medical Alley. Could you educate us a little bit about the kind of work you're doing there?
Alaina Victoria08:48
Sure. So obviously, we're going to work with medical device companies in a different way, because their goals are different. So usually, what we see is medical device manufacturers want to partner with us to show the efficacy of their device or their implant, before it's used by the patients. So they will use our science to monitor patient gait, or their motion prior to and then after the use of the device. And one thing that makes OneStep very unique is the fact that the patients can do this motion analysis from anywhere. They can collect longitudinal data that will show patient improvement over a longer period of time. So it's not just limited to data that's collected at one point in time, it's a much larger breadth of data that's available to them to analyze.
Frank Jaskulke09:38
Oh, yeah. And when I think about, you know, the push to have real world evidence, you know, historically in device and in drug, right, we do very controlled clinical studies. They give us high quality data, but we kind of all know it's not the real world that the patient lives in order that the clinician practices in that. What I hear you describing is the ability to get more real world data without it being in a big additional burden for the company, that should be better care for the patient, and also probably better future innovations as we learn things that we might not see in the controlled confines of a clinical study.
Alaina Victoria10:17
Exactly. And that is you bring up a good point, we don't just have patients that are able to perform walks within the app. So we actually have the capability to pull background data with the patient's permission, of course, and provide this insight throughout their every day life when they're unaware that they're even being monitored. And we recently had a study published that demonstrated this concept, because there were differences found between the conscious recorded walks. So when the patient goes into the app, hits record, puts a phone in their pocket. And then compared to the background walks, which are obviously they're unaware that they're being monitored. And these background walks showed, I would call them unfavorable changes in gait during the patient's regular daily activity. So when they were unaware that they were being, not necessarily detrimental, but just you saw a change in the parameters in a way that they were not as conscious of the way that they were walking. So it's very interesting to know and giving providers and manufacturers of medical devices this information, it's really interesting and can give a more complete picture of how the patient moves when they're in that natural setting that we're discussing.
Frank Jaskulke11:25
Yeah, I think our physics fans or Breaking Bad fans will understand that completely. You just described the Heisenberg uncertainty principle, right? The the sheer act of measuring something changes what you measure. And so you're providing a way to do it more in the background, less influence then potentially on the patient. If it's more in the background, that's pretty darn fascinating. If we back up, though, I think we've had a little bit of an understanding of the company itself. But let's go back in time, because for us, at least, this is not a traditional Medical Alley company as a company based in Israel, now operating in the US. I'm curious, how did this get started? Like, where did this originate out of?
Alaina Victoria12:12
Yeah, so it's funny that you mentioned physics, because one of our three co founders is a physicist. So yeah, and all of the co-founders, they were part of a very elite sector of the Israeli Defense Force, called the Tao Pyat. And it was here that they focused on solving very complex problems and innovating using high level technology. And one of the projects that they worked on involved using sensors within a phone to observe the way an individual walked. So they would extract the data from the phone to identify these qualities and parameters of gait that they then use for security purposes. And then they pivoted from that. And they were wondering, you know, how do we get this technology to the masses to help people particularly in healthcare, and the initial idea that they set out to try and bring to life was, how do we identify a stroke in an individual, because they found that there were certain changes in gait that are indicative of this medical emergency. And from there, they pivoted again, to think how do we expand this to even more people, physical therapists, and give this motion data so that it can be used in a way to help patients and providers understand their movement. And they realized that many people don't receive the physical therapy that they need. So they wanted to solve this problem and make it more available and convenient, but also founded in data. So really practicing in an evidence based model, that is something we we bring forth in the physical therapy realm, and it's very important to us. And at OneStep, we're allowing providers to do that.
Frank Jaskulke13:56
Oh, that is fascinating. And I really appreciate hearing the pivot. We work with a lot of startup companies. And we see that and we preach that to companies that you know, where you start may not be where you end up. The the flexibility, the adaptability to get there is so important. And as I understand it now, the company, and you've recently established some presence in the United States developing the market here. Why do that? What's the thought, or what's the plan as far as the US market?
Alaina Victoria14:27
Yeah. So the US market is our main market. And it's actually where we're putting most of our focus. We have a growing US team, myself included, I'm based in New York, and in the past six months, we've set up a commercial team and they are all US based and they are doing really great work together and getting the OneStep name out there for the US market.
Frank Jaskulke14:49
Oh, it's fantastic. And I think I'd seen in preparing for this, that there's been a recent addition to the product line with a fall risk assessment. Can you talk about what what that is and why adding fall risk was so important?
Alaina Victoria15:03
Sure, sure. So to give some context around that falls are the leading cause of injury and injury death in older adults. So if you want to put numbers to it, about 3 million older adults are going to be treated in the emergency setting for fall related injuries. It's a huge number and even more so, one in five falls, they're going to result in an injury, like a fracture, or worse a head injury. So falls create many complications, emotional burden to patients and their caregivers. And not to mention, they're costly to our healthcare system on a larger scale. So there's technology that focuses on fall detection. So sending alerts after a fall has occurred, which is different than what we're doing at OneStep, because we're using our gait analysis to detect these trends in gait parameters that are correlated in the research with an increased risk of false. So in particular, when you see a decrease in gait speed, and an increase in gait variability over time, these parameters specifically in the literature have shown an increase risk for falls. And what our science does is looks for these changes in patients. So we're looking at trends over time, not just one specific point in time, which is important to note. And then considering these gait parameters, as well as several other critical ones, we will flag the patients who demonstrate a risk for falls, and report that to their providers, so the providers will be automatically notified. And then they can reach out to their patients and intervene before the fall occurs.
Frank Jaskulke16:37
Oh, wow, okay, that's kind of fascinating. And, I say in a larger context, I've had a number of conversations in the last couple of weeks to make me hopeful about, you know, health care improving in quality and lowering in costs, because of technologies like you just described. We always knew prevention was the best medicine. But we didn't really have tools that enabled it to be done, you know, at clinical grade. And that can be managed in the health care system we have today, right? We all get, we need to make change. But we still got to deal with the world we have. I'm hearing you describe a tool set that makes it possible for a care provider, whether it's a loved one or a clinician to provide that support, engage in preventative care, but it fits in their workflow. It's not something that is like additive or disruptive to what they're doing. The more I hear of tools like that, the more hopeful I get that we can shift the cost burden over and move more of the activity, more of the spending to the preventative care and actually get upstream of these things. I just thank you for sharing that. It's that's really amazing technology.
Alaina Victoria17:52
Yeah, it's very exciting. And the providers that we're working with, they're very excited about this upstream move and the continuum of care. And we actually had one of our very large teams of clinics that we're working with in the US. They focus on the older adult population. And their executive said that he couldn't wait to work with OneStep to change the way people age. And I found that quote very fascinating, because it just shows how important this preventative care is, as part of the treatment plan.
Frank Jaskulke18:18
I love that. Yeah, can't wait to work with OneStep to change the way people age. That's actually meaningful. That's just not impacting a little thing that that's significant. We've got a lot of people that will be listening to this that come from a whole bunch of backgrounds, right? Health care delivery, the payment world, device, drug, digital. Is there anything that you might want to say to them that they should think about or would create new opportunities for OneStep and partnerships or ways that could help advance the business and help advance the way people age?
Alaina Victoria18:54
Sure, I think if I could say anything, it would be to just help spread the word about the the meaningful work that OneStep is doing and how we're helping people to move better, and feel better and have less pain. And if they're interested in downloading the app, anyone can download the app and try it and take a walk for themselves and get a free gait analysis. And if anyone's interested in seeing the demo clinic, they can always visit our website and set up a demo, our sales team would be happy to walk them through the different features. And it's actually really neat, because you can take a walk on your phone, and then be shown exactly what those parameters will look like in the clinic. So you can review your own data. I do it often because I'm a therapist at heart. And I can play around with that on my own and then go into the clinic and say, Oh, look at this Walker. Look at this score. That's very interesting. So yeah, if anyone's ever interested in doing that, we'd be happy to show them a demo.
Frank Jaskulke19:48
Oh, that is very handy. And I'm sure people can Google one step and find you but what what is the website?
Alaina Victoria19:55
It's one step.co.
Frank Jaskulke19:59
We'll make sure that's in the show notes. Last question as we wrap up, what's next? Where's this going? What is what does '23 hold in store for the OneStem team?
Alaina Victoria20:12
Yeah, so we actually have some exciting news. Just this morning, we released our new upper extremity capabilities. So much of our technology previously focused on capturing lower extremity movement and gait analysis. But we now have the capability to measure upper extremity joint range of motion as well. So taking the phone and holding it in your arm and performing directed movements within the app, we can measure upper extremity joint range of motion, which is a very exciting next step for us.
Frank Jaskulke20:41
Oh, that is fantastic. Yeah, that opens up I imagine not only a whole new range of treatments, but a whole new range of partnerships.
Alaina Victoria20:48
Yeah, absolutely. I mean, we've always had the capabilities within our home exercise programs to treat the full body. So our video exercise library has always included a very diverse range of exercises. But now it's great to be able to offer that objective data in the same way that we're doing to treat lower body and other medical conditions.
Frank Jaskulke21:08
Well, that is fantastic. And thank you so much for sharing that. I got to say, thank you for taking some time out of your day to share a bit of this story of OneStep and help expand awareness with the Medical Alley community.
Alaina Victoria21:21
Thank you so much for having me. It's been absolutely great.
Frank Jaskulke21:24
Wonderful. Thank you. And folks, that's been another episode of the Medical Alley podcast. If you're not already a subscriber, make sure to go to medicalalleypodcast.org. Or you can find it on Apple, Spotify, Stitcher, or wherever you get your podcast fix. And hey, would you do me one favor? Would you help share this podcast? Just tell one person you know about it, expand the reachf we all did that, this story and so many other great stories of innovation in the Medical Alley community would reach a broader audience create more opportunities for patient impact. I'd really appreciate it if you do that. And until next time, have a great day.