RenalTracker
RenalTracker is a web- and mobile-based Chronic Kidney Disease (CKD) patient-led management platform in between doctor’s visits.
1.7 million Dutch (more than 10% of the population) have at least one clinical sign of existing Chronic Kidney Disease. CKD is a progressive disease, doctors and patients need to delay dialysis or transplant as much as possible and maintain kidney function. Patients rely to the best of their abilities on their doctors’ advice, but in between the 15-minute consultations 2-3 times a year, there is a gap of validated information and no feedback loop. Most educational materials and intervention also focus on End Stage Renal Disease and preparing for Stage 5, not on Stages 3-4 where an intervention may help delay Renal Replacement Therapy.
Behavior change to help delay dialysis
For the B2C side, we are initially targeting the US, UK, Canada and Australia where there are 24 million pre-dialysis patients. Out of the total market, 38% or 9.1 million receive little to no pre-dialysis help. We believe we can reach 71% or 6.39 million via Search Engine Marketing.
We are currently developing our B2B models for the Dutch market in 2018Q2.
For B2C, the app will be based on a software-as-a-service or SAAS model. We are in the process of finding the optimal price points and we are testing anywhere from USD 17 to USD 47 per month on a recurring basis depending on the features and services that patients would want to avail.
Compared to our competitors, we are focused on behavior change for the long-term.
Other alternatives that patients use are mostly dialysis clinics that generate leads via online channel and don't have health coaches, like Davita. Aside from this, patients also use general dieting apps like MyFitnessPal.
While there are apps that are offering kidney disease focused dieting, they don't have health coaches or a behavior change-focused curriculum.
RenalTracker's features:
• Meal logging focuses on the four daily nutrients that have to be specifically restricted in a CKD patient's diet - sodium, phosphorus, potassium, and protein;
• One-on-one nutrition and lifestyle coaching with a renal nurse, dietitian, or health coach depending on the patient’s specific health needs;
• Behavior change reinforcement through a development collaboration with the US Stanford University's Persuasive Tech Labs;
• A 12-week educational bootcamp based on the US/UK Diabetes Prevention Program and National Kidney Foundation guidelines;
• Predictive analytics in collaboration with Dutch data science company Orikami.
Version 2.0 (2018Q2):
• Adaptation into a 16-week educational bootcamp of the STERK (STimuleren van Eigen Regie en Kwaliteit van leven van mensen met chronische nierschade) content. This was developed by the Universitair Medisch Centrum Groningen in collaboration with 4 other Dutch hospitals, and sponsored by Nierstichting Nederlands;
• One-on-one lifestyle coaching will be done by STERK-certified Trainers;
• A translated version of the iOS application in Dutch.
Once clinical validation has been completed, RenalTracker will begin applications for patents.
Our startup is registered as a BV in the Netherlands in the City of Nijmegen where we currently have 2 FTEs. Our subsidiary location in Cagayan de Oro, Philippines where content creation, marketing, and web development is being done employs 9 FTEs. We are the company to make this work because we're a diverse team of professionals from a broad spectrum of disciplines.
The planned clinical validation is a two-tier, 24-week pilot randomized matched controlled trial as a clinical proof of concept for a digital behavior change platform as an intervention for chronic kidney disease patients to delay dialysis. The primary outcome measures patient satisfaction and self-efficacy/perceived control of disease management. Secondary outcomes includes measurement and comparison of CKD clinical values.
Tier 1 will use a Perceived Self-Efficacy questionnaire to measure patient’s overall sense of well-being and ease of program compliance after the 16-week core curriculum. It also establishes baseline CKD-related laboratory test values per patient. Tier 2 documents CKD-related laboratory test values per patient at the end of the 24-week intervention.
Subjects will be recruited exclusively through hospital partners to have a more consistent control group using standard therapy. Primary activities include regular physician consultation visits and laboratory tests, the frequency of which will be determined when the hospital partner is selected.
Our primary research partner and clinical testing site is Universitair Medisch Centrum Groningen (Netherlands). Quint Healthcare (Germany) is a consultancy firm we are working with in the development of our clinical validation protocol.
Other product development partners: Stanford Persuasive Tech Labs (US) for behavior change and Orikami (Netherlands) for data science.
RenalTracker is also working with Vital Innovators (Netherlands) to conduct further market research and develop our B2B models based on a Social Return on Investment analysis.
The hypothesis is that Renal Tracker will have a positive net health benefit as measured by patient compliance and satisfaction versus standard therapy. Secondary outcomes include the comparison of CKD-related laboratory test values at the beginning, middle, and conclusion of the study.
On the B2C side, we are using online marketing as a way to generate leads and send them regular health teachings as a way to provide value before selling. In the past 8 years of the CEO's career has revolved around this marketing techniques. In fact, in the learning phase, we got most of our sales from this strategy.
The bigger picture in our roadmap is in reimbursements where insurance companies will pay for the services that patients get from RenalTracker. This will come after we have proven that the curriculum, does, in fact, delay the progression of patients to dialysis compared to the standard course of patient treatment. However, this will only come after at least 1.5 to 2 years of running the clinical validation. In the meantime, we are building a case for the Netherlands and Belgium as B2B.
For the next 12-18 months, we are focused only on targeting four major English-speaking countries in the US, UK, Canada and Australia for B2C.
We want to create more specific interoperability standards for transitioning care from pre-dialysis Chronic Kidney Disease (Stage 3a/3b-4) through RenalTracker to End Stage Renal Disease (Stage 5). Among the functionality augmentation proposed to improve the existing product is a module for preparing this transition to renal replacement therapy.
Product-market fit has been verified for the US, UK, Canada, and Australia and we will continue prioritising B2C international expansion in those countries. B2B in 2018 will focus on the Netherlands and Belgium.