Covid 19 coronavirus: Early-warning app maker Elarm finally gets its border worker deal - what it cost

Datamine founder Paul O'Connor - turning big-data analysis smarts from marketing to healthcare. Photo / Supplied

A local company has finally inked a deal with the Ministry of Health that will see some of up to 500 border workers (or around 10 per cent of the total) trial its Covid-19 early-warning app.

Elarm, created by Auckland company Datamine, is a smartphone app that works with biometric data collected by a "wearable" such as a Fitbit or Apple Watch. It monitors for a slightly elevated temperature, heart palpitations, subtle changes to exercise recovery rates and, where it's supported by a smartwatch such as the new Apple Watch 6, a fall in blood-oxygen saturation - all of which can be indicators that a person has coronavirus or another ailment.

An example of an Elarm user where the system detected viral-load four days before a Covid-19 PCR test came back positive. Image / Elarm

Datamine founder Paul O'Connor says Elarm can detect such physiological changes associated with Covid up during the crucial 48 hours when a person has become infectious but has yet to feel any symptoms.

The trial will run through until early May. The app will first collect data for a baseline profile of each border worker, then look for changes. Participation is on a voluntary basis and data collected will be private to each border worker. But there is also the option to sign-up to the Elarm Guardian dashboard, which lets an employer - or in this case the Ministry of Health - view results.). O'Connor says in the case of one of Elarm's early corporate customers, US conglomerate Newcrest Mining, only registered nurses working for the company can view the data.

Datamine initially put Elarm on Apple and Google's app stores with a US$4.50 monthly charge per user. But in March, O'Connor said the software had "washed its face" (covered its development costs). His company decided to make it free in New Zealand and other territories.

That said, O'Connor revealed the Ministry of Health paid $50,000 for the border worker rollout, because it requested a number of modifications.

Border workers who did not already have a wearable would be supplied with a Fitbit for the trial, O'Connor said.

"If the Elarm app lives up to its potential, it might provide early notification to our critical border workforce if they're becoming unwell. That means they can take appropriate action such as self-isolating and being tested for Covid-19," Response Minister Chris Hipkins said this morning.

But Act leader David Seymour raised questions about foot-dragging.

O'Connor's company launched a beta version in March last year. As long ago as June 2020, with its first commercial release, top epidemiologist Dr Michael Baker told the Herald that, from an infectious diseases perspective, the Elarm had great potential to make a real difference, not just for Covid-19 but other infectious diseases too. Baker said New Zealand needed to back such technology. However, Baker also added that, like any new technology, Elarm would need to prove itself in field trials.

Seymour also pushed for the MoH to embrace Elarm around the same time. Today, he said, "We've been urging the Government to adopt Elarm for 314 days now. "The trial should have taken place 10 months ago."

O'Connor said he understood the ministry's position, however. "Although it has taken a long time to get this work going, the MoH has had its hands full with controlling the virus, sorting the borders and getting a national vaccine rollout going – all things that were not in play a year ago. They are good people doing a challenging job."

The window of opportunity has narrowed with NZ border staff, who were the first to be vaccinated when the first-wave of Pfizer-BioNTech doses arrived in February. But it's still ajar. The Pfizer vaccine is 90 per cent effective, meaning several hundred border staff could still catch the coronavirus. And as has been well-chronicled over the last few days, administration around the jab has been far from effective, allowing several dozen border staff to escape the needle altogether.

And if the ministry wants to widen its scope from border workers, Elarm could also be used for new arrivals to MIQ as an extra safeguard, or before people travel.

And most of the focus of his company remains offshore. Datamine (whose pre-pandemic business was mostly doing big-data analysis for marketing clients) now has Elarm users in 58 countries, with most in the US or UK.

"New Zealand Trade & Enterprise is helping us talk to other territories, so hopefully, we can help there," O'Connor says.

"As we see in India, Covid-19 is far from solved. The double-mutant we are seeing there is going to take a considerable effort to quell."

Epidemiologist Professor Michael Baker says apps like Elarm are "the future of healthcare." Photo / Supplied

A $3m raise mooted last year has now been put on hold, O'Connor says. With major customers in the US like Newcrest (which employs 8000) and an unnamed major US hospital group as customers, the app is self-funding.

Dr Andrew Chen, a researcher with Auckland University's Koi Tū: The Centre for Informed Futures, said more information and assurances were needed over privacy if the Ministry of Health was to get real-time or periodic access to people's Elarm results (Elarm's T&Cs say that users agree to share information with the organisation paying for their account).\

Datamine founder Paul O'Connor - turning big-data analysis smarts from marketing to healthcare. Photo / Supplied

"A lot of people will be wary about 'the Government' being able to monitor their vital signs, so explaining the privacy protections should be front-of-mind alongside explaining the cool technology," Chen told the Herald.

O'Connor responded, "Each person's data is held in a HIPPA-compliant Health Vault. They own their data. It's privacy-complaint and secure." (HIPPA or the US Health Insurance Portability and Accountability Act of 1996 (HIPAA) governs a set of privacy and security standards created by the US. Department of Health and Human Services).

In terms of the potential Ministry of Health contract, O'Connor says, "No individual real-time health data would be shared."

"People will be wary about the government being able to monitor their vital signs, so explaining the privacy protections should be front-of-mind," says Auckland University researcher Andrew Chen.

"The user is the owner of their health information.

"When someone signs up for Elarm Guardian - which enables employers or MoH to view the results - they can allow or disable the four-hourly model results to be considered by health professionals."

The Ministry of Health engaged with Privacy Commissioner John Edwards over technology solutions deployed, and being potentially deployed, in the war against the virus.

In terms of overall performance, O'Connor stresses that Elarm "is not a Covid test". The app collects data about changes in your biological state - then lets you know so you can consult a medical professional to see if your have coronavirus or another ailment. "It's not a replacement for a Covid test, it's a real-time complement," he says.

Elarm aims to capture heart rate and other data that could indicate a person has entered the two to three day period where they are infected with Covid-19, but yet to display symptoms.

O'Connor says it can currently detect Covid-19-like symptoms with a 70 per cent success rate and rising, thanks to analysing thousands of data points, developed in collaboration with medical clinicians from New Zealand (including Counties Manukau DHB critical care specialist Dr Brett Gerrard), Australia, United Kingdom, Europe and the US (including rapid testing specialist Dr Todd Malan).

Members of the Datamine team, who got a prototype version of elarm running by April. Photo / Supplied

With vaccine programmes now underway, it's possible to see the light at the end of the Covid-19 tunnel.

Elarm crunches data collectd by wearables like Fibbit's bands and watches, and Apple Watch (where Google Fit is installed and, soon, via Apple Health). Photo / Supplied

But O'Connor anticipates that won't be for some time.

And he adds that Elarm could be readily adapted for outbreaks to come.