Going to the doctor’s office to do blood pressure measurements provides an incomplete picture. People are usually nervous at the office and the readings tilt high. But the biggest hurdle is that doctors can take three to six months to get the right medication and doses to control hypertension, with irregular measurements.
Early on, Olgin and Sinha decide to see how much they can improve outcomes by having patients measure at home. They undertook a study with home versions of blood pressure cuffs. The participants took their blood pressure every day. When the study ended, he says, they found that doctors were able to capture the appropriate treatment within 17 days on average.
But it was difficult to get consistent results from the home reading. Even state-of-the-art home appliances sucked – their discomfort made them difficult to use, patients had to remember to keep them charged, and the Bluetooth could be shaky. “It was an absolute nightmare to use those things,” Sinha says. “Everything about the process was painful for these people.”
A much better alternative would be to leave the rude cuff. As he ponders how he might rather use a phone, Sinha begins to wonder if a camera and flash might be extracting information from the fingertip. “Despite how far the fingertip is from your heart, it has many veins,” Sinha explains. ‘So when your heart beats, a large amount of blood comes through. It’s almost like a sound wave that alternates between extended and compressed. This is the wave pulse waveform. ”
Sinha’s idea was not original; people have been writing papers on the wave pulse waveform since the fifties. But no one has yet found a reliable way to measure blood pressure with a telephone. “There’s this holy grail in the research community – can you use a common commodity to capture things?” says Shwetak Patel, a professor at the University of Washington (and a “genius” award winner of the MacArthur Foundation) involved in the development of such home tests, recently for Google Health. Google recently released A pixel phone app that uses the camera to measure pulse rate and breathing rate. But blood pressure, says Patel, is one of those holy grails.
In 2014, one company thought it had an answer. An outfit called Aura has released its Instant Blood Pressure app in Apple’s App Store. “This app is a breakthrough for blood pressure monitoring”, writes “Archie1986” in the App Store’s top rating. But when the Federal Trade Commission investigated it, it found that the app did not work. And? The FTC also found out that Aura’s CEO had posted the reproduction of Archie1986.
Sinha feels he can do better. The easiest part was to get the waveform from the person’s fingertip. The tricky part is analyzing it to get a useful blood pressure reading. Sinha says he came up with a way out of it, though it still needs to be ratified from the outside.
When Sinha Olgin told of his plans, the cardiologist was curious but cautious. “From a physics point of view, it made perfect sense. But only when I saw the data coming in, I thought it would really work as it should, ”he says.
About the time he perfected his tools, Sinha shared his vision with a venture capitalist named Greg Yap, who specializes in healthcare. When Yap became a partner at Menlo Ventures in 2019, he invested in Sinha’s company and invited him to move to Menlo’s office in San Francisco as part of a new project called Menlo Labs.
Sinha was working on Menlo Labs and was still trying to come up with a business model for his idea. He also had to attract an experienced entrepreneur to lead the company. Another partner at Menlo, Shawn Carolan, had just the person in mind, someone he had funded in several successful ventures.