Recent studies and reports have shown the importance of gut health not only as essential to the immune system and mental health, but also as an independent and interconnected "second brain." Indeed, its 100m enteroendocrine cells are similar to neuron synapses. They not only send hormonal messages to the central nervous system, but are directly connected to the brain through the vagus nerve.
Seeking to improve general health and mental wellbeing through better understanding of the gut, Barcelona-based Indiehealth created Benergy, a free Spanish-language app for stool and bowel movement tracking.
The company's CEO and co-founder, Anna Sort González, is a nurse with experience of Irritable Bowel Syndrome (IBS) both professionally and personally. She knows that the illness is difficult to diagnose, difficult to talk about and inconvenient to live with.
"After a conversation with a friend who revealed she had not spoken about her IBS for years, Anna realized the full magnitude of the market," Alba Sort González, the company's marketing manager and the founder's sister, said at this year's 4YFN in Barcelona.
Gut health is not currently a popular topic area in Spain, but it is exploding in Anglo-Saxon countries. Alba Sort said: "40% of global research concerning the gut has occurred in just the last seven years. Many physiological processes that we thought took place in the brain actually happen in the bowel." Gut bacteria are in involved in almost every process in the human body. They control blood sugar and cholesterol levels as well produce vitamins and hormones.
Microbiota analysis
“There are many digital health tools coming out, but we have not yet seen the combination of digital health with analysis services in this area," said Alba Sort. Some companies, though, offer microbiota analysis, an area that is beginning to emerge especially in the United States.
"The Benergy app uses mobile app development technology," she added, "but we are planning to incorporate machine learning to study all the data, find correlations and identify patterns. It will be available in English within a month."
The app is intended to offer practical advice, as one might expect from a startup with a nurse as CEO. Longer term, Benergy will also offer microbiota analysis in order to recommend specific diets, and the Bristol scale analysis to identify stool shape and consistency. "Both can provide information according to the latest research in this field," said Alba Sort.
Alongside free content, Benergy offers premium content subject to micro-payments. For example, users are required to share data with a doctor to get premium access, or to watch certain health videos. "We work with a microbiota specialist and we are talking to a reputed gastroenterologist who we hope will join our team," said Alba Sort.
Team and business model
Indiehealth was founded in July 2018 by the Sort sisters. The first employee Beatriz Navarro, an engineer in charge of the technical aspects, joined in August. Anna Sort has been a pioneer in health gamification, digital health and m-health issues since 2012. She set up a health gamification consultancy in 2014 and has since spoken frequently on digital health, including a Barcelona TED talk.
Alba Sort lives in Edinburgh, and has worked for more than 15 years in marketing and branding for technology companies in hardware, software and digital services. "Our aim with the Benergy app is to get better known in the sector," she said. "We wanted to make it free because our business is B2C and it needs many users to have traction. Optional micro payments are also very affordable."
Benergy is a tool to collect data. It can even facilitate an appropriate diagnosis when a doctor sees all the information. It is also the hook in IndieHealth’s sales funnel. The next step, high-added-value annual subscription services can give the company some business margin and will consist of a periodic analysis every quarter, six months or once a year, depending on what the customer chooses.
In June 2019, Indiehealth won a spot in the fourth edition of the Emprende in Health program organized by the pharmaceutical company Lilly and the UnLtd Spain Foundation. The startup also presented its app as a finalist in the CITAEmprende 2019 contest and in #TendUP Barcelona. It will soon do so at the WebSummit in Lisbon in November.
Consumer demand
According to Dr. Elena Verdú, about one third of people suffer from gut-related symptoms (including food intolerances or immune reactions). The main problem is that true sensitivities in terms of evidence-based medicine are quite difficult to understand, as symptoms are not clearly linked to a specific trigger. Thus, the exclusion of a specific food component does not guarantee better health.
What is clear is that patients are looking for alternative solutions to conventional healthcare. “Swap test analysis is already being carried out in other medical fields," said Alba Sort. "For example, 23andme performs DNA analysis by collecting only a saliva sample. Thriva (from the UK) offers patients the possibility of doing blood tests at home. With their kit, the patient carries out his or her own test and sends it to the company, which then sends the results to the patient.”
In the case of Benergy, the subscriber will periodically receive a small kit to perform a swap test at home. The test can be carried out with a small stick similar to the cotton swabs used to clean ears.
Financing and future
Indiehealth has been bootstrapped to date, with an initial investment €45,000 and an ENISA loan of €61,000. “At the end of the year, we will consider opening a seed round, although for us the right partner is more important than the money. Specifically, we do not want to lose focus, which is sometimes inevitable when negotiating a financing round,” said Alba Sort.
Although Indiehealth has received proposals to address the corporate health angle, the company is determined to concentrate on B2C first and to test the concept on a smaller scale before embarking on B2B.
“In the medium term, we would like to study the Chinese market because feces are very important in traditional Chinese medicine and we believe we may find synergies there," Alba Sort said. "We would also like to open offices in the UK, where I am based, before taking the leap to the US from there.”
