An app on prescription

Startup Pathmate helps chronically ill people to better master their everyday life: Personalized apps and coaching offers establish a more direct contact between patients, insurers, doctors and therapists and allow for individualized therapy.

One out of three adults in Germany suffers from high blood pressure, in the 60+ set it is more than 50 percent. Without treatment, there is a serious risk of damage to the heart, brain, kidneys and other organs. Regular self-monitoring is an indispensable means of prevention, however the patients often lack the necessary support.

Startup Pathmate

“More than half of the people with high blood pressure struggle to comply with their therapy plans. One reason might be due to the fact that people with high blood pressure usually don’t have symptoms and therefore don’t feel the urge to change their habits despite the long term consequences of hypertension. Moreover, people with high blood pressure often don’t know how to measure their blood pressure correctly at home to increase their control over their high blood pressure.” explains Michelle Heppler, co-founder and CCO of Swiss healthcare startup Pathmate Technologies, participant of Insurtech Hub Munich’s 2020 Innovation Programme.

Pathmate wants to support chronically ill patients by acting as a supporter, motivator and coach in their everyday life. For this purpose, Pathmate has developed an app called ” Manoa”, which guides patients in correctly measuring and documenting their blood pressure. Manoa provides individualized and evidence-based feedback to each patient and offers tools to better manage their risk factors and diseases including medication reminders, motivation and guidance for recommended lifestyle changes and content to increase patients health literacy.

The goal: a self-determined life despite chronic illness

The core feature of Manoa is the adaptive chatbot. It guides the user individually through an interactive therapy program focussed on blood pressure monitoring, exercise, nutrition and relaxation. It suggests motivating challenges and realistic goals based on the user’s needs. “Our goal is to support chronically ill people in leading a self-determined and fulfilled life,” Michelle Heppler states.

Manoa Blutdruck scannen

Pathmate Technologies was founded in 2017 as a spin-off of the Center for Digital Health Interventions, a joint initiative of ETH Zurich and the University of St.Gallen. The technology of the digital health coach is based on several years of research by co-founders Dr. Dirk Volland and Andreas Filler, which revealed the positive effects of using a digital coach on patient behavior and their therapies.

The nine-member Pathmate team – based in Zurich and Mannheim – consists of behavioral psychologists, data analysts and computer scientists. Medical contents always are developed and improved in cooperation with external physicians and experts in the respective fields. To develop “Manoa”, for example, Pathmate worked together with experts from the Hypertension Center of the Hannover Medical School (MHH).

Marketing digital health products – the “app on prescription”

Health insurance companies and other service providers aren’t hesistant about developing electronic offers for patients, but they repeatedly notice that these offers are only hesitantly accepted on the market. “The marketing of digital health products is considered particularly difficult because patients are rarely willing to pay for the product,” explains Heppler. “Additionally, there are high standards to be met: Healthcare apps have to fulfill numerous requirements and regulatory conditions as well as provide clinical evidence in order to be listed as a medical product”.

Manoa Screenshot

However, new legislation in Germany is currently bringing movement to the market: The “Digital Healthcare Act” (DVG), introduced in 2019, enables health insurance companies to offer digital applications. Doctors can thus prescribe the use of certain apps for therapeutic purposes – but only if the apps meet certain criteria (e.g. are medical devices class I or IIa) and are approved by the BfArM and listed in the “DiGA” directory. “Manoa” is registered as a medical device class I.

For patients, this is the first time they have the opportunity to have the costs of digital health applications reimbursed. So far, this ruling only applies to the German market and not to the Swiss and Austrian markets.

New Accelerator: ITHM is looking for startups with digital health solutions

It is obvoius, that health insurance companies will massively profit from cooperations with startups like Pathmate by distributing the tried and tested digital services to their customers instead of developing solutions on their own.

Applications such as Manoa are also the focus of the H + Digital Health Innovation Programme, a coop between InsurtechHub Munich and dmac/Digital Health Hub Nuremberg/Erlangen. Startups with a focus on digital health receive support in developing their business plans and establish contacts with representatives of the digital healthcare industry in Germany. Apply here for H+.


Text: Daniel Lange