Prevention before cure: how Liva Healthcare is driving positive behavioural change

T

ype 2 diabetes occurs when the insulin the pancreas makes is either lacking either potency or volume, meaning blood glucose levels keep rising when they should taper out. If left untreated, it can cause serious physical damage to the body, particularly to the eyes, heart and feet.

Where type 1 diabetes typically emerges in childhood and appears to be caused by genetic factors, type 2 diabetes tends to be diagnosed much later in life and is linked to both genetic predisposition and behavioural factors, like a poor diet, sedentary lifestyle and smoking.

Fortunately, while most people with type 2 diabetes will require medication, lifestyle changes can help manage the condition. Some patients are even able to come off medication altogether. But maintaining these changes over an extended period can be incredibly challenging, and dwindling motivation and leave many people back at square one.

Liva Healthcare is a company aiming to improve the lives of people at risk of, or living with, type 2 diabetes, obesity and cardiovascular diseases, by helping them positively improve their behaviour and develop healthier habits.

Founded in 2015 by the team behind NetDoctor.com, the company gives users access to personal coaching programmes to help them manage their health and improve their lifestyle through an eponymous app.

Liva Healthcare co-founder and medical director Dr Carl Brandt says: “The user experience is very much about meeting a personal health coach, both synchronously in a consultation where you have time to carry out a motivational interview to see what’s important to the person and then through follow-ups where the same person follows the patient and assists them in achieving their goals.”

Alongside the personal coaching, Liva users have access to group-based interventions, tailored health plans, as well as goal tracking and self-monitoring tools. The goal is to help them prevent, manage or reverse chronic conditions through new sustainable healthy lifestyle and behaviour changes.

Users living with obesity have an average sustained weight loss of 6.8kg during their first nine months of using Liva, while 44% of users with type 2 diabetes normalised their HbA1c level and achieve 'control' of their condition after 12 months on the programme. A further 85% of users at high risk of developing type 2 diabetes reduced their HbA1c levels in six months.

The ongoing Covid-19 pandemic has led to a significant shift in the acceptance of remote healthcare among consumers across the globe. Telehealth is booming, something which Liva expects to take advantage of long after social distancing regulations are a distant memory.

The platform is currently used by clients such as Novo Nordisk, AXA Health, Amgen, the City of Copenhagen, Bupa Australia and several other key players in public healthcare, insurance and life science industries globally. The company is also a partner to NHS England on its world-leading National Diabetes Prevention Programme.

“One of the interesting things with working digitally is that we can actually interact monthly, weekly, daily hourly, whatever is needed for the patient,” says Brandt. “I think that’s very much what it’s about, really being personal, being individual, seeing every patient as a person and interact in relation to what’s needed and how they live their lives.”

In January, the company secured access to €24.5m in funding, which it is using to strengthen its position in the European digital health market.

“With this money, we’ll be able to be up there in the different markets in different countries, where we can assist healthcare providers, life science companies and pharmaceutical firms to give the best service to their customers and patients,” says Brandt.

The company also has plans to expand beyond its current indications of type 2 diabetes, obesity and cardiovascular disease. Many chronic conditions can be improved by lifestyle changes, and Brandt sees potential applications for Liva when it comes to metabolic diseases, chronic obstructive pulmonary disease and osteoporosis as well.

In March, Liva announced the launch of a new scientific advisory board, made up of several respected scientific leaders in chronic illness and behavioural change. The board will oversee the quality of the programmes Liva develops and support research into the company’s behavioural change model.

Brandt will chair the board and is joined by: University of Twente chair of persuasive health technology Professor Dr Lisette Van Gemert-Pijnen; University of Gävle associate professor of medicine Åke Sjöholm; Klinikum München Süd head of cardiology Thorsten Lewalter; La Trobe University director of rural health Timothy Skinner; and Heartbeat Labs founder and managing director Stephanie Kaiser.

Kaiser says: “There are so many apps out there and so many digital solutions and we have talked so much about this whole topic, but now is the time to actually bring to market something like Liva which cleverly combines the power of a human with digital measures.

“I’m very happy to join the board because for once we’re actually doing it and not just talking about it – this is really a solution that will change the lives of patients.”

It’s the direct contact with clinicians that Brandt and Kaiser believe sets Liva apart from competitor applications in the healthcare management space. Platforms like Healthily, or diabetes management app Quin, have similar offerings when it comes to tracking progress and keeping oneself in check – but Liva believes it’s the direct contact with a professional that can make all the difference.

“There are more than 300,000 apps out there, and the key to Liva is integrating real persons into the solution,” says Brandt. “When a solution is purely digital, it can be extremely difficult to handle for patients who aren’t as digitally literate. We can see that patients have a preference for the way Liva is set up compared to other solely digital solutions. I think that’s important, to support people where they are.”