Public health has never seemed more important than during this past pandemic year. So when Inder Singh, founder and CEO of Kinsa Health, closed the W2O Digital Health Virtual Summit in early January, his company’s successes and promise resonated deeply. Kinsa makes a connected thermometer, now used in more than 2 million American homes. That innovation is more profoundly important than it initially appears, because the insights the network leads to offer a deep predictive view into public health.
Singh explained that the company’s network detected anomalies three weeks before the March recognition that Covid-19 case numbers were surging across the U.S. The company could already tell that a “black swan” sort of health emergency was affecting a broad swath of the country. Its thermometers were detecting anomalous readings in Washington State, California, New York, Michigan, and Florida. But Singh described a frustrating emergency call he had with friends in public health. “They said it’s not credible,” he explained, “because you’re telling us that Covid is everywhere.” That was not what the CDC then believed. Amazingly, the curve created by the temperature spikes Kinsa detected in the population matched almost exactly what the one created by death rates from Covid looked like just a few weeks later.
Its belated recognition for this achievement got Kinsa a lot of press attention in 2020, but Singh and company had been working on their system for years, and had seen repeated similar successes with flu outbreaks. “I’m sad it took a pandemic to bring to light how important our work on early warning of outbreaks is,” he said. “But I’m thrilled we survived as a company to get here.” The company was founded in 2012. Largely as the result of its pandemic successes, its network of deployed thermometers doubled from about one to two million in 2020.
“The citizens of this country benefit from an early warning system,” Singh explained. “In any epidemic, there’s a four-part response. One is early warning. The next is widespread testing. The third is treatment and isolation, and the fourth is conferring immunity to populations. We do the latter three well, but we’ve never had an early warning system.” As his interviewer, I asked him who Kinsa would most like to partner with. His answer was immediate and unequivocal: the federal government. Singh says that a network of about 5 million operative Kinsa thermometers could enable the country to have “zip code level” detection of outbreaks going forward. It is a powerful illustration of how much improvement digital healthcare tools are likely to eventually enable in modern life. I hope Singh gets those partnership talks going with the new administration.
Kinsa doesn’t just sample temperatures. “Think of it as a connected triage system,” Singh explained. “A smart thermometer is the glue the allows us to consistently speak to a household early in their illness journey, before they’re seeking care.” What makes the process powerful is how the thermometer ties to a smartphone app Kinsa asks all its customers to link their device to, using Bluetooth. Once a customer takes a temperature, the app helps them figure out what it means. Should they see a doctor? Go to the emergency room? Or just do home care? “Think of it like a nurse hotline on steroids,” Singh said. As the result of all that user interaction, Kinsa creates a huge database of health information.
Singh’s background prior to founding Kinsa was in global public health, working on issues like distribution of malaria drugs in developing countries with large global NGOs. “But I got really frustrated after I saw the way the world tries to respond to infectious disease,” he said. “The sad fact is we do it with zero real-time information about where and when disease is occuring and spreading. So we thought to ourselves, there has got to be a better way.”
Beyond its clever technological solution, Kinsa added another key intervention upon which its success as a predictor of outbreaks depends. In partnership with governments, particularly cities, it has given away about one-fourth of its total thermometer deployments. “There is an extremely large group of people in the United States–a group that is way too big–that is underserved, that doesn’t have easy access to health care” he explained. “And every single epidemic that has ever occurred, flu or otherwise, has disproportionately affected the underserved. Why? Because by definition they don’t have access to care.” He said Kinsa could not have detected the anomalous incidence of Covid so early had it not been able to incorporate insights about what was happening among poorer Americans. Otherwise its demographic sampling would have been inaccurate and incomplete.
Kinsa’s data continued to offer insights even after the pandemic was rampant. “The biggest utility of our network going forward is going to be to see how fast our new interventions, the vaccines, are working. We’ve seen the effectiveness of existing interventions. In April and May when mask mandates came out, within three to seven days we saw fever levels…leveling off. The degree to which they fell was an indicator of how fast we were breaking the chain of infection.”
One of the biggest lessons Singh has taken from Kinsa’s successes so far is about the power of crowdsourcing. “We need these kinds of trusted networks of cooperation and coordination to solve big problems in the world,” he said. “I hope the Kinsa story will motivate others to not only partner with us, but also go and build these kinds of networks to solve other problems, too.”