Outside a surgery room, Maggie Deng watched the doors swing open as patients connected to wires were wheeled out on carts, while a doctor told her that prevention was too late for many of their conditions. There weren’t sufficient facilities or platforms to help them take proactive steps, the physician highlighted, hoping that Deng would consider exploring a solution. At the time, Deng was touring hospitals as a board member and shareholder for stroke rehabilitation equipment company NextStep Robotics.

“They said prescription exercise can really change people's lives while they're still healthy in a way that [...] reverses the risks [of a huge amount of diseases and conditions],” Deng recounts to the Vancouver Tech Journal. “I fully believe this is the ultimate way to change our world because medical care costs are mostly generated by people aged 45 and over.”

As an investor who had previously guided companies at Morgan Stanley, Deng believed she could help by funding a startup already addressing the issue. However, when she explored the market, she couldn’t find a single product available. Many exercise apps, she explained, focus on attracting users interested in improving aesthetics or performance rather than addressing the prevention and management of chronic conditions and injuries. This, she suggests, is because these solutions are often created by younger demographics who design with their own age group’s priorities in mind. 

So, in 2019, Deng tapped a team from one of her portfolio ventures in Vancouver and founded Ginkgo Health, a startup focused on reducing the global healthcare burden of aging. On December 8, it will launch Ginkgo Active, the world’s first AI-powered exercise prescription app.

Ginkgo Active will deliver personalized routines based on assessments and health rules related to exercise type, intensity, fitness level, and risks — a level of computation the startup claims surpasses human capability. That’s because its algorithm leverages more than 170,000 data points from healthcare research, service providers, and past user activity. 

“Professor Ginkgo represents all our algorithms,” says Deng, referring to the app’s character that guides users alongside their digital twin. “His super brain is what we call AI-powered. He knows all evidence-based, science-led rules which are applicable to each user. We have hundreds of different rules [to provide] what we call a prescription.”

The app will also take into account real-time feedback from users — such as their mood, energy levels, or whether a task is too easy or too hard — as well as their environment and available equipment. Using this information, it can adjust training sessions daily and provide a reassessment every four weeks, along with an updated prescription.

Every prescription follows three principles: targeting an individual’s conditions, working all body muscles, and minimizing any risks.

“For someone with high blood pressure, research shows that they should avoid doing head poses lower than their heart and raising it quickly,” shares Deng. “But how many people go to yoga and remember this? How many instructors will [check] people's blood pressure levels and say, ‘Maybe you’re someone who shouldn't do downward dog pose?’”

To ensure the platform was expandable and flexible, Ginkgo took a different approach to its development. While companies like Apple focused on pre-recorded videos, the startup quickly realized it wasn’t ideal due to the difficulty of adjusting timing and speed, as well as the significant memory and storage requirements. 

“Another challenge we were thinking about was, ‘How do we incorporate new research into the software?’” says Jack Li, co-founder and CFO of Ginkgo. “In the health world, new research typically takes about 17 years to become practical. Many of the medical books people are learning from are already outdated. We wanted a way to get [information] into the app almost instantaneously.”

These obstacles led Ginkgo to partner with movie studios and gaming companies, like Unity. Together, they developed a solution that combines technologies not previously used in health applications: game engines, motion capture, and 3D avatar rigging. This method allows the platform to digitize and add as many and all exercises needed, as well as scale as it expands offerings.

“About 11 percent of the determinants that affect overall health are medical-based, meaning that the other 89 percent are not,” says Li. “Exercise is part of it, but then there are also other determents [...] When we started Ginkgo, of course, exercise was the key focus because that's what's lacking right now, but it's really about holistic health. [...] Education, mental health, nutrition, and social aspects are huge components. The good thing about building this platform on an engine is that it's expandable. Just like how games are expandable, we can build an expandable virtual life in Ginkogoland. That's what we're striving for.”

Ginkgo revealed that it’s already planning more features. These include a knowledge library; additional room options, like ones for meditation; and recommendations for rest days, such as one-minute exercises. It’s also considering setting up activities between users and allowing them to earn points for virtual vacations.

Currently, the app is offering early-bird offers for individuals at $49.99 per month. It also caters to families at $8.33 per month for up to three members. Its pricing, the startup said, makes it easy for the “health organizers” in households —  the ones who typically make appointments and hire care — to lower the barrier of setting up and encouraging a solution to, say, their parents who need it.

“This is a very modern problem because [some of us] chose to have our kids a lot later in this generation,” highlights Ashley Hargreaves, Ginkgo’s CMO. “So now our kids are little at the same time as our parents are needing extra help. [...] We are also carrying more of a workload in the workforce because Generation X and boomers are retiring. So we're catapulted into this really intense period where we're caring for two generations and filling most of the management positions in society as well. I can't speak personally enough to the peace of mind that something like this brings now that we have more tools to help support our aging parents, in both preventing and managing chronic conditions.”

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