Grace McNamara CEO of EXi

Startup Spotlight is an interview series showcasing early-stage health, fitness, and wellness companies.

In this Q&A, we caught up with Grace McNamara CEO of EXi, a digital therapeutic for creating personalised exercise programmes. Founded by physiotherapists Carron and Lewis Manning, EXi sits at the intersection of fitness and medicine, connecting users to healthcare and fitness professionals. Looking ahead, by emphasizing behavior change and personalised care, EXi hopes to improve healthcare delivery.

Can you tell us about what you’re working on at EXi?

Sitting at the intersection of healthcare and fitness, we’ve created a digital therapeutic specialising in personalised exercise prescription for people at risk or diagnosed with a long-term health condition(s).

Think of EXi being to digital therapeutics what iPod was to digital music. Unlike other digital fitness solutions, EXi is classified as a medical device in app form, prescribing low- and moderate-intensity programmes and designed with multiple conditions in mind (up to 23 conditions). It’s a trusted, evidence-based, automated prescription.

The EXi platform connects people and professionals seamlessly by making it easy to share and view real-time data from wearables and smartphones in a user-friendly way. Therefore, EXi is the ultimate partner for professionals and digital therapeutics who want to engage people who need to be more active for health reasons.

How did you come up with the idea? What key insight led you to pursue this opportunity?

EXi is a purpose-driven company founded by two experienced physiotherapists: Carron and Lewis Manning. The two were driven by the realisation that no solution existed to help millions of people at the one time instead of the traditional one-on-one model.

Our vision is to tackle inequality, achieving a world where anyone can afford personalised, real-time healthcare.

Leveraging data is making that possible. The world today is like no time in the past. Technology is in your pocket, on your wrist, arm, chest, etc., and using the data to personalise healthcare is here to stay. The data that each of us carries every day has value beyond what most of us can imagine. EXi wants to put that data to good use and improve healthcare delivery, along with an individual’s self-care practices.

How did you turn your idea into a company?

After conducting research, building an algorithm, and a prototype, an early milestone was receiving funding from Sport England. This gave our founders the confidence EXi can work at a population level. Once it was clear the evidence could be brought to life for millions of people, the research published from Vitality’s Earn Your Apple Watch rewards programme provided the next tier of evidence for successful behaviour change.

At that time, I was leading health partnerships at Apple, and I knew from working with co-founders Carron and Lewis that EXi was the perfect fit to bring incentivised physical activity to all corners of the world. We decided then and there that the future of healthcare would involve incentivising behaviour change, with EXi at the forefront.

Winning a national contract from the NHS [the UK’s National Health Service] for weight management and diabetes prevention was another significant milestone. It proved governments will fund successful programmes for exercise prescription.

However, in order to bring both health and fitness industries together, we knew that we had to have a value proposition for both. Winning contracts with two large fitness platforms (including Gympass) was another milestone proving we can grow in both industries simultaneously and fulfil our purpose at the same time.

How big can this get? What’s the addressable market and how do you go about capturing it?

Globally, 1.7 billion adults have a chronic condition and only 8% use a digital tool today for management. As COVID has accelerated the demand by both patients and healthcare professionals, we predict 100% will be using a digital tool in the future.

The digital therapeutics market, meanwhile, is expected to reach $13B by 2027 with a CAGR of 20.5%. We aim to capture the market through partnership with health solutions and professionals who are singularly focused on certain conditions but, adhering to global guidelines, must cater to multiple conditions. For partners in pharma as well as insurers, we present a solution that implements value-based care.

Who is the core customer? How are you acquiring customers? And how will you grow the customer base?

We believe we have a journey ahead of us to transform this industry. But there are a growing number of people using digital health solutions as the world transitions to value-based care.

In the short-term, our core customers are health service providers who have health professionals referring to exercise professionals and using remote monitoring to augment healthcare delivery. In the mid-term, insurers and pharmaceutical companies implementing value-based care will become a key channel to reach millions of users. In the long-term, we’ll enable a direct-to-consumer freemium option.

Looking at your road map, what are some of the milestones you’re targeting over the next 3–6 months?

Healthcare professionals are only just starting to use the data that the average person has in their pocket. We’re already integrated with the Apple Health app and Google Fit, and we’re working on how best to expand the value we can return from that data for both patients and professionals.

A core focus is to improve the data collected, use cases, and impact of the data available for healthcare professionals to see, at a glance, what the data can tell them. That will enable us to become central to the health-/fitness professional workflow and to aid better care delivery and health outcomes.

To do so, we’ll be releasing our re-designed data portal with intelligence analytics across our healthcare customers over the coming months. Alongside rolling out across the NHS national Weight Management framework, we’re awaiting results of a bid for two NHS grants with multiple integrated care systems (ICS).

Internationally, we’ll establish a base in the US and advance our conversations with Cleveland Clinic, Johns Hopkins, Kaiser Permanente, and others. Finally, to achieve growth, we’ll be raising capital and building out the senior exec team.

Anything else you’d like to share with readers?

Like no other industry, healthcare has the unique advantage for partnerships to be more valuable than a field of competitors going it alone. EXi is designed to be at the centre of this market growth, unlocking partnerships along the way.


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