After over a year in the making, The ALS Association in partnership with Prize4Life awarded the ALS Assistive Technology prize in Dublin during the ALS/MND International Alliance Meeting. We are thrilled to award one of the top prizes to Dexter Ang and David Cipoletta, two young entrepreneurs that founded Pison Technology based out of Massachusetts. They blew the judges away with their easy-to-use, self-contained communication system based on muscle EMG signals. People living with ALS are able to learn and use the system to communicate in minutes. We observed first hand as participants were thrilled with its comfort and usability while testing out their technology. We sat down with CEO Dexter Ang and CTO David Cipoletta to learn more about their company and their exciting new technology.

Do you have a message for the ALS community?

Dexter: It is an honor for us to participate in The ALS Association & Prize4Life Assistive Technology Challenge because it validates that our technology is at the forefront of innovation for people with ALS. The world needs technologies like ours to be able to help all patients worldwide. They will be major partners with us as we do our research and as we begin the distribution and sales of our product worldwide.

 What are your backgrounds?

Dexter: I have a degree in mechanical engineering from Massachusetts Institute of Technology (MIT) and am currently a graduate student at the Sloan School of Management. Previously, for eight years I worked as a Senior Trader and Director of Recruiting at a premier high-frequency trading firm in Chicago. I moved home to take care of my parents and then my mother was diagnosed with ALS.

David: I triple majored in computer science, computer engineering, and electrical engineering at the University of Rhode Island. Previously, I worked as a Senior Robotics Engineer on underwater unmanned vehicles for defense contractors.

How did you get involved in ALS assistive technology?

Dexter: I got involved in creating assistive technology when my mother was diagnosed with ALS and when caring for her, I discovered the available devices that could have helped her did not work. Her hands weakened and she was unable to control a mouse. We went to the best therapists and rehab engineers all over the world and discovered that perhaps there was not a solution on the market and I was going to learn about what was possible. I went back to MIT as a graduate student in the business school and media lab to be able to build a new technology to help all people with neuromuscular conditions, people who cannot speak or move. Our technology is not limited to ALS. It also applies to cerebral palsy and spinal cord injuries.

How did you and David meet?

Dexter: When I was discovering what technologies to use, I met with dozens of people with ALS all over the country, including Augie Nieto, Bobby Forster, and Steve Saling. During that process, I learned they were tech-savvy and innovative and were pushing for new assistive technology. Bobby was the most excited about building something new. Separately, as I was networking with my fraternity brothers at MIT, a friend’s co-worker introduced me to David, who was working on underwater autonomous robotic vehicles as a robotics engineer. I told David about my idea of making a comfortable EMG solution for people with ALS. He immediately said he could build it within 2 weeks.

David: The first proof-of-concept was completed in 2 weeks.

Dexter: Since that time we have been working together to improve our products.

Tell me about your assistive technology device?

Dexter: We are creating the first, wireless system that will allow all people who cannot speak or move to comfortably control the computer, phone, wheelchair, and co-modification devices. They will be able to wear small sensors anywhere on their body and to be able to communicate easily with their loved ones and to be able to have full independence as long as possible.

What is the goal of your device?

Dexter: Right now the device is the size of a roll of pennies. The goal is to miniaturize the device down to the size of a half-dollar coin. It will be a sticker that you can put anywhere on your body and can hide it under your clothes. Clients have said that they would wear two to four sensors. However, tech-savvy users would use up to ten of these sensors on their bodies. They can wear the sensors anywhere underneath their clothes all day long and can wear as many as you are comfortable with. It is all about user experience. Each sensor has its own signals, that way we can monitor each part of the body. The more sensors are worn, potentially the faster the typing capability. I want to emphasize that the system can work with even just one sensor.

What are your future plans for your device?

Dexter: We will have a market-ready product by the end of next year and be ready to transition to manufacturing. We are ambitious and have the road map planned out, so we can be ready to go.

Honestly, a lot of people do not believe what we are doing or think it is possible. It is important to say that some people think the problem we want to solve is impossible - to get electrical signals off a person in a comfortable way – on people with fully progressed ALS. They think there is no way people could have clear, comfortable, and efficient communication. They also believe that business-wise this does not make any sense and that there is no viable business plan. We have had to combat these impossible challenges with a fully developed plan that we have completed to demonstrate our abilities. People may not believe us until they see a product at hand that is being sold worldwide.

We are also launching a clinical trial in mid-2017, including 200 people with ALS and other neuromuscular conditions to test the usability of our device. We are partnering with Rick Bedlack and Kevin Caves at Duke University and Veterans Affairs on this project.

To learn more about the clinical trial visit: pison.io

Who are your other partners that help make this product come to life?

Dexter: MIT has been a big resource in providing us with a space to work, as well as the technical expertise in partnership to solve every possible technical challenge we have. The Dean of Engineering helps us solve every problem we have ever encountered. The director of The Martin Trust Center for Entrepreneurship at MIT, Bill Aulet, helps us with marketing and our business plan. For our R&D, budget, marketing, and sales plans, we developed as realistic and honest projections as possible, using as much experience talking to electronics and medical device companies as possible. That is how we created our business projections. We are also working with Jay Beavers at Microsoft to figure out a way to use our controller to be able to move a wheelchair.

What are your plans for the prize money?

David: It is going to contribute to our R&D budget to use to transition our device from a prototype into a product. Additional engineering has to be done to make that happen. Also, it will contribute to clinical field testing to give our device to people to test at home.

What is the value of your product?

Dexter: The value for people with ALS is that they will have the first comfortable and efficient way to communicate and to control all their devices. The value for therapists is that they will be able to have one stand-alone system that is easily configurable to help all people, no matter how far progressed people are. We have one single integrated system that will control a laptop, phone and wheel chair. It will be easy to teach to families and people living with ALS to learn. The value for neurologists is that all of the EMG (electromyography) signal strength data from each person is being captured 24/7 in an anonymous way on a secure cloud. They can see the strength of the EMG signals decline, stay steady or improve on a day-to-day, week-to-week or month-to-month basis. We can actually correlate the decrease in the actual ability of a person by comparing ALS Functional Rating Scale scores with decreasing or changing EMG signals attained through our sensors. This would be the first potential biomarker for neuromuscular diseases.

That is a lot of data. How is it stored in the cloud?

David: We have a partnership with Microsoft using their HIPAA approved cloud, where we store the data anonymously.  Only the user, the user’s family, physicians, and therapists have access. Our monitoring is a diary of a person’s everyday movement. Essentially, we are crowdsourcing their living habits to improve their quality of life. For example, the patient’s caregiver can put notes in the patient portal to say they have changed his/her diet. We can see the effect of this diet change on muscle activity.

Another example: Kyle Conners (a person living with the disease) says that drinking coffee helps his muscle strength. We would not know if it mentally or physically helping him. Because we have this biomarker, we now know based on what he is eating/drinking that it is either improving, weakening, or has no change in muscle signals. We would be the first company to have this data.

During patient studies, there is a large gap in what information is publically available. Patients expect or have an opinion of what may or may not work. We provide the first quantifiable metric that all people living with ALS, neurologists, and therapists can use to measure any little thing they would like to change in their environment, like diet, for example. Patients will be empowered to measure these changes in their own bodies, so they can understand if they are going in the right path or not with their everyday decision making.

Kyle did a wonderful job helping you demonstrate your prototype at The Challenge. How did you meet Kyle?

Dexter: Kyle is very much involved in the ALS advocacy community in Connecticut and goes to every ALS event in the area. I met Kyle at the ALS TDI Tri-State Trek, which is a 300-mile bike ride from Boston to Connecticut over a three-day trip. Kyle has difficulty speaking and great difficulty moving his hands. He was looking for what device could help him personally. He tried eye gaze and a head mouse and realized those solutions would not work for him. When he learned about our product, he signed on immediately. He participated in our pilot study involving ten people with ALS.

What was your pilot study?

Dexter: We asked ten people with ALS to type their first name or a few letters. Almost immediately, Kyle started typing his entire full name without us prompting him. He was a pro at this within few minutes of training. Our pilot results showed that all ten people were able to effectively use the device and to communicate by either saying yes or no. All of them saw that the device was easy to learn, comfortable and would be effective for themselves as well as others living with ALS.

Do you have a story to share with the ALS community?

David: By coming on this trip, we met a local person living with the disease in Ireland, who came up to us and said that eye gaze was too slow for him and would like to try our device. I actually had to adjust our software speed, so that he can use it really fast. He learned to use the system in five minutes and was typing his full name after that. He was diagnosed at age 15 and he is now 30 years old. He has no assistive technology. He is also very smart and gave us some great ideas, like mapping our system to his play station controller. It is our vision to control the environment around the users.

Another person also living with ALS, privately asked us if he could test his device. He is the most progressed and atrophied person who ever tested our device. We tested it on his calf muscle and he was able to start typing. He also does not have any technology now.

The ALS Association congratulates Dexter and David and we look forward to hearing more from them about their exciting assistive technology device in the upcoming year. We will be updating the ALS community with any new progress.