ACTIVATION Health: Made-at-UCalgary app aims to change how recovery is measured

What began as a conversation at a University of Calgary networking event has evolved into a digital health app called ACTIVATION Health, a new startup company and a promising tool to measure patient recovery after surgery. 

For Dr. John Holash, PhD, an associate professor (teaching) in the Faculty of Kinesiology, the story started at a McCaig Institute for Bone and Joint Health event called SPARC, designed to connect researchers and clinicians from across the university. There, he met Dr. Fred Nicholls, MD, a spinal surgeon, and Dr. Joe Kendal, MD, an orthopedic oncologist, both faculty members in the Cumming School of Medicine. Although Nicholls and Kendal came from different disciplines, they quickly discovered they shared a common challenge: understanding how surgery patients are recovering at home once they leave the hospital. 

“I instantly saw a synergy,” says Holash, BPE’95, MSc’00, PhD’17. “They were interested in understanding how people were doing after surgery, and I had experience working with activity and health data. It seemed like a natural fit.” 

The result was the ACTIVATION Health app, which passively captures information such as step count, walking speed, stair climbing, gait metrics and other health data through Apple HealthKit and connected devices. Because the information is collected in the background, patients can continue their daily routines without relying on their memory to fill out questionnaires about their recovery.

The challenge of tracking recovery

For many surgeons, accurately measuring a patient’s recovery between clinic visits can be difficult. Nicholls says traditional assessments often rely on patient questionnaires and followup appointments, which provide snapshots of a patient's progress. 

“Patient-reported outcomes were not telling the full story,” says Nicholls. “I started asking myself whether biometric data could provide a more objective representation of recovery and help us understand the factors that influence it.” 

Continuous data can reveal not only how patients recover after surgery, but how their health and activity levels change.

Building a made-at-UCalgary app

Together, the team envisioned a platform that could securely collect and analyze activity data already being gathered by smartphones and wearable devices.

Holash stepped in and began building the platform himself with constant feedback and collaboration.

“The idea was too good to let go,” he says. “We started relying more and more on the version I had developed, and it grew from there through constant feedback and collaboration.” 

Today, the app is available through the Apple App Store for approved research studies. It has generated interest from research teams across Canada and the United States. 

Collaboration driving innovation

For Kendal, the project demonstrates the power of bringing together experts with different perspectives.

“Understanding granular details about how our interventions affect what truly matters to patients is critical,” says Kendal, MD’15, MSc’19, PGME’21. “The combination of patient-reported outcomes and smartphone-derived mobility metrics provides a comprehensive picture of real-world patient outcomes.” 

The collaboration has since expanded well beyond its original concept. The project has received research funding, secured ethics approvals, supported graduate and undergraduate student projects, and led to the creation of ACTIVATION Health, a startup focused on further developing the platform.

UCalgary's entrepreneurial ecosystem also helped move the project forward. Through the Hunter Hub for Entrepreneurial Thinking's Experience Ventures program, which is in part funded by the Government of Canada’s Innovative Work-Integrated Learning Initiatives, undergraduate students contributed to early stage venture development for the company, supporting areas such as server infrastructure and prototype development. Those experiences helped bridge the gap between research, innovation and commercialization while providing students with hands-on learning opportunities.

Looking ahead

As research studies continue and new collaborators join the project, Holash sees significant potential for the platform to support a wide range of health and recovery applications.

“We've had interest from many different research groups because recovery is something that affects so many areas of health care,” he says. “What started as a single conversation has turned into something much bigger than any of us expected.”  

To learn more about the platform, visit the ACTIVATION Health app website.