Agile, watchful, dignified: Otiom’s medical tracking infrastructure found the connectivity to match

One early afternoon, Torben, a resident at a care home living with dementia, left the building without anyone noticing. Torben was not back by dinner time and it was time for the staff to act on Torben’s absence.

And if at this point you are picturing the care home staff in panic, police cars and radio noise, and volunteers searching with flashlights, you can forget it. Instead, Torben’s caregivers can react to an alarm sent to their phones, and access the location information from Torben’s Otiom tracker.

Torben wasn’t too far and the staff could locate him in real-time and return to the safety of the care home together. Professional caregivers have an action plan to calmly follow, relatives are reassured, and Torben maintains his individuality and freedom to move, without compromising his safety.

That’s the promise of Otiom: An intelligent tag that prevents people with dementia from getting lost, maintains their sense of freedom, and gives caregivers a course of action when one is needed.

About Otiom: Intelligent tracking infrastructure for people living with dementia

This was just one example of how caregivers and individuals can find relief with Otiom. Otiom’s medical device and full solution are tracking infrastructure that prevents people from getting lost and ensures they can be found, if they wander. 

However, Otiom goes beyond continuous, invasive, and often ineffective tracking that psychologically constricts the individual. Otiom recognizes where home is, where safe turf is, and where the uncertainty zone begins.

Even when a person exceeds the bounds, their location is not instantly visible to all caregivers. First, the caregiver is notified, and if they accept to help, then they can follow the person’s location in real-time.

Otiom’s intelligent user experience design has the technology design to match. Going beyond a typical, power-hungry, always-on GPS, Otiom combines a mix of connectivity: a Bluetooth beacon that advertises itself and classifies the home turf and safety bounds, cellular connectivity, NB-IoT and LTE-M, for the out-of-bounds territory, and GPS tracking that is activated after the caregiver raises their hand to help. These technologies work together to give the people maximum freedom, both psychologically and geographically, and maximum battery life.

And the latter isn’t over-optimization. As Thomas Pedersen, Founder and CEO of Otiom, tells us, it was a primary user need in a market where trackers with always-on GPS last for a couple of days before they need charging.

A tracking solution designed with the users, for the users

Thomas Pedersen walks us through the sophistication of Otiom, starting from its preconception. Back in 2018, the Otiom team was at the early stages of developing a tracker for a different use case.

When exploring the possibilities, the Danish Alzheimer’s association approached Otiom with a need for an energy-efficient tracker for people with dementia. The interest grew and soon enough, Otiom was part of a public-private innovation partnership, with six Danish municipalities, caregivers, universities, and youth groups to explore what users need from an intelligent dementia tracker. Thomas tells us:

“In this group, we defined the different technical terms of the tracker, but we also decided that the device should be created together with the users. That’s when the users told us that battery time was a key issue. At that stage, we didn’t know how the product would look, but we started developing it together.

Later we sat in a youth group class and we had the opportunity to talk about the needs, what would be good to have, what wouldn’t be great to have and we could show different forms of the product. All this feedback came into the design process and defined the product design. “

How Otiom’s network switching navigates bounds

And so the Otiom concept came to be: A tracker that is passive by design, developed with sensitivity for the individuals and with sophisticated but simple technology to serve its users. Thomas explains the nuances of Otiom:

“The Otiom app is not constantly showing a position. The house is defined by a Bluetooth beacon, and we define it as a home, whether you’re still living inside your own house or a bigger house. listens for a Bluetooth beacon and then knows it’s at home and safe.”

However, that is still not a cause for concern because, as Thomas continues, “you can still have a larger area where you’re safe and not trigger an alarm”. If the person moves out of these bounds, that’s when the caregivers get an alarm that the person is outside the defined zone. The caregiver can then raise their hand if they are able to help. If they can’t, the alarm trickles down to the next caregiver. If they can, the tracker then actively shows the location of the person. Thomas clarifies:

“The alarm shows the last position of that beacon, stating that last time the person was home and where the beacon was placed – a “last seen here” function. Multiple helpers can get that message. And then when you opt in to help, the actual tracking starts.“

From Bluetooth, to cellular, to GPS: A network cascade for intelligent triage

As Thomas explained, the Otiom technology and network mix are intentionally selected to make the device a preventative measure that respects the individual’s privacy rather than a constant location tracker. The network switch and the caregiver’s command act as the cue to switch from passive to active tracking.

Thomas outlines how the networks work in symphony:

“Otiom switches from Bluetooth communication to NB-IoT or LTE-M today. We need to have something where we can communicate easily and a lot. So when we communicate, we get a signal from a BLE and we can do around 250,000 times a monta month and still not use too much battery. With NB-IoT and LTE-M, we can still send data packages without enabling the GPS. But when it comes to the GPS, just activating it uses a lot of energy.

So we use GPS signals from satellites only for active tracking and the device is intelligent in that way. We know the tracker is moving around and we know that it’s moving within a zone but we don’t need the GPS to be active all the time.“

From NB-IoT to LTE-M: A natural progression for precise tracking

From the device itself to the alarm flow, everything in Otiom is well thought out and optimally designed. Small data packages are part of the design to fulfill the privacy requirements and of course, a long battery life. Otiom started with NB-IoT as the band of choice – a network with low latency, high penetration, and small data packets. But in 2024, Thomas tells us that Otiom made a meaningful switch to prioritize LTE-M. Thomas explains the thought process:

“We noticed a downside of NB-IoT in active tracking. When you switch from one mobile tower to another, you don’t keep that mobile tower. That’s the intention of an agile device: to move on quickly. But, especially in urban environments, it is necessary for us to have the benefits of good GPS coverage and we need the tower location to show the location with a minute-by-minute precision.

LTE-M gives us the possibility to have active and precise tracking regardless of the general area, especially considering that the switch towards LTE-M has intensified in the last couple of years, and NB-IoT has been standing still.“

However, this was not a massive overhaul. NB-IoT has other active benefits for Otiom so the device continues to support narrowband connectivity and use it when it’s optimal. This possibility was simply an activation of the antenna design.

“We had a global view when we started to design Otiom. As a result, the antenna has specific requirements and also needs to support different bands. The final design is an antenna that supports all three bands and must work under suboptimal conditions, as we know that a lot of the users are staying inside and that can be a harsh condition for tracking. So we tested underground, in basements or parking lots with a lot of concrete, and it worked. The antenna requirements informed the round device we have today that has plenty of air around it.“

Agility, efficiency, autonomy: Otiom’s connectivity checklist

A device intelligently designed for global use, optimal battery life, and connection under harsh conditions, made to be agile and deliver freedom to the user? If we may say so ourselves, this is what Onomondo’s dream use case for connectivity looks like. We asked Thomas whether Otiom thought the same from his point of view. Does he also see this as a match made in heaven and was that match easy to find?

“At first, we were baffled by many providers,” Thomas says. He goes on to describe the initial exploration of connectivity. Otiom ordered a batch of SIMs that should seemingly allow direct provisioning onto the module they are using. However, they discovered that there was no technical path to transfer or onboard these SIMs digitally. The only alternative with that SIM provider was physical SIMs. Thomas continues:

“We thought that these are a lot of restrictions to put on us and they prevent us from being both global and mobile. We need to find vendors who are agile, who can help us. Plus we had another demand: our SIM ranges could not be vendor-locked. That’s when we met with Onomondo. We presented our needs and Onomondo fulfilled them: Freedom to move? Nobody else has it.“

In addition to finding a connectivity partner with integrations to their Quectel hardware, Otiom found in Onomondo the complete agility that they absolutely required – in technical terms as well as in the business model. Thomas explains:

“Onomondo’s SIM control allows us to design a product and a subscription-based model, where we can have devices that are inactive. A lot of suppliers today have different stages: you can either activate a SIM or terminate it, but for anything in between there are multiple settings and you pay for all of them.

Onomondo’s business model is different. You can activate the device, start earning on it and then start paying for it. But until then, we can send out devices to partners to add to their stock and payment only starts when they start using it.”

A medical device demands transparent connectivity

Otiom is classified as a medical device. To obtain this classification, there are several requirements that the device and the company operations need to fulfill. Among these, some are absolute connectivity requirements: high uptime, constant connectivity, and thorough documentation.

On the latter, Thomas describes the experience with another connectivity provider. Under their service level agreement, this provider sends Otiom numerous reports on availability and the timing of issues but little explanation of the root cause of these issues.

“We can’t add the reason why the network failed and properly document what happened. In the worst case scenario, this can cause a failure in our processes because when there is an issue, we need to report to the authorities. With our previous provider, we missed that 9 out of 10 times.”

This is a scenario Onomondo knows all too well. A chain of support tickets, a troubleshooting process that takes weeks, and more often than not, a lack of explanation at the end.

And while for other use cases, this costs time and money, for the highly regulated medical devices, there is the additional compliance cost. That’s why Onomondo’s Insight Tools, Signaling Logs and Network Logs, for transparent and direct troubleshooting, proved to be compliance-critical for Otiom.

“With Onomondo, we can switch networks if issues occur and we always get the documentation we need.“

Freedom, dignity, peace of mind: Common drivers for Otiom and Onomondo

Otiom rightfully doesn’t describe their products as simply “dementia patient tracking” because it’s more than that. For caregivers and caregiving organizations, it is a helpful, reactive tool; for people with dementia it is an enabler of a fuller life and a safeguard from a distance. Technology and design are not the end-goal but a work in concert. Thomas sums up:

“Our core job is to create a solution for the organizations that need technology to assist their staff and patients from a distance. We have users that, for example, are moving across regions, users that would like to go on vacation. Other welfare technology is usually locked to one region, but Otiom makes that possible.”

At the edge of Otiom’s vision is a world where people living with dementia and cognitive challenges can preserve their freedom and dignity for as long as possible; where relatives and care professionals are given a tool that reduces stress, uncertainty, and unnecessary use of resources.  We at Onomondo are both humbled and proud to provide the connectivity infrastructure that facilitates a fuller life for everyone, individual freedom, and professionals who save lives.