Neko Health: Spotify Co-Founder's AI-Powered Health Startup Expands to London

Neko Health, the body-scanning AI health startup from Spotify's Daniel Ek, opens in London

Prevention is better than cure, as the saying goes. Today, a splashy startup that has taken that concept to heart -- literally and figuratively -- is expanding. Neko Health was co-founded by Spotify's Daniel Ek and Hjalmar Nilsonne with a mission to improve preventative healthcare with annual full body scans and AI-powered insights that can detect conditions like heart disease and skin cancer. Now, the Swedish company is launching in London, its first city outside of its home market. For £299 and an hour of your time, the company runs a series of scans and tests that it says creates "millions" of datapoints that help determine your state of health across a range of cardiovascular, metabolic, and other conditions. An in-person meeting with a doctor to discuss the data is included in the session. Those interested in getting in line for a visit can sign up here. The company is coming to the U.K. on the heels of a strong start in Stockholm, where it has opened two clinics in its first year of operation. To date, it has scanned 2,707 people, and while 78.5% of them were found to have no health issues, results for some 14.1% of visitors raised issues that required further medical treatment. Some 1%, it said, were identified to have "severe" cardiovascular, metabolic, or cancerous conditions. Of that group, none were aware of their conditions prior to visiting Neko, the company said. Neko is Japanese for "cat" and Nilsonne tells me that it's a reference to cats having nine lives, or more specifically a lot of lucky breaks. "That's how we would hope that our system feels for our users," he said. A visit to the Neko clinic Despite the participation of a major tech figure like Ek, the company's ethos is actually very understated. As a result, it sometimes gets in its own way. When I visited the London clinic to go through the testing process to write this article, it took me a few trips up and down a London street to realise that I had walked straight past the Neko clinic, which was marked only by its logo -- an N sliced and shifted through its waistline -- at the top of a glass doorway. The rest of the operation is below ground level, making the street-level lobby look more like a discreet entry to a fancy apartment block rather than a health center. Once you enter the building and descend the stairs, you enter an equally sparse lobby with pared-down furniture, muted colours and lighting, and low-volume, soothing electronic music piped throughout. The concept is somewhere between elegant day spa and futuristic medical clinic. Once there, you're funnelled through their system. An assistant takes a few notes about you before leading you into a room where you strip down to your underpants, a robe, and slippers. A second assistant then measures your height and weight before moving you to a cylindrical chamber that feels like a cross between a tanning booth and a security scanner at an airport. The chamber itself is fitted with 70 sensors, including dozens of volumetric and other cameras, to produce a composite picture of you with 50 million data points. From there, you move to an examination bed, where you have another two scans, measurements of your eye pressure and blood pressure, and a grip test. Finally, the the clinician draws a blood sample. The blood sample is the only invasive test that Neko carries out, and altogether the experience takes under an hour. Soon after, you change and are taken to a separate consultation room where a doctor goes through your data. Neko's focus is on risks and proactive prevention rather than existing conditions. Data points are grouped and presented along the lines of different potential problems you might encounter related to them -- among them skin cancer (my moles were counted and it seems that I have many more than the average person), high blood pressure, and metabolic syndrome (a group of conditions that can lead to illnesses such as heart disease, stroke, and diabetes). If the data reveals problems, you're referred for more diagnostics and channeled to doctors for further examinations. Unlikely beginnings Nilsonne tells me that Ek first approached him to chat about healthcare over a Twitter direct message. The year was 2018, and Nilsonne's company at the time -- an AI-powered,smart home energy monitoring startup -- was running out of money and winding down after failing to find product-market fit with the big energy companies it expected to be its customers. "Then out of nowhere, I get a direct message on Twitter from Daniel." Ek had just taken audio streaming platform Spotify through an IPO and was a newly minted billionaire looking for another thorny problem to solve, something that would have "a positive contribution to the world," in Nilsonne's words. He'd gotten it into his head that he wanted to reinvent healthcare, just as he'd reinvented recorded music consumption with Spotify. "So he reached out to me. We didn't know each other, but he was aware of what I had been doing, working with hardware and software and AI." Ek offered to fund a startup with Nilsonne at the head on the spot, but Nilsonne at first rejected him. Neither of them have a medical background. But Nilsonne does come from a family of doctors so it's in his consciousness, and Ek was obsessed, so the two kept talking, and they could see something starting to take shape. Wearables like Fitbits and Apple Watches, Nilsonne said, have led to an "incredible explosion of abundance of high-quality health information." Combining that with AI and the ability to draw "sensible conclusions" from all this data, "it was very clear that we could create a different healthcare system." Thus began five years of building prototypes for the physical clinics and their component hardware, as well as the software to analyse the data. Neko itself, plus its co-founders Nilsonne and Ek, come from an unlikely location. Sweden is home to one of the world's most famous socialised medicine programs. You might assume that the existence of free, and good, healthcare would make a paid service like Neko a hard-sell to consumers. But so far at least, the opposite has been true. When the company last year announced a $60 million funding round, it had a waiting list of "thousands" lined up to get scans. Now that list is up to 22,000. Yes, some of that might be down to Neko being the latest project from one of Sweden's most famous living entrepreneurs (who is also one of Neko's major investors by way of his investment vehicle, Prima Materia). But Nilsonne believes Neko is addressing an important gap that will give the startup staying power. The majority of healthcare services, including those in Sweden and the U.K., are focused on treating conditions rather than preventative care. But because our populations are aging, the number of conditions that need treatment are rapidly increasing, and that's putting the whole system under pressure "in an unsustainable way," Nilsonne said, explaining that 75% of healthcare costs go towards chronic diseases. "Our hypothesis is that prevention and early detection could to be the things that would solve a lot of these problems. Most chronic conditions are fully preventable, or you can delay them by decades if you have effective early interventions. But of course, in our system, you basically show up when you already have the disease, and then it's too late to reverse them, and there are a lot of costs associated with it." (It is far from being the only startup focusing on preventative healthcare technology. Zoi in France and Germany's Aware are two in Europe; In the U.K., the NHS does offer a Health Check that covers many of the same areas that Neko does, although as Nilsonne points out, it's less frequent. "The NHS health check is available only once every five years to individuals aged 44 to 74," he points out. "It offers a much narrower range of tests and does not include a consultation with a doctor to discuss the results. We know from our data that chronic diseases are increasingly appearing in individuals under 44" -- which also happens to be the average age of a Neko customer -- "Therefore, it's crucial to adopt a proactive approach to health to identify potential issues early, take corrective action, and monitor progress over time."

I took the £299 scan that could save you from an early death. Does it work?

The drive for a 'preventative healthcare model' is giving rise to increasingly innovative - and affordable - options I step barefoot into the gleaming pod, remove the white robe I was handed a few moments ago and close my eyes as the circular door swings shut behind me. "Initiating," a woman's voice says in a soothing tone from a speaker above my head. "Three, two, one." A wave of heat washes over me as the telephone box sized capsule is flooded with light. Within a few seconds, an array of high-powered thermal and 3D cameras have taken 2,104 images of my body, mapping every angle, blemish and birthmark. An artificial intelligence (AI) program has begun to analyse my skin, to check for anything out of the ordinary. This scan is happening in a windowless and impossibly clean underground facility in central London. The artificial lights, recessed touchscreens and bare walls, not to mention the disembodied voice narrating the scan, feel inspired by science fiction. Stanley Kubrick would be proud. This is no regular GP's office. But it may be the future of healthcare. After being scanned I am scoured by lasers, have air shot into my pupils and a vial of my blood sent through a vacuum tube to be analysed. I am then led into a pod where a doctor talks me through dozens of different measurements on a big screen, while a hologram of my torso rotates hypnotically in front of me. Neko Health, the Swedish start-up behind this experience, is betting that members of the public will pay £299 once a year for this privilege. On Wednesday, the company, co-founded by Daniel Ek, the billionaire Spotify inventor, is opening a facility in London, only its second after launching a site in Stockholm. Last year, the company raised €60m (£50.5m) from a string of tech investors. Full-body scans are not a new idea in healthcare, but Hjalmar Nilsonne, Neko's chief executive, says the combination of better cameras, AI and data can now make them more widely available. Neko says its AI-powered scan is equivalent to a dermatologist poring over someone's skin for hours, and that the range of tests it offers would otherwise cost thousands of pounds. This is not the first time that tech industry cash has tried to solve healthcare. Although Neko would not welcome them, comparisons will inevitably be made with Theranos, the blood testing start-up that made Elizabeth Holmes billions of dollars before she was sentenced to 11 years in prison for fraud. Nilsonne has batted away any similarity, saying that unlike the secretive Theranos, his company is utterly transparent about how it works, and that it has nothing to hide. Nor does he see the company as part of the immortality trend that has seen so-called tech bros inject themselves with teenagers' blood. "We are not that motivated by helping you live to 95 instead of 90," Nilsonne says. "We're motivated by making sure that between 60 and 80 you have a great life, instead of a life filled with pain." The centrepiece of Neko's test is the full-body scan, which is followed up with a series of other tests: lasers that map patients' veins and arteries and check their heart, as well as more traditional tests such as blood monitoring, blood pressure and electrocardiograms. At the end of the test, patients are graded on dozens of parameters, outlining whether their readings are high, low, average or "optimal". My own test was blissfully free of red flags, but did contain a couple of question marks. As a relatively active 35-year-old who has never spent much time worrying about his blood pressure or glucose levels, let alone the data points in the scan like basophils, eye pressure or hs-CRP (no, me neither), I smugly sat expecting to have aced the scan. But when I received the results, an orange box stated that my HDL cholesterol levels were something to monitor. Grip power - a marker of overall strength - was also humiliatingly below average. I agreed to cut down on chips and spend more time lifting weights as I thanked the doctor with an understrength handshake. The vast majority of scans are like this. Of the 2,707 people the company scanned in 2023, almost four in five - 78.5pc - had no health issues. But 14.1pc needed subsequent medical care of some kind, and 1pc - aged as young as 33 - needed life-saving treatment to treat cardiovascular disease, a blood disorder, cancer or severe diabetes. For the majority that go through the scan without needing immediate attention, a higher-than-average reading might trigger a change in exercise or diet. And if coming back once a year becomes a habit, the tests could spot concerning trends that would not have been detected in isolation - a mole that has changed shape or a decrease in blood pressure. In theory, each year returning customers would correct the areas where they are suboptimal, dramatically cutting the chances of killers such as heart and respiratory diseases, before it is too late. "The elephant in the room is that the healthcare system should be focused on prevention and not reactively treating the sick," says Nilsonne. "But 75pc of the costs in the healthcare system are associated with chronic disease. [That] can be dramatically lowered, but we aren't doing it because we're in this reactive model. "With the health system we have today, it's very difficult to do things the way that most doctors would like to do it, because it's very resource constrained. Ultimately, what's measured is not the outcomes. What's measured is how many things are you doing, how many people are you seeing per day. "People are really asking themselves these questions about the social contracts with the healthcare system, paying taxes, and what they can expect and not expect." It all sounds good in theory. Experts are in near-unanimous agreement that the only way to stop healthcare from swallowing an ever-growing portion of the economy is to focus more on not getting ill in the first place. Wes Streeting, the Health Secretary, has said Britain needs to move to a "preventative healthcare model". Prevention being better than the cure is hardly a new idea. But the combination of data and AI could make these health checks more widely available. How much of a difference could it make? Some experts have been sceptical about the value of annual scans such as Neko's, saying they could push people and healthcare systems into expensive and unnecessary follow-up appointments - a trend dubbed over-diagnosis. Silicon Valley is littered with cases of visionaries attempting to disrupt healthcare; most of them have not worked out. Technology has a poor record in medicine, tending to push prices up instead of leading to savings. One also wonders whether the £299 price of a scan might creep up once Neko has a set of captive customers who have banked years of their health data with the company. Spotify - Ek's more famous venture - has repeatedly increased prices in the last couple of years. Demand from the public is red hot, however. When Neko opened its first site in Stockholm, slots sold out in two hours and the company currently boasts a waiting list of 22,000. Nilsonne is convinced that people will also pay up in the NHS-dominated UK, pointing out that privatised medicine is more pervasive in Britain than in Sweden. Whether people come back is another question. One scan might be a novelty, returning each year might be less habitual. The paradox of preventative healthcare is that while we hope not to get sick, a clean bill of health can feel like a waste of money. The evidence suggests that early adopters, at least, do come back. Nilsonne says that 80pc of those who came in for a scan booked a follow-up for the next year. Am I going back? As the doctor's finger hovers over the booking screen, I defer, telling myself I'll decide closer to the time. But as the scan's cholesterol readings and strength warnings swirled around in my head, I did at least skip the chocolate bar in the meal deal I bought that day, before dragging myself to the gym.