15 Minutes With The Doctor: Learn from Healthcare Entrepreneurs and Innovators

MyPreOp is an online cloud-based form into which patients enter their own medical data as part of the pre-operative assessment process. This includes standard medical history and other relevant questions which would normally be asked by a nurse in person, but do not usually require an in-person evaluation. The widespread implementation of this assessment could reduce the number of appointments that are necessary for hospitals and patients, while maintaining and even improving the quality of care provided.

MyPreOp has been adopted by 8 hospitals, and assessments have been completed by 4,000 patients in the past 18 months. They have received positive feedback from patients, nurses, and anaesthetists. This feedback and continual improvement has resulted in 73 versions of the assessment tool so far. As expected, improvements will continue to come with the adoption of more hospitals and more patient use.

“It is no secret that many people are resistant to changes to any kind of process, so to this point, the hospitals that have adopted the assessment have only been sending the form to small groups of their patients to test its effectiveness.”

Paul and his team believe that patients and nurses are more than capable of handling this shift in procedure if they are given the chance. Even those patients who are not familiar with technology or do not primarily speak English, may prefer filling out the assessment with the assistance of a family member at home to potentially avoid a hospital visit.

“This technology is ready for widespread adoption into the NHS.”

Ultramed has been termed a “commercial supplier” under the UK Government G-Cloud 10 framework, which smooths the procurement route for hospitals who want to purchase MyPreOp. The company has also recently been accepted into the Digital Health Accelerator Program through the Academic Health Sciences Network. This provides opportunities for networking and collaboration with like-minded innovators in the health and care industry.

Paul and his team want to change the way that patients receive access to the assessment. Rather than hospitals choosing a small group who will use the form, Paul would prefer that every patient given the opportunity. They estimate that 40% of patients will fill out the assessment prior to their appointments, and that 35% of those patients may not need to come to the typical appointment as a result of the process.

“It takes 17 years after something is found to be innovative and useful for it to get halfway through the NHS.”

Paul would have spent more time looking around for and learning about innovations in the industry that could have helped him as a medical director. The NHS system is under such high pressure that it often does not even seem feasible to spend time looking, let alone considering implementing a change in procedure, but it could have saved a lot of time and energy.

“What you have to do when you want to change management is relieve pressure first and then make the change.”

Find out more about MyPreOp: https://www.ultramed.co/

– Patent defined

– Patent defined

– What can be patented?

– When is the ideal time to patent?

– Patent process

– Costs associated with patenting

– Advice for those considering submitting a patent application

“The patent gives technical protection to the person who has filed the patent.”

“It is important to work out how far along in your development you are and make a strategic choice about when to file your patent application.”

“What’s termed ‘state of the art’ is everything that is available at the date that the patent application was made.”

UKIPO:

– How Usono began.

Benjamin, who is the current CEO met Victor through field hockey at the university campus. Benjamin was studying Bio-medical engineering and was researching developing software algorithms to detect muscle illnesses for children using ultrasound.

However, he had a problem.

There was no way he could fix the ultrasound probe to the muscle. One day, he asked Victor to design a product that could help him with his problem. Being an industrial design student, and passionate about developing innovation for the medical world, he agreed.

“The two of us together with another friend started to work on the project.”

They slowly gathered interest from hospitals through the simple tool they had developed to fixate the ultrasound transducer to the upper leg. They later began to liaise with hospital radiologists and cardiologists to help develop the product further.

The Probefix was launched a few months ago and allows attachment of the ultrasound device direct to the chest so the heart can be monitored. The Probefix Dynamic is an enhanced version of the first product they created. It focuses on muscle monitoring in the arms or legs and is currently being developed.

“We’re looking to develop the Probefix and Probefix Dynamic for use in muscle movement using ultrasound for applications in other areas such as stress acute cardiology and to monitor a muscle or an organ for a period of time.”

Usono contacted hospitals directly in regards to their interest for such a product and gathered their feedback.

“We’re in contact with the ultrasound manufactures such as Philips and they all agree that there is a real need and benefit from using a product such as Probefix.”

They discovered sonographers found it uncomfortable to hold the ultrasound probe in the same area for a prolonged period of time. From multiple sources of research, they found that 70-80% of the sonographers suffer from repetitive strain issues which cause them to have significant periods of work causing cost implications for the hospitals.

“The ultrasound manufacturers claim it’s too small a business for them.”

The ultrasound system is very large and complicated which includes high costs and therefore, such a small accessory is a small-scale business. Hence, they opt to work with accessory suppliers such as ourselves.

Very early on, a doctor from Erasmus University and another one in the Netherlands found the product very interesting and wanted to demonstrate it at an International Conference.

“Our advisors told us that if we wanted our products represented internationally, we had to start the patent process early.”

Usono patented the product which helped them innovate openly because the product is protected internationally and therefore, they can present it at multiple venues.

They business began while they were students, it was initially financed through pocket money and part time work. Following this, they were selected for the high tech Excel program, which is a world-rated accelerator program at their campus in Eindhoven.

“We had a lot of support from entrepreneurs and business people.”

They started to grow the business through investment from angel investors using an online platform where they raised 165 000 Euros.

“Eindhoven is the smartest square kilometer in the world, based on the number of patents in relation to the number of people.”

“That Probefix will be used in any country in the world. Also, that it will support the sonographers and the medical specialists in reducing RSI issues and also having a large impact on heart disease of patients.”

“To just do it. As an entrepreneur in health tech, I would encourage that one gets to know the field and your users, know the people you are operating with.”

Learn more about Usono

Website: www.usono.com

– How the journey to Walk with Path began?

It started in 2014, when Lise had a student project that she was working on while studying innovation design & engineering in London. The final project was about mobility and improving mobility in people with various chronic conditions.

“This led to some interest from users and others which gave me the belief in taking the project forward.”

That same year, she decided to create a business, on the back of the initial student project.

“I’ve seen the different changes that have happened which were very severe.”

There are symptoms in Parkinson’s such as ‘freezing of gait’ which have limited drug treatments. This is when someone suddenly feels glued to the floor preventing them from taking another step.

“Current drug methods don’t really help to alleviate this symptom. They can a little bit, but there’s not much assistance during ‘off’ periods.”

Lise realised there were various coping strategies which people tried. One of which is cueing, where somebody comes and helps the patient by putting a foot in front of them that they can then use as a cue to step across. This observation led to the idea of having an independent design, which would lead to independence and allow more freedom.

Path Finder is a visual cueing product attached to the shoe which provides to lead the cue in the walking path of the individual. They will see a green line that they can use as the cue to step across.

“It works well with persons with Parkinson’s but we’re also exploring it with other conditions such as stroke and other movement disorders.”

Path Feel provides vibrational feedback during walking which focuses on the population with balance issues. They’re aiming to launch the program in 2019.

These ideas are the result of a user-centered design process of iterative design. This means talking to, and spending time with users as well as doing interviews and performing thorough observations. Lise spoke to people with Parkinson’s and multiple sclerosis, their family members, and healthcare professionals to fully understand the impact these conditions have on their daily lives. She tried to understand their problems and which solutions would be best fit them.

“I created ideas, then did testing to the design process that I followed to assess the principles very quickly. This ensures the ideas are validated before spending a lot of effort and time.”

When generating the idea, the first thing Lise did was research with the affected user groups and eventually developed a small test product and built upon it each time. People follow different processes but Lise believes this is the best process to fully engage in the problem before thinking about solutions.

“The problem should always be the first thing to focus on.”

Their first funding round was from angel investors and a grant. At the moment, they’re carrying out their second round of funding.

They decided on the pricing of Path Finder based primarily on the cost of production. Given they’re producing small batches currently; their cost of production is high.

“I personally like tangible products and physical products.”

A physical product was essential for this problem. This is because our foot movements during walking have specific phases. Therefore, visual cueing needs to occur at specific times and a device needs to be placed on the foot for accurate projection.

“I did my own prototyping and I had no idea of how to do electronics. However, it was the only way I could solve the problem.”

www.walkwithpath.com

– How the journey to Patients Know Best began?

Whilst completing his A-levels, Mohammed read a book called Chaos, which was about nonlinear mathematics. It described chaotic systems like the weather, the earth’s geosphere, the immune system and the economy. It explained how chaos influenced each system. However, there wasn’t anything about chaotic systems and how to program the model of the human body in the book. This sparked some interest into software and Mohammed decided to learn about it.

“During my medical school summers, I would get a programming job. I wrote software to model the immune system and things like a heart attack. It was really interesting to use programming to help understand healthcare better and to deepen my computer skills.”

When a patient attends the hospital for an appointment, the doctors will inform them that they can have access to their records. They are asked if they want to register and 70-90% of patients do agree. The registration process simply involves an email address and password. From then on, you get access to your data although it depends on which hospitals you’ve visited.

“It works on a phone or laptop, as long as you have access to internet connection”

The platform offers the ability to share all or certain parts of your information to family members or friends. Some incredible features include adding a Fitbit, connecting a glucose monitor, and you can also message your clinical team.

“The software is great because patients realise they only have to connect to us and we’ll connect them to everybody else.”

In the UK, there are at least 4 main primary care IT systems, 6 main hospital IT system, and now there are over 100 connectable health devices. Once Patients Know Best connects to one of these systems or devices, it starts to work instantly. The PKB platform is upgraded weekly.

Patients Know Best operates as a software as a service business. There is a subscription fee paid by the health institution – The calculation is based on the number of people cared for by the institution.

“As a hospital, once you’re a subscriber and looking after patients, you can send unlimited amount of data for your patients with storage.”

Patients Know Best will be working with Dovetail Labs which won a research grant from SBRI Health Enterprise East, where they have built blockchain software to manage healthcare data – They have used blockchain to move data around from primary and secondary care settings.

“Blockchain is a very transparent approach because it keeps a log of every transaction.”

Blockchain technology is extremely powerful and it will dominate the healthcare and research industry in coming years according to Mohammad.

The best place to learn about PKB is through the website: www.patientsknowbest.com

– What is Soma Analytics?

“Soma Analytics has created an app for mental resilience. It’s a platform for preventative mental health for employers and organisations.”

An employee can track their mental health and complete various programs within the app. The employee’s information is sent to the employers. The app has a dashboard for employers that shows in an anonymised and aggregated way the results and improvements in the mental health of employees over time. The company was started because they had a friend in university who went through a depressive episode due to work related stress.

“Mental health and stress is increasingly becoming a problem for organisations.”

Staff leave jobs simply because they’re under too much stress. Soma recognised every function of an organization gets measured to the X degree, except human resources, which is actually the most important asset.

“The app helps in having insights in how employees feel in an organisation, hence improving the productivity and wellbeing of the workforce.”

The app is different from many other apps serving a similar purpose directly to customers such as Headspace. Soma operates on business to business basis and caters for both the user and the buyer (organisation).

“We roll the application out over different sites in a large workforces creating communications, campaigns and excitement. We believe this approach is quite unique since it’s targeted specifically at employers.”

Soma seek to be science-backed and evidence-based. Recently, they undertook a small randomised controlled trial with healthcare workers at the Mayo Clinic. Also, they are funded by the European Union under Horizon 2020 where their main aim is to validate their solution in a mass control trial across different organisations in Europe.

It can be challenging to acquire EU funding as funding is available under many different topics. For example, under the Horizon 2020 there are different aspects funded under academic research as well as in innovation, startups and SMEs.

“You have to work through the topics to find which suits you best. You can use the funds you get for research as well as developing the product but that depends on the framework of the funding you’re applying too.”

There are organisations in the UK that can help people acquire such funding. SAS ventures is one great organisation that could help.

“Mistakes are common in entrepreneurship, doing things iteratively is important and it is part of the lean startup methodology.”

Reading the lean startup method early on is a key recommended action.

To find out more about Soma analytics please go to Soma-analytics.com or Twitter: @Somaanalytics

“We’re not really taught nutrition as chefs, we’re taught to cook.”

The EU rules changed in 2014, requiring restaurants and cafes to list key allergens in their foods. So, Kafoodle helps chefs save time and therefore money by auto-generating the cost, allergen and nutritional information of recipes. While software options do exist to help chefs manage recipes, the emphasis is mainly on cost rather than health factors. Kafoodle is affordable to the average restaurateur and makes it easy to amend recipes to make them healthier, or cater to dietary requirements.

An Innovate UK grant in 2015 saw the software developed for the social care sector. KafoodleCare works with care homes and hospitals, and is now rolling out into schools and corporate canteens. It helps these businesses manage food the way a restaurant would, while meeting dietary requirements and nutrition targets for residents. Currently used in over 2000 locations, Kafoodle is also expanding into catering colleges to cover the education side of food and health. The company’s long-term goal is to use food as medicine by prescribing diets instead of medication.

“Care homes can save money, which is what’s key to them in the current climate, but also you’ll have people eating better.”

– The benefits of using the software and how it works

You can find Kafoodle at the website https://kafoodle.com/

“Patient scheduling is one of those things that maybe is so ubiquitous that it gets brushed aside for the bigger, shinier, and perhaps more superficial problems.”

Sibyl predicts when each patient is most likely to show and then builds a strategic schedule to maximise utilisation and minimise gaps in the schedule.

Scheduling is the front-door of care. However, it is incredibly complex and often overlooked. The focus of the Sibyl is to maximise the probability that exactly one patient is going to show up for each slot of the day.

“Slot by slot, it recommends the best-fit time for the patient and the provider of care.”

In the US, overbooking is a common practice that results in longer wait times during some periods, and idle times when patients don’t show up to appointments. Although in the UK overbooking is not practised, it has been estimated that patient no-shows cost the NHS £1 billion per year.

The Sybil technology is 75-80% accurate in its predictions, which allows medical staff to focus their interventions on only the patients most likely to miss appointments. The intelligence inside the technology has been deployed and refined at leading academic medical institutions and in one of the largest health systems in the United States. Over 500 000 medical records and 2 million appointments were analysed to make these predictions, and the tech learns in each new institutions where it’s used.

How Benjamin’s background working in a hedge fund helped prepare him for this role

You can find Sibyl at the website https://www.gosibyl.com/ or on Twitter @gosibyl

– What is myHealthSpecialist.com?

Myhealthspecialist.com is an online platform which helps people—GPs and patients—find specialists that have been recommended by doctors. The idea came about when Kartik was training to become a GP (Primary care physician). He found long email chains would develop when doctors would discuss which specialists they would suggest recommending in regards to patient requirements. It is a doctor-based specialist recommendation service for the UK.

The majority of specialist members are practicing in NHS and do some additional private work. If Kartik and his team get a recommendation for someone not part of their member network, they will contact clinicians and let them know about the service. Alternatively, if you want to have a professional online profile that shows that you are peer recommended, then you can contact the service directly. The team can take you through a series of steps to optimise your online profile, build up peer recommendations based on existing networks, and offer specialists the option to take part in GP education events. Kartik is passionate about collaboration and improving primary and secondary care relationships.

For specialists, there is a flat rate subscription fee which enables the service to be free for patients and GP’s. It’s £44 per month currently, the cost of which is can be covered relatively easy through a small number of patient referrals through the site.

It’s particularly great for new specialists within the private sector while being more efficient. There is the added benefit of a team managing your online reputation and lead generation, maintaining the technology, and getting more traffic to your profile.

At the beginning, Kartik says there is a lot of excitement so the sheer energy of that is immense, but it has been a lot of work. One thing doctors are particularly good at is multitasking. Kartik’s clinical experience feeds into what he understands about healthcare from a front-line perspective, which has been essential for the platform’s development. Having a brother who worked for Accenture helped with the technical aspects.

“GPs have the benefit of knowing a lot about healthcare, including the delivery of it, not just the biomedical side. Combined with the tech side, that has been a real advantage in the digital health space.”

Tiko’s GP Group on Facebook has been helpful for many GPs in the UK and helped Kartik star in the Pulse 50 most influential GPs list for the last few years. The idea was an experiment and he’s shocked that it has become a phenomenon in its own right.

One of the biggest issues in general practice is the lack of connectivity. Kartik sought to combat that using social media. It is a place for GPs and GP trainees that is separate from the physical and time barriers that previously existed. Kartik’s view is that anything that fosters communication and connectivity in health care is excellent.

Current work in digital health is focused at improving efficiency. However, Kartik’s view is that general practice is already very efficient. He’d like to see that same technology being used to improve the wellness and wellbeing of our doctors.

The technology could monitor how much GPs are doing in practice, with the view to predicting burnout or stress.

“There is evidence on GP and physician burnout across the board, the data is very strong, and we need to be using technology as a way of understanding how to resource a practice better and look after the wellbeing of individual doctors better.”

Tiko’s GP Group is a closed Facebook group that GP’s can request to join.

TED Talk by Stephen Johnson “Where Good Ideas Come From”

– What is MIRA and how it was invented

MIRA is a software platform that turns physical therapy exercises into video games, making therapy easier to follow.

It asks patients to complete the recommended movements to progress through each game level and as a result, the patients are playing and also recovering. While they play, MIRA tracks in real time their progress and compliance.

It runs on Windows and uses the Microsoft Kinect device, which is a low-cost motion capture camera that can track the movement from a distance. The idea came about when a group of 4 software engineering students, including Cosmin, wanted to build something cool to participate at the Imagine Cup – A Microsoft software competition for IT students and the idea for Medical Interactive Recovery Assistant (MIRA) was born.

MIRA is built as a tool to allow the specialist to create tailor-made treatment plans. This system is being used with patients of various ages. It can be used for orthopedic conditions such as frozen shoulder and hip replacements, or even neurological ones like cerebral palsy, acquired brain injuries or stroke.

The games that the system has are simple so they can be adapted to a variety of patients. At the moment there are 34 games and 31 exercises that can be combined in 420+ different combinations. Patient progress is measured by a range of factors such as compliance, repetition, speed and performance.

The startup costs for installing the system are quite affordable. For the kit to be used at home, the patient needs a Kinect device, which costs £110, and a Windows PC. The pricing of MIRA is as a subscription model, it’s only available to clinical institutions to ensure supervised quality treatment. Depending on the subscription, it is usually £10 per patient per month.

Currently, the MIRA team is focusing on the UK market but also selling across Europe. Approximately 60 clinics are using the software so far, some of which have run feasibility studies that showed MIRA can benefit patients in need of physical exercise treatment. Most of the work has been with older people, and the University of Manchester ran a large randomised control trial.

From a technical point of view, when Cosmin and the team came up with the idea, they realised they needed to use a device. In 2010, they noted that holding the Nintendo Wii was an issue for some patients. There were also issues with a smart watch type device.

The camera option of the Microsoft Kinect is helpful because the patient doesn’t have to hold anything, and being a camera it can track the user from a distance. It only has to be set up once and is accurate in terms of gross movements, even when patients move slowly

Gamification can be used for anything that needs patients to comply with their suggested treatment.

Compliance is a big issue in healthcare, getting people to take steps towards better health is positive. Cosmin and the MIRA team did find that the adoption of the gamification concept throughout healthcare was their biggest initial challenge.

When we first started, most people…directed us to speak to paediatric institutions. Suggesting that because MIRA has video games, only children would be interested in them.

They did that for the first few years but once they had results from reputable institutions and how it was useful in adults, it began to get easier!

The best place to learn more about MIRA is at the website, www.mirarehab.com or write to Cosmin at [email protected] or find them on social media @mirarehab

You can also catch his TED Talk at