Today, we have Dr Lorin Gresser, who is the creator of DEM Dx, a medical education app. The app teaches diagnostic skills by utilising the approach taken by experts in medicine. Learn how Lorin has integrated the process of decision making in medicine into an educational app, her approach to validate the app, and how she built a team of expert physician contributors.

What you will learn in this episode:

- What is the DEM Dx app and why is it important?

- Decision Making in Medicine and DEM Dx

- The success of the DEM Dx app & validation

- Keeping the app up-to-date

- Entrepreneurial lessons Dr Gresser learned throughout her career

What is the DEM Dx app and why is it important?

Doctors are taught about diseases and their symptoms, but the real world works in reverse, where symptoms appear first and a doctor must make decisions to arrive at a conclusion. The DEM Dx app utilises the thought processes of expert doctors through decision trees.

Decision Making in Medicine and DEM Dx

The app ensures that you aren't skipping steps or narrowing the decision making funnel too quickly. For example, the natural bias for chest pain is something heart related, but chest pain may also come from multiple other causes.

The success of the DEM Dx app & validation

Dr Gressler won a Woman of Innovation in 2016 award from Innovate UK. She is using those funds to run a study to see how DEM Dx changes decision making behaviours and to validate how effective the app is – This is something that is not done typically in the mobile app field.

They are close to 20 000 downloads in the last 5 months, with only a limited amount of marketing. Dr Gresser is continuing to find ways to make the app useful and make sure people use it as part of their daily or weekly habits. It has spread very well through word-of-mouth between physicians and students.

Keeping the app up-to-date

As an app, they'll be able to push out updates as they go. For example, they could add images or audio files demonstrating heart murmurs. The app does not require the latest guidelines as it is focused on the thought process behind making decisions and diagnosis in medical care.

Entrepreneurial lessons Dr Gresser learned throughout her career

In business, you're expected to fail, and it's okay to fail, because those failures can lead you to the successful projects or provide skills to apply to those other projects. It's also helpful to have a network of other entrepreneurs to get advice and support.

Find out more about DEM Dx at www.demdx.com. You can download the DEM Dx app on the Apple app store and contact DEM Dx by sending an email through the website.

On this show, we have the co-founder of N-Pro. He shares with us their story on how they have developed a unique new rugby head guard. Learn why he was inspired to create the head guard, the importance of end-user research, and the intricacies of classing a product as a medical device with CE mark approval.

What you will learn in this episode:

What is N-Pro and the idea

The reason a new approach to helmet development was needed

The innovative process that went into creating N-Pro

The benefits of classing the product as a medical device and how the product was tested

Some thoughts about the ethics of animal testing

The challenges of working in a field of innovation

Advice for people dealing with the press and media

What is N-Pro and the idea

N-Pro was founded by Mark and his wife, in part because of their backgrounds. Mark had a company that was developing sports helmets for the Irish sport called Hurling, and he was also involved in the development of safety standards for sports helmets. Meanwhile his wife, is involved in the medical device industry.

The reason a new approach to helmet development was needed

The area of head injuries in sport is a controversial and emotive topic. While there are developments in the diagnostic space, Mark and his wife were more interested in reducing the risk factors of the injury happening in the first place. There are two major risk factors for head injuries in rugby: linear impacts (90 degree blows to the head) and rotational impacts (glancing blows that make the head spin).

The innovative process that went into creating N-Pro

The co-founders could see a huge unmet clinical need in the sport. They applied it to the principles and processes that had traditionally been used in the medical environment.

The benefits of classing the product as a medical device and how the product was tested

There are a number of companies around the world looking at sports helmet development, but according to Mark, lots of companies are making unvalidated claims. When you’re looking at addressing a clinical issue, he believes all those products should be under medical device directives.

N-Pro has been through over 3 years of research and development. They started with the traditional way you would test sports head gear—bench testing and drop testing. The next step was a pre-clinical animal study.

Some thoughts about the ethics of animal testing

Although some people are against animal testing, it’s still used in the medical field. Pre-clinical studies are very common in the medical device industry. Most medical devices, apart from very low-grade risk products, would have used pre-clinical studies, which some people might not know. However, that’s what commonly happens. You have to test a number of factors in the product before you can move into human testing.

The challenges of working in a medical field which evolving

There is always more to learn in the field of concussion research in sports. Mark says the current N-Pro product is only the first version of the product. They have several other designs planned for it and will be constantly innovating the product as new research and development occurs.

Advice to people dealing with the press & media

Head injuries are a hot topic so there are stories all the time. In terms of giving advice, he suggests managing expectations with the press. They have said clearly that the product is designed to reduce risk factors. However, a lot of the time people like to turn it into a sensational headline, that this is going to solve this issue. Mark has remained consistent in his message in the fact of this sensationalism:

“We’ve always said it’s a multifactorial response that’s needed here to address this issue.”

Find out more at the website www.n-pro.com or on Twitter: @nprosports

I hope you enjoyed the conversation today - Please leave a review and subscribe on iTunes. Thanks for listening!

Today’s guest shares his expertise from years of working in the ultrasound industry. Their unique handheld ultrasound device can link directly to a smartphone or tablet. Dave Willis, the co-founder of Clarius, tells us how their mobile device can change the way doctors work, how they created the device, and their unique sales strategy.

1:00 Dave introduces his company Clarius and his product, which is a groundbreaking ultrasound device that connects to any tablet or smartphone running iOS or Android.

1:30 He was inspired to create the device when he visited a hospital department and heard how the number of consultants was much greater then available ultrasound ma-chines.

2:58 Dave’s company has removed typical hardware that ultrasound machines use and has enabled consultants to literally work with whatever mobile phone device they have in their pockets.

3:48 At the moment, the device is limited to Android and iOS as the vast majority of physicians are using devices with those systems.

4:42 Dave’s background is in ultrasound and working directly with physicians.

5:45 He feels the big advantage of his device is accessibility and affordability.

6:53 In the past, anything sub $10,000 with good image quality was difficult to find. Image quality is extremely important to new users.

8:00 The device doesn’t remove the need for training. That is still required, but it makes a range of diagnosis and treatments much more accessible to physicians.

9:20 Dave feels that this technology could be a good fit in quite a number of developing nations.

9:48 A good friend of Dave’s had developed his own ultrasound product previously, so when Dave relayed the earlier story about the hospital department with limited ultrasound equipment, they began working to create a device. A three-year window followed with development of an open source wireless system to talk to any operating system.

10:57 The product was primarily funded internally.

11:39 Dave discusses acquiring FDA and CE approval. A key tip is not to make any outrageous claims about your product in this process. The process of approval is typically six months from starting tests to final submissions based on feedback from the authorities.

13:30 Dave recommends newcomers to engage a third-party reviewer to help them with getting a product ready for the approval review.

14:23 Dave discusses their sales strategy which involves direct sales to end-users which is atypical of the industry. This can allow a dramatic cost reduction for the customer.

16:19 Clarius’s focus is point-of-care. They don’t plan to replace the big ultrasound ma-chines in the radiology department - getting smaller machines into point-of-care departments is where the biggest growth will occur in next few years.

17:45 Dave shares his personal experiences to show how ultrasound can improve accuracy for simple procedures.

18:36 The best point of contact for Dave is www.clarius.me where there is information and testimonials about the product.

I hope you enjoyed the conversation today - Please leave a review and subscribe on iTunes. It really does help the show! Thanks for listening!

Read on to see how Dave answered my final question:

Vinay: What advice would you give to aspiring healthcare entrepreneurs and innovators?

Dave: I think a couple of things. One is certainly a clear understanding of the end user. I've seen a lot of devices get on the market and fail because they miss the fundamental use model. Either they were too expensive or the image quality wasn't good enough. I think it's imperative to really understand the marketplace that you're trying to address. Then of course just having a passion for that. We were quite lucky, the founder and myself, that our whole background has really been ultrasound for a lot of years. So it was fairly easy for us to step in and we did come up with a very good product to address the mar...

Bruce Hellman is Co-Founder of an innovative app called uMotif. Today, he discusses the app he has developed. It is changing the traditional approach of how clinicians and researchers gather information from patients. Discover the importance

of design and a patient-centred approach to create impact.

00:26 This episode’s guest Bruce Hellman, CEO and Co-Founder of uMotif is introduced.

01:06 Bruce begins to describe briefly his company and the app that they have developed. It is essentially a cutting edge digital research tool to help patients and practitioners in the realm of healthcare.

01:42 After meeting some patients with Parkinson's disease, they pointed out to Bruce how beneficial the technology his company was developing would be in tracking their symptoms. The system can now track sixteen clinical conditions.

02:30 Initially the system was designed to track Bruce’s sleep patterns, but when he and his co-founder met some patients, it morphed into something entirely different.

03:03 Bruce went along to an open entry competition to win funding for his concept, and through this competition he was lucky enough to secure funding and meet patient groups. These competitions still exist, and are useful opportunities for any of the listeners that may have an idea to pursue.

04:27 Design is the difference between Bruce’s app and other systems that exist. From the word go, he wanted to do something different and something that was easier to use then other apps out there. Bruce’s co-founder was a designer, so implementing good design was a core part of the business.

05:15 Over the 4 years of its existence, the company has evolved and matured, but Bruce feels having a strong technology team is a key part of the business. All of Bruce’s developers are in house.

06:14 Bruce accepts you can outsource work, but he encourages people to see if they can do a lot of their set up work in-house.

06:48 Bruce describes how his company started collaborations with Hundred for Parkinsons and Cloudy with a Chance of Pain.

8:00 Bruce had no connections in the industry when he started. He recommends going to meet-ups and networking events. If you are going to do something that is going to make a difference to people, clinicians and practitioners are always ready and willing to talk.

9:09 The app is free to patients, and Bruce intends that to always be the case - revenue is made from charging the hospital or research study.

9:48 The platform can be customised to meet the requirements of different research studies.

10:27 The future as Bruce sees it, is that any patient will be able to use digital technology to capture more high quality data and engage patients on an easy-to-use platform. This provides high quality data to be used in clinical research.

11:10 Already huge amounts of data is imported from wearables and web data for use in the platform.

11:52 When the focus is on providing a patient with a high quality experience, it is easy to obtain quality data, and Bruce feels this approach has worked best. To set out to get data first and provide a quality experience second would not be equally effective.

12:43 Bruce’s advice is to be as focused as you can on the problem you intend to solve. A product that makes a financial impact on healthcare is more likely to be successful.

13:36 Bruce’s app can reduce costs through patient-generated data by increasing efficiency of trials. Lowering the cost of trials is a huge benefit.

14:34 More information can be found at uMotif.com or on Twitter:@umotif

Thanks for listening!

Please leave a review and subscribe on iTunes. Your reviews are really helpful and I look forward to reading them!

In this episode, we’ve got Dr Paul Upton from Ultramed. I met Paul at a med-tech innovation conference in 2016, and loved the new pre-op assessment platform he has developed. Today, he shares his story so far and reveals some valuable tips on how he developed his product.

00:28 This episode’s guest Dr. Paul Upton is introduced.

00:54 Paul’s background started as a clinician in the NHS before he moved into the development of the Peninsula Medical School where he played a significant role including writing some of the curriculum and then he moved to medical management. He has now at the age of 55 retired from the NHS and is a co-founder of Ultramed.

1:57 He wishes he had set up his own company earlier as he has always enjoyed the management side of things.

2:38 Paul met his co-founder on an airplane of all places. The guy he sat next to - Alan was a creative designer. Together, they combined their NHS and creative design skills to solve the problems associated with pre-procedure assessment of patients. Their product is essentially an easy online system for patients to input their own data before assessment to streamline the whole pre-op system.

3:32 They have now expanded to include a cath-lab system, an endoscopy and a radiology system - in essence, a whole suite of tools.

3:55 During his time in the NHS, Paul saw the problems with getting people ready for these procedures and applied his knowledge to have one system to solve multiple problems.

4:20 The key problem is the way the data is collected from patients. We are all used to doing tax returns etc. online, so Paul and Alan have presented an attractive looking interface to avoid filling out reams of paper before each procedure.

5:05 Benefits of this method include a high level of interaction from the system to get in depth data and there is built in clinical support that suggests tests to the practitioners before the patient has his/her procedure.

5:52 The system also includes ICD10 integration to gather income data. ICD is the international classification of diseases. As a result, it helps the hospital as well as the patient.

7:23 The company is only just over 2 years old. The key to it being successful in a short space of time has been being able to get the concept conveyed quickly in front of actual people. Paul has found that not only secondary care, but tertiary care centres are also interested in his product.

8:38 Paul’s experience has enabled him to be able to speak to both clinicians and managers. Often, he has found that people trying to sell a product to the NHS have been more successful if they have passion and belief in what they are trying to sell - it creates a positive vibe.

9:48 His lightbulb moment came when he was about to go into theatre and realised that the sending out forms was so inefficient. At this point, he felt that surely there was a better way to do things, and within 2 months himself and his partner had incorporated the company.

10:47 Paul feels its all very well having an idea, but having somebody with design and technology background are crucial. The creative design and concept is important, but so is marketing - which is actually essential.

12:10 In terms of finding a partner, Paul feels there are lots of small software developers out there that are relatively easy to find to contribute to a project. A designer does need to be working in the computer end of things. He describes his partner’s contribution to the project.

13:27 Startup costs are an interesting phenomenon. Unlike working freelance in consultancy, you can’t bill anybody for your time, you need to factor these costs along with your product costs - and hopefully the end result is a viable company with a product.

14:38 Paul’s top tip to aspiring medical entrepreneurs is talk to somebody who has done it before and go in with your eyes wide open. He also discusses a seed investment scheme to help entrepreneurs with new high risk ...