Israel Editor

In our previous piece (Medical Device Daily, May 5, 2015), we addressed some startups that appeared at the 20th MedTech Investing Europe Conference (Lausanne, Switzerland). The more traditional technology breakthroughs in the medical device world – referred to as the "Old New" – represent products/concepts that could potentially improve clinical outcomes, simplify or cheapen procedures, or reduce side effects.

But there are a new set of approaches – the "New New" – no less revolutionary or innovative, that are appearing on the scene, that promise changes in our healthcare systems worldwide without necessarily offering a breakthrough procedure or even presenting in the clinical setting.

With the medical ecosystem changing, and the allocation of healthcare costs being spread more evenly through the healthcare spectrum, we are seeing innovations that extend towards the preventive, primary and post-critical care environments, rather than merely to the cath-lab, ICU or surgical suite.

These new companies might have developed a new patentable hardware piece, but the essence of the solution is defined as offering a suitably differentiated business model from that encountered to date.

An example of this type of technology – in an unexpected area of preventative medicine – is Hyprevention (Pessac, France). The company offers the Y-strut product, a preventative hip support implant for patients who are deemed high-risk of hip fracture. By implanting these intra-femoral nails, the patient may mitigate the risk of resultant fracture. "We have two key markets in which we operate," said Cécile Vienney, CEO of the company. "Patients with bone metastases can prevent irreparable damage by means of an additional strut in their hip bone," she told Medical Device Daily, "but even more so, the orthopedic hip patient who is considered high risk for contra-lateral hip damage could add our minimally invasive element to the larger, more acute procedure being performed." The company has started initial clinical studies, with 15 patients treated to date across key centers in France and Belgium.

It is likely that the key driver to the development of such a preventative product is the health economic data. Such data would probably suggest that effective targeting of high-risk sub-populations, and their subsequent pre-treatment could mitigate large medical risks and payor costs. While important to balance the "primarily, do no harm" with the "ensure that you prevent future harm" ethos of preventative treatment, the existence of such an approach is indicative of a more sophisticated perspective to medical innovation and economic business models. The Y-strut product might have been available decades ago, but the respect that such a preventative solution might command is a result of recent patient sub-segmentation analysis and economic realities settling in.

A similar approach may be taken to Abionic (Lausanne), a company that has developed a rapid point-of-care testing platform for allergy testing. Using advanced nanosensor technology from EPFL (Lausanne), the abioSCOPE product offers the primary physician the opportunity to offer readouts from allergy test samples in minutes, rather than to send the sample to the laboratory for analysis. While there is highly innovative technology here (based on proprietary reagents that enable rapid nano-scale analysis) the key differentiating factor is that this is an enabler for the physician to maintain ownership of the patient, and not to elicit the more costly outsourcing services of others. Nicholas Durand, CEO and founder of Abionic, told MDD, "We are seeing a trend that, with the development of Accountable Care Organizations in many parts of the world, physician groups prefer to support in-house diagnostic capabilities, rather than to resort to using outside parties. Our technology and products are benefitting from that desire for independence."

MobiSante (Redmond, Washington) is another company that supports the premise that innovation in today's medical world might involve a broader perspective. Sailesh Chutani is the CEO and founder of this digital health company. An ex-Microsoft exploratory research investment specialist, Chutani is also co-author of a book that takes a global view of the impact of the mobile phone on healthcare. MobiSante's goal is to enable more widespread use of basic ultrasound by offering simple, cheap, software add-ons to a simple generic ultrasound probe. "It just appears to me," Chutani told MDD, "that many non-complex tests using generic ultrasound, can be invaluable in many parts of the primary healthcare system, and can save billions when managed at the primary location." With that in mind, he linked a simple ultrasound system to the tablet or smartphone, ensured high quality cloud data management and sharing – great for rapid second opinions. He then offered the non-expert physician the opportunity to benefit from the technology at a low price point.

The software specialist took off-the-shelf components, and put together a software system "that could empower a non-specialist in a game-changing manner" Chatani explained. "It is revolutionary, because it can increase medical efficiency, is time saving and life saving," he added.

Michael Tuggy, MD of the Swedish Family Medicine (Seattle, Washington) and a customer of MobiSante shared his thoughts regarding the value of the system. "We can get to a diagnosis much more quickly by scanning the patient ourselves. And within minutes of seeing the patient, we can actually have an answer as opposed to sending them off, waiting for the scan to be done, waiting for the next day for the report to come out," Tuggy said.

As the healthcare community reviews today's innovative companies, it should identify two types of revolutionary companies: those that propose breakthroughs in medicine, and breakthroughs in our management of medicine. There is reason to believe that while the latter might not be the dream of the healthcare entrepreneur of the last decade, with many of today's biggest clinical problems being in prevention, purchasing and homecare, startups are generating interest in those issues too. //

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