Female doctor in scrubs holding the Butterfly Network ultrasound 1057 x 704
Photo Source: Screenshot from photo on Butterfly Network.com

I fell in love with early-stage companies at the very beginning of my quest to help innovators tell their stories to the world. There is something magical about their belief in their ability to make the world a better place. This is particularly appealing this year, 2018, the year that Oxford Dictionary chose the word TOXIC as its international word of the year.

One of the antonyms of toxic is HEALTHY. And that is a part of the mission of each of the 2018 TedMed Hive Innovators that I watched present at this year’s TedMed. Thanks to TedMed for making the livestream available to me so I can tell you about some of these innovative startups.

Vaxxas: Replacing shots with patches

David Hoey, the CEO of Vaxxas, started his presentation by pointing out that current vaccine delivery methods involve decades-old technologies that make it difficult to immunize the most vulnerable people in the world. Currently, many vaccines require refrigeration to maintain their potency. They also require moderately skilled individuals to administer the shot via needles and syringes. These are often not available in the remote, resource-challenged parts of the world.

Hoey believed there must be a better way so he set out to develop needle-free vaccines that don’t require refrigeration. The core of his approach is the Nanopatch™ described as an ultra-high-density array of very short projections—invisible to the naked human eye–coated with vaccine.”*

Vaxxas nanopatch technology. Photo from Vaxxas.com 749 x 173
Vaxxas nanopatch technology. Photo from Vaxxas.com

Applied to the skin (he says it is pain-free), it delivers vaccine to what he describes as “abundant populations of immune cells immediately below the skin’s surface.* He says that studies “show this approach can be more efficient at producing immune response than a syringe.”  He claims that “vaccine coated on the Nanopatch™ can be stable for more than a year at room temperature.

If Vaxxas vision holds up after the scrutiny of large-scale clinical trials, it could have a huge impact on vaccine-preventable diseases that currently run rampant in remote, underserved areas. Imagine sending minimally skilled people into these areas armed with Nanopatches immunizing children without a painful shot and without the need for refrigeration. I can even envision developing Nanopatches that could be dropped into these communities via drones so that they could be administered by parents under the supervision of a community health worker.

SurgiBox: Bringing safe surgery to wherever it is needed

Physician Debbie Lin Teodorescu, the Founder and President of SurgiBox, began her clinical rotations taking care of the Boston bombing victims many of whom survived their devastating injuries because they got taken care of within surgery’s “golden hour.” She envisioned a world where everyone could have access to safe and immediate surgery. But safe operating spaces are infrastructure heavy, expensive, and not particularly mobile. She wondered,

What if instead of sterilizing an entire room we can just protect the patient.

This was the genesis of the SurgiBox, a clear plastic bubble that uses a laminar airflow system to keep the surgical field sterile.

SurgiBox “bubble” provides a portable sterile surgical field to operate in remote areas (Screenshot from video on Surgibox.org)

The surgical teams operate through ports in the bubble instead of everyone having to be gowned and gloved operating in an entirely sterile O.R. Because the SurgiBox can fit into a backpack, it can be used to bring safe surgery to wherever it is needed.

RapidSOS: Moving from emergency response to prediction and prevention

Michael Martin is the Founder and CEO of RapidSOS. In partnership with thousands of public safety agencies, the company has been able to “integrate real-time sensor data from digital health devices to vehicle telematics, home/industrial IoT sensor data, and location from any Android or iPhone smartphone.”* and “provide it to 911, first responders and hospitals in an emergency.” He says for a hundred years, emergency response has been reactive – an emergency happens and we call someone for help (911, our neighbors, our mother).

RapidSOS wants to radically transform emergency response by using big data to predict and prevent emergencies. Watch as Michael explains what they are up to.

Screenshot from RapidSOS video on RapidSOS.com 675 x 333
Screenshot from RapidSOS video on RapidSOS.com

As I sit here in Northern California under smoky skies from the Camp Fire, it is clear to me that what this company is doing is definitely on the right track. Imagine how different the outcome would have been if the small town of Paradise that burned to the ground killing at least 71 people (with an estimated ~1000 more missing) had been able to integrate data from many different sources (wind speed, atmospheric pressure, historical traffic patterns, information about mobility of its elderly residents and so forth) to sound the alarm soon after the first report of an electrical problem in neighborhood instead of waiting until it was too late for many to escape.

Day Zero Diagnostics – shrinking the speed to diagnosis to save lives

Co-founder and CTO of Day Zero DiagnosticsMiriam Huntley, started her talk by pointing out the serious nature of antibiotic-resistant bacteria. They are the cause 23,000 death/year, she said, with half of organism being resistant to at least one drug.

When someone gets admitted to the hospital with a presumed bacterial infection, doctors use a “use slow, outdated process of culture which takes 3-5 days to diagnose an infection.”* This means that doctors have to make “a blind guess” when they start the patient on antibiotics while waiting for the results of the culture. A wrong guess, she says, could have fatal consequences.

Cultures provide critical information not just on what type of bacteria caused the infection, but even more important, it tells them the status of that bacteria’s resistance or susceptibility to various antibiotics. Huntley wondered if there was a better way:

What if we could read the genome to directly learn the bacteria’s resistance?

Zero Day Diagnostics is developing a sequence-based rapid diagnostic technology tech to determine the bacterial species as well as its antibiotic susceptibility “within 5 hours instead of 5 days.” The hope is that physicians will be able to “treat patients with the most effective drug the same day they walk into the hospital, avoiding the complications, costs, and frustration associated with empiric therapy.”*

Day Zero Diagnostics graphic from video on dayzerodiagnostics.com:technology 635 x 157
Day Zero Diagnostics graphic from video on dayzerodiagnostics.com:technology

Butterfly Network wants to arm every healthcare worker with a full body ultrasound

John Martin, the Chief Medical Officer of Butterfly Network, asked this question:

What if every doctor or healthcare worker in the world had a handheld single probe ultrasound connected to a smartphone in his/her pocket instead of a stethoscope?

He says this could shave hours off time to diagnosis.

To accomplish this goal, Butterfly Network has created a whole body ultrasound system developing a “transducer on a silicon chip.” Instead of using piezo crystals like most ultrasound devices, Butterfly “uses a semiconductor foundry and supply chain” to build the chip that they say is the size of a postage stamp.

They have also developed a software platform, a mobile app, that provides “real-time AI interpretation” of the ultrasound imaging. And they have incorporated “Augmented Reality based guidance to assist users in positioning the ultrasound wand” in order to acquire the best possible image.”*

Butterfly-Network-hand-held ultrasound 675 x 450
Image from Butterfly Networks

Butterfly says they “seamlessly connect users and foster collaboration across the hospital or around the world“* and that they do so at what they call a “drastically lower cost” (“under $2,000”). They say this approach will democratize healthcare but I suspect that the price is going to have to come way down for this technology to spread widely in the developing world.

Nevertheless, I can envision a future where not only healthcare providers but also consumers, will eventually want to have one of these devices if not in their pocket, at least in their drawer. Indeed, I would like to have one for personal use now – think of what fun you could have imaging everything!

I look forward to following Butterfly’s progress.

Viz.ai: Saving time to save neurons in brain injury

Neurosurgeon turned entrepreneur Chris Mansi, Co-Founder and CEO of Viz.ai started his presentation by telling us a sad story. Four years before, he performed emergency surgery on a woman in her early 30s who had been hit by a car in London. She needed the operation to decrease pressure on her brain caused by bleeding. He told us that the operation went well, but the patient died. It had taken four hours to get into the OR and during that time her brain cells were dying.They were simply too late to save her.

To help solve this problem, Mansi’s company developed Viz LVO (LVO stands for Large Vessel Occlusion). The product integrates with the hospital’s CT scan and, using AI and deep learning algorithms, it analyzes CT angiogram images in real time in order to rapidly identify large vessel occlusions that would benefit from interventions to remove them (i.e., mechanical thrombectomy). Viz LVO received FDA clearance and in doing so “co-invented the de novo regulatory pathway for AI medical devices, Computer-Aided Triage (CAT) in collaboration with the FDA.”*

Viz.ai’s second product, Viz CTP (CT perfusion) is an automated cerebral image analytic tool that can “rapidly calculate CT perfusion parameters including Cerebral Blood Flow (CBF), Cerebral Blood Volume (CBV), Mean Transit Time (MTT) and Time to Maximum Residue (TMax).”*This provides vital information to the interventionalists treating the patient. The Viz CTP was also FDA cleared, in this case via the 510(k) pathway later in the year.

The information from these diagnostic tools is combined with a platform that can rapidly alert everyone involved in stroke care about the case providing the critical details they need to mobilize the team. By innovating across the entire workflow involved in mechanical thrombectomy, Viz.ai hopes to slash the time needed to get definitive, life and brain-saving, treatment to stroke patients with large vessel occlusions. This is BIG.

*All statements in quotes and italics appearing in this article were created for and appeared on the TedMed Hive2018 presentation.


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