At The Next Web conference 2020, Smart Health Amsterdam hosted a roundtable titled ‘Scaling your Health/AI business’. The network – just nominated for an InnoVision Ecosystem Award for life sciences and health – also hosted a digital expo booth where a dozen local startups presented their vision on how they planned to impact the future of health and healthcare.
Representing the ecosystem
When it comes to applying data science and AI to the clinical setting, the expo’s presentations reflected the impressive variety within Amsterdam region’s ecosystem. For example, there were the enablers out to help others make the leap towards data-driven innovations, such as data anonymisers Syntho, low-cost eye trackers Purple Gaze, and all-in app developers EverywhereIM. Other startups seek to lighten the workload of healthcare professionals, such as asset-tracker Blyott, decision-support system Councyl.ai, and voice recognition innovators Attendi. Meanwhile, Caro Health focuses directly on the patient: offering an automated digital health companion to help keep track of – and understand – a particular treatment.
The current COVID-19 crisis has obviously accelerated telemedicine, providing more opportunities for smartphone-fuelled companies, such as heart-monitor experts Happitech and best-in-class skin cancer diagnosticians SkinVision. Meanwhile, Olive Diagnostics sees automatic spectral urine analysis as the future of not only monitoring home patients but also diagnosing certain diseases before any symptoms arise.
And while most presenters were startups, a few could be more properly defined as scale-ups. Certainly, Inbiome has everything in place to speedily revolutionise the diagnosis of bacterial diseases worldwide while also working to potentially avoid future pandemics.
Crossing the chasm: from startup to scale-up
All the presenting startups backed their tech with passion, believing they could have a positive and major impact on the healthcare system. But how do you make that leap? Going from concept to startup is one thing, but going from startup to scale-up is a much larger and trickier beast. The roundtable ‘Scaling your Health/AI business’ was ably moderated by serial entrepreneur Sjaak Vink, founder of the TheSocialMedwork, which connects patients with new medications that have already been approved elsewhere.
Be a solution to a real problem
Vink first turned his attention to Wouter Kroese, founder of PacMed. This successful company builds Clinical Decision Support Systems – “to make healthcare more personal, precise and practice based” – now being used in several Dutch hospitals. The company is also involved in a large national collaboration aimed at applying machine learning to find the optimal treatment strategy for COVID-19 ICU patients.
“Our biggest challenge was to ensure we were not a solution without a problem,” says Kroese. “We had to find out how we could offer the most value in applying AI. We started wide, covering everything from mental health to intensive care. The next challenge was to kill off a lot of darlings and drop a lot of wonderful partners.”
“It’s the art of saying ‘no’,” agrees Vink.
1) Nail your science, 2) watch your runway, and 3) regulate the regulators
Maurik van den Heuvel is CEO of Rotterdam-based Breathomix. His company is currently working with an array of larger partners, including with the Ministry of Health on a study on whether COVID-19 infection can be measured in exhaled breath.
“I see three main challenges when scaling. First, you must make sure your science and publications are in order. This takes so much patience and time. Second, you need to manage your runway. You must be very aware how far your money can take you,” says Van den Heuvel.
“And third, you must understand and adhere to regulatory bodies. These are so complex and very open to interpretation since they cover everything from walking sticks to MRI scans. Plus, these bodies were built for multinationals who have the money to invest, not smaller companies just starting out.”
Van den Heuvel suggests that in the name of driving innovation, the government could step up here. “A case officer could be really helpful when you’re making that 1,500-page document.”
“Indeed, bureaucracy is an evil,” observes Vink. “But we need to deal with this. The Smart Health Amsterdam network can help with this. As can Philips…”
Scaling the ability to scale
Van den Berg explains the background: “We work with hospitals worldwide and many said, ‘Hey, we’re being approached by all these amazing startups with great point solutions, but our IT puts a brake on this. But Philips is already in our flow. Isn’t there a way you can help them scale and involve them with us?’”
“So here was a challenge,” says Van den Berg. “Yes, we were already collaborating on an individual level with startups, but to connect them all… Well, we needed to scale as well – to rethink our systems and contracts from the ground up.”
Understand the culture and adapt to each situation
Both Van den Heuvel and PacMed’s Kroese see the value of collaborating with larger companies and institutions. Ones which not only have experience in navigating regulatory bodies, but also a better understanding of the setting and culture where the technology will eventually be applied.
“You need to know the needs of the doctors, medical partners – all the stakeholders – and what they deal with daily,” says Kroese. “You need to understand those psychological aspects of instigating change so you can work within the existing system.”
“But as you do this,” adds Van den Berg, “you must recognise that different hospitals have different workflows and criteria. And then as you internationalise, different countries have different drivers, KPIs and tech considerations. We can help with that.”
Loopholes are dangerous for both ethics and effectiveness
The conversation turns to ethics. “At Philips, we are playing in a healthcare domain, so ethics is particularly important, with different laws in different countries,” says Van den Berg. “We take the most stringent view,” “When we begin with a startup, we make sure they used the right ethics to gather the right data from the right populations.”
“We have to think about ethics every day,” agrees Van der Heuvel. “You may not be helping yourself by gathering data from afar where the rules are laxer but where the population may be very different. Loopholes can be dangerous for both ethics and effectivity of your AI.”
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