Just before the new year the FT wrote a wonderful article about doctors who built technology companies. This came about initially from conversations with the wonder Doctorpreneurs team whose interviews are well worth reading for any budding health care entrepreneur. It was great to see that Touch Surgery whom we share an investor with. Earlier this month Balderton led a £3.5 million investment in PKB.

Read the full article on the FT web site.

Three medics and one ex-student reveal the challenges and lessons of their health-tech ventures

The full picture: Joshua Landy set up Figure 1 to crowdsource medical expertise while respecting patient privacy

As a visiting scholar at Stanford University in 2012, Joshua Landy spotted stud­ent doctors in hospital rummaging in their whitecoat pockets for their smartphones. They were using them to photograph unusual symptoms and test each other on what patients’ ailments might be.

Today, Dr Landy alternates working as a hospital critical care specialist and as co-founder of Figure 1, a Toronto-based start-up that allows doctors and nurses to share clinical images. “[Until now,] as healthcare professionals, we’ve had to resort to less than perfect communication tools, such as emails or texts, when a picture would do the job better,” he says.

Such combining of medicine and entrepreneurship has spawned its own noun, doctorpreneur, and a number of networks, including the eponymous UK-based Doctorpreneurs.

Surgeons in particular have always in­vented devices out of clinical necessity. What today’s innovators may have in mind, however, are not so much technical improvements but using technology to help redesign healthcare, from the grass roots up. As Arlen Meyers, a doctor and chief executive of the US-based Society of Physician Entrepreneurs, puts it: “A doctor can treat 20 people a day for his or her entire career — or build a device that allows a million people to be treated or not get sick in the first place.”

Doctors starting a business have insights into where healthcare is failing and the pressures that medics face — although, as with insiders in other sectors, this is not always an advantage.

“When something has caused you a lot of pain, it’s easy to assume the problem — and hence the business opportunity — is bigger than it is,” warns Ophelia Brown, an investor at venture capital firm Index Ventures. Physician entrepreneurs may have less variety of contacts and lack ex­perience of running a company, raising finance or knowing how to fit into a world where technical proficiency does not trump everything.

The peer educator

Founded: 2013, Canada, by Joshua Landy, with non-medics Gregory Levey and Richard Penner.
Equity funding: $10.5m

Goal: To enable healthcare professionals to share clinical cases, gain knowledge and crowdsource help via smartphones.

How it works: To gain clinical acceptance for its image-sharing app, Figure 1 needed to respect patient privacy with no slip-ups. It built in software features to detect and automatically block faces before images are uploaded and hired lawyers in each market to advise on local regulations. “The way we design­ed our privacy system [to exclude any identifying data from our servers] means even if our database were to get hacked and the images rel­eased publicly, apart from it being an­noying I would not worry about patient privacy bec­ause we always felt the best way to keep a secret is not to know it,” says Dr Landy.

Available as a free download in 190 countries, Figure 1 attracts 50,000 users a day. Its strategy is to prioritise building a big community of users and introduce revenue-generating services later.
Lessons: Dr Landy advises turning down funding if it would mean force-fitting the vision to please potential in­ves­tors. “Right now we could slap banner ads on our site and generate revenues. But, as a doctor, I know I’d find that incredibly irritating and offensive.”

Patient empowerer: Patients Know Best

Founded: 2008, UK, by Mohammad Al-Ubaydli
Equity funding: £5.7m

Goal: To give patients anytime, anywhere access to their medical records. As a medical student, Dr Al-Ubaydli, who has a long-term health condition, was gratified when his doctors asked him to talk them through his history. Only later did he realise it was less bec­ause of his training, and more because he had seen so many consultants that only he had the full picture.

How it works: Paid for by hospitals and healthcare bodies, PKB allows patients to ac­cess their medical records from their smartphone. The system, which is en­crypted and held on PKB’s servers, also enables pat­ients to consult doctors on­line and auth­orise anyone involved in their care, including family, to consult and add notes to their records.

Lessons: Dr Al-Ubaydli initially struggled to gain the ear of other doctors, especially his younger peers, who worried that em­powering patients would expose their inexperience. So he cold-called specialists whose patients had com­plex conditions for whom a miscommunication could prove fatal. In 2010, a paediatric gastroenterologist at Great Ormond Street Hospital purchased PKB for her pat­ients, and other departments and hospitals followed.

PKB has customers in 60 hospitals, half in the UK, and raised £3.5m from venture capitalists in November for ex­pansion overseas.

The digital therapist: Omada Health

Founded: 2011, US, by Sean Duffy, ex-Harvard Medical School student, with non-medics Adrian James and Andrew DiMichele

Equity funding: $77.5m

Goal: To use social media to prevent chronic obesity-related diseases.

Omada’s Prevent programme helps Americans cut their risk of obesity- related diseases through a 16-week on­line diet and exercise regime. Mr Duffy, a medical student on Harvard University’s joint MD/MBA course, had the idea while an intern at consultancy Ideo, for a diabetes programme accessible to anyone with WiFi. He left medical school to found Omada with Mr James, Ideo’s head of medical products.

How it works: Participants weigh themselves on wireless scales, linked to a personal profile, and are paired with an on­line health coach and group of peers with a similar body mass index, who support each other in working to­wards their target weight loss. Modelled on the US National Diabetes Prevention Programme, which requires participants to attend community halls, Prevent enrolled 31,000 participants in 2015 and aims for 100,000 in 2016.

Lessons: Just out of medical school, Mr Duffy knew little about raising finance, was baffled by how venture capitalists work and wasted time talking to the wrong people. “My advice to any budding doctor entrepreneur is to find a friend who can explain how venture capital works.”

The surgical simulator: Touch Surgery Founded: 2013, UK, by surgeons Jean Nehme, Andre Chow and, no longer involved, Advait Gandhe and Sanjay Purkayastha

Equity funding: $7.5m

Goal: To allow surgeons to mentally rehearse surgical procedures in 3D.

How it works: Designed on the lines of an interactive game, the app allows surgeons to practise making step-by-step decisions involved in removing, for example, an ap­pendix or reconstructing a breast by selecting and manipulating surgical instruments on a touchscreen.

Dr Nehme and Dr Chow developed the prototype while training as surgeons. Available as a free download, Touch Surgery has more than 600,000 users and has been adopt­ed into the clinical training programmes of Stanford, Johns Hopkins and Harvard universities. The founders plan to generate revenues through academic partnerships and by developing interactive training for medical device manufacturers on the correct use of products.

Lessons: Dr Nehme underestimated the importance of showing ap­preciation and giving feedback. “As junior doctors we had sleepless nights wondering if we’d forgotten to check a patient’s blood tests. As a CEO I learnt that for employees to care as much as you do, you really need to treat them well.”