19

JULY, 2017

Ultra Violet light
Robots
Home monitoring
Patient driven care

The winter Melbourne Health Accelerator program is over half way through it’s Winter curriculum. The pitches are much more focused and clear about who the customer is, and what the product can offer. Contacts have been organised with senior clinical staff in the hospital to discuss actual ward based problems and how the startups can overcome them.

A number of guest speakers have spoken to the group. Claredon lawyers have given a presentation on fundraising and corporate law for startups. These include business structures, key features of a company, fundraising and shareholder agreements and incentive arrangements.

Angela Watt from Melbourne Health’s ethics team has discussed how to make an application to the hospital for a clinical trial. This involves a complex submission process and she suggests startups come to see her team directly, so their background in making applications for clinical trails can be assessed, and they can be put in touch with key hospital stakeholders.

This post is about startups who paying customer is expected to be hospitals and clinics. It covers Duplex healthcare, an established hospital cleaning company with an autonomous robotic and Adyuvo, a vision of connected patients who drive their own care with smart devices and self directed learning.

Duplex healthcare has over 20 years experience in hospital cleaning. The manager is Australian inventor Murray MacDonald.

Murray was featured on the ABC’s New Investors series with an earlier product called Floorbot. Murray and Tanya are participants in the MHx program with their new product MUVi, a UV disinfectant system that can be attached to an autonomous robot able to move around hospital rooms independently as well as a pod where large hospital items can be placed for detailed cleaning.

Duplex healthcare UV cleaner.

The small business genes run through the McDonald family.

Murray had his first business cleaning cars at 14. By 15 he was selling pinball machines.  At 16 he joined up with dad delivering mini skips and at 21 he was setting up home safe electrical, fire protection. Murray went on to complete a Bachelor degree in industrial electronics then joined the family business Duplex at aged 24.

Duplex Healthcare sells industrial cleaning equipment to hospitals. The company also conducts extensive training sessions on how to use the equipment. During one of his training courses, Murray wondered why no one had produced an automated cleaning machine. He decided to do something about it, and started up another company called ‘Floorbotics’. Murray has been developing a robotic vacuum cleaners since 1996.

His latest invention is MUVi, which stands for Mobile Ultra Violet Innovation. This device is capable of moving into a room after the standard clean has been done, and disinfecting the entire room with UV light.

“You go into a hospital and you want to get well. You are not really planning on catching a hospital acquired infection”

Hospitals can be dangerous places.

There are currently 200,000 hospital acquired infections in Australia every year. They affect 1 in 10 patients. Hospital acquired infections are linked to a variety of causes including poor hand washing by staff, patients with reduced immune systems and people undergoing invasive medical procedures.

Hospital cleaning is a vital but complex area of preventing hospital acquired infections. One of the biggest issues in hospital cleaning, is human error. This means cleaning staff missing some of the surfaces in a room. Cleaning hospital rooms involves more work than most people realise. Many hospital surfaces and items actually carry infections. For example 85% of wheelchairs have tested positive for MRSA. While cleaning staff will always be required to do a physical clean of each room, the UV system can go in after woods and provide a comprehensive and consistant sterilisation, 24/7, without missing a surface.

Duplex Pod

The MUVi invention is flexible enough to manage the complexity of hospital environments. It can sterilise large items like wheelchairs, IV poles, beds and chairs, by placing them inside a lined pod that is sealed then baths the equipment in UV light for 3 minutes. It can also be attached to a small autonomous robot, that travels around the ward, directed only by a smart phone app and placement sensing technology.

Hospitals in Australia may soon face financial hardship if they don’t reduce their infection rates. A consultation paper on the pricing framework of Australian public hospitals, was published by the Independent Hospital Pricing Authority in September 2016. It suggested that Governments should incorporate patient safety into future funding models. This means not paying for unsafe procedures and unnecessary care. Many private hospitals already sign such agreements with private insurers. If patients experience an avoidable problem or error, the insurers don’t pay the costs.

Murray MacDonald on the New Inventors

Ultraviolet light has been proven by a number of academic studies to kill the dangerous types of infections that can breed in hospitals. A study in America, over two years, across 9 states showed that adding Ultra Violet light to standard hospital cleaning, was able to reduce transmission of 4 resistant bacteria (MRSA, vancomycin-resistant enterococci (VRE), C. difficile and Acinetobacter) by 30 percent.

Another trial in 2015 showed that Ultra Violet light used in a portable booth was capable of reducing bacteriophage MS2 and methicillin-resistant Staphylococcus aureus infections within 3 minutes. The study was published in the Society for Healthcare Epidemiology of America. 

Thanks to the persistence and inventiveness of Murray McDonald, this technology will soon be coming to Australian hospitals.

Consultation paper on the pricing framework for Australian Public Hospital Services 2017 - 18

Ross Hardy is co-founder and CEO. He has been in healthcare for 28 years specialising in the perioperative environment, both as an ex clinician and sales and marketing expert in the medical device industry. Ross holds an Executive MBA.

Michaella Richards is co-founder and COO. Michaella has extensive experience in digital health and biotech industries and also has been a leader in economic development with Victorian state government.  Michaella holds a PhD in neuroscience.

Laura Martin the Director, Clinical Partnerships for Adyuvo. Laura has a background in navigation systems in the US Air Force; as a Registered Nurse Div 1, she is hold post graduate qualifications in intensive care nursing and currently works in Western Victoria Primary Health Network.

The idea of Adyuvo came from Ross’s personal experiences as a patient, after having worked in the health sector for years. He was admitted to hospitals twice in 2 years, after cycling accidents. His most recent experience included being discharged from one public hospital, sent to another public hospital to a clinic that was closed after being told he had no fracture in his pelvis, only to discover that having self referred to a private ED, he had a fractured pelvis. He then spent the night on a trolley in the private ED and 26 hours later finally had a bed to go to. Fortunately, no surgery was required.

During his hospitalisation, Ross felt a strong desire to manage his own care at home. He wondered how many others did not wish to lie in bed when they could be at home? How many beds are being blocked for whatever reason? Surely someone more needy than me could use this bed?

‘We can do better’ was his overall conclusion. Ross set about ideating a connected system that is patient centred at its core. By using technology to improve communication and care delivery, this would reduce errors, prevent admissions/readmissions and save money.

Connected care is the key to a modern and cost efficient health system.

As the world’s population ages so does the number of people living with chronic diseases. The current health industry is still focused on hospitals, the most expensive and least efficient way to treat people with long term problems. As the Royal Australian College of General Practitioners Bastian Seidel commented in this weekend’s Australian, keeping patients out of hospital would not only save money but also improve outcomes for patients.

The philosophy behind Adyuvo is that the patient/consumer is the centre of the health system and that services should focus around their needs. Their aim is to help people with chronic diseases to help stay well for as long as possible, and when they do go to hospital, navigate the system quickly and efficiently

The team has a close connection via lived experience with Chronic Kidney Disease and so this condition is the current focus. By making the consumers healthcare data meaningful to them, the platform will create interest, knowledge and provide an a personalised approach to care.

Ross Hardy from Adyuvo

Most people with kidney deterioration don’t know they have problems, until they are diagnosed with end stage disease.

The impact on kidney disease on both individual patients and the nations health system is enormous and rising every year.

In 2014, close to 23,000 Australians were receiving dialysis or living with a kidney transplant to treat their kidney failure – Better Health Channel.

The average cost of dialysis for one person on average is $61,659. This breaks down to hospital dialysis $79, 072, home haemodialysis  $49,137 and peritoneal dialysis $53,112The average unit cost of a kidney transplant in the first year is $81,549 and $11,770 in subsequent years. Kidney Health Australia Submission May 2011.

Between 2014 and 2015 there were 1.4 million hospitalisations for dialysis – Australian hospitals at a glance.

In 2012 the total costs of chronic renal failure were estimated to be 4.1 billion. The cost of treating end stage kidney disease from 2009 to 2020 is estimated to reach 12 billion dollars – Kidney fast facts.

60 people die every day with renal related disease. Diseases of the kidney and urinary system contribute to 14% of all Australian deaths – Kidney fast facts.

As with all health statistics Indigenous Australians have lower than average outcomes. In 2012 – 2013 almost 1 in every 5 Aboriginal Australians had indicators of Chronic Kidney Disease. The famous singer Dr G Yunupingu died this week at 46, after missing multiple dialysis sessions. Discontinuation of dialysis is a common cause of death in end-stage renal disease patients – Pub med – Nephrol Dial Transplant. 2004 Mar;19(3):686-91.

Adyuvo’s plan is help people to stay happy, healthy and importantly, at home. Smart devices and machine learning can help achieve its purpose: treat the person, not the illness.

“There are plenty of wearable devices available like a wrist worn device that collect health data. What we want to do is make this information meaningful. Using the power of data combined with analytics, we hope to support both consumers and clinicians to achieve better health outcomes.”

Adyuvo is adapted from the Latin / Italian verb adiuvare, which means to help, aid or assist.

The Adyuvo team are looking for the right technology partner that has the most relevant experience in a heavily regulated environment because data privacy and security are high priorities. They are also preparing to raise capital and will commence this by the end of this year.

Their vision is a platform that can make intelligent assessments of the stream of health data, from data sources, smart phones and wearable devices. They want their platform to be device-agnostic, so people have a choice about which smart devices to use.

In the short term Adyuvo is about to commence building the first version of its product and is excited about the future impact of digitisation on the Australian healthcare system.

During the Melbourne Health Accelerator Program the Adyuvo team has met with the hospitals management from Hospital in the Home, the Director of Research, Governance and Ethics, Angela Watts and Professor Steve Holt who is Director and Lead Physician for Peritoneal Dialysis

During the program Ross and Michaella have appreciated getting feedback on how to shape the company’s product from the Melbourne Health Accelerator Program team and enjoyed the guest speakers, talking about company structures, raising capital, and protecting Intellectual Property.

Adyuvo is seeking partnerships with clinical and technical staff. If you are interested please get in touch.

© Wikihospitals August 2017

Kidney Health Australia fact sheet