How do you get fantastic ideas that will improve people’s health from the university lab to the local clinic? This is the challenge BioInnovate has been tackling for 12 years as part of the MedTech sector in Galway. In this article Prof Martin O’Halloran, Established Professor in Medical Electronics at University of Galway and Executive Director of BioInnovate, explains the unique recruitment process BioInnovate uses to find the health champions of the future, and his passion for bridging the gap between research and patient care through innovation.
Martin O’Halloran (MO): I’m originally from Galway. My undergraduate degree is in Electronic Engineering, completed at University of Galway, and I followed on with a PhD in Electronics Engineering. Something I’ve always been really passionate about is patient impact. Because of this, in 2012 I re-trained in clinical research to understand how to do clinical trials. This is what led me down the path I’m on today.
MO: BioInnovate Ireland is a global centre for innovation in medical technology. We were founded in 2011 by a network of thought leaders from across Ireland, Europe and the US, led by the late Ian Quinn. The programme leveraged a proven framework, Stanford Biodesign, to develop a talented, motivated and multidisciplinary pool of innovators to shape the future of healthcare on a global scale. Since its inception, the success and reputation of BioInnovate has grown immensely across the MedTech and healthcare sectors.
MO: Our BioInnovate programme produces 2.6 to 2.7 start-ups annually, on par with Stanford’s programme, and members of our Fellowship programme meet with Stanford’s Fellows every year. In fact, Biodesign’s two founders, Paul Yock and Josh Makower, often come to Ireland to meet our Fellows. The relationship is strong, and we’re really keen to maintain it. We’re proud to be Stanford’s only official affiliate in Europe.
As a solutions-oriented programme, BioInnovate’s research is focused on addressing real needs. Crucially, we advise that the question should be: Can you build an investable business, taking your concept from an idea all the way to a medical device?
This line of thinking is a way to get technologies out of the University and into the clinic.
BioInnovate in Numbers:
contributing to the health technology sector for 12 years
producing more than 2.5 companies per year
1/8 of the 450 Irish-owned MedTech companies
in Ireland participated in BioInnovate
MO: University of Galway’s location offers a few ingredients that make the BioInnovate programme work. One of the most important ones is human capital. In the region, there are people who have been working in the multinational sector for years. They might be a senior engineer or a person at manager level, and then they say: look, maybe I’d like to do this myself. We often recruit from big-name MedTech companies, drawing interest from people who say: okay, maybe I’ll try to start my own company in this space. The other element is the closeness and engagement with University Hospital Galway. This proximity gives us a unique kind of clinical access for the programme.
MO: We usually start recruitment in November, and we get hundreds of applicants each year. These are screened by the operations team, with support from the Advisory Board. Following this, we run a day-long recruitment and interview process. Rather than interviewing the candidates in a traditional format, we give them a taste of the programme over a day. This manifests as technical challenges, speed interviews, and leadership exercises.
All we do on the recruitment day is assessed by 20 to 30 reviewers, these being people who have started and scaled MedTech companies themselves. There are also investors: Angel Investors and Venture Capital Investors. What we’re trying to do is select the people who, in two to three years’ time, are credible candidates to receive investment from those same interested parties. Ultimately, we are de-risking the process by getting the voice of the investor in the room from the very start.
Support from our advisory board here is crucial. Our Advisory Board keeps us honest, as well as ruthlessly market oriented. What we mean by that is we’re in an academic institution, but we have to produce projects and people that are commercially credible. There cannot be any vanity projects in BioInnovate. Our Advisory Board keeps our interests aligned to the market. It’s this that lends to our confidence that those 2.6 to 2.7 companies coming out of the programme will succeed and scale, anchoring the medical device sector in the West of Ireland.
MO: The BioInnovate programme contributes in many ways. This might be through facilitating start-ups in Ireland or offering tailored training. We maintain relationships with Medtronic, Boston Scientific and Abbott, for example. There are three different industry training offerings: the 10-week immersive course, 3-day fundamentals course for professionals, and a 3-day C-Suite executive course.
As for the future of health technology innovation, to give an example, one year we looked at cancer care and talked to lung cancer surgeons. We asked them: What’s the most important thing for your patients? They said: that I can look my patient in the eye and tell them they’re cancer free.
To understand, the first-line treatment for lung cancer is open surgery. The healthiest patients get open surgery, and the patients who have less lung function often get radiotherapy. At the start of that journey, the open surgery patients feel they’re lucky. But then if you talk to both sets of patients six months down the line, often the radiotherapy patients feel much better because they don’t have the side effects of surgery, which are chronic pain, breathlessness, the inability to work, and so on.
In that observation, we identified that being cancer free is just one part of the problem. From a patient’s perspective, what happens for the 5 to 10 years afterwards is also an issue.
Endowave, a company from the BioInnovate programme, is trying to solve this. What they do is, rather than cutting the patient’s chest open and carving out the cancer, they’re using minimally invasive ablation. Using this non-surgical approach, scarring and chronic pain are minimised. It’s also a very small ablation, which means that you’re protecting the functional tissue of the lungs and allowing that patient to have a much better quality of life, considering 10 years down the line.
That’s the kind of thing I’m really proud of. The BioInnovate programme is giving a voice to patients’ needs, and we’re listening.
MO: Typically, projects are funded for the first two years through Enterprise Ireland, which usually gets them to where they have built a prototype device, and maybe some pre-clinical testing. The challenge then is to raise more funding for the ‘First in Human’ study, and the next step is what’s called a ‘Pivotal Trial’ in the US. That’s a regulatory approval trial. In this sense, the process involves a series of fundraising activities participants must progress through, and it can take 5 to 6 years to go from concept to product.
The programme’s industry mentors offer invaluable assistance throughout the whole timeline. I say this a lot: the currency of the programme is goodwill, and we have a huge amount of goodwill in the West. I don’t know where it came from. It may be just that the late Ian Quinn – former chair of BioInnovate’s advisory committee and namesake of the Ian Quinn Centre for Health Technology – and his cohort set a tone that we all aim to live up to, but it’s very supportive. That’s what we strive for in the BioInnovate programme.
MO: There’s a group of people we call “clinical champions”, who facilitate the programme across the country. We joke that we’re asking clinicians who obviously have loads of time and who don’t have long patient lists, to do something else. Despite this clearly not being the reality, it’s amazing that when we start in August each year, I get messages from clinicians saying: what can I contribute to this year? How can I facilitate it?
Recently, we were approached by someone who has an impressive history among MedTech companies, and they said: I just want to give back. He comes in regularly, and when he can’t make the time, he rings and apologises. We often joke in the programme: I think this relationship is the wrong way around!
The partnerships we maintain are really inspiring, but we don’t do anything to onboard this dedication, that’s a West of Ireland thing. And it’s a culture within MedTech. I can’t take any credit for that, it’s coming externally. It’s this culture, and the fact that that the programme has produced 33 companies; BioInnovate’s continued success reinforces its value. People see this and want to be involved.
MO: In a way, MedTech is probably one of the most difficult sectors in which to start a business. Comparatively, if you sell a software product, the customer is the user. In contrast, in MedTech, the user (doctor), payor (insurer or government), and beneficiary (patient), are all different, with differing needs and priorities. Moreover, MedTech is highly regulated. It’s a complex environment. So, what we try to do is de-risk that by getting into the weeds of the business plan; you need to know all stakeholders in that in that area. You need to understand what the regulator is going to ask, who the purchaser is, and how the insurers will deal with your product. You need to understand what motivates the clinicians and the clinical staff around them.
There’s a famous story in the US, where they were trying to understand why a certain brand of bandages was used by nurses, its sales overwhelming its competitor. It turned out that the nurses chose that particular brand because it was the only brand that could be opened one-handed. This made the difference.
That’s what we try to do. We try to understand all motivations, all the actors involved, better than anyone else. It’s then that you have a competitive advantage. Someone could be building the best bandage with the best wound-healing construction, but they’re losing out because of a usability issue. It’s really about understanding your customer, and that’s what we’re trying to do.
MO: As an example, let’s look at Luminate Medical, a company investigating the side effects of chemotherapy. When we were talking to oncologists, we asked: what really frustrates you about managing your patients?
One of the things they talk about is called peripheral neuropathy. When patients are going through oncology, they will start to notice tingling in their hands and feet, and that will, over time, develop into pain, and a loss of feeling. This then often ultimately means they’re at risk of falls. The way oncologists deal with this is by measuring peripheral neuropathy at every treatment. If symptoms start getting worse, oncologists will often reduce the frequency of chemotherapy. What they’re trying to do is find balance between wanting to treat the cancer, but also not wanting to create symptoms so bad that this patient is at risk of significant injury from a fall.
The solution that Luminate Medical offers is a device that goes on the hands and feet, which stops chemotherapy from getting to these extremities. A study is currently ongoing at University Hospital Galway with this technology. The way it works is that the Luminate Medical device is placed on one hand and one foot, allowing for the opposite hand and foot to operate as the controlled variables in the study. We’ve actually since been told by an oncologist that several patients wouldn’t have needed to reduce chemotherapy treatments if the device had been on both hands and feet as opposed to one each. This tells us that the device is offering real results and that, in the future, it could allow for uninterrupted chemotherapy treatments, then leading to improved survival rates of cancer patients.
I love that example because the need came from a clinic in Galway, and the solution is now being validated in the same clinic, with the support of oncologist Prof Michael McCarthy.
MO: For me, the most rewarding thing is that I’m working with 12 really smart and talented people every year. It’s difficult for these participants – they may be putting a number of things on the line, but there’s such a buzz in the programme because of their motivation and drive. As people, they’re immensely inspiring.
In terms of where I’d like to see BioInnovate go – the most interesting thing for me is those patient-prioritised needs. What we’re trying to do is support acute care, but we also want to see what’s happened afterwards, and how we can support patients once the acute event is over. I think if we can show successful companies delivering on patient or public prioritised needs, it will attract more investor appetite.
I’ve said this before, but the currency of the BioInnovate programme is goodwill. It’s conducted through the support of those willing to give their time, and I’m never cynical about the health service when I see people like that. Going out of their way just to just to pitch in, and it’s all about helping patients. That’s what they’re motivated by, and it’s amazing to be a part of that community.
The BioInnovate Ireland Fellowship, fully funded by Enterprise Ireland, is a 10-month, full-time specialist medical device and digital health innovation programme. Based on the needs-led innovation approach first proposed by Stanford University, the programme guides multidisciplinary teams through a full cycle of innovation, from needs identification to designing and prototyping viable solutions as well as securing funding.
