Creating CPR tools for the rest of us
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Frank Boermeester Frank Boermeester - February 9 2012

Only about 30% of people who need CPR actually receive it. That is a tremendous waste of lives.  So imagine if we all carried a CPR coach around with us, permanently.  It is a feasible future, if people like Dr. Ivor Kovic have their way.  Ivor is an emergency physician from Croatia who gets called out in the field when bad things happen.  As an avid user of modern technologies, he’s found that his iPhone has become an indispensable medical device.  Recognising the opportunity, he’s set up a company—IvorMedical—that seeks to put user-friendly first aid technology in everybody’s hands. 

Ivor, you’re an emergency physician?

Yes, I’m what they call a pre-hospital emergency physician.  It means that I go out in the field when bad things happen—accidents, cardiac arrests, etc.  In Croatia we also rely on paramedics obviously but physicians get sent out too if the situation is serious.  This type of work is a great opportunity to use modern consumer technologies because we’re detached from the hospital’s infrastructure and its resources.  In the process I’ve become very reliant on my iPhone because I use it to access all sorts of medical databases and medical apps (ed. note: Ivor recently explained how he uses his iPhone at Mobile Monday in Amsterdam – have a look at the video here).

How did that happen?

Well, we’ve had to take initiative. Unfortunately in Croatia there is little interest in new technologies at a policy or institutional level.  As such, we have to rely on our own resources.  But we’re making progress, mainly because we’re a team of young people who are comfortable with modern technologies.  First we started using certain types of databases with medical information which we could access using our smart phones.  Then we started experimenting: we installed hotspots in our cars and we’re trying out the iPad to write our reports.  Today I still go out in the field with an A4 block of paper to write my reports.  They’re basically structured questionnaires with plenty of tick boxes. After each case I need to fill in the report, leave a copy with the patient and one with the hospital, and then transfer the data to my computer.  We wanted a simpler solution which is why we’re digitizing the report for the iPad, with the idea that we can print out a copy inside the ambulance and mail out a copy to the hospital immediately.

Fortunately we have a pretty good mobile network in Croatia. As a result my iPhone has become an extension of my arm.  I use it to double check dosages and generally use a lot of medical apps.  We’re also documenting our work in the field, via digital reports but also with photos.  We’re taking loads of photos and including these in our reporting and in our databases.  Note that none of this is official. We’re taking the initiative here and we hope that we can one day prove that it is worthwhile to invest in these technologies.  The opportunities are tremendous.

But surely a lot of dedicated healthcare technology is available on the market today?

It is true that a lot of dedicated hardware is already available on the market but I’ve tested a lot of that technology.  Tough books, for example, are horrid machines.   I don’t like the design and they’re unbelievably user unfriendly too.  The interfaces are so complex and busy.  It’s as if they’re assuming that doctors are a different type of human being, super-smart and accustomed to super complex interfaces.  No! We’re just human too.

Look at the types of solutions being developed for sales people these days. They’re all designed to be used on Android or iPhone platforms and their interfaces are so elegant. Why can’t the same principles apply to healthcare? We need to learn from other industries.  I always have a feeling that in healthcare we lag behind to other sectors when it comes to technology.  If I travel to Belgium I can use an ATM with my bank card no problem; the system will recognize me, authorise my access and give me cash. But if I go to a doctor in Belgium there’s no way he or she could access my medical record via digital channels.  Even in the local context medical practitioners and doctors mostly aren’t connected digitally.  Even in New York they tell me that hospitals don’t talk to each other with the result that there is enormous waste in unnecessary medical tests, not to speak of the waste in lives.  Security and privacy concerns are the barriers they keep saying, but that doesn’t seem to stop the financial sector where these are also a concern.

So this is why you set up your company IvorMedical? How’s the business going?

Obviously I never thought I’d ever start a business—I’m a doctor—but the need is so great, we have to take the initiative. I’m using so much excellent technology at home, but none of it is officially available in the work context.  We need to change that.

When I first set up Ivormedical I started presenting my ideas and tools at conferences.  I won some awards, some money started coming in, and gradually the snowball started rolling.  Luckily I met a number of really excellent people with engineering and design backgrounds.  And most of these people happened to live in my neighbourhood, which was surprising and really good to learn.

At this point we’re surviving. We’re not making any real money and what we do make is ploughed back into development work.  Our goal is simply to keep moving forward.  Every week something happens that propels us forward another step.  The key challenge at the moment is finding capital for the next step.  For example, we have a patent application pending which is really expensive and time consuming.  We’re developing medical products hence there is a lot of lab testing and certification to be done.  I guess that Croatia isn’t the ideal place to build this type of business since there is very little risk capital available here.  The Venture Capital sector is only just getting off the ground here. I was fortunate, however, to get one of the first spots available at the university’s new science park and business incubator.  Things are beginning to happen here but not as fast as I’d like it to move.

Tell us about the products you’re developing.

First we developed an app for the iPhone that helps people do CPR.  It provides educational videos and helps the user do CPR in a real situation.  The app is available worldwide and has sold pretty well in certain regions—Israel for example.  We’re currently translating the app in other languages and adding other functionality.  For example, one idea is to have it locate the nearest defibrillator machine by connecting to local databases of such machines.  We’re also developing new apps such as one that teaches you to use a defibrillator—in case you do come across one and have to use it.  Another idea is to create a network of rescuers: a location aware app that connects trained first aiders so that if there is an emergency the nearest rescuer can be alerted immediately.

The potential to save lives is incredible.  Research shows that only about 30% of people receive CPR when they need it.  If we can help change those statistics then lives will be saved.  Just imagine if everyone carried around a CPR coach with them, permanently.

With our new product we’re taking it a step further by developing a multifunctional first aid device.  Basically it is an ergonomic tool designed specifically for doing CPR. It looks good obviously, but it is also designed so that it is easier and less physically taxing to do CPR. It allows for a handgrip that is much less taxing on the wrists and palms of your hand. This is really important since CPR can be physically demanding work. It is not unusual for a CPR session to take 10-20 minutes. Moreover, research has shown that 80% of cardiac arrests happen at home, and they happen to older males—with the result that elderly women are most likely to be in a situation where they have to do CPR.  That’s why we’ve focused on good ergonomic design.  In addition, the device also communicates to the user: it provides instructions and video demonstrations, it calms the user down, it calls for help and it gives the user feedback on how they’re doing.  The device has movement sensors so it can tell whether you’re doing it too slow or too fast.  Finally, we are developing a product that is priced much lower than anything else currently available on the market. Larger technology companies also offer first aid devices but they tend to be much more complex and expensive—and none are ergonomically designed.

I think we have something here that could really make a difference.  It’s so cool to see experienced first aiders smile when they first use the device.  The problem with a lot of CPR equipment is that users just don’t like it. They’re too complex and make too many demands on the user.

Any tips for other entrepreneurs in the health space?

Be open; don’t behave like the dinosaurs out there with their non-disclosure agreements and obsession with IP.  Be more like Google.  Who cares if you don’t get a patent? If I don’t get a patent I’ll make our technology open source.  I’ve learnt that when I’m open good things happen.  Also, believe in yourself. Don’t let the critics put you off.  You have to push forward and give it everything.  Obviously listen to good advice but don’t let all the so-called ‘experts’ out there tell you what will work and what will not.  Remember, this is a new and pioneering field.  Resistance to change is inevitable.


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