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(Transcribed by TurboScribe. Go Unlimited to remove this message.) This technology has been around for 50, 60,

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70 years using the same rod lenses, and

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so we felt it was about time that

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an innovation was made in the space to

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help surgeons operate more streamlined.

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Dr. Liz McLaughlin is a physician-turned-co

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-founder.

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She sat in operating rooms, watched surgeons work

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around a rigid endoscope that hadn't fundamentally changed

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since the 1960s, and decided to build a

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better one.

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Timpani Medical is redefining how endoscopic surgery works.

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Variable angle visualization, integrated cleaning, a single-use

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platform, a market worth over 12 billion dollars

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in the U.S. alone.

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Starting in ENT and already getting clinical feedback

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from surgeons at Mayo Clinic, John Hopkins, and

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UPenn.

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But here is what most people in the

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industry would not have seen coming, the former

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COO of Carl Storck USA, the number one

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rigid endoscope company in the world, is now

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the chairperson of Timpani's board.

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Someone who spent 30 years selling the product

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Timpani Medical is here to replace.

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He chose their side, and that is where

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this conversation gets uncomfortable.

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How do you defend design choices where regulation

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risk timelines push towards compromise?

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Liz said something in this conversation that I

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keep coming back to.

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I fundamentally believe that if we stop developing

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hardware, we're goosed.

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So I think we have to have people

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doing hard stuff for hard problems in hardware.

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This episode is about what it takes to

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build a physical product in one of the

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most regulated, most scrutinized industries in the world,

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where design is not decoration, where the gap

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between an idea and a product that ships

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is enormous, and where the people who close

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that gap matter more than most people realize.

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This is Why Design.

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Liz, welcome to Why Design.

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Thank you so much for joining me.

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Thank you very much for having me, Chris.

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You're very welcome.

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Looking forward to diving into this.

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So, Liz, you didn't start Timpani from a

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trend deck.

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This began with clinical immersion and seeing a

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problem up close.

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But so before we get into your background,

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take me back to a moment where everything

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shifted, where were you exactly when you saw

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the unmet need?

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Perhaps you could play the scene for us.

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Yeah, absolutely.

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So the program that myself and the co

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-founder did is a program called BioInnovate.

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It's a program that's really focused on needs

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led innovation.

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And so part of that is stepping back

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and looking and observing in the clinic, whether

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it's the operating room, whether it's the outpatient

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department and trying to see where there are

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gaps in the healthcare system.

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And really for us, some of the real

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challenges were occurring in the operating room.

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And they weren't just occurring for the patient,

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they were actually occurring with the surgeons and

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the types of tools that they had access

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to.

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And really driven by Rory, whose background is

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in medical device design, he could really see

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that there was an opportunity here around being

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able to see around corners, being able to

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operate without having to continuously change the angle

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of view of the tools.

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And so those insights of how the surgeon

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was performing the procedures were part of how

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the tympani story began.

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Amazing.

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So to correct me if I'm wrong, so

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before tympani, it was to change angle, you

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change tool.

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So it's lots of kind of in and

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out.

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And I guess quite a long procedure that

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which those cuts down.

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Yeah, depending on the clinical area.

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So I think one of the things that

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really drove me towards the solution in this

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company was, you know, the technology that we're

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talking about is a rigid endoscope.

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Rigid endoscopes are used for lots of different

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procedures.

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They're used in ENT surgery, they're used in

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neurosurgery, they're used in laparoscopy, they're used in

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urology, gynecology.

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So really lots of different areas where this

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issue is a problem.

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And traditionally how the surgeons have used the

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clinical, the site of intervention was with a

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rod lens.

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So a rod is a long pipe of

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light.

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And so that light is at a fixed

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angle.

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And so they have to change the angle

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every time that they use the scope at

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the moment.

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And so we felt in the modern kind

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of evolution of technology that this is kind

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of a crazy way for surgeons to be

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operating.

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And that's kind of how it evolved.

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And this technology has been around for 50,

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60, 70 years using the same rod lenses.

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And so we felt it was about time

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that an innovation was made in the space

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to help the surgeon operate more streamlined.

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And what did the clinicians say when you

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guys asked, why is it done like this?

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So actually one of the key moments for

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us, we were working with some US-based

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clinicians and Rory had a bit of a

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sketch on the back of this paper around

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trying to access and illuminate the surgical site

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in a better manner.

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And the surgeon said, I was only thinking

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about that last night.

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I was like going to sleep thinking, how

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on earth do we get more light into

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the small spaces in ENT so that we

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can do the operations better?

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So I think those kind of aha moments

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that we're not the only one thinking about

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this problem and that what we've seen is

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validated by the clinician.

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It was really important point for us very

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early on.

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Amazing.

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Was that the first kind of moment where

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you thought we might actually be able to

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solve this or fix this problem?

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I think it was probably the first moment

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where I thought it was a problem that

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was worth solving, I suppose.

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Knowing whether you can fix it or not

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is kind of an iterative process, I think.

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Before we dive back in, this one is

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for founders and CEOs building physical products.

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If you're thinking about hiring a VP of

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product, chief product officer, or head of R

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&D, this is not just another hire.

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It defines how your roadmap is set, how

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your teams are built, and how your company

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competes.

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At Kodu, we specialize in securing senior product

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and engineering leaders for hardware businesses entering their

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next stage of growth.

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Focused, discreet, high consequence.

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If that decision is on your horizon, find

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me, Chris White, on LinkedIn, and let's talk

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it through.

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Perhaps you could give us the elevator pitch

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of Tempany and who you are, what you

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do.

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For those who don't know.

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I'm Dr. Liz McLaughlin.

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I'm the co-founder at Tempany Medical.

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Tempany Medical are redefining how endoscopic surgery is

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performed by integrating variable angle visualization and integrated

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cleaning into a single use platform for rigid

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endoscopy.

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This is an over $12 billion market opportunity

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in the US alone across multiple clinical indications,

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starting off with ENT.

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Amazing.

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You've clearly practiced that for the investor pitch.

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It's never the same twice, though.

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That's the key.

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No.

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Good.

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So long as the call there is relevant.

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Design in medtech is often treated like a

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nice-to-have, but if something isn't usable,

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it doesn't get used.

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When did you form your opinion on that?

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I think very early on when we were

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doing needs-led innovation during the YNB program,

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I had a good understanding that there's a

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lot more to the process of healthcare innovation

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than meets the eye.

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So you can have a lovely looking product,

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but the end user and the different stakeholders

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that interact with this are actually hugely important

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in whether that product gets adopted or not.

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And that is probably something that's being more

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and more acknowledged over the course of time.

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And I think it's really important to have

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that at the heart of your business.

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We're quite a unique founding team, actually, from

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that perspective, with my background in clinical medicine

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and Murray's in industrial design and medical device

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design.

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We come from quite a different background than

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a lot of traditional medical device teams, and

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that has a lot of strengths in terms

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of us having very clinician and user-centered

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discussions around both the product features, but also

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the usability and the human factors of the

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product.

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Amazing.

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And why do you think in med tech,

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science still gets undervalued?

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I think the complexity of the engineering in

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medical devices is front and center, and it

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has to be because it has to be

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both really robustly designed, extremely safe, and there's

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a huge amount of regulatory barriers to getting

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a product to market.

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And so that's where a huge cost base

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comes into it in terms of running programs

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within either small companies or big companies.

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And then there's sort of an afterthought.

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But I think from where we have worked

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best is that we have really strong clinician

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relationships, which have driven a lot of our

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product features.

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And so the engineering then can fit into

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that nicely after you've had that work done

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with the end user.

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And there's really not much you can do

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if you've engineered the product and then go

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to the end user.

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So it's probably a legacy issue as to

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how products were designed and then handed over.

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And as regulatory has increased in its burden,

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you've had to just add more engineering costs

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that build and test, build and test, build

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and test for the regulatory requirements has meant

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that it's actually just harder to fund that

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design phase process.

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And it does mean that you have a

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longer time to market.

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And I suppose that's the other dance that

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you're trying to work out is how fast

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can we get product to market?

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Yeah, exactly.

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And it leads me on to my next

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question.

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How do you defend design choices when regulation,

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risk, timelines, push towards compromise?

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Because you want to have a great looking

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and usable product as well.

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Yeah, absolutely.

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I think it's, you have to integrate it

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into your processes.

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So, you know, we, as I say, we

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do every eight or nine weeks we're meeting

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doctors around our product.

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And we're not compromising on that piece.

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Regulation is here.

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It's going to always be here.

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It has to be here.

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So you just have to be creative.

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And I suppose work with people who understand

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the interface between the fact that it needs

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to be well designed and regulations.

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So that's where you have to be kind

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of a broader thinker when it comes to

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00:11:15,450 --> 00:11:15,950
your strategy.

275
00:11:17,330 --> 00:11:20,630
Yeah, I'm guessing, especially in your case, you

276
00:11:20,630 --> 00:11:24,470
know, you're competing with a, you know, a

277
00:11:24,470 --> 00:11:27,670
technology that's been around for decades, you know,

278
00:11:27,830 --> 00:11:33,610
and clinicians, I'm guessing, aren't the quickest to

279
00:11:33,610 --> 00:11:35,070
adopt, to change.

280
00:11:35,290 --> 00:11:36,590
You'll probably correct me there.

281
00:11:36,790 --> 00:11:40,290
But, you know, so it's got to stand

282
00:11:40,290 --> 00:11:40,550
out.

283
00:11:40,670 --> 00:11:43,330
It's got to make them want to use

284
00:11:43,330 --> 00:11:43,430
it.

285
00:11:43,850 --> 00:11:44,010
Absolutely.

286
00:11:44,310 --> 00:11:46,630
And so I suppose I've mentioned at the

287
00:11:46,630 --> 00:11:49,290
beginning, quite specifically, that this is a single

288
00:11:49,290 --> 00:11:49,910
use endoscope.

289
00:11:50,390 --> 00:11:52,090
And so when you look at single use

290
00:11:52,090 --> 00:11:54,730
as an evolution, a lot of the single

291
00:11:54,730 --> 00:11:57,730
use products have been just the same product

292
00:11:57,730 --> 00:11:58,710
in a single use version.

293
00:11:58,990 --> 00:12:01,470
From our perspective, why bother?

294
00:12:01,950 --> 00:12:02,750
There's no point.

295
00:12:03,270 --> 00:12:05,130
So you have to have differentiation if you're

296
00:12:05,130 --> 00:12:08,070
going to introduce that real kind of hard

297
00:12:08,070 --> 00:12:09,890
shift from a reusable to a single use.

298
00:12:10,270 --> 00:12:12,990
And that's something that we've worked really hard

299
00:12:12,990 --> 00:12:16,150
on to make sure that moving single use

300
00:12:16,150 --> 00:12:18,910
is differentiated, but it's also at the least

301
00:12:18,910 --> 00:12:20,010
impact as possible.

302
00:12:20,150 --> 00:12:22,030
So you're not just moving single use for

303
00:12:22,030 --> 00:12:22,610
the sake of it.

304
00:12:22,850 --> 00:12:26,330
You're moving because it has better features, better

305
00:12:26,330 --> 00:12:29,450
impact for the patient, and also is much

306
00:12:29,450 --> 00:12:31,850
more ergonomically designed.

307
00:12:32,690 --> 00:12:35,010
So one of the huge pieces of feedback

308
00:12:35,010 --> 00:12:37,570
that we always get is, oh, my goodness,

309
00:12:37,670 --> 00:12:38,630
this is so light.

310
00:12:38,770 --> 00:12:39,910
It's so easy to use.

311
00:12:40,490 --> 00:12:42,630
And that's just a really phenomenal piece of

312
00:12:42,630 --> 00:12:44,050
feedback that we weren't expecting.

313
00:12:44,170 --> 00:12:45,090
We didn't design that in.

314
00:12:45,170 --> 00:12:46,270
We didn't think that that was going to

315
00:12:46,270 --> 00:12:48,370
be the kind of number one thing that

316
00:12:48,370 --> 00:12:49,270
we get feedback on.

317
00:12:49,830 --> 00:12:52,890
But because we've been in market discussing with

318
00:12:52,890 --> 00:12:56,770
customers when we give them prototypes, they really

319
00:12:56,770 --> 00:12:57,430
want it to be that light.

320
00:12:57,570 --> 00:12:58,970
And actually, then you come back to the

321
00:12:58,970 --> 00:13:00,670
engineers and go, it has to stay that

322
00:13:00,670 --> 00:13:01,070
light now.

323
00:13:01,430 --> 00:13:05,650
So then there's a real sorry, how light

324
00:13:05,650 --> 00:13:06,650
was it when you brought them?

325
00:13:07,410 --> 00:13:12,610
So yeah, but that's a really important piece

326
00:13:12,610 --> 00:13:16,610
for us about kind of how do we

327
00:13:16,610 --> 00:13:17,950
get people to change practice?

328
00:13:17,950 --> 00:13:21,010
And actually, ergonomics is a really important thing.

329
00:13:21,630 --> 00:13:24,570
Surgeons are looking to have a professional practice

330
00:13:24,570 --> 00:13:27,330
beyond their clinical training of 35 years, most

331
00:13:27,330 --> 00:13:27,610
of them.

332
00:13:28,070 --> 00:13:31,210
So you can't have something that's really heavy

333
00:13:31,210 --> 00:13:33,350
that causes them neck pain, back pain.

334
00:13:33,510 --> 00:13:37,950
And actually, 80% of the rhinologists surveyed

335
00:13:37,950 --> 00:13:39,950
in the Australian study have neck and back

336
00:13:39,950 --> 00:13:41,150
pain associated with their practice.

337
00:13:41,250 --> 00:13:43,690
So it's actually a really big problem.

338
00:13:44,950 --> 00:13:47,770
And so design and ergonomics and human factors

339
00:13:47,770 --> 00:13:50,510
actually comes full circle as to why they

340
00:13:50,510 --> 00:13:51,530
will change as well.

341
00:13:51,830 --> 00:13:55,030
So it integrates that piece of how do

342
00:13:55,030 --> 00:13:58,570
we compete with the incumbents, but also why

343
00:13:58,570 --> 00:14:00,070
is the design piece very important?

344
00:14:01,870 --> 00:14:07,870
Was that a happy accident that you're solving

345
00:14:07,870 --> 00:14:08,490
that problem as well?

346
00:14:08,490 --> 00:14:10,830
In some ways it was, but in a

347
00:14:10,830 --> 00:14:11,970
lot of ways it's to do with the

348
00:14:11,970 --> 00:14:13,070
advances in the technology.

349
00:14:13,410 --> 00:14:15,810
So when you look at the traditional technology,

350
00:14:16,410 --> 00:14:17,990
there's a rod lens and a camera system

351
00:14:17,990 --> 00:14:19,470
was put at the back end of it.

352
00:14:19,730 --> 00:14:22,290
So it creates this back heavy piece of

353
00:14:22,290 --> 00:14:22,630
equipment.

354
00:14:23,390 --> 00:14:25,130
We're putting a camera at the tip.

355
00:14:26,470 --> 00:14:28,750
And so the system is much lighter overall,

356
00:14:28,910 --> 00:14:31,330
just by virtue of the fact that we're

357
00:14:31,330 --> 00:14:33,390
using a different technology.

358
00:14:34,330 --> 00:14:36,810
So when we started to design it, it

359
00:14:36,810 --> 00:14:38,390
was always going to be lighter because of

360
00:14:38,390 --> 00:14:40,710
those legacy issues that they've had with the

361
00:14:40,710 --> 00:14:41,030
product.

362
00:14:42,050 --> 00:14:42,230
Yeah.

363
00:14:42,630 --> 00:14:43,050
Brilliant.

364
00:14:43,750 --> 00:14:47,430
And then, you know, for someone listening or

365
00:14:47,430 --> 00:14:51,890
watching that works within medical devices, medtech, what's

366
00:14:51,890 --> 00:14:55,430
one design principle they should steal or borrow?

367
00:14:57,470 --> 00:14:59,650
Keep talking to your customers.

368
00:15:03,030 --> 00:15:06,150
So we were around a little while and

369
00:15:06,150 --> 00:15:08,650
we did a first iteration of our product

370
00:15:08,650 --> 00:15:09,570
development during COVID.

371
00:15:10,530 --> 00:15:12,770
And actually we had loads of sessions where

372
00:15:12,770 --> 00:15:14,790
we were sending prototypes to the clinicians.

373
00:15:15,110 --> 00:15:17,390
We were doing video sessions in their temporal

374
00:15:17,390 --> 00:15:18,090
bone labs.

375
00:15:19,190 --> 00:15:21,810
And yet we couldn't really hit the nail

376
00:15:21,810 --> 00:15:23,450
on the head in terms of, are we

377
00:15:23,450 --> 00:15:24,510
getting this right or not?

378
00:15:24,930 --> 00:15:28,670
And so we took a step back, maybe

379
00:15:28,670 --> 00:15:31,970
towards the beginning of 23 and sort of

380
00:15:31,970 --> 00:15:34,130
re-scoped how we were going to discuss

381
00:15:34,130 --> 00:15:36,830
things with the customers and went back out

382
00:15:36,830 --> 00:15:40,310
and, you know, had a lot of interviews,

383
00:15:40,750 --> 00:15:45,330
market feedback, variations on features, you know, how

384
00:15:45,330 --> 00:15:46,890
far do we need to go on the

385
00:15:46,890 --> 00:15:49,510
engineering side in terms of that angulation?

386
00:15:49,990 --> 00:15:52,090
Do they want 10 different angles?

387
00:15:52,370 --> 00:15:53,650
Do they want five angles?

388
00:15:53,650 --> 00:15:54,790
Do they want three angles?

389
00:15:54,970 --> 00:15:56,970
They're actually happy with two angles.

390
00:15:57,470 --> 00:16:00,810
And so by talking to the customer over

391
00:16:00,810 --> 00:16:02,730
and over again, we were able to actually

392
00:16:02,730 --> 00:16:06,330
narrow down how our engineering roadmap looked like.

393
00:16:06,510 --> 00:16:09,030
And then that makes it much more attainable

394
00:16:09,030 --> 00:16:10,790
in terms of your product development.

395
00:16:11,010 --> 00:16:13,530
So you can add all these bells and

396
00:16:13,530 --> 00:16:15,810
whistles and features if you're not talking to

397
00:16:15,810 --> 00:16:18,550
them and you're probably going in the wrong

398
00:16:18,550 --> 00:16:20,750
direction because most of them, if you really

399
00:16:20,750 --> 00:16:22,890
nail down and you say, okay, what will

400
00:16:22,890 --> 00:16:24,110
do 90% of your procedures?

401
00:16:25,170 --> 00:16:29,850
And that's where you can really get things

402
00:16:30,610 --> 00:16:33,290
right or wrong, I think, if you're not.

403
00:16:33,590 --> 00:16:34,570
Yeah, absolutely.

404
00:16:34,870 --> 00:16:37,310
Your first product doesn't need to be the

405
00:16:37,310 --> 00:16:40,170
one that you finish with.

406
00:16:40,410 --> 00:16:44,150
It's the minimum viable product to get out

407
00:16:44,150 --> 00:16:44,670
to market.

408
00:16:46,250 --> 00:16:48,310
It's funny you say minimum viable, right?

409
00:16:48,470 --> 00:16:51,830
So, and maybe I think that's a really

410
00:16:51,830 --> 00:16:53,870
challenging thing in medical devices.

411
00:16:54,050 --> 00:16:55,510
I think it's actually one of the biggest

412
00:16:55,510 --> 00:16:58,990
hurdles because in all other product developments, consumer

413
00:16:58,990 --> 00:17:02,110
brands and anything that's not as highly regulated,

414
00:17:02,370 --> 00:17:05,089
you can iterate quickly and put it in

415
00:17:05,089 --> 00:17:05,390
market.

416
00:17:06,010 --> 00:17:10,930
Medical devices, because you have so much regulatory

417
00:17:10,930 --> 00:17:14,349
to get through, your minimum viable product actually

418
00:17:14,349 --> 00:17:16,550
needs to be, how quickly can you get

419
00:17:16,550 --> 00:17:20,210
a simulated test model to test your minimum

420
00:17:20,210 --> 00:17:20,550
viable?

421
00:17:20,930 --> 00:17:23,770
So it's actually a slightly different thing of

422
00:17:23,770 --> 00:17:25,430
getting to market with your minimum viable.

423
00:17:25,630 --> 00:17:26,810
It's how quickly can I get to the

424
00:17:26,810 --> 00:17:29,730
customer to test it, be it a simulated

425
00:17:29,730 --> 00:17:32,270
model, an animal model, a cadaver specimen.

426
00:17:32,590 --> 00:17:35,790
That's the real MVP cycle that I think

427
00:17:35,790 --> 00:17:38,530
people need to really think about and get

428
00:17:38,530 --> 00:17:39,850
that piece correct.

429
00:17:40,570 --> 00:17:44,050
Because if they get that wrong, it can

430
00:17:44,050 --> 00:17:46,570
cause a lot longer term issues.

431
00:17:46,890 --> 00:17:50,350
So identifying where and how you get that

432
00:17:50,350 --> 00:17:53,030
so-called MVP tested in a medical device

433
00:17:53,030 --> 00:17:54,270
roadmap is key.

434
00:17:56,590 --> 00:17:59,230
Yeah, because I'm guessing that will unlock funding

435
00:17:59,230 --> 00:18:00,970
and customers because you've proven.

436
00:18:01,130 --> 00:18:01,450
Exactly.

437
00:18:01,730 --> 00:18:02,750
Yeah, exactly.

438
00:18:03,690 --> 00:18:05,250
Well, okay.

439
00:18:05,350 --> 00:18:08,250
Well, let's talk around kind of some decisions

440
00:18:08,250 --> 00:18:10,470
that defined Timpani then.

441
00:18:10,690 --> 00:18:14,730
People romanticize startups like it's all instinct.

442
00:18:15,670 --> 00:18:20,870
Your path sounds more disciplined, more disciplined de

443
00:18:20,870 --> 00:18:21,290
-risking.

444
00:18:21,590 --> 00:18:24,090
Perhaps you could talk me through a moment

445
00:18:24,090 --> 00:18:26,310
where it started to feel like a real

446
00:18:26,310 --> 00:18:26,790
company.

447
00:18:28,050 --> 00:18:32,010
You followed, I think, the Stanford biodesign approach.

448
00:18:32,850 --> 00:18:35,690
What was the hardest filter for your idea

449
00:18:35,690 --> 00:18:36,270
to pass?

450
00:18:37,750 --> 00:18:43,170
So I think understanding markets that are not

451
00:18:43,170 --> 00:18:47,110
really, really hot and sexy effectively is really

452
00:18:47,110 --> 00:18:48,130
challenging in MedTech.

453
00:18:48,470 --> 00:18:50,450
So you'll always be able to get data

454
00:18:50,450 --> 00:18:57,910
on heart failure, valve replacements, stents, neurovascular, peripheral

455
00:18:57,910 --> 00:18:58,290
vascular.

456
00:18:58,650 --> 00:19:03,310
They're all really well-defined areas of medical

457
00:19:03,310 --> 00:19:05,890
device development and have really, really strong data.

458
00:19:06,110 --> 00:19:07,610
So I think when you're going into more

459
00:19:07,610 --> 00:19:11,270
of an area which is around tools and

460
00:19:11,270 --> 00:19:14,510
instruments, that becomes actually much more tricky to

461
00:19:14,510 --> 00:19:18,650
quantify numbers and strategize around that.

462
00:19:19,050 --> 00:19:20,710
I think I had a little bit of

463
00:19:20,710 --> 00:19:23,810
a leg up advantage in understanding that coming

464
00:19:23,810 --> 00:19:26,770
from a clinical background, having sat in many

465
00:19:26,770 --> 00:19:29,450
operating rooms, watching lots of different procedures using

466
00:19:29,450 --> 00:19:31,830
rigid scopes that I was able to, even

467
00:19:31,830 --> 00:19:33,390
if I didn't have the numbers, I could

468
00:19:33,390 --> 00:19:35,230
go, these are used in a lot of

469
00:19:35,230 --> 00:19:35,630
cases.

470
00:19:35,930 --> 00:19:40,190
Even if I can't pull exact numbers, I

471
00:19:40,190 --> 00:19:43,890
know when I speak to an orthopedic surgeon,

472
00:19:44,410 --> 00:19:47,390
a general surgeon, a neurosurgeon, an ENT surgeon,

473
00:19:47,710 --> 00:19:48,970
they all handle these scopes.

474
00:19:49,170 --> 00:19:51,970
And so you get that validation more easily

475
00:19:51,970 --> 00:19:52,830
from that community.

476
00:19:53,770 --> 00:19:56,590
But I do think that market and market

477
00:19:56,590 --> 00:20:01,430
quantification is very challenging and you just have

478
00:20:01,430 --> 00:20:03,310
to keep chipping away and trying to get

479
00:20:03,310 --> 00:20:04,510
as much detail as possible.

480
00:20:05,290 --> 00:20:07,950
And as you said, like I think that

481
00:20:07,950 --> 00:20:10,270
for me, I was using some instincts to

482
00:20:10,270 --> 00:20:12,110
make some of those decisions because I had

483
00:20:12,110 --> 00:20:12,590
knowledge.

484
00:20:12,810 --> 00:20:16,170
So I think instinct is a combination of

485
00:20:16,170 --> 00:20:20,070
gosh, knowledge and maybe the community around you.

486
00:20:20,150 --> 00:20:21,810
So I don't think it happens in isolation.

487
00:20:23,450 --> 00:20:24,130
No, absolutely.

488
00:20:24,710 --> 00:20:27,210
I'm guessing, you know, on those areas where

489
00:20:27,210 --> 00:20:30,850
there is more data available, that's because there's

490
00:20:30,850 --> 00:20:32,770
obviously been a lot more research done.

491
00:20:33,030 --> 00:20:34,750
There's a lot more medical devices in that

492
00:20:34,750 --> 00:20:35,050
area.

493
00:20:35,210 --> 00:20:38,850
So is it harder to therefore get funding

494
00:20:38,850 --> 00:20:42,050
in that area or in, say, an area

495
00:20:42,050 --> 00:20:45,770
like ENT where there's not as much data?

496
00:20:46,010 --> 00:20:50,410
Yeah, I think funding in medical devices is

497
00:20:50,410 --> 00:20:51,130
challenging.

498
00:20:52,030 --> 00:20:54,390
I think we're in a situation now where

499
00:20:54,390 --> 00:20:55,690
hardware is really difficult.

500
00:20:55,810 --> 00:20:57,050
I suppose this is why you have this

501
00:20:57,050 --> 00:20:58,570
podcast is talking about hardware.

502
00:20:58,910 --> 00:21:00,390
Hardware is hard.

503
00:21:02,070 --> 00:21:04,890
I fundamentally believe that if we stop developing

504
00:21:04,890 --> 00:21:06,250
hardware, we're goosed.

505
00:21:06,650 --> 00:21:08,150
So I think we have to have people

506
00:21:08,150 --> 00:21:11,310
doing hard stuff for hard problems in hardware.

507
00:21:13,490 --> 00:21:16,470
But funding is difficult in medical devices, full

508
00:21:16,470 --> 00:21:16,810
stop.

509
00:21:17,090 --> 00:21:18,830
So I would not like to say, you

510
00:21:18,830 --> 00:21:20,470
know, just because you're doing a vascular device,

511
00:21:20,570 --> 00:21:20,930
it's easier.

512
00:21:21,250 --> 00:21:23,270
I think it's just a more known pathway.

513
00:21:23,750 --> 00:21:26,810
It's the structure of your road map is

514
00:21:26,810 --> 00:21:30,350
clearer and your go to market strategy is

515
00:21:30,350 --> 00:21:30,650
clearer.

516
00:21:30,950 --> 00:21:33,450
And then the also piece that is important

517
00:21:33,450 --> 00:21:35,390
is that you've got a clear line of

518
00:21:35,390 --> 00:21:38,870
sight on strategics and acquirers and kind of

519
00:21:38,870 --> 00:21:40,150
how they're playing out in the market.

520
00:21:40,630 --> 00:21:43,050
So that's the difference.

521
00:21:43,710 --> 00:21:46,390
Doesn't mean that there is no funding.

522
00:21:46,390 --> 00:21:50,030
No, but it does take a bit more

523
00:21:50,030 --> 00:21:51,350
work and a bit more creativity.

524
00:21:53,590 --> 00:21:54,610
Yeah, absolutely.

525
00:21:55,190 --> 00:21:58,810
So what's, you know, you're gaining funding.

526
00:22:00,330 --> 00:22:03,910
So what surprised you most around turning the

527
00:22:03,910 --> 00:22:06,010
clinical need into a fundable business?

528
00:22:08,270 --> 00:22:10,310
How many hours I would spend on the

529
00:22:10,310 --> 00:22:11,150
phone to solicitors?

530
00:22:13,790 --> 00:22:15,730
Have you kept a tally?

531
00:22:15,990 --> 00:22:17,070
No, I haven't kept a tally.

532
00:22:18,330 --> 00:22:20,470
I'm fairly good friends with them though.

533
00:22:22,730 --> 00:22:28,530
No, I think medicine and clinical practice is,

534
00:22:29,170 --> 00:22:33,110
and analyses in particular, it's all go, like

535
00:22:33,110 --> 00:22:35,510
it's quick decision making and then you're done.

536
00:22:35,910 --> 00:22:38,190
And I think what I, what always surprises

537
00:22:38,190 --> 00:22:40,730
me in this, in, I suppose, the more

538
00:22:40,730 --> 00:22:42,330
business side of things and the more company

539
00:22:42,330 --> 00:22:45,050
development is there's nothing that happens really quickly.

540
00:22:46,150 --> 00:22:48,350
So it is just a case of like,

541
00:22:49,250 --> 00:22:51,930
you just have to keep showing up every

542
00:22:51,930 --> 00:22:55,210
day and keep moving things onwards.

543
00:22:55,610 --> 00:22:59,250
And so there's, I suppose, a resilience piece

544
00:22:59,250 --> 00:23:01,530
there that just because it didn't happen yesterday,

545
00:23:01,590 --> 00:23:03,250
doesn't mean it's not going to happen today.

546
00:23:03,490 --> 00:23:05,190
And so you have to keep motoring like

547
00:23:05,190 --> 00:23:05,350
that.

548
00:23:05,470 --> 00:23:07,470
So that's probably the biggest surprise.

549
00:23:08,150 --> 00:23:12,590
But also one of the things I think

550
00:23:12,590 --> 00:23:16,070
medicine probably prepares you for more, because there's

551
00:23:16,070 --> 00:23:18,330
so much uncertainty in medicine and you have

552
00:23:18,330 --> 00:23:21,510
to make decisions without all of the information

553
00:23:21,510 --> 00:23:22,650
at the table.

554
00:23:23,390 --> 00:23:26,610
So in a startup, you're always making decisions

555
00:23:26,610 --> 00:23:28,410
without having 100% of information.

556
00:23:28,570 --> 00:23:32,090
So I think there's synergies from that piece.

557
00:23:34,050 --> 00:23:35,010
Yeah, absolutely.

558
00:23:35,770 --> 00:23:40,430
And you went through the Enterprise Ireland pathway.

559
00:23:41,810 --> 00:23:43,810
Yeah, going through that programme.

560
00:23:44,550 --> 00:23:46,490
First, before I get into the question, if

561
00:23:46,490 --> 00:23:48,890
you could outline what that is for people

562
00:23:48,890 --> 00:23:50,450
that may be listening in Ireland.

563
00:23:50,710 --> 00:23:52,610
Yeah, so everybody in Ireland who works in

564
00:23:52,610 --> 00:23:53,950
startups knows who Enterprise Ireland is.

565
00:23:54,210 --> 00:23:58,270
So for those who aren't familiar, Enterprise Ireland

566
00:23:58,270 --> 00:23:59,210
is a state agency.

567
00:23:59,890 --> 00:24:03,130
It is actually one of the biggest backers

568
00:24:03,130 --> 00:24:04,530
of startups globally.

569
00:24:04,670 --> 00:24:08,490
I think it's top three under of early

570
00:24:08,490 --> 00:24:10,430
stage businesses across the world.

571
00:24:10,710 --> 00:24:12,290
That might be old data, but that is

572
00:24:12,290 --> 00:24:13,970
definitely something that was in place a number

573
00:24:13,970 --> 00:24:14,450
of years ago.

574
00:24:16,010 --> 00:24:17,890
They have a number of different programmes.

575
00:24:18,210 --> 00:24:19,790
Some of them are university based.

576
00:24:20,070 --> 00:24:22,190
Some of them are based on funding as

577
00:24:22,190 --> 00:24:23,150
part of equity rounds.

578
00:24:23,310 --> 00:24:24,870
And then some of them are funded through

579
00:24:24,870 --> 00:24:29,410
partnership programmes with the Department of Trade and

580
00:24:29,410 --> 00:24:29,990
Enterprise.

581
00:24:30,750 --> 00:24:32,270
We have tapped into all of those.

582
00:24:35,230 --> 00:24:40,250
And we're really lucky here to have access

583
00:24:40,250 --> 00:24:40,990
to those programmes.

584
00:24:41,170 --> 00:24:44,930
And there's a myriad of businesses based, a

585
00:24:44,930 --> 00:24:46,650
lot of medtech business based on the West

586
00:24:46,650 --> 00:24:49,070
of Ireland that have worked with Enterprise Ireland

587
00:24:49,070 --> 00:24:50,790
to get their businesses up and going.

588
00:24:51,330 --> 00:24:54,090
And a lot of products now either very

589
00:24:54,090 --> 00:24:56,670
close to market or in market as part

590
00:24:56,670 --> 00:24:57,130
of that support.

591
00:24:57,350 --> 00:24:59,370
So very successful agency overall.

592
00:25:00,990 --> 00:25:03,850
And so we've been really lucky to be

593
00:25:03,850 --> 00:25:04,710
able to work with them.

594
00:25:05,890 --> 00:25:08,410
One of the quirks, I suppose, is that

595
00:25:08,410 --> 00:25:09,570
at the beginning of a lot of these

596
00:25:09,570 --> 00:25:12,370
projects is you do what's known as a

597
00:25:12,370 --> 00:25:14,910
commercialisation fund that's based in the university.

598
00:25:15,210 --> 00:25:17,690
So there's a university hold the budget, and

599
00:25:17,690 --> 00:25:22,210
then you have to be founders effectively, working

600
00:25:22,210 --> 00:25:24,810
through the project, trying to de-risk their

601
00:25:24,810 --> 00:25:26,710
technology roadmap, their opportunity.

602
00:25:27,530 --> 00:25:30,450
I think it's an interesting one for a

603
00:25:30,450 --> 00:25:33,650
space like life sciences and medical devices.

604
00:25:34,430 --> 00:25:37,990
To raise initial capital for an idea from

605
00:25:37,990 --> 00:25:40,310
friends and family is really, really tricky, especially,

606
00:25:40,510 --> 00:25:41,170
I think, in Europe.

607
00:25:42,810 --> 00:25:45,690
So this allows you to have a kind

608
00:25:45,690 --> 00:25:48,590
of period of two years de-risking opportunity

609
00:25:48,590 --> 00:25:51,890
and then going to specific angels or seed

610
00:25:51,890 --> 00:25:54,450
funds with not just something on the back

611
00:25:54,450 --> 00:25:55,150
of a piece of paper.

612
00:25:56,170 --> 00:25:58,410
And I think that's a really important piece

613
00:25:58,410 --> 00:26:01,650
of how do we get hardware products from

614
00:26:01,650 --> 00:26:04,170
inception out into the marketplace.

615
00:26:04,950 --> 00:26:06,870
So that's the first step.

616
00:26:07,950 --> 00:26:10,810
Subsequently, then, we were very lucky to get

617
00:26:10,810 --> 00:26:12,670
a disruptive technology innovation fund.

618
00:26:13,470 --> 00:26:15,530
This is a partnership project.

619
00:26:16,790 --> 00:26:20,650
So how it works is there are usually

620
00:26:20,650 --> 00:26:24,510
one research performing organisation, so a university or

621
00:26:24,510 --> 00:26:29,010
an academic institution, then another industrial partner, and

622
00:26:29,010 --> 00:26:31,330
then the lead partner effectively is generally either

623
00:26:31,330 --> 00:26:32,850
the startup or the SME.

624
00:26:33,750 --> 00:26:36,550
And so you have this consortium and you're

625
00:26:36,550 --> 00:26:39,410
working on a defined goal, but it's really

626
00:26:39,410 --> 00:26:40,970
a kind of industrial research.

627
00:26:40,970 --> 00:26:42,470
So it helps companies that are trying to

628
00:26:42,470 --> 00:26:45,390
be very innovative and, you know, not just,

629
00:26:45,630 --> 00:26:48,290
you know, taking the next step on their

630
00:26:48,290 --> 00:26:49,850
own, but really trying to take big leaps

631
00:26:49,850 --> 00:26:50,810
in terms of technology.

632
00:26:51,530 --> 00:26:56,070
So we've had two of those funds awarded

633
00:26:56,070 --> 00:26:59,050
to the company and it works with the

634
00:26:59,050 --> 00:27:00,990
National College of Art and Design and RCSI

635
00:27:00,990 --> 00:27:04,670
and UCD in Vermont and then Gentian Services

636
00:27:04,670 --> 00:27:05,270
down in Shannon.

637
00:27:05,270 --> 00:27:08,730
So have had a very broad base of

638
00:27:08,730 --> 00:27:12,270
collaboration across multiple institutions through those projects, which

639
00:27:12,270 --> 00:27:14,670
I think is really powerful as well.

640
00:27:14,930 --> 00:27:18,010
And coming back to kind of how complicated

641
00:27:18,010 --> 00:27:21,750
medical devices is, you know, you just need

642
00:27:21,750 --> 00:27:25,070
as many levels of expertise as possible to

643
00:27:25,070 --> 00:27:27,490
get you to the next phase of development.

644
00:27:27,970 --> 00:27:29,090
You can't hire it all.

645
00:27:29,250 --> 00:27:29,950
It's not possible.

646
00:27:30,570 --> 00:27:30,810
No.

647
00:27:31,350 --> 00:27:33,590
So you get to tap into the hive

648
00:27:33,590 --> 00:27:37,250
mind, so to speak, you know, then there's

649
00:27:37,250 --> 00:27:38,910
an advisory side, is there, or is it

650
00:27:38,910 --> 00:27:40,050
more of a kind of go out and

651
00:27:40,050 --> 00:27:44,130
seek advice or experts within the community?

652
00:27:44,550 --> 00:27:48,730
There are advisory mechanisms through Enterprise Ireland as

653
00:27:48,730 --> 00:27:48,970
well.

654
00:27:49,850 --> 00:27:52,330
And so there are smaller grants you can

655
00:27:52,330 --> 00:27:55,330
get to support very early stage projects to

656
00:27:55,330 --> 00:27:58,050
kind of tease out ideas, get some mentorship

657
00:27:58,050 --> 00:28:01,510
and that as well throughout the lifecycle of

658
00:28:01,510 --> 00:28:01,870
the business.

659
00:28:02,190 --> 00:28:05,030
So I think where we're at now, actually,

660
00:28:05,290 --> 00:28:08,030
as an ecosystem is that we're all starting

661
00:28:08,030 --> 00:28:09,950
to kind of outgrow what supports were there

662
00:28:09,950 --> 00:28:12,810
now and private capital isn't where it needs

663
00:28:12,810 --> 00:28:14,690
to be to get these companies to the

664
00:28:14,690 --> 00:28:15,090
next phase.

665
00:28:15,210 --> 00:28:17,630
So we're kind of looking to figure out

666
00:28:17,630 --> 00:28:20,350
how you can get companies to a certain

667
00:28:20,350 --> 00:28:20,730
point.

668
00:28:21,930 --> 00:28:23,230
Everything's going later and later.

669
00:28:24,230 --> 00:28:26,630
M&A is later, like Series B is

670
00:28:26,630 --> 00:28:27,770
later, Series C is later.

671
00:28:28,050 --> 00:28:31,310
We now have another funding gap, but I

672
00:28:31,310 --> 00:28:34,830
suppose that's a positive outcome of how the

673
00:28:34,830 --> 00:28:37,810
ecosystem is maturing, that you're not just having

674
00:28:37,810 --> 00:28:39,410
lots of seed projects that are going nowhere.

675
00:28:39,590 --> 00:28:40,850
You actually have quite a number that have

676
00:28:40,850 --> 00:28:43,290
gotten quite far and now just maybe need

677
00:28:43,790 --> 00:28:46,250
the last little leg up to get to

678
00:28:46,250 --> 00:28:46,570
the market.

679
00:28:48,110 --> 00:28:48,330
Yeah.

680
00:28:49,130 --> 00:28:49,490
Awesome.

681
00:28:50,710 --> 00:28:56,070
What have you learned about yourself through that

682
00:28:56,070 --> 00:28:56,690
process?

683
00:29:00,850 --> 00:29:05,390
I like moving things forward.

684
00:29:05,590 --> 00:29:06,670
I like the progress piece.

685
00:29:06,870 --> 00:29:06,990
Yeah.

686
00:29:07,430 --> 00:29:10,970
Also, I think I love building something from

687
00:29:10,970 --> 00:29:11,230
nothing.

688
00:29:11,490 --> 00:29:15,170
So we first kind of got offices in

689
00:29:15,170 --> 00:29:17,170
a place called the ATU.

690
00:29:17,210 --> 00:29:19,510
I hope this is kind of a university

691
00:29:19,510 --> 00:29:26,430
co-located incubation center effectively.

692
00:29:27,370 --> 00:29:30,350
So we started out there and kind of

693
00:29:30,350 --> 00:29:31,930
in the last year and a half, we've

694
00:29:31,930 --> 00:29:32,910
moved into our own offices.

695
00:29:33,490 --> 00:29:36,750
And it's that kind of forward momentum of

696
00:29:36,750 --> 00:29:40,770
like, okay, we're not just a project anymore.

697
00:29:41,050 --> 00:29:43,650
It's actually building something that's more robust.

698
00:29:43,970 --> 00:29:47,030
And so I really enjoy that part.

699
00:29:48,410 --> 00:29:50,950
Other things I've learned about myself, I became

700
00:29:50,950 --> 00:29:53,330
a mom as part of this whole process

701
00:29:53,330 --> 00:29:53,730
as well.

702
00:29:55,210 --> 00:29:57,630
I don't know which I've learned more from

703
00:29:57,630 --> 00:29:57,990
actually.