ZAORY

If asked you to close your eyes, and thread the eye of a needle, could you do it?

Every day around the world, surgeons are forced to do this impossible task when operating patients!

20 million of these broken bones (humerus, tibia and femur), are operated every year using the same method developed in World War II, over 80 years ago. As a result, there are increased risks and trauma for the patient, excessive radiation exposure through X-rays (particularly a problem for pregnant women risking the health of their fetus), longer operating times and patient stays which increases costs.

This is the situation in First-World countries, but it gets worse in Developing countries.

At least half of the world’s population does not have access to essential health servicesAt least half of the world’s population does not have access to essential health services as reported by the World Bank and the World Health Organization, most of them in places like Africa or Southern Asia.

I volunteered in clinics in Africa, Uganda, to investigate this situation and it's hurting to see the region of Kalangala for instance, with 84 islands and only 15 Health Centres across all these. Out of these 15, only 2 of them are “equipped” to perform surgery with minimum resources.

I have been here and even assisted in delivering a baby in one of the even less equipped centres. Uganda and their people are very resourceful but not with everything.

When a patient shows up to one of these clinics, if they are even close to one of the 2 equipped to complete a surgery, the patient requires X-rays but then the machine needs to recharge every 30 minutes due to the lack of energy in the region and low quality. When fixing a broken bone in a first-world country, they spend up to 2 hours shooting X-rays to treat the broken bone, this is not viable in places like Kalangala.

If the patient is not in a condition (physical or economical) to go to the Capital, Kampala, for a slightly better hospital, then this patient will be asked to wait for it to heal, often generating major limb deformations that harden their life.

When it comes to broken bones, first-world citizens have equipped hospitals that expose us to excessive and damaging amounts of radiation while increasing risks and costs to patients and delaying the crowded waiting lists. In Developing countries, healthcare centres are not even equipped, and unless patients travel 100s of kilometres and spend their lives saving (nearly 100 million people are pushed into extreme poverty due to this) for “similar” treatment, they are forced to live with body deformations or amputations.

We have developed an Artificial Intelligence system that substitutes the need for X-rays when operating broken bones. It runs on a Mixed Reality headset (a type of goggles with clear lenses that lets you look at the real world as well as display virtual holograms on top of it).

This model provides real-time information to the doctor on how to operate a broken bone on from start to finish using the following approach:

To fix a broken bone you need an implant, a metallic rod that goes through the broken bone, but you cannot place this implant without X-rays because you cannot see it. Our system uses the camera on the headset the doctor wears to look at the implant before placing it and builds a 3D scan instantly. Now the doctor looks at the patient and our model builds 3D holograms telling the doctor where to open up the patient on the arm or the leg, where to position the implant and where to fix the implant to the bone.

All these steps that were before the responsibility of the doctor’s skill and the lengthy hours of an X-ray machine can now be performed by a junior doctor in minutes instead of hours, meaning big hospitals will accelerate waiting lists, eliminate risks from X-rays, blood loss, anaesthetics and reduce costs to patients while small clinics will now be able to operate broken bones even without X-ray machines and limb deformation and amputation with be lowered exponentially.

Our technology is to assist every hospital and every doctor operating every single one of the 20 million broken bones (humerus, femur and tibia) operated using implants and this common medical procedure.

This will make the lives of surgeons easier, improve patient outcomes and reduce waiting lists considerably and it will open a window for small health centres and clinics to operate on patients instead of sending them to other hospitals 100s of kilometres away or choosing a bone deformation or amputation, something never before possible.

Although the system currently targets 20 million fractures in the humerus, femur and tibia, we are working to scale the software to also assist on operations involving broken shoulders, hips, knees, etc. aiming to assist 100 million patients by 2030.

I grew up around hospitals, spending most of my early years in or around an operating room I quickly experienced how simple surgeries were delayed for hours and I learnt how to perform major trauma operations before I was 10. This early involvement frustrated me at the lack of innovation in hospitals and how, due to their obsolescence, patients suffer.

Years later, I travelled to Africa and while working in a healthcare centre in Kalangala, Uganda, I saw how the problems that we experience in Europe are only accentuated and worse in Developing countries with even less resources.

I have spent the past 5 years trying to solve the way we fix broken bones because it’s the one way I can introduce AI in the operating room and access a global problem, the access for health equity in Developing countries (by providing surgeons with tools to operate patients) and Developed countries (by accelerating waiting lists and not leaving patients waiting until it’s too late for them).

I am still in touch with these clinics in Kalangala and look forward to starting to test this technology with them soon to help their community and grow from there in those needed regions. At the same time, my lengthy story around hospitals as a kid has also opened the doors of many hospitals in the UK and EU looking forward to helping their respective communities.

Additionally, my team includes experienced doctors who have suffered from this problem all over the world and are helping develop it in a way that can help everyone. Our team has doctors with experience operating in Sri Lanka, Cameroon, Gaza, the UK, the USA, and Europe, in places of peace and the middle of a war. 

This level of experience, selflessness and personal motivation has been key to building a solution that can help everyone, everywhere, regardless of the surroundings.

True health equity.

We are a young startup and we have received a little bit of Angel Investment in our journey to help us build the technology to a standard that is accurate and safe to use on patients.

We are a for-profit organisation, but we are still navigating the regulatory journey and as such we do not have clients, but we do have the interest of a number of hospitals and organisations interested in using our technology upon regulatory approval.

At the moment, we are conducting clinical trials in Spain, and we have operated on 10 patients with exceptional results compared to standard methods. Now working to secure more hospitals for pilot programs post-regulatory approval.

To protect our technology, we have a published patent and a PCT and we still have a few other patents pending to file.

While we have done a great job building this technology and in staying close to different communities to get their input and create something tailored for everyone we are still working to improve our business approach so that we can support and offer this technology to the regions that need it in developing countries. 

We have the upside that this technology is also creating a huge impact in First-World countries and as such there is a chance to generate recurring revenue while supporting needed regions but we need the help of people who have done this before to help us.

We also require legal/regulatory support so that we can confirm with the necessary bodies in the different countries that our technology is safe to use in their patients. This is something we are getting comfortable within the USA through the FDA but not in places like Africa, Southern Asia, etc.

Additional visibility would also increase the opportunities for others to join our mission and further funding would help us start pilots earlier.

There is currently no guidance system in the market for the broken bones (humerus, femur and tibia) we are targeting, the only solution as performed by every surgeon (and explained in the journals) is guesswork and X-rays. That is if you have an X-ray machine, not often encountered in rural areas or developing countries.

Our solution uses the minimum expression of a product, a piece of software, something that is cheap and reliable. It then runs on a Mixed Reality headset that allows the doctor to easily be guided without any external input, leveraging the power of Artificial Intelligence, LiDar Sensors, cameras and beyond.

We started working on this software back in 2019 even before Mixed Reality headsets where technologically advanced enough as to do what we wanted them to do and eventually the technology caught up and we are the first one to move into this new market we are creating of AI-navigated surgeries.

And because it is software base, any surgeon using this technology, regardless of where they are based, can receive updates and support to more broken bone operations as we scale our R&D efforts to hip, knee, shoulder fractures...

We aim to use this technology to operate on patients with a broken bone safely, cheaply and in less time while opening a window for small healthcare centres in developing countries to treat all those patients who before had to spend their savings going to a hospital with an X-ray machine and spend hours in the operating room. Now they can be operated in minutes near their homes.

We are in a position to impact 20 million patients a year, delivering better care, contributing to healthier ageing and at a cheaper cost while impacting the whole healthcare industry by accelerating waiting lists. By improving this surgery now surgeons will be able to operate at least twice as many patients in the same time from the same condition.

We are working to ensure healthy lives and well-being for anyone, everywhere, by giving them access to health care in rural or conflicting areas far from fully equipped hospitals and by accelerating waiting lists.

We can reduce the operating time from 2 hours to 30 minutes, we can reduce or eliminate the need for X-rays, we can reduce risks to patients from blood loss or additional trauma and we can reduce costs.

Because the patient suffers less in the operations, we contribute to the patient’s healthy ageing which means the patient will visit the hospital fewer times during their lifetime and we can reduce hospital stay post-operation from 13 days to 7 days. All of these, combined with the up to 75% reduction in operating time, amounts to a substantial reduction in patient costs whether they are in low-income areas of the USA or rural Uganda, anywhere.

At the moment, our software has the potential to impact 20 million patients annually but with the scalability benefit and our goal to treat 100 million patients a year by 2030. With this we provide health equity for the poor and the rich, those on the waiting list and the operating room, and those in rural areas and big cities. 

Artificial intelligence, computer vision, LiDar sensors and tracking algorithms.

These 4 pieces of technology, when introduced in a Mixed Reality headset, have all the power to identify which type of operation the doctor is performing, where is the patient and what limb is been operated on and to guide them accurately to the exact spot where they need to operate.

This article shows a simple version of what we have created:

https://www-sciencedirect-com.ezproxyberklee.flo.org/...

Our current software version though, is exponentially more powerful as we leverage the AI capabilities to guide the surgeon and identify the patient.

We also know this works because we have already used it. First during 100s of trials using fake/plastic bones, then we operated 15 cadavers at a research institute and as of today we have already operated 10 patients in a hospital with 100% accuracy.

3 Full Time

3 Part Time

2 Contractors

Since summer 2018

We select the most resilient people for our project and we pride ourselves on having diversity of backgrounds as one of our cultural pillars. We believe the best ideas come from collaboration and to achieve that, you need a mixed background.

We have a leading clinical researcher who struggled at school and never got good grades but because she was resilient and believed in herself, by age 29 she finally got accepted into a University to study Medicine. It took her 10 more years than other students but she is the best clinical researcher I have found.

We have a strategy advisor who is over 65 years old, for many he would be too old to work for anyone but he counts on decades of experience and wisdom that is hard to find from someone with an MBA.

Our first CTO is transgender (male-to-female), and she made the change while working for us. By then we had already announced that this person was joining the team and used her original name so, as soon as she told us about her transition, we redrafted all our communications online to show that she was our CTO with her preferred name and pronouns.

We make ourselves available and hear from anyone within the team and those interested in us looking for those who have the passion to do good regardless of their background.

We license our technology to big OEMs who then offer it to hospitals. The OEMs are the implant manufacturers that are already going to be used on the patient’s broken bone so it is an easy introduction into their product portfolio since we can now give them an added value to their simple metallic implant.

This is optimal in first-world countries and is a contrasted model that gets us to revenue and profitability but we are yet to confirm a pathway to access the rest of the world.

I want to take the opportunity to be involved at SOLVE to work with experienced advisors to help us find a better way to introduce this in regions like Africa or Southern Asia.

We are considering the option of using the revenue from the US or Europe and similar, to subsidise the introduction of this technology into those needed countries. Thankfully, because software maintenance is low on cost, this should be something relatively easy to accomplish.

Until we receive regulatory approval and can kick off the commercialisation part of our plan we require venture capital and we are already working towards that front. Raising £2 million to get us through regulation, IP and to start commercialising.

In the past we have been successful securing awards from startup competitioins (TATA Group UK Startup Competition - £15,000), Angel Investment (£250,000) and government grant funding from the UK (£500,000) and we are now on track to do the same.

Through our partnerships with OEMs in the US or Europe, we aim to reach profitability within the next 3 years which means we won’t need to raise more money.

Since we are license-based, we guarantee a recurring revenue model.