Computer generated transcript

Warning!
The following transcript was generated automatically from the content and has not been checked or corrected manually.

OK. Um Good afternoon, everyone. We have an absolute treat for you for our next plenary session. Um So we will be talking entrepreneurship and innovation, skills from people who've been there and done it and are experts. Um And well, are currently doing it, I suppose. Um So we have four brilliant speakers and then we'll have some time for a panel of questions at the end. Um So it's a real pleasure to er introduce our first talk, who is the founder of Proxy, er, and a plastic surgery registrar and lots and lots of other titles um to do with innovation. Um But so it's a pleasure to introduce um Doctor Nadine Hashh Haram. Um There we go. Hello and thank you. And I'm so happy to be addressing all of you today as you all know. My name is Nadine has Ham. I'm a reconstructive plastic surgeon, a consultant surgeon at Ge in Saint Thomas. And I'm also the lead for clinical innovation and the founder and CEO of proximity. What I'd really like to share with you today is my journey, the journey I've been on and my passion to deliver equitable health care building a successful business around it and really focusing on the operating room, as we know, digital technology is changing the world and it is most certainly changing health care. What we know is access to safe surgery still varies all over the world. And in the same way, equitable access to technology does as well. And so with that in mind, our job is never done, we must do more. And my journey of discovery with technology has really been one of opportunity of making the seemingly impossible possible and of realizing that yes, the constant pursuit of better is demanding. But I really believe that with technology in our corner, it gets a whole lot easier and the opportunities can be limitless. I didn't start out wanting to build a business or to be an entrepreneur. I'm a reconstructive plastic surgeon who solved problem who had some questions and who tried to make a difference as with many entrepreneurs, it always starts with a personal story. And for me, my story starts, I was born in San Diego, California to Lebanese parents. At the age of 10, we decided to move back home to Lebanon to be closer to family. This was just after the Civil War had ended. My parents wanted to connect with our family to be closer to our heritage and culture as the country was rebuilding after the civil war culture shock, moving from sunny San Diego to post war Lebanon. Now, the early nineties in Beirut was an interesting time. Uh The scars of war were still very visible uh both from an infrastructure perspective, but also from a people perspective. Um patients who were unfortunately victims of trauma and blast were living with those morbidities and the sequelae of those morbidities as well. And when I was 14, I asked if I could accompany a family friend who happened to be a reconstructive surgeon to watch what he did at work. It was 1996. Uh the massacre it happened and there were 100s of women and Children who had been affected by those blasts and trauma injuries. And what was really distressing for me was the fact that the people who had survived the violence now had to live with the consequences. Some were literally carrying the scars of war and trauma that could affect their lives forever. So I spent the day watching him operate on young trauma victims who had suffered burns contractures. I distinctly remember 16 year old who had a contracture to her ankle and through simple classes and a skin graft, he was able to change her life. And I remember rushing home excited telling my mother that I had found my calling that I wanted to be a reconstructive surgeon. Um And I haven't never looked back to this day. I love what I do. But as I went through the lengthy process of medical school, followed by surgical training and specialization, a nagging feeling crept up on me for every person I helped. I was acutely aware of all the other people that I wasn't able to help. I enthusiastically volunteered throughout medical school and through my training to take part in various global health initiatives, traveling to places all over the world to help set up sustainable reconstructive surgical practices where they were in short supply and often in high demand. But how much could I actually do in a matter of weeks or days? Passing on skills and knowledge. It had taken me years to master. But more importantly, what happened when I left and I came to recognize the landscape of surgical practice and provision that was littered with challenges. Firstly, of course, massive inequalities to access to care were all too obvious to me, this was of course, again, the commission, the LST commission publishing that 5 billion people around the world lack access to safe surgery. That's more than half of the world's population. And with that, there was a true compelling need to think about the role that digital surgical solutions can play where we look today if 5 million people lack access to surgery and 18 million people die as a consequence. And 310 million patient procedures are performed globally and still not meeting the need. And in order to be able to meet that demand, we need to perform another 143 million operations which would require 25 million more members of staff to do that. Then seriously we have a massive supply and demand gap and we need a plan B and this is where thinking about building sustainable solutions and technologies to support and augment what we do can make a massive difference. Now, we know that these challenges extend beyond the global South. It's not just a problem there. It's a problem everywhere. Look to the NHS, our vacancy rate is 12% and burn out is real and more than ever people are leaving our wait list is about 7.6 million and patient safety incidents have increased by 30% since 2015. So these are challenges we have to think about today in terms of how we address and how we overcome them. And when I created proximate 2016, I had a vision of using very familiar everyday digital technologies like mobile devices, video streaming to connect operating rooms and people. And the solution we came up was was simply to start with a video streaming platform with an augmented reality overlay to give the observing a remote surgeon more of an immersive experience of what it was like to be in the operating room. Now, of course, since then, we moved considerably into more of a platform approach which we'll talk about over the years. Proximity has been used to facilitate the exchange of knowledge over distances. And to achieve this, we've been connecting and integrating people, processes, devices across operating rooms to really give a comprehensive view of the operating room, almost that connected layer between the cloud and the or and bring all this multitude of devices together. And this is what really sets us apart from other players in the market, our ability to join up data from different sources, curate it together and centralize it in one platform. And in all the ambient video and audio data that we've captured, we have something invaluable that went beyond the barrier, busting possibility of telepresence and rich educational resources. But something that could really transform the paradigm, which was rich data precious data captured in a secure and anonymized way that would truly and objectively enable us to extract insights that would benefit patients, help codify surgery and ultimately unlock efficiency gains for hospitals and the DZ report and many others globally recommend digitization is one of the key ways in which we can improve productivity and patient outcomes. A major tilt towards technology and innovation like A I that has the potential to deliver transformation and care if delivered properly. And when we look at health care today, we know that hospitals are generating petabytes of data in a year and 80% of it is unstructured and 90% 97% is unused, which is a real shame. So whilst we might have all the data here lies the critical challenge it exists in silos. Each piece of equipment operates alone as a point solution and further compounding that issue is this fragmentation and lack of standardization that's happening. This inconsistency makes it so difficult to integrate data from different sources to truly gain a holistic stitched up vision and surgical data only becomes a meaningful piece if it's pulled together to tell a story. And so we really need to paint a picture of how systems, devices and people work together, allowing us to understand the cause and effect relationships within the operating room. Today, we have the opportunity to leverage technology to lay the foundation for structured standardized data collection from the or to then be truly used for actionable insights to pinpoint areas of improvement, to address our health care problems and to guide us towards more effective and more efficient health care systems. And this is what we're trying to do. Approximately. We're looking to transform the once analog or into an interconnected digital ecosystem where data from any device or software can be captured and analyzed, recorded and digitized to create a single source of truth. And we were able to create a total solution that provides real time connectivity enables access to knowledge transfer data integration and storage and analytics, harnessing all of this together to change how we deliver health care. And by coming at this at an infrastructure level, we can now really transform the or rather than just coming in as an app, we're coming in as an infrastructure. So think of us as the operating system of the operating room. The operating room is more than a room. What happens? There is more than procedures, the people who work, there are more than staff lives are restored there. Tomorrow's experts learn there, health care moves forward there today. The or can be even more because proximity is there. Proximity is the only operating system for intelligent operating rooms. Our technology empowers med tech companies and hospitals with real time connectivity, unified data control, powerful development capabilities and A I enhanced insight with proximity information flows in and out of the or in real time data is captured and structured to create a single source of truth, an insight in the patterns and practices are discovered. It's how to make everything that happens in the or knowable and sharable. So you can learn more innovate faster and optimize every minute. Keep the ors pre to be more than a rule by operating at full intelligence only with proximity with proximate. You're not just in the operating room, you're part of a connected ecosystem, a dedicated copilot by your side. Always ready to assist, provide insights and optimize your workflow. Proximate empowers you to deliver the best possible care every time by harnessing real time data and insights acting as an or control center, automating workflows and future proofing your or with A I applications all while providing real time connectivity for sharing expertise and knowledge and managing data through its comprehensive video library. And we have a rich source of data with more than 80,000 individual video views of surgical procedures securely archived. This represents more than 100,000 hours of video stored on the platform. And the potential of this data is immense to date. We house about 100 terabytes of video, audio and device data across the world. We are essentially recording the blueprint to optimize healthcare performance every single day on proximity. And this has been possible because of our collaboration with amazing health systems and hospitals and industry partners as well. Each player sees the data's potential when brought together on a single platform. And today we are available in many facilities around the world, partnering with device companies, partnering with academics to publish journal articles and and bring evidence to what we do. We've been working with a hospital partner where we demonstrated the opportunity time that could be used for more cases. And with the approximate data, we were able to show that a third of our time was wasted with no surgeries happening. 83% of turnover time was inactive and there was a 21 minute range between fastest and slowest prep times. 59% of the time the E pr metrics were not accurate. And so all of this is untapped potential white space. This enables us to look at all these opportunities in a really effective way and proximate is essentially painting the perfect picture of how this white space can be truly transformed into insights. Now, let's not forget every outcome. Every case is a person and this is a case. I'd love to share with you of a patient many a few years ago who had unfortunately suffered complications following a surgery that had gone wrong. She'd been in and out of hospital for a couple of years. Itu PGE feeding almost bled to death and suffered and lived a really awful life for a few years. Um, also suffered consistent obstructions or um herniation. She had an abdominal wall malfunction as well and really needed uh a definitive procedure. Now, for her, this procedure um was suggested that she should go overseas because they had more expertise, but she was too nervous to leave, couldn't afford the overseas costs and wanted to stay close to her, to her family. And so she reached out and said, couldn't proximately help, could proximately provide that expertise. And we obliged an expert surgeon from the UK dialed in and worked with her local team and together they were able to reconstruct her. Five days later, she was home that summer, she was living her best life with her grandkids and, you know, able to do all the things she's, she was unable to do for those two years. And that patient is my mother. We've been able since then to train many more doctors on this, these procedures using this technology. And I'm really grateful to my mom for allowing me to share this story with all of you. Now, my journey feels like it's just starting every day brings new discoveries, challenges solutions. We'll never stop innovating and expanding the platform while staying committed to our mission of democratizing access to safe surgery. The healthcare market is experiencing rapid growth as this market matures and approximate is offering a secure A I ready application layer between the or and the cloud where we can deploy models either our own or others to analyze critical metrics pre intra and postoperatively. And more than ever, we're focused on delivering tangible value to systems through enhanced connectivity, actionable insights to streamline processes and bringing these uh these applications beyond the operating room. The future of health care is undeniably intertwined with connectivity and data and their numerous applications. And just as proximate has pioneered real time collaboration, medical field. We're now at the forefront of driving transformative change through advanced real time connectivity. I'm constantly reminded that the power of proximity lies in its ability to bring people closer together, physically, emotionally and mentally, the relationships and the collaborations established through proximity and the impact that these connections have is really the most rewarding part of the job. I wanna thank you for helping me today. I hope that each of you found something valuable in what I shared. Um I hope this has been an insight or an inspiration that resonates with your unique journey as well. Throughout my journey, I've been continuously inspired by amazing people. And that inspiration continues to drive me each day. I've also been fortunate to build a solid support network group of people. I can always count on. And I've learned that asking for help when needed is not a sign of weakness. It's actually a sign of strength. And I've learned that by reaching out and gaining new perspectives and forging new connections, this can only make us stronger. Of course, the most significant source of inspiration and support comes from my own family that have been by my side from the very beginning. And they're the ones who keep me going day in day out. Balancing my role as a mother, an entrepreneur, a CEO advisor, investor while continuing to practice surgery has been one of the most rewarding things in my life. The operating room is where it all began and it remains a consistent source of inspiration. And it's here that I witnessed the profound impact that we can have in people's lives and a reminder of the power of human connection and the transformative potential of innovation. It's why I started this journey and it's what will keep me going. Thank you so much. OK. Thank you. Uh Miss Nadine, uh her for really inspiring presentation and uh sharing the insights of her story. Our next speaker is Mister Grant Nolan, a plastic surgery trainee co-founder of my nodes. The floor is yours to present. Awesome. Thanks so much. Um Hello what? Well, firstly, what a tough talk to follow. Um uh Nadine's been a certain, a, a clear source of inspiration, you know, it's incredible to see um plastic surgeons doing this, this amazing stuff. So, um my name's Grant Ed and I'm a, a plastics reg and we, we're two years into a journey similarly looking at uh again, that theme of data like data is, you know, as I've said recently, data is the new oil. Um And I do kind of believe that it's gonna be the thing which takes us from, you know, where we are today to the future. If you think about all the big innovations that are coming at the moment A I surgical robotics, like what do they need? They rely on good quality data like data is, is the, is the bedrock. So um I'm gonna talk about operation notes which seems a kind of niche topic and a bit random. And I wanna talk about how we took that journey from, you know, this, this kind of spark of an idea like how do we improve the quality of data? Very similar i in the operation theater and then trying to turn that into AAA start up and a business. So let's start right at the beginning. So I if if you've got your phone, I want you to grab it out and scan this QR code, please flush it up. Jump on there and you should jump onto a ment meter and we're gonna do a word cloud. So jump on, get your phone out and then I will switch this over. Let me just do that now. So. Ok. Right. Switch the technical stuff over, stop and twice a day. Ok, cool. So we're starting to get some stuff coming through. So if you haven't seen it, the QR code is still in the corner there. So tell me in your own words, what are the, what are the biggest problems with the operation is in your hospital? So I'm assuming that most of you are, are surgeons. Um So tell us about what, what, what, what, what, what grinds your gears kind of what, what, what keeps you up at night in this sort of kind of niche area. OK? Of course, you've got some stuff coming to you. So paper notes. Yeah. Unable to extract data, unable to, this is interesting, unable to extract data was actually what drove me to this project. Like I just thought it was madness in the 21st century as an sho I was spending my time moving data from this part of my screen to this part of my screen. Can't read them yet. So handwritten missing, I was speaking to a a trust and they were saying they lose a few every year, just kind of disappears, isn't it? Um Lack of structure, unstructured yet headedness. Yeah. Those are the same stuff. OK. Time consuming. No pictures. No images. OK. Cool. Um Yeah, I think that data side is, is just so powerful, really think about how we learn as surgeons. Like we just need data to, to, to move forward. So fine. OK. I'm gonna take that off now and move on to back to my other presentation seamless. So um yeah, really interesting hearing about some of the challenges that you guys said and this is what we kind of really started with is our, our, our, our point. This is an op note that I was involved in. You can see that we didn't need to um wipe out any of the patient demographics cos the the label actually got messed up. So one of the challenges and we've touched on some of the, you know, like emissions and INAX and the data is, is pretty alarming at this. Like 90% of documents have some form of emission eligible, uns unstructured, unstandardised is repetitive. And then we've also got these delays and even when you kind of move to an electronic system, people kind of think. Alright, that's great. We're gonna move to a sys electric system but very quickly you end up with a kind of word document version of this and you still have the same IMA emissions and axes, you still have an unsized nature, you can read it all great. It's still pretty repetitive and you, you get rid of the paper delays, but it's an incomplete solution. It's kind of digitization. We're just taking a paper process and, um, putting a sticky plaster on it and this is the kind of stuff that we know why it matters, right? So this is the end result for us, like we said, no data for research and audit. You know, occasionally we, we, we, we hear about people having day complaints, investigations, people putting drains out on day one, sending patients home cos it's not written in the notes and it's just hard at the moment to kind of deliver that great care and it's pretty inefficient for us. And this was really our starting point with, with Marvex, we were kind of like this is a massive problem, this affects surgeons and patients. And my key learning point over the first kind of 18 months was that actually not much of that stuff matters to the people who make the decisions. And this was kind of a bit of a learning point. I don't know if you guys have heard of clinical coding. Um So clinical coding is, is, is how basically hospitals get paid. So it's essentially like after the patient is discharged, their medical notes are reviewed and they're reviewed by these, these physical people called clinical coders and they read through our notes and assign these four digit codes and what we said and then the hospital gets reimbursed. And this is really kind of the, the the learning point I guess is that, you know, you can have these amazing products, but you actually really have to be solving a fundamental issue in the NHS. And when I say a fundamental issue, what we really mean is, is money, you know, we can fight it, we can huff and puff about it. But that is the reality of the system that we work in any innovation that's coming through has to have a financial gain and a financial lever to it. Otherwise it's a nice to have, you know, the biggest problems in healthcare at the moment are we've not got enough people and we've not got enough money, right? And everything else kind of stems from those two challenges and until you can start to get innovations that fit into these boxes, they just sit in the nice to have pile. Um and it's really hard to move things forward. It's really hard to move things forward with NHS trust anyway. But really, you know, the key learning II think that we found was really earning is you have to get that financial piece and that business piece sorted. So this is our financial piece. This is how we get to do all the cool stuff by, we can solve this problem. And if we solve this, then everybody gets what they want and we have a real true, true win win. So this is currently clinical coding, right? I don't know how many of you knew about this, but this is how the hospital gets paid. This is literally the only way the hospitals get paid at the moment. But there are some massive issues here. The first one is what we write as surgeons and what the clinical coders need aren't the same. It took us again about two years to work this out. Um And it's a very interesting one because as a surgeon, you write great notes for you, they get sent to the clinical coder, they code them, you s you score like 97 95% because you're like, yeah, all the data, the data that we've got there, we've faithfully coded. But what we haven't seen is the stuff that wasn't written down, it took us ages to work this out, but it's really, really hard to see. But actually the stuff of the surgeons, right is not the same as what we need. Um There's a really good example and I can kind of jump into a little live demo here. So this is my uploads and really the one, well, the one thing that we really solve is around that reducing that mismatch between the two. So we try and capture the details that the surgeons weren't gonna write. This is the business case behind it. This is how we get to do these cool things. So this is my notes, it's a browser based application. Um It's built around you as a surgeon. So it does your kind of common operations here at the top, I'm not this special surgeon who can do eyes and knees. It's just from demo to lots of people. But um if I show you a kind of a quick, a quick one for skin cancers like the commonest malignancy in the world, I did this one on Taylor Swift and really like like, like we said, we need a system which is fast efficient for surgeons to use but also captures that data that the surgeons don't know is important and this is the business case. So really mark this is a documentation assistant which provides all those benefits to, to us as surgeons, I'll turn on the automated coding here. So we'll just fill it in as we go. So we're doing an operation, let's say we've done a wilo excision of BCC right temple and a local flap. You know, it asks what theater you're in normal stuff that you would record it in the in in your process of documentation. You know what surgeon was involved. This is useful for logbook. We've managed to automate the logbook. You know, we we, we keep a logbook for you to save you a bit of time. Um What was the anesthesia, for example, that said this was under local and it's all intelligent enough. So if you say local, it's gonna ask you what local. And if you say general, it's gonna ask you what general you know, which is the need to test the clever bit comes down here. So let's say we were doing a, a lesion on the scalp on the left side, you can of course draw on all of this as well, kind of. So let's say you've done this nice flap here, it's nice scalp rotation flap um as we kind of get the details coming out. So it's asking us now, what procedure did we perform? And that was the key thing. How do we align what the surgeon and the clinic go to say, so we get the same thing. So let's say we've done a wide local excision. It asks about the reconstruction and let's say we did a local flap. This is where the magic comes in. He asked me as a surgeon, was there hair on that flap. Completely bizarre, right? But this is the kind of information which the clinical coders need to get to the right codes. So you'll see as I fill in the right things there, it starts to automate that hair buring flap of skin to the scalp. If I say no, then it's gonna ask me more questions about the blood supply and the subcutaneous pedicle to again get to the right coat. And this is the business case. Basically, this is how we get the exciting things that we want to be able to use into, into the NHS. Um So yeah, that was the kind of the one of the key real learning points early on was like how do we make it fit this box so that we're able to do these things. And the two problems that we were addressing for the hospital was around that mismatch. And the second thing is there's not enough um capacity in that automation side. And that's really what we built as I've just shown you there, really, it's a tool for surgeons which helps us capture that granular data and then it starts to automate, make the the medical occupation. But also the the billing goes at the same time as well. And then kind of how that process changes as things kind of go. Well, we actually will skip straight from the medical notes all the way to the codes and of course, it's highly accurate. So the hospital gets fully paid as well. Kind of does it work to answer is yes. Um We've actually managed to show that we could by doing this, you know, there's a clear financial return for hospitals which has been able to drive this, this technology forwards, you know, from eight surgeries, we were able to increase like 1800 lbs, so massive amounts of of revenue to gain, gain there. And that's again the business case which helps us get the stuff that we want in, in terms of kind of bringing it back to us as surgeons. Well, how do we make a system which really makes it fast and easy for us? And that's always been our, our drive. We spend so much time with surgeons working with them to make it quick and easy. We've got, for example, if you do things the same way each time as we know, actually, we do like carpal tunnel. For example, we will allow you to say that to your setting, enable you to kind of move through that much more quickly. You can add diagrams, photos, videos and of course, you've got that data there for audit for research and for your logbook as well. Yeah, and I think that's kind of our, our, our real final point is that whenever you're thinking about these innovations, it's just really important to try and think about all the different stakeholders. And there are so many in in health care that you have to kind of end up with a slightly different value proposition to each one of them. You know, here you can see ours in, in a little bit of detail, how we try and focus on where we can deliver value to those different stakeholders cos everyone has slightly different needs, right? You know, the thing for the health care is obviously around that finance side at the moment. But actually when we speak to surgeons, it's obviously a completely different, completely different pitch, completely different discussion. So thank you very much. Um It's been really nice speaking to you guys today. Um I'd love to connect with you. You know, you can find me on linkedin, send me, send me an email. Um We're always looking, you know, to speak to surgeons more about this and, and kind of building this with surgeons at the forefront of what we're doing. So. Um Yeah, thank you so much Asle for having us and I'll stop there. Brilliant. Thank you so much, grant, great talk as always, um I'm gonna break our plan very quickly and go and ask a question that has been asked to you from the chat. Um And it's about clinical coding. Um Cos this is from Laith who asks, how can we optimize clinical coding to overcome its challenges? Really good question. Um Clinical coding is a mess. It is an absolute mess and it's not just in the UK, it's worldwide, you know, the, the big problems are, there's just not enough of them a bit like everywhere in healthcare, right? Some of the, some of the, the, the top problems are, there's like a 50% turn rate of junior clinical coders. So it's a really, really hard area to, to, to work on it. And it's, it's, I guess it's one of those processes which is, it's com completely manual at the moment. Um So I think there's, there's lots of stuff that's coming, you know, A I is looking at how they can improve this. For example, some people are using robotic process automation. Um and there's lots of exciting stuff that's coming in that in that domain, there's lots of cool nudging technology that's coming in. So for example, you're writing a clinic letter or you know, the the the exciting things you leave your phone on the side, it listens to the conversation and then writes you a letter for you. And I think the new clever thing will, it will start to nudge you and say, oh, you know, you said this is this, do you mean the patient has? So you said high blo high blood sugar, for example, do you mean the patient has type two diabetes and then you'll get to the diagnosis code? So I think there's an element of, of technology which will help this. Um, surgery's a slightly different one because obviously, unlike a clinic letter or a ward round, you only get one opportunity to get the data, right? I'm not sweat, things like Mars, I think have an edge because we just have to get it right the first time, you know, it ties into what proximate you're doing there. It's all about the data, right? And the data in surgery is abysmal. Um So yeah, it would be interesting to see um how it develops. Fantastic, I think um I mean almost in every single plenary we've had so far as it always goes back to data, how can we collect it better? How can we use it better? Um, so it's a pleasure to introduce our next speaker who is er Bryn Davis, who is the chief business development officer at Prox me and is gonna talk to us a little bit about structuring a business from a start up. Hi, everyone. My name is Bryn Davies and I'm delighted to be here to talk about business models for innovators. Thank you to assets and in particular Harris for inviting me to come along today. I'm delighted to share a little bit about my story and the background that I've been on. But also think about how you can build business models and a business plan to enable your innovations to be a success and reach the patients to deliver the benefit. That's intended just a bit of background context on me. Um I'm currently Chief for Strategy and Business Development Approximate. I've been there nearly seven years now building the business from C stage right the way through to series C and beyond my career. Prior to that was really around commercial leadership with a decade in medical device industry, followed by around a decade in the digital med tech world. Working throughout that time with surgeons, really aiding and abetting and doing the best I can to help build the businesses. So their innovations obviously reach the patients in need all around the world. I've worked at Blue Chip to see stage to scale up and even done some advisory on exits in recent times. So delighted to be here and looking forward to this discussion and a little bit about me just for context I've got a couple of young kids live up in um up in, near Bakewell in the peak district, come down to London a lot for work and originally from Wales, and as you can see from the three images on the right, the beautiful country of my, my homeland on days where uh fortunately it wasn't raining when they took these photos. So a little bit about me in a bit of context, but um again, delighted to be here and thank you very much in eight minutes. I'm gonna go through what a business model and why it's important, give you some tools. So you can actually map your business model and you can engage in it and really turn the idea that you have from an innovation or a business that you've already started into a sustainable way to help patients and build that business that you want. Why is it important? Well, there's a couple of points on this. Clearly, the business model is how you derive value from your product and service that you delivering. And it's important to know that within a business model, there are four key key value drivers. It's about how you create value or a value proposition. It's also called how you deliver value. What's the mechanism that you deliver that to the user and user experience, how you capture value. This is very much around the revenue model that I'll talk about in the next slide or two. And then how you defend value. A lot of people forget that it's really important to build your business with defensibility in mind. There is an interchangeability that's used in the marketplace between a business model and a revenue model. Um Effectively, this slide that you can see from airbnb is essential to any pitch deck for fundraising. And the, the calculation that you'd use or the formula that you'd use is where you look at your market penetration by percentage multiplied by average selling price over 12 months. And that gives you your annual projected revenue. It needs to be simple, credible and and ambitious. But again, this is the revenue model even though it says business model on the Airbnb side, this is really a revenue model. And what I'm gonna be talking today is a little bit more holistic about the four f drivers of which this is clearly one of them. So coming back to describing those four value drivers, the value and creating value is really that part where it's a solution to a problem. What are you providing to who, which person is to really drive that value, deliver the value through that mechanism of action. As I said, capture how you get paid and importantly by who and particularly in the health tech or the health market. If the mechanism by how you get paid is really clearly important because there's various processes to follow uh from procurement and supply chain and so on. And then how you defend your, your value, how you build that sustainable business over a period of time. So let me give you some examples. I'm gonna pause in between each of these to give you a chance to have a guess of which company I'm talking about. These aren't necessarily all in health by any means. Uh And I'll start with one of the biggest companies in the world is a bit of a hint. Well, they create value by having a huge aggregation and breadth of choice to discover and buy goods. They deliver that value through an online store, uh e commerce element and they then deliver it to you at speed and with higher reliability, they capture value by paper use every time you go on you pay, there are subscription services as well, particularly around delivery and they defend the value due to the sheer mass of that user reach and the, and the breadth and access of products. So I'll pause for 10 seconds just to see if you uh you can have a guess. Well, for those of you who may have got it right. I'm sure many of you have this is clearly Amazon er and their, their real business model er example and, and a little bonus point if there is no er the Amazon logo has an narrow from A to Z because it covers every single product from A to Z and hence the arrow is in that direction. Here's another business model example, this is more around a two sided marketplace business model. And this is where you uh generate revenue from both the supply and demand side of things. So I'll show here that this company creates value by aggregating the supply and demand. They deliver the value mainly through an app. Uh an app based experience on IOS and Android. They capture value by paper use particularly in their original business model and they defend value. But they were very much the first mover advantage in this. And incredibly you experience that actually lets you know how long a period of time until you you get the service. So again, I'll pause for a few seconds while people have a think the list one is is Uber. They obviously supply and demand with individuals like ourselves with the taxi drivers on on the supply side and then they pay per use even though they're now going into a subscription model. As many of you may be aware, here's one in the health sector as a software as a service business model. This is where we create value by connecting to surgical experts. Uh You deliver that value by delivering as an online web and mobile application. The value is captured you paid via subscriptions and also a white label approach. And it's defensibility because of the sheer number and volume of the footprint and certainly these edge devices, cameras and audio for a hint for a few of you with a completely own tech stack built from the ground up. So that really means that from a contracting perspective, it's compliant. From a privacy and securities perspective, I'll only give a few seconds on this because I'm sure those of you who know me and with the introduction earlier will know that this is the elements of the fundamentals of proximate business model. Uh This is where we started. We're moving uh into further different business models as we go forward. But it's really exciting, but it gives you a, a picture of where we are at today. The final one I'll share is as an example. Um and this is a direct sales model. So the the solution to a problem, what they think about is they've got a superior, minimally invasive uh surgery device and associated consumable that delivers the superior use experience and also a potentially improved outcome for patients. They deliver value by directly shipping training service and support with direct sales people in the field. And they capture the value either through a one off capital sale or maybe a leasing model, a financial model and then paper use on the consumer roles and they defend value very much through their advantage of being first mover for many years. And they use experience particularly in the latest model come out has been loaded. So I'll pause for a few seconds there. This is very much a medical device and when it's surgery and this is intuitive. Now, interestingly about intuitive how their traditional business model is. What's on the screen. Much, like I mentioned with Proximate, there's definitely a shift with new business models thinking about subscription and revenue based models that are sustained over time and may be playing around and thinking about how encapsulate on data or efficiency and so on. So now for the last few minutes, if, if that long, I'll share some tools with you of what you can use clearly, you can use this uh really simple er business model um process to really think about what it is for you on the creation of value. I think about the persona, how we deliver value is really important and you can really innovate here. Think about drone delivery is an innovation around delivering value, the capture values of revenue model. And again, don't forget how you would defend it. So which by writing these down and following these four steps, gets you thinking about your business model and really will then take you into what many of you may have seen, which is the business model canvas. And this really is a a fantastic activity. I either print these out and write and they've got great prompts on there. You can do it on a mirror board or with flip charts um and, and sticky pads on it and an A one process. It's really great to workshop this out and really think about each of those different elements that produces your entire business model. So this would be the next step that I'd recommend. And there's a great couple of books. These are my own ones. I've taken a photo of about how you, how you follow the process of the business model generation. And within one subsection, the value proposition design is, is really clear, really easy to follow. There's lots of pictures for people like me, it's, it's fantastic and engaging and simple. And I'd really recommend it for, for anyone interested in neither business model or value proposition design. And I'm really understanding what is the problem solution that you're reaching and who for and how that can be monetized. So what's next? What now? Well, the first thing is don't panic, there's no panic at this stage. The next slide will show a number of different tools. They're all extremely accessible, they're low cost, they're fundamental to your business and something that really can shape your thinking, speak to your colleagues, speak to friends family about how this might work and most importantly, speak to those customers out there, not only the users, but also those that may be willing and able to pay. So the power really is in your hands in these going forward. So these are my final takeaways. Please consider your four value drivers and get them written down Google business model model innovation of four week MBA, the four week MBA. I'm not recommended necessarily. But they've got some great, great er, pages about different business model and how you can compare them by those two books. Can't recommend that enough. They're simple, low cost and engaging. Uh and, and easy to follow, do have a go at the business model innovation, either print out old school or use a mirror board or a template online. And finally, for those who are interested about digital business model, there's a free course on Coursera about this digital business model from Lund University, which is fantastic and I'd really highly recommend that. So I'd say thank you. Please drop me a direct message if you need to or follow me on this social media on linkedin in particular or X if needed. So, thank you very much for, for listening. I appreciate your whistle stop tour. If there's any questions I ate them or as I say, hit me up on the uh on the details in front of you. Thank you. This was a brilliant presentation by uh Mister Davies. So without further ado, we'll go on to your uh final speaker in the session today. Uh MS Louisville, uh he's nac venture capital investor and plastic surgery registrar. The floor is uh yours hoping everyone can hear me and see my slides. Ok, great. Uh Well, thanks everyone um for joining today. I'm uh hopefully gonna tell you uh a little bit that you don't know about financing innovations. Um This is me Um I've studied at a few places. I've worked um in the NHS for a long time and I've also worked for a VC Fund. I've met lots and lots of um entrepreneurs, some good, some bad. Uh And I'm hoping I can use my experience to uh to lend you some, some insights today so that you're fully armed for when you have your next big idea. I think it's really helpful to start with a definition of innovation. Um This is mine um helps me sort of guide my thought processes, a new product or process. And II think it's really important to remember that, that your innovation doesn't have to be a tangible. It can be a new way of doing things or a combination of both, which differs significantly from what's sort of already out there, which creates value, which is financially sustainable. Something people forget when they work in an industry, which often doesn't talk about money. Uh And which is kind to people and the planet and your value creation can be making money, it can be better patient outcomes, it can be better staff or patient experience, it can save money, it can just bring joy. I'm gonna talk about three things. Why do you need funding? Where can you get funding? Uh And how do you get funding? So the first question is, do you even need funding? Bootstrapping is a phrase I hear from a lot of entrepreneurs. Er this is a bootstrap in case like me, you had no idea what one was, er, bootstrapping comes from a phrase to pull oneself up by one's bootstraps, which has been used throughout the 19th century to, er, to try and describe the sometimes impossible task of bettering oneself unaided. And the concept can be traced back as far as 1785. This is a book called The, er, Incredible Adventures of Baron Munchhausen. Er, and this picture depicts, er, this uh fictional German nobleman trying to pull himself and his pony out of a swamp, using his own ponytail, er, as you can see a fairly, er, difficult task and so some start ups try and do this. Er, they try and innovate without using external funding, that's called bootstrapping. The problem with bootstrapping is it's great if you can do it, but it's slow and innovation really needs to be fast. Firstly, because the faster you develop things, the faster you can get them out to patients. And secondly, because if you're not fast, you'll get left behind. The most successful innovators, er, get cracking really quickly with a minimum viable product, they get feedback and they refine as they go because innovations a race and if you don't scale as quickly as you possibly can, you will get left behind or you'll get devoured by these big incumbents that are already out there, you will do a lot of work and you'll spend a lot of money on developing a product and then these competitors will let you do the research and then they'll copy you, uh, with greater market penetration and you're kind of out of the race. Um, that's particularly the case for, um, MedTech Health Tech BioPharma. Uh, because you've got all these big competitors here, here are some things that don't work when you're innovating, keeping quiet, going into stealth mode. Uh, and relying on patents, patents are only useful if you have more money to spend on lawyers than these big companies here, things that you should do utilize first mover advantage, develop a brand that people recognize, gain customer loyalty, something that football clubs do really well, create high switching away costs with an ecosystem. That's something that Apple does really well and scale as fast as you possibly can, preferably fast enough that the big companies want to acquire you rather than squeeze you out of the market. And for most entrepreneurs, those big companies are acquiring you that it it, that's your exit plan rather than doing something like an IP O successful innovation at scale and at pace requires a lot of money for outflows like er MVP development, intellectual property rights. You'll spend about 30,000 lbs on intellectual property research and regulation to get an approval. You'll spend about 30,000 lbs, your brand identity, an app or a website might cost you 30,000 lbs and you need to spend some money on your company. Registration and maybe an accountant to write up your financial statements. Pay your team a salary, please. If you're not paying your team a salary and they're working for free, you don't have a financially viable business. Um, you should probably be thinking about spending 250,000 lbs in the first year. And I know that sounds like a lot of money. But the more funding that you have, the faster you innovate, the faster you get, get your uh innovation out to people and the more people you can reach most people massively underestimate the amount of funding you need. Here are some typical levels of funding for companies you've heard of today in 17 million Fitbit, not heard of today, but you probably know them proximity has raised 100 and 30 million and probably more by now. CMR Surgical who make the versus robot have raised over a billion. And uh just to show that sometimes raising money isn't the answer. Er Babylon raised over a billion as well. So the next question is, where can you get funding? Uh There are a few different places uh and companies at different stages use different sources of funding. So the first thing to talk about is a seed company. So this is a company with a product but maybe no revenues and no users. Uh they might look to business angels. So people uh individuals that, that want to invest money in good ideas or government grants will talk about those. If you're a start up ie you have users and revenues. Uh, you might reach out to a venture capital fund for some money. If you're a growth company, ie e you've, you've reached break even financials and your company is profitable, but it might be expanding faster than you can finance internally. You might go to a bank and bank debt is actually a great source of funding. Uh, You might go to a private equity fund. Uh and despite their reputation, they can be quite useful. And once you're a mature company with stable financials, at some point, you might want to IP so that is selling shares in your company to uh to corporations and retail investors on the stock market. And the primary reason for doing this is to let your previous investors exit your first port of call as a clinical innovator or a scientific innovator should be the N HSA accelerated access collaborative, er all of these slides, lots of the info is taken off their website. So just go and have a look. It's a collaboration in and in industry and the collaboration is aimed at coordinating things. So, so it streamlines adoption of new innovations and the result is a raft of accelerator style funding um across sort of all business stages. We're gonna talk about a few of them today. This is on the website as well. If you want to have a, a closer look. Um The first one to talk about is uh the easiest way to get advice is to contact one of your local academic health science networks. There are 15 in the UK. They all run different um programs supporting innovation specifically within the NHS er and for people with a well developed idea, there's also a NHS clinical Entrepreneur program grant funding will provide you with uh maybe 100 or 200,000 to help you develop your MVP and generate proof of concept. Um The Small Business Research Initiative uh is funded by NHS England. It's supported by the health science networks. SPR I run competitions um which have specific focuses and if you're in a falls into this group, you can apply to them. You get, as I said about 100,000 over 18 months. These are the ones from the last 12 months, keep an eye on the website. There are new ones coming out all the time. They've invested about 100 and 50 million over the years. You can also go to the MRC and innovate UK. Uh The website is U kri.org. Er they run lots of lots of things but they run this biomedical catalyst twice a year. Uh You need to have project costs up to 4 million and they'll give you a grant of up to 2 million. The challenge really is that you need to match fund it. So you need to come up with 50% of the money from other sources. Incubators and accelerators are very useful. They give you access to lots of things like partnerships, mentoring a peer to peer community learning programs, teaching you about NHS procurement commissioning, business case development, things like that. Um Some of them will also give you a Bursary or a stipend. And increasingly they're moving on to the venture spectrum where they will expect some sort of equity return um in exchange for helping you maybe in the region of 5% which brings me on to cash in exchange for equity, which is what a venture fund does. Um Lots of entrepreneurs struggle with the idea of giving away equity in their company. This is a typical dilution scenario. You start off with 100%. By the time you've taken on all your funding, you might end up with 18% of your company. And that sounds terrible. Right. Um Why would you give away all of that? Well, the reality is, it's probably much better to have 18% of a company worth 100 million that reaches patients on a global scale than 100% of a company worth a million that's siloed to your local NHS trust or maybe a company that hasn't gone anywhere. And if you aren't successful with your um start up, you don't reach it to acquisition or IP O you have no personal financial liability to any of the, the people that have invested in you, that's the way investment works. Uh So that sounds like a pretty good deal to me. If you approach a VC cos you need some serious money. Uh It's really important to understand how they work. The idea behind a VC uh fund is that um we invest when the company is smaller, we take a certain amount of equity and we exit maybe about seven years later when the company is worth a lot more and 80% of the companies in the portfolio don't really generate any money, in fact, lose money. And so you need to prove to me that you're one of the companies that is gonna be my unicorn that's gonna fund the whole process. Uh So the question from every VC when you go to them will be, is there the potential for your company to generate maybe 10 times the return uh on the money that, that, that the VC puts in? And if the answer to that is no, you're gonna have a really hard time. So think about that early on in your journey. These are some of the VC funds or the probably the, the, the most active VC funds investing in healthcare in the UK. The ones on the left are the main ones to think about. Lastly, how would you get funding? Three things? Really? This is very simplified. You need to incorporate a company go on company's house. Uh It's very simple. It, there's a step by step, you know, guide it costs 50 lbs. You might want some uh guidance for drawing up your financial statements and, and thinking about how many shares you have. Think again about your value proposition. If you don't tick all of those boxes, please go back and have another think have an elevator pitch. This is a one minute narrative which you give to someone when in the elevator in the hospital they say. So, what's your idea? I'd really encourage you to think about this early and start using it. Talk to someone in the break, er, a useful phrase to start you thinking about it is, you know, when this really annoying thing happens. Well, my innovation does this to solve it. Once someone's intrigued by your elevator pitch, you need to have a pitch deck to show them the whole journey. Er, that's the whole topic in itself and you need to value your company. Uh Lots of entrepreneurs come to a VC saying, well, I need 20 million and I don't want to give away more than 10% equity. That's not really how it works. What you need to do is objectively think about what the value of your company will be in, say seven years time, um and calculate the equity that you give away based on that. That's also a very big topic. Um which if you'd like to hear more about that and the pitcher side of things scan the QR code and leave me your email address. Um And I'm running some sessions in maybe February next year. That's it from me. Thank you for brilliant presentation. Lots of information uh for everyone to, to process. So, uh and thank you for leaving the details without further ado because we're ever so slightly overrunning, we'll conclude with the group uh Q and A session. So I'll introduce the panel for the sessions. We've got uh Victoria uh Hatcher, who's the proximate VP for global marketing and sales. Uh You've all listened to uh Mister Grant Nolan's presentation and uh MS Louis uh go given just a brilliant um presentation just uh now, uh there weren't many other questions additionally from the chat, but the one I I'd have to uh all of you, um uh what would be one piece of advice for a clinician in this conference? Uh who has an idea where to start? So maybe let's start with uh Grant. Yeah, great question, where to start. Um The main thing is just to start, but at the same time to start cautiously and carefully, so don't quit your job. Um But start doing something because everyone talks about something, everyone has ideas in the shower, right? But there's people who get out of the shower and do something about it which you change the world. So just just start doing something. Um and, and, and then see how it goes, but just be kind of open to criticism open to that cos entrepreneurship is this weird combination of like, OK, being like convinced that you're on something but at the same time, like listening and being adaptable. So just try and try and do the both of those. It's really hard, continuously improve their feedback. Uh Next step, I'd like to get an opinion from uh Mister Victoria Hatcher. Thank you. Um I'm a bit of an imposter here not being a clinician, but I'll channel mine and Nadine. Um it, it's really important to get insight from uh from your perspective as well. I think we've got different ideas and you may have completely different perspective. Yes. Although I think we'd probably, um we'd probably agree on this one, having seen it in action and that's around growing your network. Sort of don't try and do it all yourself. There are so many people out there doing this already, you know, we've got people on this panel. So, um reach out Nadine in her early days, you know, use linkedin as a, you know, greatest ally. Um She, she was bold and brash and sort of, you know, asked, asked for favors of people and now she tries, tries to repay it back wherever she can. So, um I would definitely say sort of, yeah, go out, build that network, ask the questions, test what you're thinking. Um And that's a really, really good way to, to move the dial. Thank you very much. And uh I'd like to hear, uh, Louis's, uh, opinion as well. Uh, I think my, I've got to, um, first one get a co-founder, er, entrepreneurship is really hard. Everyone's nodding. Um, it's really hard. It's ry, you have to be so resilient. It's really hard to stay motivated. People will, um, you know, not everyone will be enthusiastic about your product, get someone to do it with you. Um, and my second piece of advice is have an, have an elevator pitch. Uh And tell as many people as you possibly can. Everyone thinks, I can't tell people what my idea is because they'll copy me. They won't, no one else wants to spend, you know, everyone's got their own idea. No one will spend the time on your idea. Tell as many people as you can, it gives you ownership, it gets you feedback. Um Yeah. Amazing. Thank you so much brilliant talks. Um We are four minutes over but um we've had a few really good questions basically. Where can we get more of this? It was so good. Um So I want a really, really quick answer from everybody. Um Where can people access resources to support entrepreneurs? Um Grant. Um There are some amazing books and that's a really lame answer, but I II didn't used to read books at all, but there was actually so much amazing stuff in some of the, in, in some entrepreneur books. So II, I'll maybe I'll send AAA proper reading list on um linkedin and people can find it there. But um yeah, that, that would be one key thing. You know, the stuff I've picked up from, from some II listen to more audible rather than actually like leafing through them page by page. So that would be one thing. Um and just go to events like there's, there's tons of events in London. Um There are other events in Manchester and Liverpool and all these places, there are Start up MedTech events that just go to and speak to people. There's, there's loads of interesting stuff going on. So, yeah, I guess. Great, please. Um Hot book for me is a book called Disciplined Entrepreneurship by Bill Owlet. Uh It's super accessible. Uh It's easy to read like over a coffee um in chunks. Uh R CS Innovation Hub is a good place to go. Um I think they're running a few courses next year. Um And as it as well and the NHS accelerated access collaborative website. Yeah. Yeah. And we'll be hearing from Ryan tomorrow who is the chair of the I hub. So make sure you come back for tomorrow and finally, Victoria final words. Yeah, I was gonna say some of those already to repeat them. Um There are a gazillion podcasts as well. Um Some of them hit and miss so sort of find your own style. But you know, digital health Today, digital health round table, that type of stuff. There's And if you, if you like and have seen any um sort of founders or companies that you have loved, then definitely, they're founders will be doing talks on one of those many podcasts. So sort of go, go find them and listen to them. Amazing. Thank you so much. Um All three of you and everybody else who is speaking um Brilliant. We'll uh we'll close the session. Thank you.