Entrepreneur Rx_Andrew Heuerman: Audio automatically transcribed by Sonix

Entrepreneur Rx_Andrew Heuerman: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

John Shufeldt: Hello everybody, and welcome to another edition of Entrepreneur Rx, where we help healthcare professionals own their future.

John Shufeldt: Hey everybody! Welcome back to another episode of Entrepreneur Rx. We're happy to see you back. Happy New Year to everyone. I hope it was safe. Today, I'm excited to have a chance to speak with Andrew Heuerman, who is a founder and CEO of The Patient Company. Andrew, welcome.

Andrew Heuerman: Hi, John. Thanks for having me.

John Shufeldt: Oh, my gosh, of course, this will be cool because this is a really cool. For someone who's in the business and knows how difficult this issue is, is your job and this is a cool product. Give us a little bit of your background.

Andrew Heuerman: Yeah, absolutely, so my background is primarily in new product development, commercialization, healthcare innovation, even as far as venture investment and company formation, that type of work within healthcare, specifically. I was pre-med, classic pre-med dropout story. I was basically three and one-half years in, stumbled into a business class, and thought, holy cow, I can accomplish some of my STEM goals through product development within healthcare, and I never really looked back, honestly.

John Shufeldt: That's cool, but then you did a master's and something that, I've never seen this as a master's, and it was so cool. It was entrepreneurial transactions. What did that entail? Because that's genius.

Andrew Heuerman: Yeah, that's exactly right. Through the Central Michigan University program, that's now the Masters of Entrepreneurial Ventures, but it was a great program. For someone, again, my, the majority of my undergrad was clinical, it's probably straight pre-med, biochem, and to go into the business school, like I said, quite literally, just poking my way around, I tried to get a minor in business in undergrad, and just because I wasn't in the business school, I wasn't able to accomplish all the same credit load and all that stuff, but following, I was looking at these roles that were really, I'd say, most resemblance to like a product manager. I was missing a clear business degree. So I was like, I don't just want a business degree, I want a business degree that's going to help me actually get these products, these ideas from start to finish, and I felt like that program was perfect for just that. Got a big binder from the program still, my weekly notes, that I referenced to this day. So it was definitely beneficial.

John Shufeldt: That's really cool. Yeah, when I saw the title of the Masters, I thought, wow, how relevant is that? It's very cool. And so I ... a lot. So give me some idea, how you went from that to where you are now. What inspired this idea?

Andrew Heuerman: Yeah, so previous to starting The Patient Company, I was working for Spectrum Health, which is now Corewell Health as they merged with Beaumont up in Michigan. So they're now the largest healthcare system up in Michigan. But at the time I was doing work with them related to, I'd say as early as idea development. So one big thing that we did was we're going out and just basically helping to improve the culture of new ideas. So there's clinicians, physicians, everyone working in the healthcare system, a ton of smart people that all have one thing in common, which is they don't have much time, right? So everyone has these great ideas and they sit on the proverbial shelf, right, where they can't be touched or they don't have time to progress them forward, and that's exactly what our program was all about, our division within Spectrum Health. So we would go in, we would basically help support the idea development, help support bringing these ideas forward, and we would take all the way from a general problem statement to something that's licensed out into the field. That's exactly where this idea came from. We had one clinician who actually, unfortunately, had four or five individuals who are injured under them in one month in several different months, all from moving patients from one flat surface to another, which is called lateral patient transfer.

John Shufeldt: Really? Did they just drop them?

Andrew Heuerman: No, so sorry, so this is the employees getting hurt actually, in this scenario. So back, wrist, elbow, shoulders, neck, upper extremity, musculoskeletal, yeah, exactly. And yeah, so there's a lot of interesting things, I did end up graduating, I guess I left this part out, but I end up graduating with a kinesiology degree. I was really attracted to all of the, I describe them now as patient movement-type projects. So anything orthopedics or musculoskeletal injury prevention, rehab, all that tech stuff was always naturally interesting to me. And this problem again, what stood out to me and I tell people all the time, is the individual who brought the problem forward, actually has to meet off campus. They thought they were uncovering some dirty secret that their manager wouldn't want to know about and all this stuff, right, because of just that culture of all these clinicians are so strong, they're able to move these patients, getting injured is almost a bad thing on the clinician, not on the work environment itself. It was those types of things throughout, stayed really consistent that were just really interesting and problematic. Ultimately, it came down to, is there a better solution out there today for this issue? And the answer was no across the board. So that's where we jumped in and we took it again all the way from the problem statement from that clinician to product that's now available in the market.

John Shufeldt: That's very cool, what are some of the ..., I have to say, for a large health system that's really forward-thinking to do almost a tuck inside the hospital system. I don't know whether, maybe they are now, but I think Mayo may do it, but I don't know of a lot of other hospital systems or healthcare systems that approach that globally. What other cool ideas have you come across?

Andrew Heuerman: Yeah, I'll try that. I'll stick with the thumbs that have either spun out or have been stopped entirely. But I do want to reference one other thing, which is that work I was starting on was back in 2016, and I think you're right, that's unique perspective that I lend to people today is, obviously, I do work and support others in this field all over the place. And since I have the kind of, like you said, global perspective that I would say it was also really early on is something I find helpful yet today. But yeah, a lot of different projects all over the place, right? Like I said, I found myself working with a lot of orthopedic surgeons just going in and shadowing cases, stuff like, oh man, wouldn't it be great if this tool worked this way or if we had a different type of screw, or like all these types of things that were, I'd say more incremental in innovation, but a lot of those led to joint partnerships with other medical device manufacturers and really quick license that was more of just forming or, like an organic partnership that was already in place. What we found was, like you're describing on the tech transfer side, if you were to think of it like a university, all these reps from these other manufacturers would come in, they talk with the surgeons, then they'd go back to their development teams and talk about all the good conversations, the feedback they had before the product is on the market, almost exactly like the physician was describing. And it wasn't, it wasn't, I would say, something that was malicious intent, right? It was something that was beneficial to both sides. The physician is asking for something, the rep thinks they can make that change, and then boom, now the rep is making money off the physician's ideas. That was really where we focused, but when we were doing that type of work, we were only receiving, let's say, 152 to 300 ideas a year. More like here's an idea a day from a surgeon, and then what we did was we actually blew it up, took a digital approach, went in, did these sessions, all this stuff, everyone from environmental services to the CEO, we went and sat with and talked about their problems and their ideas. We ramp that idea, count up from 150 to 2000, and I learned a lot of interesting stuff in those years of getting 2000 ideas in the year, and really in those that stage was my job to go solicit ideas and go through them. And what I found was really interesting, I think the first thing that I share is that if all of the ideas, the best ideas that we know will work were on one software document shared publicly, I would still guess about 90% of those ideas would not go pursued. And maybe that's a healthcare-specific issue, but there's just so much that goes into, hey, I've got this great idea, to actually getting the product to market. The average path is 5 to 7 years, costs millions of dollars to get any medical device into market. Pharmaceutical is worse, any class three device, forget about it. I think that's the perspective of these people that, that brought these ideas forward. But anyways, I'm not answering your question directly, so let me get back to a couple of ideas that we worked on that I thought were really interesting and less technical that we spun out right away. So I mentioned kind of the orthopedic ones. One that I really liked was a, there was a Lab Dropbox project that we had and ended up being licensed under three specific products. And the prototyping for this took a month maybe, bring a brilliant engineering intern on, and really what the issue was in several environments where you do, let's say a urine sample, you put your urine sample into a lab Dropbox following collection, right? Next person comes in, they do their urine sample, they open the same Dropbox, and put their urine in. What you'd find really commonly is tampering with who's is who's, right? A label comes off one, it goes on the others, and it spills one, it gets dropped, all these types of issues that seem really avoidable. So we made a really simple Dropbox, we just put it in the sample at the top. There's a lock on one side and then there's a pass-through door where it can only be opened on the opposite side of the box. If there isn't space, you basically wouldn't be able to drop it in, you'd have to go find someone, just again, a really simple analog solution to urine collection, tampering, or mishandling. That's a really good example. We worked on all sorts of projects like a female urinary collection device that's actually been licensed out, companies running with that, right? A securement product for endotracheal tube holders, and then another one for helping to manage, I'd say, like ligaments or specific aspects of patients during surgeries, so like positioning tool or imaging tool, or excuse me, a positioning for imaging or surgery, all sorts of stuff. And I think the reason why I go through this and rattle them off is the range of who these people came in from, I think is really important to point out as well. Like I said, quite literally from environmental services to the CEO, and I think that was what was interesting. When we moved away from just the physician focus or the surgeon focus, we found there's a lot of areas for improvement, and again, that's where the idea for SimPull came from was a patient transport manager.

John Shufeldt: You came up with the idea for what you're doing?

Andrew Heuerman: Yes.

John Shufeldt: What's been the most challenging, even with your almost perfect background, kinesiology, and then this entrepreneurial master's, what has been the most surprising and/or challenging thing?

Andrew Heuerman: Oh, man, I think I'm going to get a loaded answer here because we started the company January 2020. We got our first check, March 5th, I think it was. So I would say the headwinds have definitely been the most challenging. You know, everything from, everything we do, hopefully, it's already coming out clear is that it's based on user feedback. So we were shut out from that hand-in-hand user feedback for almost 24 months. So we were having to do a lot of development, not necessarily blind, we were still able to get people to support it, but when you're building a physical product, actually getting your hands on it, kicking the very real tires, that's critically important for development. So I would say items like that not going into the field for an extended period of time for that development basically led itself to one additional iteration. We did our best, brought it in, did pilot work, did demonstration work, found there are still a couple of gaps, and then moved forward to the next iteration. Outside of that, supply chain, I know it's a terrible answer but when the microchip delays came through, that negatively impacted us by about eight months and it happened at one day. Just, hey, there's no chips available, we don't know when they're going to become available, we'll keep you updated. And then by the time we got chips for our next iteration, our next set of devices, was about eight months later.

John Shufeldt: Wow, yeah, probably never would have, maybe and, probably never would have anticipated that one. Even in March of 2020, I don't think any of us saw the total meltdown of the whole supply chain. Go ahead and describe, go ahead and define the product, so for people who haven't looked it up yet, then we'll have all the notes and links in it, but go ahead and describe it because it's a really cool product.

Andrew Heuerman: Yeah, absolutely. Again, going back to the problem statement, I'll take it apart from there, unfortunately, we found that a lot of clinicians were being hurt while they were moving patients from one flat surface to another. And John, you brought up or alluded to clinicians aren't the only people, patients were getting hurt as well. So it was really common to see either patient drops or patients moved in a way that was intolerable, created injury, caused injury, and that was really where we started. So we went in and found that every other product today when you move a patient just from one flat surface to another, we're talking 3 to 5 feet at the most. Every other product, you actually have to place something under the patient first. So whether it's a sling or some sort of assistive device, actually rolling your patient onto that surface was more than half the issue. And one thing that stands out to me is everywhere I go, they call that process log rolling, which may not seem like a big deal, but when you realize the national standard is referring to our patients as logs, it starts to create red flags, right? More and more touchpoints, you hear it over and over again, and that becomes one of those things you're like, let's put that to rest, right? Let's put that term to rest, let's come up with a better one, but that was interesting. And part of the battle was trying to figure out a way to move patients from one surface to another without rolling them at all, that's really where the problem started. So what we found was we needed to have some sort of product that connected directly to whatever sheet was underneath the patient. So that was really where we started was, how do we make this connection method safe, secure, connect to what's under the patient, and obviously with that typically being a sheet of some kind, not tear that sheet while we're moving them? So, came up with a novel approach, which is essentially a very smart winch on a pedestal that moves around about the size of a vacuum cleaner that attaches to a sheet with a strap material that is antimicrobial, flame retardant, extremely tough, it rated for 1200 pounds, and then using a method that is really safe and secure to those sheets. So effectively, what we've done is we've created a process where instead of turning and adding all these steps in, we just simulate that manual pull by connecting our device directly to the sheet that's underneath the patient. So just really quickly connected that way, you press one button and they slide right over and it's working for two flat surfaces.

John Shufeldt: Can you use a sheet off the bed or is it a special sheet to actually put down first?

Andrew Heuerman: No, any sheet, and that's really where I think our product stands out is, despite the environment scenario, etc., you can still use our device as long as there's some form of a sheet underneath the patient. Of course, some sheets work better than others, we'll have some that we recommend, but ultimately every sheet will work. And then also the way that the device works, it's a bar, so think of it as like a curtain, if you have a sling or some sort of surface under the patient already, maybe it's some sort of monitoring or anything like that, you can connect directly to that as well. You just put the bar through the two straps that are on the side of the surface, you can pull by that means as well, so they can stay on the surface if they need to be on it, they can be moved by sheet if there's nothing else under them. The bar itself detaches from the device, so you can do that setup completely by yourself, takes about a minute, and then just pressing the device down. Excuse me, pressing the button down is the whole force. There's no manual force required at all by clinicians for this.

John Shufeldt: And you could do a one-person move.

Andrew Heuerman: That's correct, yeah.

John Shufeldt: That's amazing.

Andrew Heuerman: So we're really excited about it. I think one thing to point out there on the one-person move is found a lot of stuff again through the development on standards, that was interesting. One being that OSHA, ANA, NIA, JCO, everybody agrees that no more than 35 pounds should be lifted by any given clinician at any time, which hopefully, there's a lot of people raising their eyebrows everywhere going, hold on, there's never been a day in my career where I haven't lifted that. And I think that's what we're really looking to use this device as a paradigm shift. Or we know that clinicians are tough, we know you're capable of moving these people, but we also see the injury data and it's not going down despite these other products. There's no need to move patients in this way anymore, right? There's a product that can do it really fast, really effectively, very safely. Use the product, save your back, use your back for other more important clinical tests so, yeah, we're excited about what we've come up with here.

John Shufeldt: Yeah, that's interesting. How many patients, do you have any idea how many patients you've moved to date?

Andrew Heuerman: To date? Yeah, just we're coming in on 500. So we're just approaching FDA readiness and commercial launch. We've done a lot of research, pilot activity under individual IRBs, as well as starting to get out into the field now with that final product. But, yeah, just about 500 and the first big number for me is 1000, pretty consistent data out there showing that for every 1000 transfers, that would be at least one injury. And those injuries are very costly, right? So we can start to put a number to how much we're saving, how much time or saving, how many backs are saving out there as soon as we hit that thousandth number. So we're halfway there and we're just about to commercially launch.

John Shufeldt: Well, and once you're out, it'll be 1000 a day.

Andrew Heuerman: ... Or more ...

John Shufeldt: All the amount of transfers, all of us participate in is just you don't even really think about it and knock out what I've never been hurt doing one and I try to chip in on, because I'm large, I try to chip in on the heavy part of the patient, for lack of a better way to say it, but it is just a matter of time.

Andrew Heuerman: Absolutely. I think that's well said.

John Shufeldt: Yeah, it's interesting. Okay, so you got the idea for the product, you have some delays given supply chain and everything. And then once it was built, what was your go-to-market strategy? How did you, that seems to be a real large barrier for people because they have this great idea, but like, how do they get it out to the masses and the masses are not easily penetrable?

Andrew Heuerman: Well, no, absolutely, and I think, really, I want to mention two things. The first is that this is not just an acute care product focused entirely in acute care, and the big reason is, obviously, we had a great partnership with Spectrum Health. We had a really good, I'd say like conflict of interest type stuff put in place, which basically said, hey, we'd be happy to research and use this device, but we can't be the first ones. So this was developed here, you got to go get this out there, get in front of other people. Basically, like you're describing, instead of getting it to the masses and get to one other group before we could come back to Spectrum Health. So that was a really good thing for us to have, again, going back to how that division, that department set up, enabling work like that to be done. So that was a huge benefit. Found another hospital system up in Michigan that unfortunately was having a lot of issues with lateral transfers. Their data was really consistent with national averages in terms of injury rates, and it was costing them a ton of money. Their nursing staff was going out the door, they can`t work in that environment. So they saw this as an opportunity to help support their problems. We brought the product into there, the first iteration that was back in March of this year, and then we got three other hospital systems outside of that to sign contracts, to sign work, to actually use this device in the field, get a review of it. And I think the most exciting update is, through that work, obviously, we did iterative development and iterations through the feedback that we received, but when we got what we thought was the final device done this past fall, we took it to a site that didn't really have any contract work in place yet they were intending to use it on a limited basis before purchasing of any kind. We did a feedback session with about 40 ..., ran through all of the scenario, planning all sorts of different types of sheets and surfaces, and really a fun session with them. At the end, nobody felt like there was a need to pilot the device, that all felt comfortable and we're excited to start adopting it. So I think that's really where again, we had to take that long haul approach of we're going to do research project after pilot, make sure that the clinical evidence is there, really treat it like you would with any other med device development until we get that kind of good indicator, which luckily we got this fall from a system saying, hey, all green lights here, we can't wait to use this thing. We know it's going to help our patients.

John Shufeldt: It'd be really interesting going to some of the associations and you've probably done this, if you went through a workman's comp insurer and said, look, you're spent, you know how much you spent last year on back injury related to lateral patient transfers, what if you give us a discount on their workman's comp insurance if they use this device?

Andrew Heuerman: That's exactly what the next phase of the business is. I think from the inception to really today, we've been just focused on technology development, right? Making sure it fits the clinicians' needs. It can do everything that we're marketing it to do, so on and so forth. And now it's really about going from this direct model of, hey, here's a device, buy it, use it, to something that's more of, I would describe as pay per use, right? So whether that's what you just described, whether we find a way, a pathway to reimbursement, whether we have a model similar to CT or negative wound pressure therapy, where you actually pay per click, that is where the hospitals are going to get extreme value from, because now there's no upfront capital risk like you're describing of, hey, we bought this device and now we have to do these transfers and I'm sure it'll pay for itself one day, you know, we'll have a smart model and a way to either finance or purchase through those models to actually show ROI and show benefit, hopefully on transfer number one.

John Shufeldt: ... you could, also, if I was a hospital CEO, I'd say, look, we're going to use this device, we'll try to negotiate a per-use model, and if you don't use it and hurt your back, we're not covering you for workman's comp. Unless it's an absolute emergency, we're not covering you for your workman's comp claim because it didn't need to happen. Now, I don't know if you can do that legally, but I would think going to the nurses' associations and the different unions, they would be absolutely supportive of this. Because all of a sudden, it'd be like, what do you mean you didn't want to spend a few thousand dollars to protect your nurses?

Andrew Heuerman: That's exactly right. And so I think that gets into really with our launch happening today, right? Three goals for 2023, that's one, pursue, whether it's like you're describing, endorsement, reimbursement, support to get to that type of a model because again, it's more effective for how healthcare systems purchase product today, and then number two, get devices out into the field, ramp that count up to about 1000 but 100,000 by year-end, so we can show the value that we're creating in the marketplace, and then the third is actually subsequent product development. So we do have IP filed patents, filed on an attachment to our device that actually allows for turning and proning of patients with just one use there effectively as well. So that's a huge advantage, I know obviously, been in the news a lot this past week and a half. Unfortunately, the situation with DeMarre Hamlin on the Buffalo Bills, part of his care plan, the way I understand it would be to be proned every 6 hours. So I think this is a great example and I'm really happy to share this one publicly because imagine being a nurse on this huge high-profile case floor and you're being told, hey, go in and manually turn that person every 6 hours despite the fact that he's intubated, despite the fact that there's six family members in the room watching your every move, all of this stuff, remove that scenario entirely and have this product just effectively turn in prone patients for you, that's our really next big swing in 2023. They nailed it on the reimbursement and policy and endorsement side, but I wanted to throw out those are the other two goals for the year.

John Shufeldt: That's very cool, you, man, you've come a long way, congratulations.

Andrew Heuerman: Thank you, yeah, it's been a long road. I've listened to a couple of your other podcasts and I hear all the people say, you know, going through that FDA process, not for me, I went into digital health, and here's my project. I'm like, man, these are really smart people. This has been a long road, but finally seeing that that value to, again, the clinicians and patients makes it all worth it.

John Shufeldt: Yeah, just if you saved one person's career because career longevity is important and you screw your back up, it's sometimes game over for.

Andrew Heuerman: Absolutely.

John Shufeldt: And the costs associated with that are huge. So you're really doing not only the patients but the staff a huge favor. It's funny, when you were talking, I was thinking of all the stupid things we do in emergency medicine every day that puts clinicians at risk, not purposely. Just like you said, log roll, I laugh, is what we've always called it, and nobody ever thought about it is derogatory or negative. It's like, we're going to log roll and I've got the neck. And, but if you take a look, if you had a kinesiologist follow a nurse through their typical day, and they have it much worse than physicians, they would cringe at all the stupid stuff we do ... the patient care. Picking them up off the floor, it just, all the stuff that just prone to injury.

Andrew Heuerman: Exactly, and I think that's really generally the whole thesis of the company, right, is there's a huge nursing shortage, this workforce, the environment of this workforce is terrible, right? Nurses are sustaining just as many injuries as any other job in any industry. And we believe that there's a lot of things like that can be removed or replaced through automation or through a product that can do that physical lift for you. So I think that's, again, that's really what we're after, and it's funny you mentioned the difference there between physicians, nurses, and then even techs. I think what I found during our customer feedback was how many physicians would come in, They'd look at the product and they go, oh, I'm not moving patients, I'm not moving any patients. Yeah, that's tough for me. And nurses are finally in a position of power, which I think is great to start saying the same thing of, hey, that's not for me either, and we got to get better technology and there to do that for us. So we are happy to stand again side by side, both physicians and clinicians make sure that the product is being used right, make sure that there's anything in terms of adjustments, accessories, etc. that we can provide. Our goal is plain and simple, we want to prevent our care force from stopping to move our patients manually. It's just not worth it.

John Shufeldt: Very cool, Andrew, thanks. This has been amazing and it should be very inspiring for people who again want to do what you're doing. How can people find out more about the patient company and about you?

Andrew Heuerman: Yeah, definitely. So our website is ThePatientCompany.com, our product page is BetterPatientTransfers.com. So either we'll take you to SimPull, which is the name of our product short for simulated pull. Please reach out to us there. We've got forums where you can reach out to us there. You can also connect with me via email. I don't know if you're going to be able to put that in there, John.

John Shufeldt: Sure.

Andrew Heuerman: I'm happy to put my email, and then also on LinkedIn, pretty active on LinkedIn, which I know John is as well. Yeah, find me, figure out a way to connect with us. Like I said, the product is available now, so really looking forward to getting into users' hands. If you want a demonstration, you want to see the product in person, that would make my day. Reach out and let me come show it to you and your potential staff, looking forward to it.

John Shufeldt: That is, actually, we'll have everything in the show notes, Andrew. Thank you very much for taking the time. I'm sure you're just a little busy.

Andrew Heuerman: No, I appreciate it, John. Looking forward to catching up with you soon. Thanks again.

John Shufeldt: Thanks to you too. Thanks, everybody. We'll be back to you soon. Have a great rest of your week.

John Shufeldt: Thanks for listening to another great edition of Entrepreneur Rx. To find out how to start a business and help secure your future, go to JohnShufeldtMD.com. Thanks for listening.

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