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Have you ever wondered how a simple university project could transform into a revolutionary healthcare solution? That's precisely what happened with Airalux Medical, a promising biomedical engineering startup shaking up the world of incentive spirometry for postoperative patients. Established by Josh Freedman, a bioengineering student at the University of Pennsylvania, Airalux is tackling a problem plaguing healthcare technology for decades: improving patient compliance with breathing exercises after surgery.

From Classroom to Operating Room: The Birth of Airalux Medical

Josh Freedman's journey into healthcare innovation began in the challenging bioengineering program at UPenn. A perfect storm of interests - math, physics, biology, and a fascination with medicine - led him to pursue a degree that would ultimately spark a game-changing healthcare solution. But Airalux Medical wasn't born overnight. During his senior year, Freedman and his team took a unique approach to their project. Instead of rushing to choose a topic, they consulted with dozens of nurses and doctors for an entire month. Their goal? To understand the real-world challenges faced by healthcare professionals every day. This methodical approach paid off. Through their conversations, they uncovered a significant issue with incentive spirometry - a critical but often overlooked aspect of postoperative care. It was this discovery that set the wheels in motion for what would become Airalux Medical.

The Problem with Puffing: Why Traditional Incentive Spirometers Fall Short

To understand the importance of Airalux's innovation, we need to take a step back and look at the current state of incentive spirometry. These devices are given to patients after inpatient surgeries to prevent lung complications such as atelectasis and pneumonia. They're crucial for recovery, but there's a big problem: patients often don't use them correctly, or worse, don't use them at all. Why? The current devices have barely changed since the 1970s. They're clunky, unintuitive, and provide no feedback or accountability. It's like giving someone a treadmill with no display and expecting them to stick to a rigorous exercise routine. Not very motivating, is it? ### Breathing New Life into an Old Device: Airalux's Digital Solution This is where Airalux comes in. Their solution is a smart, digital version of the incentive spirometer that brings this vital medical device into the 21st century. But what makes it so special? The device features a user-friendly interface with a screen and speaker to guide patients through exercises, a smartphone app for patients to track their progress and access educational materials, and a dashboard for healthcare providers to easily monitor patient compliance. It's like having a personal breathing coach right at your bedside, encouraging you every step of the way. And for healthcare providers, it's like having x-ray vision into their patients' recovery process. ### The Uphill Battle: Navigating the Challenges of Healthcare Innovation Developing a medical device as a startup is no walk in the park. It's more like scaling Mount Everest in flip-flops. One of the biggest hurdles Airalux faces is competing with the low cost of existing devices. But Freedman and his team aren't backing down. They've focused on demonstrating value to hospitals in ways that go beyond just the price tag. Hospitals face large expenses when patients develop postoperative lung complications, so the greater price point of the device will reflect only a small portion of the value generated by decreasing complication rates

From Theory to Practice: Airalux's Journey to Clinical Trials

Now, Airalux Medical is taking the crucial step from concept to clinical validation. They're gearing up for a small-scale clinical trial in partnership with the thoracic surgery department at UPenn. This isn't just a formality - it's a make-or-break moment for the company. The trial aims to test their primary assumption: that the digital device will increase patient compliance with breathing exercises. It's a bold claim, but one that could change the face of postoperative care if proven true. Key aspects of the upcoming trial include targeting 20-30 patients over the summer, collaborating with Doctors and their advanced practice providers, and submitting an IRB (Institutional Review Board) application for approval. It's a small step, but one that could lead to giant leaps in patient care if successful.

The Road Ahead: Airalux's Vision for the Future

So, what's next for Airalux Medical? Freedman has a clear vision for the company's future. Rather than trying to build an empire, he sees Airalux potentially being acquired by a larger medical device company after achieving key milestones. These milestones include obtaining FDA approval, building a small sales force, and establishing traction in hospitals. This strategy aligns with Airalux's focus on a specific product rather than a broader platform technology. It's a targeted approach that could pay off big if executed correctly.

Lessons from the Frontlines of Healthcare Innovation

Freedman's journey with Airalux has been a crash course in healthcare technology innovation. Here are some key takeaways for aspiring healthcare entrepreneurs. Customer research is king. Understanding the real needs of healthcare providers and patients is crucial. The healthcare system is complex. Billing, coding, and reimbursement are just as important as the technology itself. Hospitals have competing priorities. Balancing improved patient outcomes with financial considerations is a delicate dance. These insights have helped Airalux navigate the choppy waters of healthcare innovation and position themselves for potential success.

The Bigger Picture: What Airalux Means for Healthcare Innovation

Airalux's journey is more than just a story about a clever device. It's a testament to the power of fresh perspectives in healthcare. By bringing a digital-first approach to a decades-old problem, Airalux is challenging the status quo and potentially improving patient outcomes in the process. Moreover, Airalux's story highlights the importance of bridging the gap between academic research and real-world application. By taking a university project and turning it into a viable healthcare solution, Freedman and his team are showing how academic institutions can be breeding grounds for innovation.

The Human Element: Why Airalux's Solution Matters

At its core, Airalux's innovation is about more than just technology - it's about people. It's about the patient struggling to use a confusing device after surgery. It's about the nurse trying to ensure their patients are following through with their breathing exercises. And it's about the hospital administrator looking for ways to improve patient outcomes while managing costs. By addressing these human needs, Airalux has the potential to make a real difference in people's lives. And isn't that what healthcare innovation should be all about?

FAQ (Frequently Asked Questions)

What is an incentive spirometer? An incentive spirometer is a medical device given to patients after inpatient surgeries to perform breathing exercises. These exercises help prevent lung complications such as atelectasis and pneumonia that can occur due to prolonged periods of lying in bed and the effects of anesthesia. How does Airalux's device differ from traditional incentive spirometers? Airalux's device is a smart, digital version of the incentive spirometer. It features a screen and speaker to guide patients through exercises, a smartphone app for progress tracking, and a dashboard for healthcare providers to monitor patient compliance. What are the main challenges Airalux faces in bringing their product to market? The primary challenges include competing with the low cost of existing devices, demonstrating value to hospitals to justify the increased cost, and conducting clinical trials to prove the effectiveness of their digital solution in increasing patient compliance. How is Airalux planning to validate their product? Airalux is preparing to conduct a small-scale clinical trial in partnership with the thoracic surgery department at the University of Pennsylvania. The study aims to test whether their digital device increases patient compliance with breathing exercises compared to traditional spirometers. What is the long-term vision for Airalux Medical? The company aims to obtain FDA approval, build a small sales force, and establish traction in hospitals. Eventually, they envision being acquired by a larger medical device company with the manufacturing capacity to scale the product.

<p>hello everyone this is Cole from the American Journal of healthc care strategy I am joined this evening by Josh fredman of the University of Pennsylvania and aerux Josh please introduce yourself and tell us what you do hi my name is Josh Friedman I'm a current Master's student in bioengineering at upen also did my undergrad there and graduated last May I am also the co-founder and CEO of ax medical which started as a senior design project in the bioengineering department at Penn and we're now spinning out into a company that's going to be my job for the foreseeable [Music] future that is so impressive that you started that as a senior project and then also the biomedical engineering one of the hardest degree programs it combines that mechanical engineering for I understand which is really challenging but also the medical and biology part what got you into that in the first place back in undergrad yeah so I started out as bioengineering at Penn and kind of liked it the whole way when I was in high school I was always interested in math physics and biology and I was also interested in medicine I would watch these surgery shows with my mom and did some basic nanop particle research back in high school so I thought bioengineering ing would be an interesting major for me when I started college and I went through the intro classes and stuck with it so you started aerux in the final year of your bioengineering program why did you then go for a masters after that I know a lot of people especially those who start companies usually they leave off with the Bachelors yeah so aru started as a senior design project back then it was Inspire and the fall when I decided that I was going to apply for the accelerated Masters program at pen I really wasn't 100% sure what I would be doing after undergrad I was thinking of taking a consulting job I was thinking of maybe maybe starting a company based on the senior design and I really kind of did the Masters first because I thought it would be a valuable degree for me second because I kind of lost a year of school due to co and I kind of wanted to just stick around and experience college for one year and it would also give me more time to utilize Penn's resources and figure out what I would want to do afterwards we were talking about a VC beforehand another one of those pen companies it seems like pen has a really good program for uh startups and Entrepreneurship so I I get why you wanted to take advantage of those resources yeah I want to ask though when it comes to getting a master's degree in the same subject as your undergrad and specifically in the biomedical engineering did you find that the work was valuable that you did yeah absolutely so a lot of the classes that I was taking in undergrad were very technically focused it was like the hard engineering Labs where you used to zap cockroach legs to make them spell out be and all this other crazy stuff so in my masters I was kind of able to Branch out into more of the kind of business side of the engineering classes there's a whole engineering entrepreneurship department at pen which is really really great they have been so incredibly helpful informative to me and other classes within engineering and one outside of engineering that's in Wharton that somehow counts for my degree and it's been really insightful of course that's excellent I would say so especially with the accelerated Masters program at pen they allow you to if you want to take more classes you can get it done in four years without having to pay extra which I would definitely recommend so let's go back for a minute you know talking about that senior design project what did that start that project start out as uh you know I I don't know a lot about the biomedical engineering space I'm not as technical as yourself of course so you know if you can explain what that started out as and then where we are now with things yeah 100% so this senior design programs at pen every engineering will have you kind of work on a year-long project with a group of people so in August when class started I had my group of people and we had to figure out what were we going to do for the next year so I think one of kind of the best decisions that I've made was instead of just kind of picking a topic at the beginning of the class we spent the first month of class kind of slacking on assignments but reaching out to dozens of nurses and doctors and basically just asking them to complain about stuff to us and eventually we kind of picked up on this incentive barometry Pro problem that really resonated with the team and we decided that that was something that we would want to work on for the next few months as we kind of continued working on the technology itself for the class we also completed validation outside of the class kind of talking to doctors and nurses and you know validating that this was a problem worth solving and we kind of got more and more positive feedback the team and I decided that this would be something that would be interested in continuing even outside of the scope of the senior design class so what is that exact problem that they had so right now basically every single patient who gets an inpatient surgery where they have to stay in the hospital will get a device called an incentive spirometer when you have one of these surgeries you've been anesthetized and you're kind of lying in there in the hospital bed for days after surgery and that can leave your lungs prone to complications such as atelectasis pneumonia and things that can lead to reintubation and a whole host of complications so to prevent that hospitals give you this incentive or therapeutic spirometer and you're supposed to do breathing exercises with it they tell you every commercial break it's around like every 10 minutes to kind of reinl your lungs the problem is that a lot of patients aren't actually doing these exercises for a number of reasons they don't understand why they need to do it they don't understand how to do it they know that there's not too much accountability and then on the provider side they really have no way to tell whether or not the patients are doing these exercises besides going in and asking them and we've heard a lot of times they'll say yeah I was doing them when the device is still sitting in the plastic or kind of nowhere near that yeah so that's kind of the problem that we set out to solve with our Innovation it kind of seems like it hasn't been something that people have really worked on for many years it seems like it's a very old technology right I'm I think the original incentive perometer was patented in the 70s or 80s and it's kind of just been the standard of care since wow so what are you doing differently what was the design that you guys made that clearly went very well when you showed it to clinicians yeah so what we've been working on is kind of a smart digital version of the incentives barometer we have a handheld device that's in a much neater form factor than the kind of clunky standard of caroan that has a screen and a speaker both to kind of guide the patients through the exercises instead of just dealing with the piece of plastic where they're not getting much feedback we also have a smartphone app where patients will be able to see their progress over time and also see kind of educational videos and anything else they might need on there and the providers will have a dashboard where they can easily see all of their patients and they can tell like you know look hey Cole you're not doing your exercises you know are you in pain do you need anything wow very impressive so what I'm wondering about that is is this also you know are you looking at this being in every hospital is this going to be in home health what are the different areas that this kind of product is going to be used in yeah so the workflow that we're currently envisioning is very similar to the regular incentive perometer so they give it to you after your surgery you do exercise with it while you're staying in the hospital and then it gets sent home with you where you can continue to do the exercises but it's a little less crucial once you go home and it's the same idea with our device they'll get it after their surgery they'll hopefully do their exercises more often than they're currently doing them and then they'll be able to take it home afterwards and if they need to continue doing exercises they'll be able to wow and so does that mean you have to get it low cost enough right where they're able to take this device home are they going to return it afterwards yeah so that's kind of one of the biggest challenges with the device that we're coming up with is we're competing against a $2 piece of plastic so we really need to rationalize the increase in cost that's going to come from digitizing it right now we're looking at around a $100 price point which is based on the amount of value that we'll be providing to the hospitals the way we rationalize it is hospitals have this Baseline rate of post-operative lung complications which cost them a bunch of money because these inpatient surgeries are generally paid for through an insurance package called a drg which is a flat rate so any additional care is going to end up getting footed by the hospital so when a patient gets one of these complications a lot of the time the hospital can end up footing the bill so we're saying we're going to increase the probability of those complications by a certain percent by getting patients to do these breathing exercises so there's kind of an expected Savings of so far we have around $500 per patient so we would be paying a $100 of that for our device and the hospital would be getting an 80% margin of that well that is a impressive margin for a medical device that's not common in in the industry so that's that's excellent how did did you figure out you know was that something that when of your teammates were involved in or were you guys all working on it how to get the costs down because I assume when you were building it initially the costs on the device were probably quite High your first prototype yeah so the costs for our first prototype building the unit itself probably was around $80 with all of the components wow what we've been doing now is kind of gradually finding more efficient component on that will still get the job done but of don't include as much unnecessary features and kind of technicalities that we don't need and we're hoping that once we would move this device into mass production instead of a bunch of college students soldering it together in a lab we could get that cost down even more of course and then you're able to pay for the development of the programs wonderful so does it plug in to systems like epic and Cerner what does that dashboarding look like exactly yeah So currently we have our own app which is going to make it easier for us to Pilot the device in the near future integrating with epic is not particularly easy for a bunch of bioengineering college students so we've definitely been told by doctors and nurses that it would be very helpful for them to just be able to go into epic and see this data without switching windows and fumbling into an app So eventually that's something that we would want to support but right now now it's kind of just a small dashboard on the app itself where you see all the patients how many exercises they're doing if they're successful in those exercises and then you can kind of use that information as you will but all that of course goes into where you guys are now I think we were talking about before the show started that you're just starting to do a a clinical trial on this device right can you tell us about what that's looking like yeah so kind of one of the biggest assumptions of this business right now is that this fancy digital device with all of its bells and whistles is actually going to be able to get patients to do more of the breathing exercises that's our biggest assumption right now and when we've gone out and spoken to investors that's kind of one of the biggest reservations that they've had so kind of the main way that we would be able to test that is just by getting it into a few patients hands and seeing if they do more exercises we have some Partners in the thoracic surgery department at Penn Dr D jar and pecket as well as a few of their advanced practice providers that work in the thoracic surgery department so we've had an introductory call with them they were pretty excited about the device and right now we're in the process of writing up an IRB that will submit hopefully we'll get approved and then they'll be able to try the device on some of their patients and see how many exercises they're doing how how long do you think until we're going to be able to see these results we're hoping that it'll be over this summer we anticipate filing the IRB in the next few weeks it should be expedited so hopefully it'll only take a few weeks after that maybe some back and forth and the device development since it was a senior design project we've had a mostly functioning prototype basically since last April so we'll be able to go into the lab and get some of those made ourselves pretty quickly once we need to wow and then they see around five eligible patients per week and we're kind of targeting 20 or 30 in this small study just to see if they're doing more of the exercises so hopefully we'll have some data this Summer that would be excellent I'm excited to see what the the results of that are I'm sure you're very very excited about that what led you to actually because you know I'm assuming there's some risk involved in this you don't have unlimited time and you know you could have gone into maybe consulting or something else you know Consulting especially for biomedical right now is pretty lucrative especially coming from pen so why did you choose to do this over doing something that you could have made a lot more money or had a bit easier go of things yeah there are a few reasons I think one part of it is definitely the passion like I really enjoyed doing this as a senior design project and I do think it's a real problem and it a large Market opportunity and it's a possibility to benefit a lot of patients with a superior device so I really wanted to help with that I think this is going to be a great experience for me even if it doesn't go well I'm hoping it does I'm still going to learn a ton and I'll hopefully have decent exit opportunities no matter what happens with Hera what are some of the biggest things that you've learned during this experience you mentioned that the the lessons and the information you've come away with has been very valuable for you I'm sure other organizations are probably going to look at your resume that way as well what personally do you think you've really learned from this experience that you're going to take with you to all of your future rules yeah I think some of the most important things that I've learned to date I think with any business it's extremely important to talk to customers and know your customers so that you're making sure that you're solving a problem that really exists and kind of ensuring product Market fit because I think that's one of the biggest thing that can kill businesses and I think a lot of kind of firsttime entrepreneurs make the mistake of not doing enough research on the market spending a bunch of money developing a product that no one's actually interested in so I think that's probably the biggest thing I've definitely learned a lot about the Health Care System itself in terms of kind of how things are done billing and coding what hospitals care about you know is it better outcomes reimbursement all those things that I think will kind of give me more insight into you know a future career in healthcare either from the investment side or from the entrepreneurial side I was just going to say how did you learn your customer how did you come to know your customer we participated in the VIP accelerator through Venture Labs at pen and they really pushed us to do a lot of customer Outreach to date I think we've spoken to around 50 doctors and nurses by literally just cold emailing people setting up interviews and then really just asking them open-ended questions not trying to lead them with our product we purposely talked minimally about our product before interviewing them so that we could get a real honest opinion from them on their current workflow how things are done kind know what problems they're experiencing what they care about and then going from there talking minimally about the product so you can get honest feedback is is very important I found that especially when you share an institution with someone some sometimes they're very excited for you to succeed and so they might you know give you the idea that it's more successful than it actually is no one wants to call your baby ugly exactly oh that's great very very good so that's excellent where do you see if everything goes well the future of this going is this a company that you think is going to get acquired or is this an organization where you'd like to build it out and maybe even come up with more medical devices I'm thinking personally that since this isn't really a platform technology it's kind of just one main idea we've filed a provisional patent application for it hopefully converting that soon we would build out this device get FDA approval maybe build a small Salesforce to get it in a few hospitals and build some traction and then eventually you know get it acquired by a larger medical device company that has the manufacturing capacity to really scale it absolutely that makes makes a lot of sense well congratulations Josh on everything that you've done so far it's very impressive it's inspiring for me to hear I'm sure our audience is also um going to like this as well so I really do appreciate your time today thank you for coming on thank you for having me</p>

Airalux Medical's Journey: Transforming Postoperative Care

Transforming Postoperative Care: The Journey of Airalux Medical and Joshua Freedman

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