John Collins holds over 20 US patents on new products and manufacturing processes and spent his career as a leader in technology-driven businesses. At CIMIT, he has accelerated more than 600 start-up projects and he shared some lessons learned through this process with the d·HEALTH Barcelona fellows on their Graduation Day.
When most people think about medtech, which is a very common description, they think of devices. And what we're finding in today's world is a clear blurring of the lines between devices, apps, diagnostics and Big Data. It’s kind of hard to think about a device that isn't using data in one form or another, so we thought it was important to move away from the classic description. The term HealthTech is more inclusive now and it’s a good description of where the engineering world and the medical world come together versus the pharma side, which tends to focus more on the life sciences.
You can never stress enough the importance of making sure that you're focusing on a real and important unmet clinical need. Ask yourself: “Who is going to buy this product?”. Unfortunately, the reason I think this one is so important is that so many times technology is coming out of academic arenas where projects are selected based on technical merit and uniqueness, not necessarily on their clinical need. A recent poll of over a hundred start-ups that failed showed that the number one reason was the lack of customer demand in 42% of them. It’s amazing.
People don't listen to customers, and this is our second top lesson. It sounds like a simple thing to say, but a lot of times it's not done. Particularly, people coming from academics are used to advocating, so they'll go and talk to customers. Well, you don't talk to customers; you listen to customers.
And the third lesson is that we keep stressing the importance of practicing informed, rational persistence. The healthtech journey is a long, complicated process. It has a lot of ups and downs and you really have to be prepared for some down times.
I don't really agree that there's an overabundance of start-ups because there's an overabundance of problems that need to be solved. So the question is, why aren't we doing a better job of solving those problems? And here is where we keep going back to people not understanding the nature of the problems.
It used to be easier before. Imagine we had a surgical procedure that needed a device to do a certain thing, we could solve it and see the surgeon as the buyer. That was great, but in today’s world work is being done in different workflows and if you want to have an innovation it’s got to sit within the system. If you’re going to improve something, you need to make sure there isn’t a bottle neck upstream or downstream that prevents the actual benefit from coming to fruition.
There’s a ton of unmet needs in the healthcare sector. I would say that we need solutions that simultaneously improve quality of care, access to care and reduce its cost. Those are the ones that are going to work and covering one of the three conditions isn't enough; you have to hit them all. And that’s not an easy task.
Undoubtedly, one of the key trends I'd highlight is the imperative to cut costs. Everyone is under cost pressure, so the more direct the cost saving is, the more attractive it's going to be for the buyers and clearly for investors that are looking for high reliability. Start-ups should take advantage of the increasing amount of data and personalized solutions that can be tailored to the exact situation they are dealing with.
Start with a really good problem. It's better to be working on a big problem and have a partial solution than have an ideal solution for a small problem. And also make sure that you understand what the workflows are so that the solution you're providing is adequate. Unfortunately, it's not rocket science: it's easy to say and very hard to do.
It's always hard. A very important element of being a successful entrepreneur is networking and being part of the ecosystem. And that takes time. I think it’s very difficult to go to a new setting and try to raise funding. A lot of the networks are friends of friends. Business angels see a thousand ideas a year and maybe invest in just ten of them. Very few of these ideas are earth shattering so how do you differentiate? The only way that happens is through trust and relationships.
One of the things we're trying to do at CIMIT is to connect some of these ecosystems. Frankly, physical proximity is less important than relationships because you can have contact worldwide. I've seen teams scattered all over the globe, particularly where small teams are taking advantage of government programs to have development sites in one country and sale sites in another. That's something I'd probably try to figure out if I was a Catalan start-up that wanted to sell in the US: how to start pooling that network and then take a look at other places in the world where there is access.
Yes, and many start-ups in the US are really frustrated dealing with the FDA. Everyone completely agrees with a rigorous review process, but they’d rather have a predictable one and that’s not happening in the US. This adds risk and investors don't like risk. Hence, a lot of times we're suggesting that start-ups look elsewhere, where the regulatory process is more straightforward: not easier, just more predictable. The EU is an obvious choice and some places like Brazil or Australia are also good options.