Sunday, August 14, 2022

Exclusive - Global Health Tech Platform, Proximie Digitizes Operating Rooms

Digitizing operations and diagnostic rooms have become necessary as the world accelerates its pace to accommodate the global shift towards digitalization. Digital transformation in healthcare has become one of the main pillars driving innovation in the health sector. It creates a robust foundation that will positively impact technology on human lives.

Proximie, the global health technology platform digitizing operating rooms (OR) from all around the world, provides clinicians with the proper means to virtually interact with each other in a way that mirrors the same experience of collaborating under one roof. With the incorporation of live-virtual alliance with mixed-reality (MR) technologies by using artificial intelligence (AI), machine learning (ML), and augmented reality (AR), Proximie is delivering a reinforced approach to remotely interacting in a live protocol to furnish a solution tailored to accustom to the needs of high-end hospitals.

Inside Telecom sat with Proximie for in-depth analysis with founder and Chief Executive Officer (CEO) Dr. Nadine Hachach-Haram to highlight the company’s inception, the role of the COVID-19 pandemic in accelerating the healthcare sector’s needs of its technology, collaborations, and the role of the rising fifth-generation network (5G) will have its futuristic growth.

INSIDE TELECOM: Could you please introduce yourself, Proximie, and the Eureka moment that led up to the company’s inception? 

Dr. Hachach-Haram: My name is Dr. Nadine Hachach-Haram, and I’m the CEO and Founder of Proximie. I am also a Consultant Plastic Surgeon and Head of Clinical Innovation at Guy’s and St. Thomas’ NHS Foundation Trust in London. 

There were two Eureka moments for me really; the first one came when I decided I wanted to become a surgeon. The second came when the idea for Proximie was born.

Growing up in postwar Lebanon in the early 1990s definitely shaped my desire to become a surgeon. Seeing the human impact conflict exacted on my homeland had a profound influence. You would see a lot of deformities, people with arms and legs injured and missing. Things that perhaps you shouldn’t see as a teenager. I look back at devastating events such as the Qana Massacre in 1996 as a pivotal moment. My Mum’s family is from Qana, and we used to spend our weekends and summers there. At that point, I started to get interested in the ability to help patients and to look for opportunities. Soon afterward, when I was 14, a family friend who was a plastic surgeon was going down to Sidon (a city 40km south of Beirut on Lebanon’s Mediterranean Coast) to do some reconstruction for some young trauma patients who had deformities in their legs from burns, contractures, and blast injuries. He was probably a bit surprised I wanted to go with him! But he was willing to take me, which was great; I owe him everything for that. I still remember the day. I saw him operating on these children, and I think at that point, I just knew that this was what I wanted to do. I was mesmerized. After that, I wanted to see what was going on any time I could get into an operating room. Even now, I still love it. It’s very humbling when you are in an operating room, the patient is asleep, and you have a team around you trying to make a positive difference in a patient’s life.

Once I became a surgeon, I spent ten years working on global health initiatives around the world. During that period, I definitely found myself feeling like I simply wasn’t doing enough. You start to look back and see what impact you’ve had and how much you’ve actually been able to scale expertise or support independent delivery of care locally. When I looked at the Lancet Commission that revealed five billion people in the world lack access to safe surgery, I realized that we were only scratching the surface. That it was really about building scalable, sustainable models of support and delivery, so I started to look at technology, and the idea for Proximie was born.

I founded Proximie based on the ethos that shared knowledge leads to accelerated learning and better patient care. Proximie was built to allow experts to virtually scrub into operating rooms and cath labs around the world, to support, coach and mentor each other, and to really look at the continuum of expertise throughout a surgeon’s career. I had been exposed to early-stage telecommunications platforms, but all of them are anchored to one moment in time. One meeting, one call, one conference, but then it’s gone. The options available did not enable a continuum of sharing knowledge and expertise, and they were too passive. You can’t do remote surgery in 2D. It has to be more immersive than that. What we wanted to do with Proximie was to create a multi-sensory experience that was a catalyst for collaboration and could digitize a surgeon’s footprint.

We wanted to extend the geographical reach of a surgeon and create the effect of a borderless operating room that could empower physicians to remotely share knowledge that could ultimately reduce variation in care and help save lives.

INSIDE TELECOM: Not many people, companies, and industries can say that the pandemic was an accelerating force in their development; based on that, you could give us some highlights of how the global health crisis affected Proximie? What were some of the challenges faced during the pandemic? 

Dr. Hachach-Haram: There is little doubt that the complexities posed by COVID-19 have been unprecedented and that the pandemic has had a profound impact on the way healthcare is and will be provided. It has tested the capabilities of healthcare systems all over the world, which has compelled pragmatism, collaboration, and innovation in order to try and meet the varied challenges presented by this viral pandemic.

Necessity is the mother of invention, and we have seen how COVID-19 has forced innovation at a pace that was previously unthinkable. The urgency that was needed to try and combat COVID-19 has been a catalyst for incredible collaboration. We have seen the blurring of lines between the private and public sectors for the greater good. This has certainly been the case at Proximie, where we have been deployed around the world to remotely connect surgeons and healthcare workers in the battle against COVID-19. As a frontline NHS surgeon, myself, I’m immensely proud that we have been able to help in the acute phase of the pandemic.

One of the key facets of why our platform has been used all around the world to battle COVID-19 is due to the way we designed Proximie. It was designed from the outset so that it would never be a siloed product. It has now been used in every surgical specialty and can extend across the whole surgical industry or ecosystem within a hospital. That software-first approach has enabled us to quickly layer on really exciting new technologies, and to the broadest user base possible, at a time when people have desperately needed to work efficiently, remotely. The key is accessibility. Proximie needs to function in a wide variety of geographical areas, social contexts, and environments, but also be malleable to innovative ideas, technologies, people, or hardware companies.

The pace of innovation tends to be quicker in software than hardware. It’s important to remember that a software-first approach means that we can continue to innovate and adapt quickly to the needs of our customers, delivering value on a continual basis. This doesn’t preclude us from integrating into existing hardware in the operating room, and this is no mean feat to be able to integrate with older pieces in some parts of the world and the latest machines like robots in others.

That software-first approach means we have been able to form the basis of a responsive approach to some of the challenges being posed by COVID-19. Due to the virus, there has been an urgent need to incorporate integrated technologies into routine or complex practices because of the requirement to find ways to seamlessly maximize healthcare resources, scale the delivery of expertise and reduce the transmission of the virus.

In many respects, Proximie was built for a pandemic of this nature. From enabling self-isolating clinicians to remotely support colleagues on the front line to virtually connecting MDTs for hand trauma and cancer management so that every clinician can connect and collaborate off-site during COVID-19. We are finding new ways to apply our technology to amplify the skills of frontline clinicians. For example, at the tail end of last year, at the height of the Omicron variant, a globally respected interventional radiologist from the University Hospital of Strasbourg virtually scrubbed into proctor a series of Cryoablation procedures that took place at Guy’s and St Thomas’ NHS Foundation Trust. Was it not for Proximie, and these important cancer procedures would have been postponed? To read about some of the innovative ways clinicians have harnessed Proximie, read here.

Proximie has also been used extensively for training purposes, to democratize surgical skills and techniques remotely, while access to travel and operating rooms has been restricted.

A recent paper, published by Dr. Albert Hajj in The Journal of Urology, concluded that Proximie “allowed more flexibility in patient scheduling and reduced travel costs with similar outcomes” compared to face-to-face, and I think we’re increasingly seeing this during the current pandemic. Proximie is being used to enable surgeons to stay connected, stay safe and collaborate from a distance. This is obviously critical as we continue to try and stop the spread of COVID-19. Surgeons have been looking at ways they can limit physical numbers in operating rooms yet increase clinical expertise.

I think COVID-19 was a catalyst for the rapid adoption of Proximie and many other technologies, but what’s most exciting for us is that our platform is now being hardwired into clinical pathways all over the world, and that is only going to benefit the patient.

It’s certainly not going to dissipate once the world has successfully battled COVID. If anything, their use will become more habitual as we layer on new technologies.

INSIDE TELECOM: 2021 has surely been a positive hectic year for the company, as Proximie partnered with Vodafone UK on a 5G remotely assisted surgery trial with Cardiff and Vale University Health Board. Could you tell us about the benefits of this partnership? 

Dr. Hachach-Haram: Having the best connectivity is imperative for delivering digital health services at scale. This was one of the main motivations for partnering with Vodafone – Europe’s leading mobile network provider. 

Building on our existing partnerships with digital infrastructure providers in the operating room, the Vodafone partnership has increased our access and allowed us to provide complete, connected surgical care to a wider audience.

INSIDE TELECOM: How will 5G continue to impact the company’s core technologies positively? 

Dr. Hachach-Haram: In this space, we know we can’t be static, and we’re always looking at new and innovative ways to serve our surgical community better. One area of perpetual focus is connectivity, which is a central theme to everything we do at Proximie. Today people die unnecessarily without access to simple surgery, in both the Global North and the Global South. If you can solve the global connectivity issue, we know we can redress the inequities in healthcare that exist all over the world. We know that today people die unnecessarily without access to simple surgery; in both developing and developed nations. By solving the issues that can compromise a surgery in any area of the world, such as not being able to access the right clinical skills or the right equipment, we can help to ensure that the 300 million-plus surgeries that happen each year can be delivered in a consistent way, and in a way that helps to save lives.

We need to increase our capacity to deliver better, quicker care and further than ever before. It’s incumbent on us to continue to push the boundaries of what is possible in an operating room and harnessing the power of 5G will certainly help us do this. For example, our recent partnership with Vodafone Business enables us to layer on the best of their innovative technologies – from 5G, IoT, and Edge Computing – onto our software, allowing us to play an even more proactive role in democratizing access to safe surgery.

We believe Proximie is perfectly positioned to harness the powers of new technologies, from 5G to SpaceTech, and channel them directly into operating rooms all over the world. To empower physicians with real-time insights and data and enable them to create better patient experiences. The ingredients for better-connected healthcare systems are right in front of us.

5G undoubtedly has a huge role to play in creating better-connected healthcare systems. It has the power to ensure the best technologies and innovations are made more freely accessible to patients all over the world, eradicate low latency, and continually improve patient outcomes.

By integrating connectivity technologies such as 5G and Space Technology, we can revolutionize healthcare and make it more efficient, effective, affordable, and, most importantly, accessible. Proximie is ideally positioned to harness the power of 5G and direct it into operating rooms all over the world to do just this.

INSIDE TELECOM: How many countries is Proximie dispatched in? Is there a specific market in which you’re looking to grow other than the U.S. and EU? 

Dr. Hachach-Haram: Proximie has conducted tens of thousands of surgical interactions and is deployed in 500 hospitals in 50 countries on five continents. We have also continued developing partnerships and contracts with over 40 major medical device companies and have access to 90 percent of operating rooms and diagnostic suites in the UK, US, and EU.

INSIDE TELECOM: According to your company, the software is provided free of charge to charities. How are you looking down on these efforts and spreading the use of Proximie’s technology to countries with a weak medical landscape? 

Dr. Hachach-Haram: The important thing for me is that access to safe surgery is not the reserve of a specific region in the world. Variation in care happens in high-end hospitals in the US, as it does in rural, one-bed hospitals in the middle of the desert; I think sometimes people think this is a Global South problem. It really isn’t. The Lancet Commission revealed that five billion people in the world lack access to safe surgery, so everything we do at Proximie is about accessibility. What we’re really talking about is building scalable, sustainable models of support and delivery and getting our platform into the hands of as many people as possible. We want Proximie to be as ubiquitous as a scalpel, with the ultimate goal being the Operating System of the Operating room. That means in every single healthcare system on the plant.

Leveraging private-public partnerships bring together powerful innovations and well-designed delivery models that are critical to addressing gaps with inequitable access to safe surgical care; we are incredibly proactive about trying to find the right partners to collaborate with in order to help provide better access to our platform. In addition to working with the NHS in the UK, in December 2021, we were proud to announce a new partnership to transform Kenya’s safety and quality of surgical care. We teamed up with Jhpiego, a global health non-profit and Johns Hopkins University affiliate working in +40 countries, to implement the Johnson & Johnson-funded Obstetric Safe Surgery Project in Kenya.

The aim of the project is to support the Kenyan government’s commitment to reduce maternal and newborn deaths and obstetric-related injuries by improving the quality of caesarean sections. In Kenya, 71 percent of facility-based maternal deaths are associated with caesarean sections, and 90 percent of maternal deaths are linked to poor standardized care.

Our technology is helping to expand and enhance the learning by obstetric surgical teams and provide mentorship in Jhpiego’s project, which is now underway in five hospitals in Makueni County. By helping to virtually train and mentor surgical teams in Kenya via real-time, remote consultation, we are feeding best practices into Kenya’s health ecosystem and providing better patient outcomes.

INSIDE TELECOM: Earlier in September, Proximie partnered up with Teladoc Health to connect operating rooms globally; what was the incentive that led to this collaboration? And are there more partnerships on the horizon? 

Dr. Hachach-Haram: Teladoc Health is the global leader in whole-person virtual care, so we were delighted to announce our partnership in September 2021. It forms part of our wider partnership program to strengthen the health ecosystem and further our ambition to connect operating rooms globally.

It is a global agreement, focused initially on the US market, which sees our software integrated into Teladoc Health’s Solo platform for hospitals and health systems, enabling an integrated experience for surgeons.

By layering our software into Teladoc’s platform, we are delivering a connected surgical care experience where operating room devices can communicate effectively with each other and capture valuable insights that will provide feedback to both surgeons and the broader health ecosystem.

We are continuing to explore and develop partnerships and trial new technologies. Collaboration is central to driving meaningful and impactful change. From the outset, we wanted to ensure Proximie was not static or a siloed product. We are keen to involve the best thinking from other sectors to support our mission and expect to announce some exciting partnerships throughout 2022 – which we kicked off with our partnership announcement with Vodafone’s Centre for Health with Deloitte. 

INSIDE TELECOM: As Big Tech companies look to continuously invest into virtual reality (VR), Augmented Reality (AR), Artificial Intelligence (AI), and Machine Learning (ML) capabilities to foster a metaverse. What can Proximie take from these endeavors to further develop your offering? 

Dr. Hachach-Haram: I think Proximie is at the epicenter of some fascinating developments, specifically how technology is being harnessed in order to provide better care. Surgery is adapting and evolving before our eyes, and Proximie is playing a central role in its evolution, both now and in the future. As a practicing surgeon myself, that’s hugely exciting. We wrote the commission on The Future of Surgery a couple of years ago, which looked at what it is going to look like in the next 5–10–15 years, and we’re already seeing how it is becoming more connected, more data-driven, and increasingly amplified through different technologies and mechanisms that exist. The patient surgeon interface is changing so quickly, and as we layer on AI into different applications, having access to real-time insights will improve patient care.

I’m really passionate about innovation in healthcare and how we can leverage technology to improve the care our patients receive all over the world, so I would always encourage anyone with a good idea to follow their instinct and go for it. But the key thing for me is the purpose behind the technology. What are you trying to achieve, and what problem are you solving?

Disruption in healthcare has many challenges, but I can say with experience that if it is really solving a problem, then adoption can be swift and decisive.

I think there are a number of ways the technologies you mentioned can have a positive impact, but equally, I’m always quite wary of new technologies that can be overhyped and fall into that ‘tech for tech’s sake’ category. I think we need to ensure that any of these new digital health technologies have a clearly defined role and purpose in relation to the patient.

To be honest, I’m really not that interested in imagining a dystopian future that has been visualized in science fiction books, particularly if it’s going to replace real-world experience, patient experience, and patient-centric care. This is one of the reasons that from the very beginning, we wanted everything we do to be evidence-based. Proximie has been clinically and scientifically validated in 20-odd independent research papers.

We have moved past the novelty phase of a lot of these technologies, so now is the time for any existing or new entrants to the market to show genuine, real-world usefulness. Not a gimmick or fad, but tangible evidence that the technology can help us create more efficient and scalable models of healthcare delivery.

It’s one thing to have a great piece of technology, and it’s another thing to have the necessary skills to implement and integrate them into complex healthcare settings, which can be incredibly varied worldwide. Proximie was born out of a need, and my ambition as a surgeon was to find a solution and scale it is using technology. I wanted to try and create a solution that could empower surgeons to collaborate in real-time in a very visual and engaging way. We talk a lot about “by surgeons, for surgeons.” So, we designed the platform to be used in austere environments, which is why we are currently used in developing nations and by the UK military, connecting field hospitals with NHS surgeons to provide better care for front-line military personnel. Accessibility, affordability, working at low bandwidth with existing or easy to resource hardware, all of these elements were factored in with the end environment in mind, which is crucial. Proximie can secure approval for use in a new hospital within three weeks because we know and understand the environment. I’m not sure that is the case with every mover and shaker in the VR, AR, and MR space. I think having our mission and purpose at our core has been integral to our subsequent growth.