Did you know that patients undergoing physiotherapy often stop their rehabilitation program because they don’t want to inconvenience their caregivers who take them for appointments? Physiotherapy involves many sessions stretched over a long period. Besides, recovery requires equal participation from the patient, who must strictly follow the therapist’s program. XCLR8 has developed wearable sensors and applications for orthopaedics and physiotherapy patients. “Using this technology, we’ve created a surveillance tool to monitor patients through their rehabilitation process remotely,” explains Lincoln Dacy, Co-founder and CEO, XCLR8.
Connecting Patients to Their Therapists Remotely
Patients mount the motion sensor to the limb they’re working on. It captures data in real-time and sends it to the application on their phone which supports them with a visual description of how they’re doing their exercises. “We worked with senior citizens to make sure the technology is easy enough for any patient over 60 years to use,” says Dacy. In addition to capturing the patient’s compliance to the program, the sensor also sends the data to the therapist’s web platform enabling them to monitor the patient remotely. “The therapist can look at this and intervene if there is an issue. For example, if they’re short of breath, their blood oxygen levels are too low, or they’re suffering massive fatigue levels, the system will stop them from doing the exercise,” explains Dacy.
The technology aims to reduce hospital visits of patients undergoing physiotherapy, making it more affordable and accessible. The collected data also enables therapists to make better and informed decisions. “Earlier, when they enquired about the patient’s pain or difficulty levels, they assessed it based on other patients’ feedback. They didn’t have the tools to gather the right data points to make a proper assessment,” says Dacy. Therapists have also been able to identify several tell-tale signs. “We’ve been able to intervene before there’s an issue,” he adds.
With customers in Egypt, Australia, Malaysia and Hong Kong, XCLR8 recently received HSA approval as a registered medical device in Singapore. “We have the clearance to do clinical trials inside SingHealth and NUHS healthcare clusters,” informs Dacy, who is confident that the approved research collaborations will lead to mass clinical adoption. The startup has trials coming up with SGH for pulmonary rehabilitation and NTFGH and SKH for knee osteoarthritis. “Our goal is to keep patients outside the hospital and find out whether we can give them the same level of care in a way that’s safer, faster and cheaper,” says Dacy. XCLR8 also has trials lined up at SKH for shoulder injuries.
Besides hospitals, the Singapore-based startup is also working with insurance and corporate partners for patients with chronic pain in the knee, shoulder and back. XCLR8 has developed home exercise therapy sessions for chronic pain management. “It’s at a very early stage, but we have been getting many enquiries for this because the costs associated with workers compensation are one of the highest related to the physiotherapy industry,” says Dacy. The company’s focus is currently on knee, shoulder and spinal injuries. “These have a high volume of patients coming through the hospital, and we want to look at the 90% of patients that can benefit,” says Dacy. He adds that focusing on these areas also receives a lot of support from hospitals and their internal staff. “By working with our technology, it allows the therapists to allocate time to more complex cases.”
When Dacy was enrolled in a Masters program at SMU, his mother back in Australia had a stroke, and he couldn’t be involved with the caregiving cycle. The experience inspired him to look for ways technology could create access for people in similar situations. The project began three years ago as part of his Master’s thesis. When it received positive feedback, the co-founders decided to continue developing it outside the school. While Dacy is more hands-on with the startup’s day-to-day operations, its other two co-founders are involved financially. The 13 member team includes full-time developers and part-time medical advisors. Spine, knee and shoulder specialists help the team develop medical protocols and clinical validation studies.
Challenges of Navigating the HealthTech Industry
What Dacy thought would be a simple project turned more complex and challenging to navigate than he expected. “If I were to start again, I probably wouldn’t have started a digital health company,” he confesses. Dacy realised that creating the product is the easiest part. “To go through the regulatory system at the hospital and government level, to get all the approvals and different departments coordinating together is much more difficult,” he says. “Not to mention trying to sell a product that nobody’s heard of or thought there was a problem. We have to go out and change an entire industry paradigm to get the product accepted.” As the founder of a healthtech startup, Dacy highlights the importance of finding early adopters. “Support from healthcare providers is helpful because they fight internally to push the product through the healthcare system and get approvals.”
Dacy has found it easier to do business in Australia than in Singapore from the perspective of getting approvals. “Singapore is an excellent stepping stone. It’s easy to set up your business, and there’s a lot of government support, but there are a lot more processes you must follow,” he says. Relatively, in Australia and Malaysia, he’s found people’s mentality makes it easier for a healthtech business to move forward. “You can start clinical trials much faster. People are willing to try first before they go through the whole process of getting approvals,” notes Dacy. Since paperwork can take up to a year to get through, the small-scale trials in controlled environments allow startups to build new technology to learn faster and improve. Trialling the product offshore has enabled the company to accelerate its growth. “It proves the potential of our product, and they get the belief to work with it.”
Now that he knows how long and complicated the process from conception to clinical adoption can be, Dacy advises aspiring healthtech entrepreneurs to think about some pertinent questions before beginning. “Ask yourself whether you can convince the people around you to become your early team. You have to think why you’re passionate about it and what will make you pull through when things don’t go as planned,” he says. His biggest advice is not to be afraid to show your product to people. The early feedback proves beneficial in developing a user-centric product. “Don’t worry what they think of you. With each meeting, you learn something new which takes your product a step closer to the market.” It’s also crucial to have a strong support network. “It becomes all-consuming, so you have to make sure your family and loved ones support you on this journey because it affects them as much as you.”
Sources of Motivation and Guidance
Despite the industry’s challenges, the opportunity to make people’s lives better is what Dacy likes the most about healthtech. “Each time we bring on a new patient, we’re enhancing their quality of life, their recovery process and starting to get better patient outcomes. It is very satisfying to me how using simple technology like sensors and integrating to collect data has been able to help people in many different places,” he says. The entrepreneur tackles the stress by making sure he disengages from work a few times a week. Walking down the river in Singapore or canoeing around the islands of Sentosa with his phone turned off helps the CEO clear his mind. “I find it very therapeutic to listen to the waves and winds with nobody around,” says Dacy.
A piece of advice from his dragon boat coach helps Dacy in all areas of his life, including business. “When I asked him how do I go faster, he told me just to pull harder,” says Dacy. “When you don’t know what to do or whether you’re going fast enough, all you can do is pull harder and keep pushing. You can’t sit back or wait for an easy fix.” He credits his early business lessons to Rich Dad Poor Dad by Richard T Kiyosaki. “It teaches you a lot about managing money and what it takes to be a business owner as opposed to being an employee or self-employed,” says Dacy.
XCLR8 is excited to be a part of the Galen Growth HealthTech Cohort for the opportunity to meet other startups. “I’ve reached out to a few startups to see what they do and if there’s a chance to collaborate. You introduced us to a big corporate which helps us with visibility,” says Dacy. However, he points out another critical advantage. “Being a part of the Cohort gives you a kind of stamp of approval in the digital health industry. It indicates that you’ve reached a certain degree of development.” The entrepreneur believes this is particularly useful when you’re approaching the industry with new technology. “Most people in the industry know Galen Growth, so if you’re in this Cohort, they believe it’s worth giving you time for a pitch,” he notes.
[Originally published by Galen Growth in July 2021]
