EVOTECH: Improving Access to Minimally Invasive Surgery through Low-Cost Endoscopy

EVOTECH: Improving Access to Minimally Invasive Surgery through Low-Cost Endoscopy

Uganda
Organization type: 
for profit
Project Stage:
Start-Up
Budget: 
< $1,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

We want to make it affordable for doctors to perform minimally invasive surgery (MIS) in resource-poor hospitals in the developing world. This would allow operations such as the repair of complex obstetric fistula without the use of general anesthesia, and reduce recovery times from weeks to hours.(For more about fistula see http://nyti.ms/4gANn8. For more about MIS see http://bit.ly/8WinZQ)
A major bottleneck to the use of MIS by resource-poor hospitals is the cost of imaging equipment (currently upwards of US$70,000). Evotech has developed an imaging system that costs less than $3,000 and plugs into any laptop computer. We are currently testing the device with traveling doctor organizations, and plan to introduce it more broadly once it is perfected.

About Project

Solution: What is the proposed solution? Please be specific!

Existing endoscopy systems cost upwards of $70,000, weigh over 100kg, and require specialized parts and labor to repair. In the developed world, this is not a problem, as hospitals have easy access to capital, leasing, and well-developed infrastructure. However, resource-poor hospitals in developing countries often have to pay up-front and can’t afford this price. They are also often far away from anyone who can repair the equipment. Without endoscopy, many operations cannot be performed without opening patients up, which not only means a longer recovery time, but often requires general anesthesia (which these hospitals often also lack access to). Many patients therefore go untreated. EVOTECH’s innovation is to build a low-cost system (under $3,000) using off-the-shelf parts, which are easily repaired or replaced. The system weighs less than 5kg and plugs into a USB port on any laptop. This puts endoscopy within the range of affordability for thousands of hospitals that could never afford it before, so they can treat millions of patients who would otherwise be turned away. EVOTECH’s long term plans for remote training will make it possible for doctors in the US to train surgeons in developing countries thousands of miles away without leaving their homes.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

<strong>- Current Activities:</strong> Product Development EVOTECH has built prototypes of its EVOCAM endoscopy imaging system, which works with inexpensive off-the-shelf endoscopy scopes and plugs into any laptop computer. In addition, EVOCAM can broadcast images through Skype, which will in future allow remote training. While the prototypes already work (and have been used on fistula patients in Mbarara hospital in Uganda) we are currently improving them for durability and usability and developing an improved software interface. <strong>- Near Term:</strong> Product Evaluation and Distribution EVOTECH is currently making its prototypes available to doctors trained in MIS operating in low-resource environments as a means of getting use-case feedback to perfect them for widespread rollout. EVOTECH is also building a network of traveling doctor organizations, medical schools, and fistula hospitals throughout the developing world through which it will market the system. <strong>- Long Term: </strong> EVOTECH will market its system for other operations in which the Evocam could make the difference in low-resource environments, such as female sterilization (allowing women to choose to stop having children) and gastrointestinal surgery. EVOTECH will also further develop the process for remote MIS training.
About You
Organization:
Evolving Technologies
About You
First Name

Moshe

Last Name

Zilversmit

Twitter
About Your Organization
Organization Name

Evolving Technologies

Organization Phone
Organization Address
Organization Country

United States, CA, Santa Clara County

Country where this project is creating social impact

Uganda, MBR

How long has your organization been operating?

1‐5 years

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Innovation
What stage is your project in?

Operating for 1‐5 years

Tell us about the community that you engage? eg. economic conditions, political structures, norms and values, demographic trends, history, and experience with engagement efforts.

Our project engages directly with doctors operating in developing countries and indirectly with their patients The patients are typically low-income rural women who have difficulty accessing any other hospital. The doctors we target are either trained in or interested in learning endoscopic surgery, but have no access to equipment in their hospitals. The main groups on which we are initially focused are traveling doctor organizations (Doctors Without Borders, Medicine for Humanity), made up of trained doctors who travel from developed countries to operate on underserved populations on temporary missions. These doctors are a perfect fit, since they often already have practice in and understanding of endoscopy and their only barrier is the price and bulkiness of the equipment. We have already conducted a trial with Medicine for Humanity in Mbarara. Uganda, and were able to help three fistula patients who would otherwise have been turned away. EVOTECH’s founder has been getting feedback from traveling doctor groups as to the Evocam’s features for the past year. In the longer term, as the device is perfected, we will engage medical schools and hospitals.

Share the story of the founder and what inspired the founder to start this project

Moshe has been a tinkerer since birth. His interest in medicine and engineering peaked in university and he began his quest to develop extremely affordable medical devices utilizing techniques in frugal innovation. The idea for EVOTECH was born in a conversation on the steps of Kilimanjaro. Moshe and his co-founder were brainstorming ways to bring minimally invasive surgical devices to the Bottom of the Pyramid. They knew that the cost of the imaging system was the major barrier, and thought of combining inexpensive laptops (of the One Laptop Per Child variety) with the low cost imaging sensors they knew were available off-the shelf. This led to the idea of the EVOCAM. Moshe Excitedly contacted Dr. Tarnay, a prestigious and dedicated volunteer physician from UCLA medical center. Dr. Tarnay expressed great interest in the EVOCAM and its telemedical capabilities. The EVOCAM offered a technology he never knew was available for his organization's medical trips to Uganda. The EVOCAM enabled Dr. Tarnay and his fellow volunteer physicians to perform MIS surgery and treat patients that they would otherwise have had to turn away.

Social Impact
Please describe how your project has been successful and how that success is measured

EVOTECH’s main success thus far has been the development and successful use of its prototype endoscopy imaging system. EVOTECH partner Medicine for Humanity successfully used the EVOCAM to treat 5 fistula patients in Mbarara hospital in Uganda, 2 of which would otherwise have been turned away. The EVOTECH team was able to watch the operation streaming from the EVOCAM live over Skype.
EVOTECH was also selected to participate as an MIT 100K Emerging Markets Track Finalist, received the 2011 MIT Technology Dissemination Fellowship, and was selected as a San Francisco HubVentures Incubator Fellow and Finalist.

How many people have been impacted by your project?

How many people could be impacted by your project in the next three years?

More than 10,000

Winning entries present a strong plan for how they will achieve growth. Identify your six-month milestone for growing your impact

- Adoption of EVOCAM by 4 traveling doctor organizations
- Testing and/or adoption by 3 other partners- fistula hospitals, medical schools, low-cost hospital chains
- 300 operations performed

Task 1

Manufacture 5 more prototypes and monitor use by partner traveling doctor organizations; refine device to quality needed for mass production and sales.

Task 2

Select and seek partnerships with fistula hospitals, medical schools, and low-cost modern hospital chains.

Task 3

Choose 3 partners and pilot use with prototypes.

Identify your 12-month impact milestone

- Larger scale production of sale-ready product
- Adoption of system by 3 in-country partners
- Initial development of remote MIS training system and package
- 3000 operations performed

Task 1

Seek investment for larger scale production

Task 2

Develop training system with US volunteer doctor organizations and developing country partners

Task 3

Prototype and pilot training system with US doctors and developing country hospitals/medical schools

How will your project evolve over the next three years?

Over the next three years we plan to widely commercialize the EVOCAM to every developing world hospital with doctors trained in MIS, and market our remote training program to every hospital and medical school with doctors open to learning MIS remotely.
Initially EVOTECH will evaluate the prototype with select traveling medical organizations to conduct customer development. During the customer development process EVOTECH will refine the product to meet the specific needs of the developing world physicians. With the product realized it will be brought to scaled production quantities. Marketing and sales activities will be carried out in Africa, China and India through government contract programs, and local distributors.

Sustainability
What barriers might hinder the success of your project and how do you plan to overcome them?

<b>Primary Barrier</b> For many doctors, the problem is not just a lack of endoscopy equipment, but also a lack of training in MIS. Doctors who have already been practicing for many years may also show reluctance to adopting new methods.
We plan to overcome this barrier by initially targeting specific more receptive groups:
- traveling doctor organizations (doctors are already trained but existing equipment is not in hospitals they visit and is too bulky and fragile to bring with them)
- fistula-repair and sterilization campaigns (government or donor mandate to treat as many patients as cheaply as possible, therefore systemic imperative to learn innovative techniques)
- low-cost modern hospital chains (in India, these chains are seeking innovative ways to raise margins and serve more people and are therefore open to new methods)
- medical schools (doctors still learning are more open to new techniques)
<b>Other barriers:</b>Remote training will require internet access and power, which may not be available, but operating with the EVOCAM only requires a battery-powered laptop

Tell us about your partnerships

We currently have a partnership with Medicine for Humanity, a leading traveling doctor organization based out of UCLA hospital, and are currently developing partnerships with fistula hospitals, low-cost hospital chains, and medical schools in Uganda and India.

Explain your selections

Money was used from the founders' own pockets to build the first clinical prototypes.

How do you plan to strengthen your project in the next three years?

Over the next three years EVOTECH will focus establishing partner relationships with traveling medical groups, bring the EVCAM system to scaled manufacturability, and market and sell the system in Uganda, with other African nations shortly following and entering the Chinese and Indian markets.

Challenges
Which barriers to health and well-being does your innovation address?
Please select up to three in order of relevancy to your project.

PRIMARY

Lack of physical access to care/lack of facilities

SECONDARY

Limited human capital (trained physicians, nurses, etc.)

TERTIARY

Lack of affordable care

Please describe how your innovation specifically tackles the barriers listed above.

The EVOCAM System is designed to meet the specified needs of the developing country doctor. It is compact and easily transported in a backpack. It does not require an autoclave or other capital equipment for sterilization, it can be cleansed by a chemical soak. The system is designed for easy and low cost repair with little technical expertise required. Because the system is able to connect to the internet, Ugandan physicians can be trained by remote physicians, thus increasing the number of MIS trained physicians on the ground in Uganda. The EVOCAM System will cost less then $3,000 or 5% of the cost of current endoscopy solutions.

How are you growing the impact of your organization or initiative?
Please select up to three potential pathways in order of relevancy to you.

PRIMARY

SECONDARY

Grown geographic reach: Multi-country

TERTIARY

Influenced other organizations and institutions through the spread of best practices

Please describe which of your growth activities are current or planned for the immediate future.

Initially EVOTECH is partnering with Medicine for Humanity. As the organization conducts medical trips, they will train local Ugandan Physicians with the EVOCAM and leave the device with the newly trained doctors. Medicine for Humanity volunteers are then able to train and proctor live surgical cases from the United states. From their home office in the US, MFH doctors will be able to train new Ugandan doctors as well as the local doctors continuing to train their fellow Ugandan colleagues. This model will repeat itself in many hospitals with various medical organizations throughout Uganda, starting first at Mbarara Hospital. Lessons learned in Uganda will be used to bring the model to Kenya. EVOTECH will then partner with larger organizations such as Doctors without Boarders.

Do you collaborate with any of the following: (Check all that apply)

NGOs/Nonprofits, For profit companies.

If yes, how have these collaborations helped your innovation to succeed?

Our collaboration with the NGO Medicine for Humanity in Uganda has allowed us to conduct successful pilot evaluations in the field. Using the EVOCAM, Medicine for Humanity was able to perform its operations more quickly and efficiently and thereby treat more patients than they usually have time for. The EVOCAM also enabled MFH physicians to provide care to patients requiring endoscopic visualization. Without the EVOCAM these women would not have been candidates for the fistula repair procedure and would not have been cured. These collaborations are key to the rollout of our innovation, because they are the only way to refine and prove the viability of the device.

Comments

stavewalker (not verified) /

This puts endoscopy within the range of affordability for thousands of hospitals that could never afford it before, so they can treat millions of patients who would otherwise be turned away.

Samuel Lozano

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