Devices & Diagnostics

One startup’s quest: Standardize neonatal resuscitations, guide physicians through crisis events

A country physician-turned-innovator has created a device to help physicians resuscitate the more than 10 percent* of babies who are born not breathing. Neonatal is a growing area of global concern and has a lot of room for innovation. Already, nonprofit Helping Babies Breathe, an American Academy of Pediatrics program, educates birth attendants on how to […]

A country physician-turned-innovator has created a device to help physicians resuscitate the more than 10 percent* of babies who are born not breathing.

Neonatal is a growing area of global concern and has a lot of room for innovation. Already, nonprofit Helping Babies Breathe, an American Academy of Pediatrics program, educates birth attendants on how to resuscitate babies.

But, sometimes, even seasoned physicians need decision guidance in this crisis situation, Dr. Peter Coelho, MedicalCue founder and CMO, said.

Inspired by his time as a practitioner delivering babies in ICU, as well as his firm belief in Atul Gawande’s The Checklist Manifesto, Coelho created NeoCue. It’s part hardware, part software, and monitors vitals then pushes them through a care algorithm to offer cues (get it?) to the physician. The goal is to facilitate physician decision-making during a crisis moment to save newborns from birth asphyxia or injuries associated with too much or lack of oxygen.

“It’s the chaotic erratic behavior under stress that is the weakest link in crisis events,” Coelho said.

His goal? To standardize crisis care, starting with neonatal resuscitation. Such a device, if it does indeed standardize crisis care, could bring down costs for providers, payers and families, Coelho said.

The hardware, the sensor, works like “a car navigation system–it takes data points and tells you where you are on the road and where you need to be going to get to your destination.”

It’s attached to an umbilical clamp that doubles as venous access if needed (plus the accompanying umbilical vein catheter). There’s also an exothermic pad with an embedded scale.

But it’s the software component that is the true innovation. Buttons appear on a touchscreen, prompting physicians with next step after next step, standardizing care. And, Coelho said, former  IDEO  engineers helped design the touchscreen user-interface.

“(There are) 273 actions to perform within a three minute period. That’s very challenging,” Coelho said.

With a platform technology that hits on many of healthcare’s current trends–decision guidance, standardizing care, checklists, sensors, lowering the cost of care–it was important to Coelho to start with neonatal care.

“Babies are our future. They have a disproportionately small portion of innovation. It’s the greatest opportunity for impact with innovation. Your dollar goes further with newborns than it does with any other area of healthcare.”

But the California-based startup does plan to develop the technology for other medical crisis spaces, and Coelho mentioned surgery and radiology as examples of areas that might benefit from such a system.

“This is a type of device I need in all spaces of my job. I’m building myself a tool that I really need,” he said. “I need decision guidance or decision assistance. There’s an overwhelming amount of information I have to process on a moment to moment or daily basis. . . . We find that humans are not perfect decision makers.”

Coelho hopes to commercialize NeoCue by mid-2016. MedicalCue closed a $1 million round of seed funding in April, completed a set of software trials at Lucille Packard Children’s Hospital earlier this summer and was accepted as a startup at the Fogarty Institute for Innovation.

Working with Dr. Thomas Fogarty at the Institute has made all the difference in company growth and creating and achieving near-future milestones, Coelho said.

“It’s basically like being a tomato plant from Target, and he gives you great soil and food and sunlight. He really puts you in a greenhouse.”

Without it, Coelho said he’d still be toiling away on his device in his office. As a chief of staff at a hospital, he was reviewing cases and how healthcare workers were responding to crisis events.

“I just felt ethically I had to make some changes,” he said. And so, he quit. He took his own money and made up some concepts. Then, through a mutual connection, met Fogarty, who insisted the device be made.

Coelho paraphrased Fogarty: “There’s no such thing as impossible. Somebody’s going to figure it out. The question is whether it’s you.”

Regardless of this device’s success, in this time of healthcare reform, patients’ trust in physicians is paramount–and standardizing care is one significant way to gain that trust.

“It’s a revolutionary period in medicine, where the public is now opening the doors and looking into the healthcare closet,” Coelho said. “A lot of trust has been given to physicians–and we need quality measures and quality control and feedback for our healthcare workers on ‘This is where you are and where you need to go.’ (Physicians) want to do a good job for you, but we don’t have all the tools to do it.”

*Helping Babies Breathe reports 10-20 percent of babies are born not breathing.