350 Million Reasons to Disrupt the Medical Device Industry | Craig Robertson | TEDxGlasgow


Translator: Theresa Ranft
Reviewer: Leonardo Silva How important is your vision to you? Imagine you wake up tomorrow morning and you had black spots
obscuring your central vision. Sadly, for increasingly large numbers
of people in the world, this has become their new reality. And I want to tell you
about the 350 million people that this may be affecting, and how the major players
in the medical device industry are going to let them down, and how that creates a vacuum for small, innovative
and ethically-driven companies to come and actually do some good. I’m the founder of such a company. We’re focused on the eradication
of preventable blindness, and we’re currently focused
on type 1 and type 2 diabetes and the sight loss that that can bring. But how many people
are we talking about here? Well, the truth is, nobody really knows. It’s somewhere between 4 and 500 million. Let’s take this audience as an example. If you represented the world, one hundred of you –
I’d better not point – one hundred of you would be diabetic, but only 50 of you would know. The other 50 would be undiagnosed. Seventy of you would go on
to some kind of diabetic sight loss, and five of you would go blind. There are these huge numbers of people who don’t know they’re on this pathway
to diabetic blindness. And anything you do in this space, because the medical device industry
has become lazy and complacent, anything you do in this space
is considered to be disruptive. For example, shipping devices
to the developing world, or even talking about price. That’s one of the primary problems. So, if you look at the medical
device industry in the round, most things are built and designed
for the US healthcare market. It’s the biggest market in the world, it’s about 1.6 trillion dollars in size. What that means
is that most of the devices are generated for that big market
in the developed world. In the developing world
where there’s most of the diseases, the devices just don’t go. So if we look at diabetes, most of the diabetes in the world is in a swathe between the Gulf
all the way up into Asia and Australasia. So, to illustrate
the problem that we’ve got: I was in a tertiary-level
hospital in Delhi, which is a super, super specialized
ophthalmic hospital. I said to the guy in charge,
“What is it you need? What is it that would make
your diagnosis easier?” And he laughed, and he said,
“Well, nobody ever asks us this. The big companies turn up,
they tell us what they have to sell us. We tell them we can’t afford it
and they go away again.” This guy was using
a handheld ophthalmoscope from 50 years ago. So, to talk about
the way out of this deadlock, what I want to talk about
is our company’s journey. We’re a company of engineers. As it turns out, we’re radical engineers, we’re the “enfant terrible”
of the medical device companies. Who’d have thought a Scots company
would be disruptive? So, we make devices
that are precisely focused on the disease. What that means is the engineering
becomes quite straightforward because all of the things
that are around the disease become the engineering constraints
that you build around. So where and how it’s going to be used just become two more
of the engineering constraints. If you look at this picture here, this is where the majority of revenues
are currently being made. This is our area of deployment. So, you can see things like cost,
safety, and clinical utility are the three principles
of a medical device company, or so they should be. Safety, well, it makes perfect sense – you should always have
a world quality management system with which you design
and build the devices. Clinical utility, though, is the key. Once you focus on
the actual disease modality itself, then it all becomes very straightforward. For diabetic retinopathy, for example,
you need best quality optics, the best you can make. You need light, portable equipment – look at where we’re deploying it. And you also need to focus very precisely
on how you find the disease. Now DR, which is what produces
those black spots, those tiny blood clots, you need to be able to see that down
around 10 or 15 microns, which is a tenth of the thickness
of a human hair, and that’s quite scarily small. You need the kind of optics
you won’t find in your mobile phone but that you might find
in an astronomical observatory, or something like that. And that’s particularly difficult. So, we’ve managed to build our device for something like 5 or 10% of the cost
of these guys up here, and that is considered
to be very disruptive. Not only that, we dare to name
our price, which nobody else will do. So I just want to very quickly
show you inside my eye. I’m the mad guy doing a live demo
for a [TEDx] Talk. So you can see there my optic disc
which is, I’ve got to say, healthy. We can do an exam in something
like two or three minutes, not the half an hour or 45 minutes
that it might take anywhere else. We’re able to do this, we’re able to build
all of this incredibly bespoke, high-quality equipment because we are a small company. Our suppliers love us,
they talk to us daily. And what I’ve got to say is that vacuum
that we were talking about, well, this can come
and fill that vacuum with us and we invite them to, because so long as you’ve got
the end of it of engineering and an ethical heart
with which you sell your devices, then you can actually make
this kind of a difference. Thank you. (Applause)

6 thoughts on “350 Million Reasons to Disrupt the Medical Device Industry | Craig Robertson | TEDxGlasgow

  1. This is the way to spend a life. My admiration for this guy is enormous. I hope he has the support of every billionaire within earshot.

  2. (Shaking my head) This video is struggling to make 2000 views over a year. Meanwhile 24,000 people are watching Taylor Swift every minute…

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