Innovative device leads to healthier patient hearing
If there’s one profession for which you don’t want students to have learning gaps, it’s medicine. Yet that’s exactly what Dr. Paolo Campisi saw while working with medical students at the University of Toronto — gaps in how they learn the skills associated with his specialty of otolaryngology (commonly known as ENT or ears, nose and throat).
A surgeon at the Hospital for Sick Children, as well as an associate professor and director of postgraduate education at U of T’s medical school, Dr. Campisi saw students were having trouble acquiring the skills needed to accurately diagnose inconsistencies related to the ear.
“It’s not their fault,” he says. “One factor is time, because we’re not a major specialty. Another problem is that it’s technically challenging to use a small instrument to look into an ear and come up with an accurate diagnosis.”
During discussions with colleague Dr. Vito Forte, it became clear students needed the time and opportunity to develop these skills beyond what was possible within the constraints of seeing patients during a brief training period.”
“The answer wasn’t more time to lecture or show big pictures on a screen, but rather some kind of instrument that would mimic the experience of looking into an ear with an otoscope. And we went through a number of prototypes developing a simulator that can do just that.”
The result is the OtoSim, brought to market and sold by OtoSim Inc. The simulator consists of a rubber ear made to scale, and a computer display integrated into the model where the eardrum would be in a patient, which can display images of ear canals that correspond to a wide range of medical conditions.
It’s an invaluable complement to the hands-on training of medical students, and provides the experience of looking into far more ears than would be possible using only patients for training. Improving diagnostics related to the ear may not seem significant on the surface, but the OtoSim device has farther-reaching effects. Better diagnostic skills will lead to more effective health care all around, but there is particular potential here to reduce unnecessary use of antibiotics, which reduces the overall burden on the healthcare system.
A population-based study of Canadian preschoolers looking at treat- ment records from across Canada found almost half a million dollars per year is spent on unnecessary drugs for ear infections in this age group alone. Prescribing antibiotics frequently, particularly when they are not medically indicated, is linked with the development of resistant strains of bacteria, which are harder to treat than other infections, and are more likely to cause permanent harm or death.
The OtoSim was developed as a prototype in 2009, and clinical trials with third-year medical students quickly demonstrated its value in training aspiring doctors. However, at that point the two inventors — with teaching and research duties as well as their clinical roles — weren’t in a position to develop the simulator further without external assistance and support.
In late 2010, MaRS Innovation (MI) — a non-profit established to develop intellectual property stemming from academic and medical research into viable businesses — became involved, and in January 2011 OtoSim Inc. was created with MI’s support.
“MaRS Innovation made the seed investment to carry the technology forward, because they believed in the prototype and the product,” says Andrew Sinclair, CEO of OtoSim and one of the first employees of MaRS Innovation.
OtoSim first went to market in September 2011 and had generated $500,000 in revenue within a year. Dr. Sinclair says the company is aiming to generate $1-million in 2013.
“We’re also raising additional capital to accelerate sales and marketing; there is more sales potential than we have resources to pursue right now.”
Particularly helpful in broadening awareness of the OtoSim has been the word of mouth within the community of medical education.
Dr. Sinclair credits early adoption at Boston Medical and Stanford, as well as the support of the Toronto medical community, with getting out the message that the simulator is a powerful teaching tool, and points out that international endorsements have been key. “The goal is to become the name brand that everyone recognizes,” Dr. Sinclair says.
Thus far, more than 100 institutions have purchased more than 200 OtoSim units. Of these sales, 15% have been within Canada, 65% to the U.S., and the remaining 20% to more than a dozen countries including Australia, New Zealand, Singapore, Malaysia, Spain, Mexico and Brazil.
The next major market OtoSim plans to pursue is Europe, and it is targeting a number of medical and educational trade shows in the months ahead. Dr. Adrian Gooi, who teaches in the department of otolaryngology at the University of Manitoba and is the new director of online learning at the U of M medical school, points out that while the tool has the potential to reduce unnecessary therapies, it also will help doctors to catch problems they might otherwise miss.
“It really does give students more competence in assessing an ear, and when these students go into practice, it translates into better diagnosis, fewer false positives, less over-prescription, and many noneconomic outcomes as well, such as quality of life,” Dr. Gooi explains.
The company’s marketing focus for sales beyond North America has been on trade shows and conferences related to otolaryngology, medical simulation, and professional education events. With persistence, this strategy has started to bear fruit.
“It doesn’t sell itself on a website; you really want people to touch it and understand it and use it,” says Dr. Sinclair. “Recognizing the value typically takes about 15 seconds when medical staff see it, but finding the money can take months.”