Bringing the ENT Clinic to the Community

From a highly skilled surgeon practicing in the UK's National Health Service (NHS) to an entrepreneur transforming the ear and hearing health sector, Dr. Krishan Ramdoo's journey has been anything but conventional. Today, Dr. Ramdoo is the brains behind the groundbreaking Tympa system, a novel ear and hearing assessment platform making waves on the international healthcare stage. 

A native of the UK, Dr. Ramdoo began his medical career in 2009, serving as an ear, nose, and throat (ENT) surgeon for over a decade. He further advanced his proficiency in the field by earning a PhD in ear and hearing health.

His first “aha” moment came early in his medical career when he encountered a 79-year-old lady admitted for an infection in the geriatric ward. Despite treatment, she remained confused and disconnected from society. Upon examining her, Dr. Ramdoo cleared the wax that was built up in her ears and conducted a hearing test, only to discover she had age-related hearing loss. 

When Dr. Ramdoo fitted her with a hearing aid, she transformed into a vibrant and engaged individual, planning her 80th birthday with her family. The realization that prompt and simple interventions could drastically improve patient lives ignited the passion for his job even further.

Driven by his dedication to improving patients’ lives, Dr. Ramdoo had a second epiphany when he noticed patients had to wait considerably long periods of time to see healthcare specialists. The equipment was inadequate, and the workforce was underutilized. He realized there was a need for a digital pathway that would bring the ENT clinic to the community; thus, Tympa Health was born. The startup, originally founded in late 2017, has since grown to scale, extending its reach beyond the UK borders.

Tympa Health’s revolutionary device, the Tympa System, is a hardware-software solution that brings ear and hearing clinics to community settings. It empowers healthcare providers like nurses and allied health professionals to conduct comprehensive ear assessments digitally in order to provide more immediate care. By doing so, Tympa makes ear and hearing healthcare more accessible and efficient while also establishing a digital record for each patient.

Tympa Health's mission extends beyond making ear and hearing care more accessible. The company is also dedicated to raising awareness about the growing prevalence of hearing loss. According to Dr. Ramdoo, by 2030, hearing loss is set to overtake diabetes and cataracts in the top ten disease burdens due to the aging population. He adds that hearing loss is the single largest modifiable risk factor for the prevention of dementia, making early detection and intervention crucial.

To date, the Tympa System has been used on more than 250,000 patients in the UK alone and is now seen as the gold standard of ear assessments in community settings. It is used by three of the top five high street audiology practices and more than 100 community pharmacy chains, opticians, and residential homes.

The Tympa System is a Class 1 medical device in the UK, and in the US, it’s FDA-registered as 510(k) exempt. The company has also built what Dr. Ramdoo confidently claims to be "the world's largest bank of ear and hearing healthcare images and videos," which will provide valuable insights in the future. The company is currently in the process of expanding to the US, with two major pilots already underway. 

For Dr. Ramdoo, who committed full-time to Tympa Health about three and a half years ago, this is only the beginning. As Tympa Health continues its expansion, there's no doubt that the world will be listening to what Dr. Ramdoo and his team have to say.

Key Learnings From Dr. Ramdoo’s Experience

• A problem-solving framework is integral to entrepreneurship. Focus on a patient-centric issue where you can identify a clear gap with the existing technology stack.
• Seeking feedback is an important virtue across every function in a startup. However, you don't necessarily have to agree with all of the external input. Balancing feedback with your vision and understanding is vital to making better decisions.
• Your ultimate goal is to transform people into believers of your solution, whether they are investors or potential users. One of the best ways to do this is by providing them with something tangible. Showing rather than telling is a much more effective strategy for conversion.

A Proactive Approach to Problem-Solving

In the early days, Dr. Ramdoo’s primary focus was on the product itself. He knew that he had to create a solution that could effectively address a real-world issue in order to change the way things were being done. So, he broke down the problem and identified the key challenge. 

When it comes to assessing someone's hearing, you need to look inside the ear, but if there's something obstructing the ear, like wax or an infection, proper examination becomes impossible. Thus, he focused on developing a tool to address this middle phase, the proper examination of the ear. The otoscope, the device used for ear examinations, hadn't evolved much since the 13th century, and Dr. Ramdoo saw that as a clear opportunity for innovation.

Upon that realization, Dr. Ramdoo began with a basic proof of concept and went on to win an innovation prize, which he then used to gather broader feedback from colleagues. “If you've got something tangible to show, it just helps people understand it,” he says.

Dr. Ramdoo has always kept patients – his end users – front and center. He aimed to make healthcare more efficient, ensuring that only patients requiring intervention ended up in the specialist's office. He spent the first 12 to 18 months diligently refining the product before trying to raise awareness for what he was building. Operating heads-down in stealth mode allowed him to stay focused on product development, which was crucial for shaping the direction of Tympa and fine-tuning its value proposition.

Once he nailed the gist of what he wanted to solve and how he was going to address it, Dr. Ramdoo consistently sought feedback and iterated accordingly. By focusing on feedback, even from colleagues initially skeptical of his product, he was ultimately able to develop a device that could substantially improve ENT care.

The Importance of Active Listening and Balancing Feedback

Dr. Ramdoo’s willingness to actively seek opinions and listen to others was pivotal in the refinement of Tympa's product and strategy. He says, "You may think you have the best idea in the world, but if you're unable to accept feedback, then you're never going to evolve your product. If people give feedback, it’s for a reason."

But, this is a nuanced subject. Regarding feedback, Dr. Ramdoo reiterated, “It's essential to carefully evaluate the input you receive from others. Seek out those who will be honest with you and try to understand their perspectives.” 

Any big idea faces negative and positive feedback early on. Sometimes, the negative feedback can be accurate, coming from a good place, wanting to prevent you from wasting time and energy on something that may not pan out. And sometimes, as Dr. Ramdoo puts it, “People may have concerns about potential changes or how your product could affect their work or business.” 

While feedback is crucial, that doesn’t necessarily mean you have to agree with everything you hear. Balancing feedback with your overall vision and understanding the motivations behind the responses you receive can help you make better decisions. If you’re onto a solution that will ultimately help patients in a demonstrable way, then it might be best to tune some things out and press on.

Despite some initial resistance, Dr. Ramdoo used the feedback he got to refine his approach, ensuring that Tympa was addressing a need without unnecessarily disrupting existing workflows and incentives. His ability to dissect and analyze such input was vital in developing the Tympa platform.

While some naysayers were more concerned that Tympa might disrupt the status quo, over time, it became evident that the platform actually helped specialists focus on more complex cases that required their time and expertise.

Navigating Fundraising: Presenting a Tangible, Patient-Centric Product

Having a good idea might open some doors, but to convince crucial stakeholders, showing them what you’re doing instead of telling them is a much more impactful strategy. In Dr. Ramdoo’s own words, "We have a physical device, and although it's a [combination of] software-hardware, just seeing it changes the mindset."

Tangible demonstrations can resonate with investors and potential users, making it easier for them to grasp the product's value and potential. Being receptive to feedback and iterating accordingly is a crucial part of the early development process. If you take the right actions during that phase, regulatory and commercial rounds become much easier. 

Dr. Ramdoo admits that putting together a tangible, patient-centric product was at the core of Tympa's development strategy and a significant factor in its early fundraising success. For him, raising awareness about your company has to be strategic. He says, “The best time to talk to an investor is when you're not raising money.” In the early days, the Tympa team focused on the product, keeping their heads down and trying to be as cash-efficient as possible. They were able to raise some non-diluted grant funding and a series of seed rounds, which helped the team develop a commercial product.

Today, the Tympa team is getting ready to commercialize in the US. To help ensure success, Dr. Ramdoo emphasizes the importance of thoroughly understanding the entire landscape. 

“Before raising money to bring the technology to the US, we spent about a year understanding the landscape in the US, which made it easier to speak coherently about our go-to-market strategy."

With the recent FDA ruling allowing over-the-counter sales of hearing aids, Dr. Ramdoo recognized another potential opportunity for Tympa that’s similar to how eye tests are done before purchasing reading glasses. Offering quick assessments can ensure customers are appropriate candidates for over-the-counter hearing aids.

Dr. Ramdoo’s approach to commercialization revolves around effectively managing growth to sustain both the drive for success and the sense of accomplishment. Reflecting on the company's US expansion, he states, "It feels like you've almost got a startup within a startup. We kept the team very lean where everyone is doing a bit of everything because if you grow too quickly without a structure, that hunger for a sense of achievement will be your doom."