Picture this. You’re a medical device sales rep covering a procedure in one part of your territory. But unexpectedly, you get a call from a physician needing case support on the other side of your geography. What do you do?
There’s no way you can cover the case, right? The drive-time won’t allow you to get the hospital in time. Perhaps your only option is to provide phone support?
3) Read the following transcripts from my interview with Paul Schultz.
Before we dig in, you need to listen to these 2 brief messages.
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Okay, for you ambitious medical device and medtech doers, here’s your program…
Scott Nelson: Hello, hello everyone. Welcome to another edition of Medsider. This is your host, Scott Nelson, and on the program today we’ve got Paul Schultz, who is the cofounder of Nurep, which is a mobile platform for medical device companies that allows on-demand virtual device support to physicians in the operating room. So welcome to the call, Paul. Really appreciate you coming on.
Paul Schultz: Thanks, Scott. It’s a pleasure to be on.
Scott Nelson: 00:00:29 Okay, so let’s first start with what is Nurep, what is this platform that I just mentioned, and then I’d like to dive into how the idea for this platform was born.
Paul Schultz: Sure. So Nurep is a mobile health technology platform and what it does is bring the live remote medical device rep into the operating room to a physician’s own mobile device for guaranteed 24/7 support. It’s initially on the iPad and it allows medical device reps to support more physicians by supporting them remotely, and it offers physicians guaranteed 24/7 medical device support.
Scott Nelson: Got it. Got it. 00:01:10 So in layman’s terms it’s like a GoToMeeting for the operating room basically.
Paul Schultz: Yeah, you could consider that. I mean, there’s definitely a lot of features that differentiate it from consumer-based products, you know, such as GoToMeeting or Skype. It’s a secure and HIPAA-compliant video service and we’re really changing the customer engagement model in the medical device industry, which is currently a one-to-one, and we’re switching that to a one-for-many by allowing physicians to get in contact with the best rep in the US based on location availability and connectivity. And so we’re essentially connecting that physician with the best rep, giving him the comfort and convenience of accessing the entire rep force media-wise.
Scott Nelson: Got it. Got it. Okay. So that’s a real decent overview and I definitely want to ask you more questions regarding what this platform looks like, but I think the audience will have a good understanding of kind of what we’re dealing with here in Nurep. 00:02:19 So before we get into the specifics of the product, let’s go back to where this idea initially came from, where it was born.
Paul Schultz: Sure. Yeah, so myself and Adam John, the cofounder, we were both working as management consultants at Campbell Alliance towards the beginning of 2012, and we were working with Genentech. Genentech [00:02:42] is a pharmaceutical company and we were working with them on a mobile strategy project for one of their top oncology products, Avastin, and during that engagement we were helping them define how to sell to an oncologist with an iPad, selling complex oncology products. During this engagement, we felt that a company as innovative as Genentech really wasn’t harnessing the power of mobile technology to address some of the challenges they were facing with regard to interacting with physicians. They were really doing more of the same, converting print material to digital material, and mobile technology, mobile health technology specifically, really wasn’t their core competency. They’re really focused on building the best groundbreaking drugs, and technology wasn’t their focus.
Scott Nelson: Mm-hmm.
Paul Schultz: So we really during this engagement felt that there was a need for a company to really improve the interactions between healthcare professionals and the life science representatives they were relying on through mobile technology, and that was how the vision for Nurep was born.
Scott Nelson: Okay.
Paul Schultz: So…
Scott Nelson: Go ahead. Go ahead.
Paul Schultz: I was just going to say, yeah, we were really focused broadly across the entire life science industry initially, but our physician advisor, Dr. Edward Bender, really honed in on the pain points in the medical device industry and we confirmed that through several initial rounds of market research.
Scott Nelson: Got it. You just answered my question, is it started out in pharma or kind of the biotech space but you’ve now begun to focus on the device space. You just answered my question.
Paul Schultz: Okay. Yeah, I know. I mean, Adam John, he carried the bag as a sales rep at Johnson & Johnson and at Merck, and so he actually felt the pain as a rep. And our physician advisor, who is extremely [00:04:35] with the current support model, really proactively came to us and expressed [00:04:35] the pains that he was feeling as well.
Scott Nelson: Got it. Got it. Now, that’s interesting. 00:04:46 And the physician advisor, you said Dr. Bender, he’s a cardiac surgeon, correct?
Paul Schultz: Correct. He’s a 35-year cardiac-thoracic surgeon, Chief of Cardiology at St. Francis Medical Center. The interesting thing about him is he actually codes on his own, so he has developed 25 iOS applications specifically for cardiac surgery on his own. So he’s kind of known to do surgeries by day and code by night.
Scott Nelson: Got it. Yeah, that’s fascinating. I had no idea. 00:05:20 And so I guess let me ask you first, how did you connect with Dr. Bender then?
Paul Schultz: So he’s an innovator, he’s an early adopter of technology, and I was looking for the latest thing. We had a landing page, kind of a launch page on our site online when we first started out, and he reached out to us, he was one of the first people to ever contact us actually, saying that he was really excited about our vision. And so he actually—he lives south of State, West Missouri, and he went to the Worldwide Development Conference by Apple, the big Apple conference in San Francisco, and that’s where we met. So we actually met at this conference and we had a conversation around our vision and a lot of excitement around the possibilities and opportunities in the medical device space.
Scott Nelson: Oh wow, that’s fascinating. 00:06:09 So how did he come to find out about your landing page?
Paul Schultz: That’s a good question. I guess through just natural search. I would have to ask him that. I’m not quite sure specifically, but he somehow was able to find us. [Laughs]
Scott Nelson: Yeah. No, that’s a fascinating story. I would presume he’s pretty dialed in to like the tech space, especially where it intersects with medicine. So cardiac surgeon in St. Francis, he’s probably got a very keen awareness of what happens in the operating on a daily basis. 00:06:44 I want to go back to where you started in your consulting relationship with, is it Gentech? Am I pronouncing that right?
Paul Schultz: Genentech. Yeah, Genentech.
Scott Nelson: Genentech. One of my friends, Joe Hage, who runs the Medical Devices Group on LinkedIn, he made a comment once I thought was really funny. It’s that the Internet forgot about the medical device space, and in this case you could say technology forgot about the healthcare space in general because it seems like so many companies that are so high-tech in respect to the life sciences, it’s almost like they are clueless when it comes to technology that you and I are both familiar with that allows for more efficiencies in the business model. So that’s an interesting point.
Paul Schultz: Yeah, and I think that’s why digital health and mobile health are becoming such a booming industry right now because of what you just mentioned, the industry kind of forgetting about the medical device and the healthcare space, and now a lot of problems that haven’t been addressed are now being really looked at with a different eye, with technology being the potential solution for some of those issues.
Scott Nelson: Yeah. Yeah. Well, that’s interesting. So you connect with Dr. Bender and then you discuss where to maybe start with a minimal viable product. 00:08:08 When you initially began to explore the fit kind of within the device space, you mentioned Adam John, your other cofounder, had carried the bag before, but did it surprise you how much reps are involved in procedures on a daily basis in what kind of goes on inside the operating room or the cath lab or the interventional suite?
Paul Schultz: Yeah, that was a real eye-opener. I mean, even working as a consultant in the industry for five years, I wasn’t as familiar with the medical device sales space and it was extremely surprising. And doing the research and finding out that a rep is physically present in the operating room for the majority of medical-device-related procedures was really interesting, and every time we have to bring awareness around this as something that’s commonplace, not only in the US but globally, and a lot of people are surprised by that.
Scott Nelson: Yeah. Yeah, there’s no doubt, and I think you were recently quoted in another piece as kind of the dirty little secret in healthcare is that [laughs] reps are actively involved in these procedures, but to be candid, I think that would surprise the general public a lot if they knew how involved reps were. But on the flipside, in a lot of circumstances reps are absolutely needed because they bring the expertise to that specific case because that’s their little world, that’s their little niche where maybe a physician has to perform a wide variety of surgeries and they don’t get to see all of the complex cases and where certain technologies may fit. 00:09:50 So this will provide us a good transition to the actual product, the Nurep platform, because I want to talk to you about what specific challenges and pains that you and Adam saw in conjunction with Dr. Bender and others specific to the device space, and then where Nurep fits in or where you see it fitting in.
Paul Schultz: Yeah, definitely. Yeah, so the end-person model is great and physicians respect that, and if that could exist onwards that would be the best approach, but unfortunately there’s a lot of changes in the healthcare environment that are making the in-person model no longer sustainable, specifically the medical device tax, uncertain and declining reimbursement on medical device products and cost pressures in hospitals. All these factors are causing device companies to look for ways to improve efficiency, and in doing so they’re reducing the number of headcount to support physicians out in the field. And so physicians aren’t used to the same level of support today as they once were used to, and this is having an impact particularly in rural areas where physicians are reliant on the physical presence of one rep who typically had a broad geography. And now [00:11:06] their peers are getting [00:11:07] fired and that rep is asked to cover an even broader geography, so they’re struggling to meet the demands of their customers and physicians are being frustrated as a result because they’re either having to delay cases until the rep is physically present in the operating room or even worse proceeding without the rep, so they’re proceeding without the optimal [00:11:31] team present, which can lead to [00:11:33] patient care and [00:11:35] admissions. So a lot of factors that are causing just a general decline in the number of reps available [00:11:44] that’s really impacting physicians’ ability to provide quality patient care.
Scott Nelson: Great. And I can certainly attest to those things you just mentioned, and they really go hand-in-hand. I’m sure you’ll agree they go hand-in-hand with so many headwinds facing the med tech space.
Paul Schultz: Right.
Scott Nelson: And often headwinds are costly and equate to less margin, so the natural inclination is for a lot of device companies to reduce costs, which in a lot of cases has reduced the sales force, the sales and marketing headcount, which then equates to bigger geographies and bigger bags of product. So I think it’s definitely a huge, huge issue, and that’s where personally I think what you’re doing with Nurep is really cool.
Paul Schultz: Thank you.
Scott Nelson: So those are some of the big challenges. 00:12:40 And so when you began to kind of create your MVP or your minimum viable product, what did you see as like the primary things that you wanted to address upfront?
Paul Schultz: Yes, when we first started, we really just kind of laid out all the features that we thought would be useful and there were quite a few features. Initially, we just wanted to get everything out of the bag that we thought would be important for a rep and a physician during a remote case. So when we came up with all the features, we realized that a mobile product really couldn’t support all those features. And through [00:13:23] lean startup methodology we honed in on four key features for our launch platform, and those features are product feeds, which provide all the medical device content to prior to a procedure; a call pulse, which connects the physician with the best available rep in the US using a proprietary algorithm, and we can talk about that; and then live video, so a HIPAA-compliant mobile live video infrastructure; and then the last one is analytics, so being able to record some of the analytics from the case as well as a rating for the physician to rate the quality of support provided.
Scott Nelson: Got it. Okay. Okay, so those four key features. 00:14:14 And those are the four key features that are built into the product as we’re recording this interview today, correct?
Scott Nelson: Got it. Got it. I’d like you to break down those four different features in a little bit more detail…
Paul Schultz: Yes, definitely.
Scott Nelson: But before we do that, you decided to launch on the iOS system or the Apple system, the Apple network, platform, however you want to describe it. 00:14:52 Why was that the case, and then will you eventually develop for the Android platform?
Paul Schultz: Yeah, it’s a great question. So we looked at this really carefully before we decided to make a decision to go with Apple, and the latest research from Manhattan Research Group, which came out in March of this year states that 72% of physicians own a tablet for professional purposes and that that trend is increasing, and their primary platform is the iPad or the iPad Mini, if not the iPhone as well. So we made a decision based on that to go with iOS. And we also found that the top 25 medical device manufacturers, all of them have their sales and support staff in the field on iPads.
So it was a pretty obvious decision to go with that as our launch platform, but the challenging decision was to go iOS native or to go HTML5, which is kind of cross-platform. We made the decision to go iOS native because the look and feel and the simplicity is going to benefit the physician. So it’s much more dynamic, much more intuitive and easier to use if we build natively as opposed to building non-natively.
Scott Nelson: That’s an interesting point. 00:16:17 Why don’t you real briefly explain the differences between that native and HTML5? Because it seems like a lot of applications are moving in the direction of HTML5 for the cross-platform functionality, but expand on that a little bit.
Paul Schultz: Yeah, I mean different companies are making different decisions, and I think Facebook made the decision to get rid of the HTML5 and go native. So there are a lot of different opinions on that. But in short terms, what iOS native is is you’re building it in the code Objective-C for iOS specifically, so its own language essentially. When you build an HTML5, it’s essentially a website that you can wrap, what they say wrap, you can wrap the application into an Android app, an iPhone app or an a web app.
Scott Nelson: Okay.
Paul Schultz: So you can code it once in HTML and wrap it. There are limitations in the user interface and some of the structure, and as a result some people even build hybrid apps between iOS and HTML5.
Scott Nelson: Hmm. Okay. Interesting. But needless to say, I think you made the correct choice in developing or at least starting out with iOS for sure. I mean, I can’t remember the last time I actually saw a rep that carried a non-iOS tablet.
Paul Schultz: Great.
Scott Nelson: In fact, I don’t know if I’ve ever seen a rep carry an Android tablet that was provided by the company, and I guess the same thing applies for physicians too. Only like the geeky tech nerd physicians would maybe try… [Laughs]
Paul Schultz: [Laughs]
Scott Nelson: …I mean, I’ve seen maybe have or carry like one of the newer Android tablets. But yeah, interesting nonetheless. 00:18:15 So let’s dig into those four key features, and why don’t you start—we’ll just follow the same order—why don’t you start with the product feeds or the content, and then move on to the call pulse, the live video, and then the analytics?
Paul Schultz: Yeah, sure. So when the physician and their operating room staff are preparing for a procedure, they can pull out their iPad in the operating room in a sterile low-cost sleeve and open up the Nurep platform, and prior to the procedure they can select the devices that they’re preparing to install or implant or use during that particular case. When they select the devices, product-specific feeds load onto their main dashboard on their device, and these product feeds contain all the content related to that particular device right at their fingertips. So IFUs, product manuals, surgical training techniques, animations, really any digital content that the manufacturer wants to provide to the physician that’s quickly accessible, and they can review multiple products right there.
Now, when they need support in the operating room or the cath lab, they can select an on-demand call button, then when they select this they can do one of two things. They can select a specific rep [00:19:43] they have a relationship with, preserving that one-to-one relationship, or they can select the best available rep. And this is really the power of our platform and how we’re changing it to a one-to-many relationship.
Nurep first identifies the location of the physician and then connects them with the best rep in the US based on location, availability and connectivity using our proprietary algorithm. Once they’re connected, the physician instantly obtains live video support in a secure and reliable connection right within the operating room. Once the call is complete and the support has been provided, all the analytics for the case are recorded into a secure database and provided back to the medical device company. The physician can also rate the quality of support provided, and that information is also provided back to the device company. That’s really a high-level overview of how the platform works.
Scott Nelson: Okay. Okay. I think for the most part each of those features makes a ton of sense, and you probably chose for a reason, right?
Paul Schultz: That’s right.
Scott Nelson: Because they’re fairly easy to understand, they address a lot of the major challenges. But in terms of the product feeds and the content, that first feature you mentioned, so that’s basically all of the content that the manufacturer or the medical device company wants to provide the physician specifically for the case support.
Paul Schultz: Right.
Scott Nelson: So a video animation of the device, IFUs potentially, product brochures maybe…
Paul Schultz: Right.
Scott Nelson: 00:21:20 I mean, that’s basically what…
Paul Schultz: Yeah, we built it robust enough to allow a number of different file formats.
Scott Nelson: Mm-hmm.
Paul Schultz: And we’re really building this up to be very robust, so we’re going through an iteration right now to improve the robustness of the product feeds to allow for more content and in different tiered levels of content to align with some of our early customers’ needs.
Scott Nelson: Got it.
Paul Schultz: But yeah, essentially, the content management system on the back end, it allows the manufacturer to manage that content in real time for their customers.
Scott Nelson: Got it. Okay. 00:22:02 And then the call, you referred to that button, you know, if I’m a physician or a tech in the OR, the cath lab or something like that and I actually want to get in contact with the rep, it’s the call pulse button you mentioned, is that what you were referring to…?
Paul Schultz: Yeah, that’s right.
Scott Nelson: Okay.
Paul Schultz: Call button. On-demand call button.
Scott Nelson: Got it. 00:22:21 And so it’s interesting because I can understand the idea of preserving the one-to-one relationship where you basically directly connect that physician with the rep that they’re typically used to working with, but help me understand how you came up with the concept of finding the best available rep.
Paul Schultz: Yeah, this really comes back to the issue of device manufacturers reducing their headcount in the field. So when that local rep is too far away because they have a broader geography and they’re having to travel much more and they’re unavailable, this allows the physician to get in contact with one of their peers because the local rep is no longer available to support them. So it’s essentially potentially giving that physician the comfort and convenience of getting the support they need when they need it from the best available representatives, whether it’s their local rep or another rep. And so it’s essentially a support system to kind of piggyback on the local rep and give the physician the support they need.
Scott Nelson: Okay. 00:23:37 Two followup questions there because I think this is starting to make sense why you built that feature, because correct me if I’m wrong, but in a lot of situations, particularly with a device maybe that’s not often used, that hospital may not know who their existing rep is. Maybe there’s been rep turnover or they don’t even know who that rep is, so that would be the idea behind it.
Paul Schultz: Mm-hmm.
Scott Nelson: It would connect him with the best available rep, and that device company on the other side could basically somewhat route that call to whoever is currently covering that territory.
Paul Schultz: Right. So if the local rep can’t take the call, it continues to pulse out kind of in a sonar-like fashion until the call is connected with a rep. And so it’s really helping out the system. It’s really improving the value of the device manufacturer support to the end user, which is the physician. It’s going back to why physicians are frustrated right now because they’re having to reschedule cases around the availability of their local rep, and that shouldn’t be the case. They should be able to proceed with procedures when they need to have them scheduled, and that’ll increase the throughput, increase the efficiency of the hospital system by allowing them the comfort and convenience of getting support whenever they need it.
Scott Nelson: Got it. Yeah, makes a ton of sense. 00:25:03 And then also, two other sort of questions around this, kind of one and the same question really, but would it be possible to potentially connect, you know, if I hit that call pulse button, to connect with like an internal, like an inside clinical specialty team in a sense? And then as a followup, would it be possible to connect with maybe a KOL that is on contract, a physician thought leader that’s on contract with that device company, to almost facilitate the conversation there? Do you follow me?
Paul Schultz: Yeah. No, that’s a great question. We’re investigating both of those right now. So the power of our kind of communication algorithm if you will is that we can triage the request any way that the device manufacturer wants really, whether if it’s the pulse to the local rep and then to the clinical specialist in-house after or if it’s just the rep force out in the field, maybe even a call center if the reps are unavailable. There’s a lot of different use cases that we’re investigating from that angle.
Going to the KOL angle, that’s something we’re really looking into right now, sort of a specialist on-call, if you will, feature.
Scott Nelson: Yeah.
Paul Schultz: And we anticipate having that rolled out sometime early next year.
Scott Nelson: Yeah, I can see there being a ton of value around that, about being able to facilitate that sort of conversation, or that sort of engagement anyway.
Paul Schultz: Yeah. Going back to that physician-to-physician support, there’s a lot of interest in the med tech space for providing that type of solution in emerging markets, and so we’re looking at that as well.
Scott Nelson: Oh yeah. Yeah, that’s a great point, something that I didn’t even think of before you mentioned it. Yeah, because that typically amounts to [laughs] a physician flying in to Latin America or something like that and doing some training, but then what happens after that, after the initial training, which oftentimes is not enough…
Paul Schultz: Right.
Scott Nelson: So, cool. For the sake of time, let’s move on to the other two features, the live video and then the analytics. The live video I think makes a lot of sense other than in an environment like an OR setting for example, maybe not the cath lab setting, but in the OR there’s a lot of fluid involved. It’s not the cleanest environment for gadgets. 00:27:39 What’s your solution around that?
Paul Schultz: Yeah, so right now we’re kind of building out a prototype. It’s a low-cost sterile plastic sleeve similar to the x-ray [00:27:50] that you would see in an operating room that basically protect the iPad and keep it in a sterile environment while preserving the resolution of the cameras on the iPad. There are also slits on the plastic sleeve that allow it to connect to an IV arm so it gets it out of the way. And then when the rep needs to get a better view of the procedure, one of the OR staff or the OR nurse or the cath lab tech can grab the iPad and maneuver it so the rep can get a better view.
This is our early way to get to market. It’s kind of a low-cost easy solution. We don’t want to get into the hardware business right away, but we’re also looking at prototypes for kind of carbon fiber iPad arms that connect to the bedside and a couple of other potential hardware solutions.
Scott Nelson: Got it. Okay. Cool. And then lastly, the analytics. 00:28:47 Explain the analytics feature again, because I know you mentioned the ability to provide feedback as well as sort of a built-in rating system as well. So expand on that a little bit.
Paul Schultz: Yeah, so the analytics are going to be pretty basic at first. We’re just collecting basic data initially, so you know, how long was the case, what rep or reps and what physician were on the call, what location. And then, as you mentioned, the quality. So device manufacturers can provide a couple of metrics that they want to rate their sales and support staff on such as quality of support, customer service, clinical knowledge, etc. And this is an optional rating feature to give the physician the ability to kind of get some real-time feedback on the quality of support.
All this information is really just collected in a secure database and provided back on a quarterly to the device manufacturer. In doing so, we’re hoping that this will improve the quality and then allow manufacturers to really hone in on where the training needs are, where the gaps are in knowledge, etc., something that they don’t get today.
Looking in the future, we want to be able to record these cases actually recording to video and storing those videos, which could help hold a variety of different applications. And so that’s something in the future we want to make sure that we have the [00:30:30] regulatory and kind of we’re in safe harbor essentially to do that, so we’re still working on that.
Scott Nelson: Got it. Huh, my brain is starting to think about this a little bit more. The wheels are starting to churn, I guess is the better description there. But yeah, there’s a ton of value around being able to provide feedback there. So an in-house training team or even from a management perspective, you can get a better idea of where that particular person who helped out on that case could shore up some of their clinical knowledge and get a better idea of where the focus needs to be from an education standpoint. That’s interesting.
Paul Schultz: Definitely.
Scott Nelson: Yeah.
Paul Schultz: Yeah, it’s definitely not a tracking tool or anything like that. It’s very basic analytics that are recorded in real time and provided back, so it’s really meant to try to improve the model and give device manufacturers some data that they’ve never seen before.
Scott Nelson: Got it. Got it. Cool. 00:31:33 I want to ask you this question now before we get to your proposed business model and then what the response has been within the industry, but while we’re on the topic of product, what other features do you see building in at some point into the future?
Paul Schultz: Yeah, so we’re currently looking at different features and prioritizing those for future releases, and it really comes down to some of the specific needs for particular applications in different therapeutic areas. For example, [00:32:08] orthopedics, spine-related procedures, there are a lot of different devices and utensils on many different trays. Typically the device rep comes in with a laser pointer to point out particular items. We want to replicate that in a digital form, allowing the rep to essentially annotate video with their finger in real time on the iPad and then send a screenshot of that to the OR staff so that essentially it replicates the laser pointer in the operating room. That’s one feature we’re really excited about.
And then, another feature is really just to be able to share content in real time with the OR staff, so whether it’s the rep showing them a visual of the device and explaining how to implant it to a number of other applications. That’s another really important feature as well.
Scott Nelson: [00:33:04] Almost like taking what we now consider like an in-service but making that virtual as well.
Paul Schultz: Yeah.
Scott Nelson: Yeah.
Paul Schultz: Yeah, you could essentially use our platform for that. That’s not the major use case but it can definitely be used for that type of in-servicing.
Scott Nelson: Got it. Cool. And sort of that overlay feature, that would be similar to what we see in an NFL football game where one of the commentators basically in essence draws on the screen, is how we kind of see it on the other end of the TV.
Paul Schultz: Right, right. Exactly, because the OR staff doesn’t really necessarily need to see the rep on the other end all the time unless they’re physically trying to show them something, so you can essentially see the rep’s face being replaced with a screenshot that gets flashed over in real time with those visual annotations embedded over the screenshot.
Scott Nelson: Got it. Yup. Okay, cool. 00:34:07 I know we’re running short on time here, so let’s briefly discuss kind of what your proposed business model is and then kind of what the response has been within kind of the medical device industry from a company perspective as well as from an individual rep perspective, and then we’ll talk about what healthcare providers think about the Nurep platform as well. But let’s start with the business model.
Paul Schultz: Yeah. Yeah, so right now we’re currently actively investigating the best [00:34:39] market strategy and business model. We’re looking at two different approaches and one is a price per call, so a fee for every time a call is conducted or a case is conducted over Nurep. The other business model is a licensing model, so an annual license for use over the platform. We’re leaning more towards a licensing approach initially so that we can get it out in the market [00:35:07] concepts and really start to hone in on what the ideal pricing structure business model would look like.
We’ve received phenomenal response from medical device manufacturers [00:35:19] probably launch the demo mobile. We’re receiving one to two inquiries a day from interested medical device manufacturers and they’re looking at using Nurep for a number of different purposes to address some other challenges. But that’s really where we’re at with that.
One of our biggest challenges right now is figuring out how to go to market with healthcare professionals because it is easy for us, relatively straightforward for us to implement on the medical device side, but we want to make sure that we are very strategic with how we market with the healthcare professional side. So that’s something that we’re working with [00:35:58] so far with our early customers right now.
Scott Nelson: Got it. [00:36:01] On that note, because this sort of fits under the business model as well as what you just mentioned, going to market within the healthcare provider community, who do you envision, who’s responsible, I guess, for supplying the hospital or the surgery center, wherever the case is going on, with the actual hardware, the iPad in this case? And then who do you envision being responsible for sort of training the healthcare providers, the techs, the nurses, in some cases the physicians?
Paul Schultz: Yeah, so the first question you asked, we really don’t have a good answer for you on that quite yet. That’s something that we’re still working through. So yeah, we don’t really have a formal position on how we’re going to get mobile devices to the physicians. Either it’s going to be on their own mobile devices or dedicated devices under the [00:36:59] level.
Your second question… Sorry, what was your second question?
Scott Nelson: [00:37:06] Who’s responsible for kind of training the healthcare community in how to use the app?
Paul Schultz: Yeah, we’re anticipating the app to be as intuitive as possible with some overlay training on how to use it, but we’ve really built this app using Apple [00:37:24] guidelines into consideration to really provide an off-the-shelf instantaneous user experience where physicians can download Nurep and already know how to use it just through intuitive Apple development.
Scott Nelson: Got it. Got it. And those are, in my opinion anyway, relatively small hurdles because, I mean, like you just mentioned, 70% of the physicians I think based on that Manhattan Research have tablets and the overwhelming majority are Apple tablets.
Paul Schultz: Right.
Scott Nelson: iPads or iPad minis.
Paul Schultz: Yeah.
Scott Nelson: And then with increased usage I think it’s been my experience that healthcare providers are becoming more and more used to moving around within the iOS or the iPad or the iPad mini.
Paul Schultz: Right. Yeah, there will be some training on the rep side because we need to make sure that they’re operating within HIPAA-complaint bounds, and there’s going to be best practices on how to use Nurep, where not to use Nurep, etc. So there will be some training in the implementation on the medical device side.
Scott Nelson: Got it. Got it. Cool. And then you mentioned that the response on the medical device company side has been overwhelmingly positive. 00:38:52 Have you had any actual device reps sort of respond in a negative way, thinking that you’re encroaching on their neighborhood, [laughs] on their [00:39:03]?
Paul Schultz: Yeah. Yeah. No, we’ve definitely had those. We’ve definitely had those, but those have been not the norm. So the majority of reps we have spoken with have seen this as an opportunity to drive more business and see more physicians and address some of the challenges that they’re facing with respect to the current model. So the reps out in the field that are really trying to drive business are going to see this as an opportunity to increase their compensation and support more of their customers.
Scott Nelson: Sure. 00:39:40 And then also, have you had any device companies respond in a way that surprised you? Like they weren’t interested or they didn’t see the potential value in something like this?
Paul Schultz: I actually haven’t seen that specific negative response. We’ve had a lot of interesting use cases that we weren’t anticipating that they’re currently assessing in the field with some of the reps to see if there’s a viable business model around that. For example, just going to a completely repless model in certain areas where they have no reps just to [00:40:16] growth. So they don’t want to increase their headcount but they want to try and increase the growth of their business, so they’re looking at potential ways to sort of use Nurep as an extender, if you will, into areas where they don’t currently have any customers or support.
Scott Nelson: Oh yeah, I would think that would be a huge win if you could utilize that, utilize a platform like Nurep for those sorts of situations.
Paul Schultz: Definitely.
Scott Nelson: Yeah, cool. So as I mentioned—do you still have a few minutes? We’re running kind of longer than I…
Paul Schultz: Yeah. Yeah. I have a call at 11, but yeah.
Scott Nelson: Yeah, okay. Cool. So a couple of other questions sort of in conclusion. 00:41:00 Real briefly, can you talk about your experience at Blueprint Health, maybe what stood out? Were there any surprises that you experienced during your time at Blueprint?
Paul Schultz: Yeah, Blueprint was phenomenal. It was the healthcare accelerator with the largest mentorship community specific in the healthcare industry, and really the best part of that program was being exposed to other likeminded entrepreneurs. We were in a class with 11 other companies, and getting to work with them and face some of the same challenges and learn from each other, that was really the best experience, is really being embedded in the community and working side by side with other entrepreneurs that are trying to address problems in healthcare.
Scott Nelson: Yeah. 00:41:53 And other than your own company, did you have any favorites that you [00:41:58] saw? [Laughs]
Paul Schultz: [Laughs] You know, I don’t…I mean all the companies there were…
Scott Nelson: I’m putting you on the spot, Paul. [Laughs]
Paul Schultz: Yeah. [Laughs] All the companies were high-caliber to be honest. They do a superb job of selecting companies that have a solid team addressing a real problem and have the opportunity to really build a great solution in a large market. So they’re a great [00:42:27] and hats off to Brad Weinberg and Matt Farkash for really leading the way there.
Scott Nelson: Yeah. Cool. 00:42:34 And then, real quickly, in regard to your background as well as Adam’s, and you recently brought on another member of your team, Nick—I’m going to mispronounce his last name. How is his last name…?
Paul Schultz: Damiano.
Scott Nelson: Damiano you said?
Paul Schultz: Yeah.
Scott Nelson: Got it. So you mentioned that you and at least Adam knew each other through your background at Campbell. [00:42:56] So real quickly, you and Adam are early on in what appear to be successful careers. Why did you pull the trigger and go in this direction of starting your own company, and all of the risks that coincide with that you decided to go down this path?
Paul Schultz: Yeah, I think it really just had to do with a lot of the trends that we were seeing in the industry that pointed to a need for our solution. When we did the investigation, nobody out there was really doing this and it really got us excited that we could create a new marketplace, a marketplace where providers and suppliers are communicating to each other in a remote fashion over secure video. Nobody was doing this. Telemedicine was out there but nobody was taking it to the next level to improve patient care from the medical device space. And that was really what got us excited, and when we visualized the product and the solution, we really felt that this had legs.
And Nick, we consider him, you know, he’s a third cofounder. He’s a dedicated member of our team. We met him at a Hackers and Founders Meetup pretty much a couple of months after we incorporated and he was a perfect match for our team. He aligned with our vision and was an expert in medical device engineering. He has a Master’s and Bachelor’s Degree from Stanford in Engineering and was working in a medical device [00:44:39] startup developing complex algorithms for a [00:44:42] pacemaker. So his experience in that really helped us develop our communication algorithm from the proprietary technology that we have today.
Scott Nelson: Yeah. Cool. Cool. Well let’s end it on that note. Thanks a ton for your willingness to come on and tell us a little bit more about Nurep as well as what the experience has been like thus far.
Paul Schultz: Yeah, thanks Scott. No, it’s been a pleasure having me on board and it was really great speaking with you as well.
Scott Nelson: Got it. And I’ll have you hold on the line here in a second, but for those of you listening, thanks for your ear through the entire, what are we on, close to 40, 45 minutes now? I really appreciate your support in listening to this program. And remember, if you’re listening to this online, we do have a podcast. Just go to iTunes or Stitcher Radio or Downcast and just do a search for Medsider or “medical device” and you’ll find the podcasts. You can download it for free, or subscribe for free, I should say. That way, all the interviews will automatically be delivered to your device of choice whenever there’s a new one posted. So, anyway, that’s it for now. Until the next edition of Medsider, everyone. Take care.
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