"We Can Do Better Than the US and EU". How VRNow Treats Phantom Pain in Virtual Reality – Interview

Without having experience in MedTech but with the support of doctors, in 2022, the company Advin Global began developing the VR simulator VRNow, which helps military personnel and civilians treat phantom pain in virtual reality.Today, the device is installed in over 10 hospitals and is patented in Ukraine and Germany.We spoke with the CEO of Advin Global and VRNow Lab, Artem Chyhyrynskyi, about how to launch a MedTech startup from scratch, why this endeavor makes sense specifically in Ukraine, and why virtual reality in medicine is not limited to just software.Ukrainian VR InnovationCan you explain in simple terms how VRNow works with musculoskeletal disorders?Imagine that an arm or a leg does not perform the full range of motion: the angle of inclination does not allow lifting the limb higher than, for example, 50 degrees. In virtual reality, a person performs a set of exercises, like extinguishing light bulbs. Each time, the light bulbs appear slightly further and higher. The person starts getting engaged in the game and forgets that their limb hurts, and the range of motion begins to increase.The full immersion in the environment and game mechanics is effective. There are numerous cases where doctors have noted that this patient had never lifted their arm so high in classic exercises with balls or a Swedish wall.What makes your product unique?The uniqueness of VRNow lies in the fact that this system is effective not only after amputation but also after other types of mine-explosive injuries (i.e., the nature of war), as well as civilian injuries, such as post-stroke rehabilitation.We have obtained a patent for the utility model of this development: a comprehensive virtual reality system with a unique Virtual Limp Mode to overcome phantom pain. This means that a person without a limb can "grow" it in virtual reality and use it to complete an exercise course. The patent includes the trainer complex, software, and all exercises.Our product is patented in Ukraine and Germany. We expect a patent in Italy, Poland, Austria, and France soon (we submitted applications last year). The next step will be filing for a patent in the USA.Why is VRNow both software and hardware, rather than just software that can be run on any VR headset?The notion that there's enough software for VR is something we often hear—and it's a virtual reality trap. For tasks in MedTech, the solution must be comprehensive. If a particular solution only requires a specific Oculus, that's fine, but this hardware must be tested and selected specifically for this software.The configuration of this particular device includes sensor systems that attach to the body and collect information on how various exercises work for the patient, among other things.What distinguishes the product from similar ones?We have created the most realistic 3D graphics possible through a combination of hardware and software. Our competitors all have cartoonish gaming graphics.Also, with competitors, the user sees only hands, whereas with us (and this was the most expensive part of this development), they see the whole body. This way, they fully identify and calibrate their parameters to the parameters of the virtual 3D avatar. Such technologies exist, but in the giants of the gaming industry, not in medical products.What are your plans for product development?Two to three updates are planned for the year. This does not affect the price for the clinic: the simulator costs 1,800,000 UAH, and if the hospital purchased it, for example, last year, it will receive all updates.We also plan to release a simulator for post-stroke conditions and psychological relief by 2027. Additionally, we are working on a VR product to improve vision.As of the end of the third quarter of 2023, €128,000 was invested in the project, and 11 people were working in the team. What are the figures now?Currently, about 15–16 million UAH (€285,000–320,000) have been invested in the project. The investments in the product have not yet paid off, and we continue to invest in development every day.The number of people in the team is constantly changing, but on average, there are 10–15 specialists working. We also currently have four open vacancies. We work with medical specialists on a contractual basis, depending on the tasks.Are you looking for external investments?Last year, we won a €50,000 grant from the Seeds of Bravery program by the European Commission. Now, we have advanced to the second round of the major European accelerator, EIC Accelerator. If we win, we will be able to enter the EU markets more effectively and quickly: we will cover clinical validation in the EU, regulatory aspects, R&amp;D, collaboration with universities, and so on.We have not yet attracted any external investors, although VRNow Lab is working on it.How many simulators are currently installed and where?VRNow is installed at Unbroken, "Okhmatdyt", Nikopol City Children's Hospital, the "Path to Health" center in Dnipro, and several departmental hospitals and military hospitals that I cannot name. In total, about 13. In the next two months, we plan to install 5–7 more simulators.About the Company and Its Social ProjectsBehind the development of VRNow is the company Advin Global. What is their expertise, and what other projects have they developed?Advin Global is a service company that has been operating since 2017. Since 2022, we have also started building an ecosystem of our own products. Everything we release is based on AR, VR, and 3D technologies. Although VRNow was born in Advin, the product has now been spun off into a new company called VRNow Lab.Advin continues to work on both commercial and social projects. For example, "Places of Memory" – an interactive VR route through the Kyiv region, which recreates key locations where the capital was defended in the spring of 2022. At last year's peace summit in Switzerland, we showcased virtual reality videos of destroyed Ukrainian cities.Why are you interested in doing social projects, and how do you balance it with commerce?We are almost 10 years old, so we have a client base (including Visa, Coca Cola, Delonghi, and McDonald's) and a financial cushion. Additionally, social projects are not always entirely non-profit—sometimes at least the cost of the work can be covered.My opinion as a business owner (and the entire team shares it) is that it's not just about donations. AR/VR is our support for Ukraine in international politics – through immersive technologies, we can convey the context much more deeply than through just videos.Our technology is 100% made in Ukraine, and it is important for us to remain that way, although sometimes it affects investment attractiveness. We were offered to move it to another jurisdiction, but we have a principled position not to do so.Are there more Ukrainian clients or those from abroad?Last year it was about 50-50, with even a slight advantage for Ukraine. On average, we receive 20-30 applications per month from Ukraine.This year, most likely, there will be a greater advantage from abroad because we have entered the Polish market and are also actively entering the UK market.Did you have experience with MedTech before VRNow, and why did you decide to create a product specifically in this direction?In 2022, after the first 3–4 months of the full-scale war had passed and we had somewhat "stabilized," my partners and I started thinking about our next steps. We had a certain amount of money that we could spend on international marketing or the development of a new product.The idea of VRNow as using VR to overcome phantom pain came from one of our employees—we are always open to suggestions that could develop into a product. We previously had no experience in MedTech, but we immediately liked the idea, so we delved into the subject.We looked at what is being done in the US and Europe. We realized that our team's technological stack would allow us to create something similar (and even better), so we decided to give it a try, understanding that there is already a need for such a product in Ukraine, and unfortunately, the demand will only grow. After that, we garnered support from specialized doctors and rehabilitation centers (such as "Path to Health" in Dnipro). They guided us on what specific functionality is needed for users to physically recover while using the machine.Read also"Creating 20-40% of Jobs in Ukrainian IT". How Genesis Builds an HR Brand: Interview with CEOAbout MedTech in UkraineWhat are the main stages of implementing a MedTech product for actual use in hospitals?First, gather a team: technical specialists for IT development and practicing doctors. Second, ensure testing in a real hospital. The test results will provide insights on how to improve the product—refinements may take 6-12 months.When the product is ready, it is necessary to take care of intellectual property (obtain a trademark for the product, copyright for the software code, and a patent if the product is unique), as well as obtain a certificate of conformity (gather scientific evidence and conduct clinical validation). Obtaining the certificate may take up to a year.As soon as you have a certificate of conformity, you can sell the product to hospitals. Trade shows specializing in MedTech work best for sales—in the past year, we attended more than 12.Further, educational seminars can be held for doctors, which will improve their qualifications and enhance your recognition. We hold full demo days in hospitals across different regions, where doctors and patients can test our product.What challenges may arise during this process?It is a very complex, meticulous, and expensive task in principle. Specifically, we also faced many obstacles in the path of clinical trials. Because our product is used particularly for injuries related to military actions, and they are often treated in departmental hospitals that do not have the right to conduct research.Is there a difference in collaboration with public hospitals compared to private ones?Almost nothing, but private hospitals, in particular, look at the return on investment put into this simulator. Public hospitals do not sell services for money, so they don't have this issue. On the other hand, this is precisely why they might want to purchase the product but lack the funds. We try to help with this: we have a fundraising division and run campaigns to assist hospitals in raising funds.For example, Visa helped raise funds for equipment for the Lviv rehabilitation center Unbroken. When people in Lviv's transport paid with a Visa card, one hryvnia from each trip was donated to the fundraiser.How do you generally assess the MedTech sector in Ukraine? What works well, and what issues exist?The Ministry of Digital Transformation provides great support to MedTech startups – an entire ecosystem is being created for this domain. Because MedTech is not only about medical devices, but also, for example, software for doctors.In Ukraine, it is important to develop this sector because for such a large number of patients, we need to implement innovative approaches in various fields: from rehabilitation (including sexual) and surgery to mental health. Ukraine is currently a market where this can happen relatively quickly and with maximum efficiency. This is a phenomenal opportunity that has unfortunately arisen due to the tragedy of war, but it is very much needed. Just as DefenseTech is rapidly developing here, MedTech should too.From the state's side, it would be desirable to see additional regulatory sandboxes. This would make it easier for foreign capital to enter and invest in the research and development of medical technologies.What can the commercial sector do?The commercial sector should not be afraid to invest in clinical trials and research—this culture is generally lacking in Ukraine. Additionally, they should not be afraid to collaborate with public hospitals—they want innovation. It seems that if a hospital is public, then it has some old walls, and everything is frightening and gray. But this stereotype should be broken.To what extent should MedTech R&amp;D development in Ukraine be centralized?Largely decentralized because there are many different directions, and specialization is needed everywhere. This is not an industry that can "produce fakes": where one can hypothetically claim that some great architecture was created, but in reality, it's just wrapped in a nice ChatGPT cover. Mistakes cannot be made because the cost could be the patient's health.Read alsoHow Blockchain Affects the Stability of Cryptocurrency: Explained with Examples of Ethereum, Solana, and Polygon

Comments