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Company of the month: 11 Health

On 30 May, Michael Seres sadly passed away following a sepsis infection, aged 51. Michael was a passionate patient advocate and campaigner, as well as being a successful entrepreneur. Michael and MedCity’s paths crossed many times over the years, in particular during the early stages of him developing his business, so we know his passing will be a great loss to anyone that knew him. In tribute to Michael, our June Company of the Month is the company he founded – 11 Health.

The inception of 11 Health was the result of a deeply personal journey for Michael Seres. Diagnosed with Crohn’s disease at the age of 12, Michael had already endured 25 surgeries by the time he became an early recipient of an intestinal transplant in 2011.

He was just the 11th patient in the UK to receive an intestinal transplant, and was warned that five of the earlier transplant recipients had not survived. Despite this, the operation was successful, albeit Michael would continue to battle with health problems for the rest of his life, including having a stem cell transplant and three bouts of cancer.

It was during the difficult process of rehabilitation from his transplant operation that Michael was fitted with a temporary ostomy bag (a pouch attached outside the body to collect intestinal waste). He keenly felt the same frustrations as many thousands of patients before him – at this low-tech solution that is prone to spillages and complications, and comes laden with emotional and practical challenges for patients.

With so many battles already behind him, Michael was not one to simply accept the situation without a fight. Despite not having a background in engineering or medical devices (he had been a successful licencing agent until now), Michael researched and developed his own solution, with parts sourced online. Sensors on the bag would warn him when it was full, and so would prevent it from overflowing. He then added further developments to allow for measuring outputs that would provide better data for his doctors.

A business opportunity

From here, 11 Health was born. Recognising that his innovation was, essentially, the first attempt to develop the design of ostomy bags in the last 60 years, Michael turned his hack into a business.

Paul Gordon is 11 Health’s Chief Marketing Officer, and also knew Michael for over 20 years:

“After his operation, Michael always felt very privileged and very lucky – that he owed it to the person that had given him life to see the possibilities before him. He also felt strongly that, to make a change for fellow patients, he needed to create something that was not just a pressure group, but was a thriving commercial entity.”

Despite interest and investment in the UK, Michael and his team had found the barriers to selling into the NHS difficult for a start-up business. Sensing opportunities in the US, he set up shop in Orange County, California and, in 2018, launched a new product – an iteration of the sensor that he had made himself in hospital.

A smart ostomy wearable

11 Health now offers the world’s first smart ostomy wearable – the patented alfred SmartBag – along with their SmartCare platform. With solutions for patients, nurses and doctors, the system improves quality of life for patients, as well as providing enhanced monitoring and patient data for healthcare providers.

Paul continues: “What happened in the States was amazing. Michael’s advocacy work had already long before stretched to the States from his hospital bed. He was invited to all sorts of places to speak – in hospitals and health conventions and he gave a TED talk… It was just amazing.”

Following two years of growth in the US, the company has recently launched its latest wearable –SmartBag 2 – a more streamlined iteration, with enhanced monitoring and reporting capabilities.

Paul says: “The amount of data that our wearable can generate is extraordinary and it transforms patient care. Patients are able to self-monitor, but also clinical teams have access to a dashboard which allows them to remotely monitor the patient, predict complications, and therefore hugely reduce readmissions back into hospital.”

Personal connections

A strong communicator and true ‘people person’, Michael’s blogging during and after the process for his 2011 transplant attracted over 100,000 readers, and he used social media to interact with fellow patients and even his own doctors. He believed firmly that “healthcare isn’t about technology, it’s about relationships”. This trend continued, and was the central tenet of his activism around patient engagement.

It’s no surprise therefore, that the 11 Health solution doesn’t only provide the hardware and app for monitoring patient data. It also includes peer-to-peer support for patients through its Patient Coach Programme. This gives patients direct access to a trained patient coach – someone who is also, or has been, an ostomy patient.

Telehealth care is also included, through an in-house team of nurses who provide clinical expertise, real-time patient assessment, and real-time chat for patients.

Paul explains:

“When a patient has an ostomy, they have 1000 questions about their health and about what life is going to be like… Can I work? Can I shower? Can I be intimate with my partner? Can I go swimming? Can I ever be more than 100 yards from the bathroom? A nurse may not have the time to go through all these questions and, in some cases may not even know the answer.

“So, whenever we add a new patient, we give them access to a patient coach. Someone who’s been there. And, certainly for the first 90 days of being a new patient, what they form with one of our patient coaches is probably the tightest and most intimate relationship they have in their life. They have deeper, more personal conversations than they would even with their partner, parents or children.

“That’s something that, when we talk to patients, shines through as crucial to the incredible customer satisfaction results we see. It came very much from Michael’s personal experience, and will be just one of the examples of his spirit living on in the company.”

Growth in the US, but heart in the UK

Although 11 Health’s business growth has been in the US, its roots remain in the UK, and Michael’s activism and engagement in the UK has undoubtedly had an impact on our digital health industry.

MedCity CEO, Neelam Patel, had many exchanges with Michael as he began to build 11 Health:

“Michael showed great passion in pushing forward innovation development, and particularly patient-led innovation development. During the time 11 Health was in its infancy, we were also in our infancy in starting up MedCity and we learnt a lot from each other. At that time, digital health companies were few and far between, and particularly patient-led companies. There were no clear regulations or technical standards at the time, and no widespread adoption of digital health. We worked with him on completing a health outcomes analysis, and on mapping adoption of digital health in both the UK and US. This all fed into our work in highlighting and trying to resolve the challenges that digital health industries were facing in lack of evidence and regulatory standards and a complex ecosystem to navigate.

What was really commendable about Michael was that, even after 11 Health began to take off in the US, he never lost his passion for the UK health system and the NHS in particular. He continued to engage and played a really important role as a patient ambassador and champion. That’s something we are really sorry to lose.”

Paul Gordon points out that, although the company’s efforts are primarily focused in the US, and that is where their growth has been until now, there remains a firm intention to grow internationally, including in the UK:

“The aim has always been to be an international company and to grow into the UK and other markets with similar challenges. So beyond 2020, our intent is definitely to return to our origins in the UK and to once again look to support the UK by growing the business here.”

A future beyond ostomy wearables

Aside from growing business in the UK and beyond, 11 Health also sees a place for themselves in medical tech for other health conditions.

“We’re, at our heart, a medical wearables company, and where we can produce smart medical wearables that help people in other areas of healthcare, we’ll do it. And, of course, we’ll also be looking at other medical conditions which are analogous with ostomy care – where, as we’ve already seen, aspects of the wider health ecosystem haven’t supported patients enough,” explains Paul.

Continuing to take the lead from patients

Michael Seres spoke passionately about putting patients in control of their healthcare, and bringing patients into the process of designing solutions. So how will the company continue to let patients take the lead, having sadly lost their chief patient advocate?

Paul explains how the company remains dedicated to this ethos, largely through the patient advisory group that has been established within the company. A group of at least six patients or former patients (also employees of the company) take a key role in influencing decisions, keeping the focus on patients’ experiences.

“That group has been created to make sure that we never lose sight of why we do what we do, which is to support patients. We will never become a faceless corporate entity that sees patients as commodities – that isn’t what Michael ever wanted. Michael’s wife, Justine, is also now on the board of 11 Health. She’s a wonderful person, who sees her role as being the custodian of Michael’s vision in that respect, and we’re delighted that that’s the case.”

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