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Company of the Month – Metronomic

Founded in the US in 2018, Metronomic was established in the UK in July 2019. Their first product – Materno – is an app designed with the US market in mind, to facilitate pregnancy care. It incorporates elements of telehealth, remote monitoring and patient advice, as well as AI-driven predictive analytics. We spoke to founder Dr Sujith Krishnan in September, on the 1-year anniversary of his move to the UK. 

The move to the UK

You might wonder why a company developing a product focused on the US market would re-locate to the UK. Founder, Dr Sujith Krishnan explains that, although the reasons were largely personal family reasons (discomfort with his six-year-old’s school doing ‘active shooter’ drills was one driver), there were also practical benefits. With a technical development team based in India, and developing customer base in the US, Sujith has found being in a timezone that meets in the middle quite an advantage. “I spend time with the India team in the mornings, and then the evenings with the US market,” he explains. 

There are other advantages to the UK, of course. The Seed Enterprise Investment Scheme (SEIS) has made raising early investment easier for the business (the scheme allows investors to claim tax benefits including income tax relief of 50% of the amount invested). Their latest fundraise of £225k is nearly complete, £125k of this raised under the SEIS scheme. 

Sujith is also an enthusiastic advocate of the Innovator visa, which has allowed him and his family to settle in the UK for at least 3 years to establish the business. Sujith says he was able to navigate the process relatively easily, with support from MedCity. MedCity is one of a small number of bodies invited by the home office to review applicants for the visa (and is the only life sciences-focused endorsing body), because of our expertise in the sector. Before endorsing (or sponsoring) an application, we work with the applicant to review aspects of the business such as their business case, fit for the market and investment plans. 

“My innovator visa application was made extremely easy to navigate by the proactiveness of the entire MedCity team. A process that would have typically taken  3 months to complete was done in less than 3 weeks. Most endorsing bodies only provide endorsement to companies they are incubating and some also take payments in the form of equity or cash payments for endorsement. MedCity provides endorsement purely on the basis of the innovativeness of the concept, the business appropriateness of the idea to the UK and beyond, and the profile of the person applying.

Because of the support of the team at MedCity, the visa process was as smooth as one could ever expect it to be. I think my success in the UK so far is in no small measure due to that help and the attractiveness of the Innovator visa.”

Having completed both his surgical training and his MBA here, Sujith isn’t completely new to the UK. He also comes with a long background in medicine, including the last 15 years in healthcare technology. The seed of the idea for Metronomic originally came when Sujith wrote a business plan for remote monitoring disease management as part of his MBA. With improvements in technology and connectivity, as well as cost benefits of cloud computing, and more acceptance of telehealth in general, Sujith is now seeing that original idea come to life. 

The birth of Materno

The aim of Metronomic is to take specific conditions, and build technology solutions with deep capabilities around it. Their first app, Materno, targets pregnancy and incorporates telehealth, including audio/video consultation and device integration, as well as bringing in predictive analytics through AI and machine learning.  

The telehealth aspects of the app allow for communications between patient and doctor, with tools specific to pregnancy. It can integrate with a range of devices, including to measure blood pressure, glucose and weight, as well as an FDA-compliant foetal heart monitor. It also includes practical tools for the expectant mother, like appointment-tracking and tailored health advice. 

With a focus on the US market, the analytics side focuses on the areas that significantly increase the cost of pregnancy care in the US, including gestational diabetes and pre-eclampsia.  

Picking pregnancy as the first condition to tackle was informed through both cold, hard logic, as well as a more personal experience: 

“Pregnancy is a very easy-to-define condition with protocols that are reasonably well laid out. But, there are still lots of unexpected complications that do happen. I use my wife as an example, as she developed mild gestational diabetes in her 37th week of pregnancy. It led to an early unplanned-c-section, primarily because the risk of gestational diabetes wasn’t adequately picked up. These are the sort of things we’re trying to predict better by, say week 20, which adds a little more surety in terms of treatments and planning.  

Because, now, computing is obviously a lot more effective, faster and cheaper, you can do things a lot quicker than you could in something like the Framingham Heart Study, which took 50 years of analysis to come out with your heart risk score. Now you can look through data for the last 1015 years and come up with patterns, explains Sujith. 

COVID impact

With the development of their first product at a critical stage, the COVID-19 pandemic has been something of a double-edged sword. With Sujith’s travel to the US to meet potential partners and customersuspended, pilots that were due to be launched in July were pushed out to September.  

On the other hand, the acceptance of telehealth has grown significantly. The Centers for Medicare and Medicaid Services (CMS) has allowed for doctors to be paid the same for telehealth interactions as they would for face-to-face appointments. Add to that an increased interest in telehealth from patients keen to minimise the risk of exposure from unnecessary clinic visits, and you can see why the team sees a lot of promise in their solution. 

Pilots and further developments

Pilots of the Materno app have just launched in three regions in the US, with 10 OBGYNs and around 100 patients involved in each. The pilots will last for three months, and the aim is to follow with a commercial launch, with around 100 doctors on-boarded, in early 2021 (they already have a pipeline of almost 1,500 doctors through direct relationships and channel partners). 

The team hope to move to more in-depth trials of their AI-generated predictions of complications in the coming year. They are also looking at how their AI engine might be used to introduce a level of automation for answering queries and concerns from patients. 

Designing for doctors’ needs

Feedback from the doctors they have worked with so far has been positive, and Sujith and the team are confident their product is fairly unique in the marketplace. Certainly, there are a number of maternity apps that are focused on the expectant mother’s information needs, but not many that are focused on what the doctor needs to treat the patient more easily. Sujith firmly believes that doctors should be more closely involved in the design of healthcare technology to achieve its full potential in improved health outcomes: 

“The most important relationship in healthcare is between the doctor and patient. If you can provide tools that strengthen that relationship, that is what’s going to change healthcare, I feel. If you provide the doctors with the tools to manage, monitor and stratify their patients better, then the doctors will end up providing better quality care, says Sujith. 

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