The Future Is Now: “Now we have Star Trek’s Medical Tricorder on a smartphone” With Cloud DX CEO Robert Kaul & Fotis Georgiadis

Obviously a simple smartphone app that can effectively screen for TB would have a huge impact on the diagnosis and treatment of that disease — we hope to be a part of the eventual eradication of TB in humans! More broadly, the promise of a “Medical Tricorder” is nothing less than the democratization of medicine. If you can get effective diagnosis and treatment information — with high accuracy — from a sleek device in your home, school or office, it will help make healthcare more available, affordable and convenient. People ask if doctors are afraid they will be replaced — we reply that on the contrary, most doctors welcome new technology that makes their jobs easier and their patients healthier, as long as it works. Doctors would rather be treating patients than typing data into the EMR… That’s one reason most of the investors in our company are doctors!

As part of my series on “Bleeding edge” technological breakthroughs that seem copied from science fiction, I had the pleasure of interviewing Robert Kaul, founder & CEO of Cloud Diagnostics (or Cloud DX for short), an award-winning digital healthcare startup that’s known for creating easy to use medical technology inspired by science fiction. Robert was born in the far north of Canada, and moved from Vancouver BC to New York City in 2005. Cloud DX is his sixth startup as founder or senior executive — and the most fun!

Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?

My parents were medical professionals (Dad-doctor, Mom-nurse) and I studied science in University so I’ve always been fascinated by medical technology. I was introduced to the device we now call Pulsewave (our advanced blood pressure monitor) in 2009 and I thought it was extraordinary, so in spite of having just being fired, and with literally zero money, I bid for and won the exclusive US rights to the product! I quickly had to write a business plan and with that I was able to raise nearly $1 million. Six months later I sold my fledgling company to the manufacturer of the product, and joined them as global VP of Sales. Within two years I was appointed CEO of that company, and in 2014, with some partners, we bought out all the Pulsewave technology to form Cloud DX. So that meeting in 2009 started it all.

Can you share the most interesting story that happened to you since you began your career?

Before moving to New York City, I owned a tiny film & TV production company in Vancouver BC. Right out of film school I rented a camera and went to Whistler BC to make a documentary about a weekend long film competition. I was just practicing, but I followed several of the teams and got some great footage. Then I learned that the official TV producer sent by the big network to cover the competition was delayed by a snowstorm — by the time he got there, the competition was over. I somehow got his cell number, called him out of the blue, and it turned out that I had exactly the footage he needed! So that’s how the very first video I ever shot wound up on CityTV in Canada. That producer later tapped me to help produce a feature film. The lessons I learned were — always do your work at the highest level even if you think you’re just practicing, and pay attention because luck is about recognizing opportunities.

Can you tell us about the “Bleeding edge” technological breakthroughs that you are working on?

Cloud DX is best known as the winner of the Bold Epic Innovator Award from the Qualcomm Tricorder XPRIZE competition. Our prize-winning entry, the Vitaliti™ Tricorder is capable of measuring all of a person’s vital signs continuously, analyzing tiny samples of bodily fluids with a ‘lab on a chip’ designed by our partners at Stanford University and then autonomously diagnosing 19 separate medical conditions, as varied as HIV, Mononucleosis, Sleep Apnea and Hypertension. One key feature of the system is the ability for the Vitaliti software to detect and diagnose respiratory diseases by recording and analyzing the sound of a person coughing. We are commercializing our wearable Vitaliti continuous vital sign monitor and also our Cough Analysis software application right now, and we hope to launch the first commercial products to emerge from an XPRIZE in 2020.

How do you think that will help people?

We are already working with several academic institutions to prove out compelling use cases for our Vitaliti medical wearable. It’s the first consumer-friendly, comfortable wearable that can do multi-lead ECG as well as measure continuous blood pressure without any kind of inflatable cuff. It will be used to monitor patients after complex surgery, as they go home from the hospital, to make sure they are healing well and getting better. People who have complex chronic conditions will use it to help stay out of the hospital. It will be used to monitor patients before outpatient procedures like cardiac CT scans. There are even uses planned for ambulances and aboard airplanes. Meanwhile, in 2019 we’ll begin using our Cough Analysis smartphone app to screen patients for tuberculosis in Maputo, Mozambique. We hope that after our study is complete, our app becomes a standard screening tool for TB all across Africa and in other developing countries.

How do you think this might change the world?

Obviously a simple smartphone app that can effectively screen for TB would have a huge impact on the diagnosis and treatment of that disease — we hope to be a part of the eventual eradication of TB in humans! More broadly, the promise of a “Medical Tricorder” is nothing less than the democratization of medicine. If you can get effective diagnosis and treatment information — with high accuracy — from a sleek device in your home, school or office, it will help make healthcare more available, affordable and convenient. People ask if doctors are afraid they will be replaced — we reply that on the contrary, most doctors welcome new technology that makes their jobs easier and their patients healthier, as long as it works. Doctors would rather be treating patients than typing data into the EMR… That’s one reason most of the investors in our company are doctors!

Keeping “Black Mirror” in mind can you see any potential drawbacks about this technology that people should think more deeply about?

The clear danger is the growing economic inequality in the world. If the only people that can access our new Tricorder technology are the rich, then we will have failed in our mission. We are committed to working with stakeholders and partners that share our vision of the wide availability of our devices & apps, on Android phones in the poorest countries as well as on iPhones in the rich world. We are thrilled to be working with groups like our partners Joule Inc, a Canadian Medical Association company, as well as with the XPRIZE Foundation, Qualcomm Life and the Roddenberry Foundation, to deliver our products to patients in Africa and soon other developing nations.

Was there a “tipping point” that led you to this breakthrough? Can you tell us that story?

When we began our XPRIZE journey we knew we could measure vital signs accurately… but not continuously. All the other aspects of our Tricorder we had to invent from scratch. The real breakthroughs came about halfway through the competition when the working Tricorder prototypes started to come together. We were testing it in the hospital, and it was able to autonomously diagnose a condition in a test patient that the human doctors and nurses had missed (and not the one we were originally testing for!). We were all stunned — it was like the AI had come to life! It was at that moment that we realized that we had a chance to really change the way healthcare is delivered around the world.

What do you need to lead this technology to widespread adoption?

Commercializing a new medical device or software app is a long, expensive, sometimes exhausting endeavor. We must meet stringent FDA and Health Canada regulations, as well as international standards. We have to conduct independent 3rd party academic studies to prove our devices and software are accurate and effective, and ideally those studies need to be published in peer-reviewed medical journals. We need to prove that our solution meets the so-called “quadruple aim” of medical innovation — (loosely paraphrased), it has to work better for doctors, it has to be easier to use for patients, it has to produce better health outcomes, and it has to cost less than the current standard of care. We have accomplished or are in the middle of accomplishing all these requirements. Now we just need to keep going. Our technology is beginning to be used across Canada, and around the world. In the United States we are partnered with some amazing organizations, including University of California San Diego and Trapollo LLC, a company owned by Cox Communications. Our goal is to keep delivering great products and work every day to scale up our sales, deployments and patients under care.

What have you been doing to publicize this idea? Have you been using any innovative marketing strategies?

Cloud DX has done a really good job building our brand, entirely with in-house resources. During the XPRIZE competition we were able to capitalize on our perceived status as a genuine innovator to leverage an appearance in a feature length documentary from Smithsonian Channel called “Building Star Trek”, which in turn lead to speaking engagements at San Diego Comicon! We’ve spoken at TEDx Toronto, SXSW and this year we were featured at TEDMED. We’ve part of the Singularity University ecosystem, and our appearance at Singularity University Canada was covered by Discovery Channel. I could go on and on. I’ve found that there is no substitute for genuine “earned media”, but usually it’s a full time job for a whole team of people, and so our profile in the media, with only me, Sonny Kohli (my cofounder, Chief Medical Officer, and a full time doctor) and our great graphic designer doing the heavy lifting, is remarkable.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

All my cofounders and many of our investors are key members of our extended team, but I have to single out Dr Sonny Kohli, our Chief Medical Officer. He’s a full time practicing physician in Oakville ON, but he still finds time somehow to speak at multiple events every year, visit customers all over the world, appear on TV, and constantly work on raising money. Sonny is a former Canadian Astronaut Program finalist, he’s spent time in Haiti volunteering after the huge earthquake there, and he also oversees many of our clinical studies & trials. And if that’s not all, to date he’s done all of that without drawing a steady salary from Cloud DX! Sonny is the public face, and also the heart & soul, of Cloud DX and we wouldn’t be here without out his tireless work.

How have you used your success to bring goodness to the world?

We discuss this all the time at our Technology HQ in Kitchener ON. A few years ago we worked with the local health authority near Kitchener ON to care for some very sick patients in the local community who had multiple chronic conditions. It was great because it meant that our coders, developers and engineers could actually visit the patients they were helping. In one memorable case, a tech worker recieved a huge hug and heartfelt tears from a lady who said we saved her husband’s life by detecting early warning that he needed to go to hospital. You don’t get that when you are coding software to maximize clicks on websites. Our mission to deliver care to those who need it definitely keeps us going even when times get tough!

What are your “5 Things I Wish Someone Told Me Before I Started” and why. (Please share a story or example for each.)

  1. Everything takes longer and costs more. This is a trite statement but we forget it at our peril. No matter how you plan, it seems everything takes 2 times as long as costs 2 times as much, so you need to be flexible enough, and resourceful enough to keep going even in the face of this fact.
  2. Really listen to dissenting voices. I once made the mistake of hiring the wrong person for a key job, in spite of the cogent objections of my someone on my leadership team. This person had the support of other managers, and so I went ahead even though we did not unanimously agree. I fooled myself into thinking I could make it work. It did not work out, and we lost precious time and money as we figured that out. Also it wasn’t fair to the person we hired. So — lesson learned. Really listen to those dissenting voices and get to the bottom of where they are coming from.
  3. Communicate with your team, more than makes you comfortable. I’m constantly running into this challenge. It’s hard to discuss your fears and stressors with the people you lead — you want to give them the impression that you have everything completely under control. Of course they see right through you so if you don’t communicate they just wonder what you are not telling them.
  4. Don’t ever assume that someone else has done the due diligence. Really — we need to teach this to kids in middle school. It’s so easy to assume that someone bigger, smarter or richer than you has given any proposed project, partner or investment a hard look and so you don’t have to do it. This is almost always wrong and making this mistake can be fatal to your plans or even to your company.
  5. Here’s one I was told and it has helped me every day: “Courage is not the absense of fear; courage is the conquest of fear”. As entrepreneurs we are always terrified — of failure, of letting down our customers, our investors, and especially our long suffering families. Every day we have to conquer that fear just to get out of bed — but we do it, over and over and over again. Here’s another great quote I live by some days: Winston Churchill once said “Sometimes it’s not enough to do one’s best. Sometimes one must do what’s required”.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

Gosh that’s a tough one! I wouldn’t presume to invent a new movement. If I ever achieve a modicum of influence I would throw it behind those leaders who are fighting for equality of access to resources in the poorest parts of the world. We hope to make our own modest contribution to rural, developing nation healthcare and we hope to aspire others to join with us.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

I’ve quoted Winston Churchill above and I’ll do it again — my favorite WC exhortation, given to the British nation during the darkest hours of WWI: “Never, never, never… NEVER Give Up!”

Some very well known VCs read this column. If you had 60 seconds to make a pitch to a VC, what would you say? He or she might just see this if we tag them 🙂

Cloud DX is delivering genuinely innovative solutions to some of the largest current problems in healthcare, including hospitalizations due to chronic illness, infectious diseases in the developing world, and non-adherence to medication. We design and manufacture unique, clinical grade medical devices and couple them with cloud-based machine learning algorithms to detect and classify disease conditions. Our Cough Analysis mobile app can screen patients for tuberculosis, using only the sound of their cough; our Vitaliti wearable continuous vital sign monitor can stream all the main vital signs including non-invasive blood pressure, without a cuff, for 12 straight hours. Our revenues are increasing year on year and we are poised to grow strongly in the United States as we take advantage of new CMS billing codes for remote patient monitoring. We’ve raised $13M to date without yet taking any VC, and we are backed by physicians across North America, including by Joule, a Canadian Medical Association company. We’ve won many awards including the first Bold Epic Innovator XPRIZE and “World Changing Idea” from Fast Company. We’d like to find a large financial partner to help us take our innovations global. Please email [email protected].

How can our readers follow you on social media?

Linked In: https://www.linkedin.com/in/robertkaul/

Twitter: @robkaul

Thank you so much for joining us. This was very inspirational.


The Future Is Now: “Now we have Star Trek’s Medical Tricorder on a smartphone” With Cloud DX CEO… was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.

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