Updated 21 July 21
Ali Haddad is a fairly extraordinary entrepreneur. He has a first class honours degree in Neurosciences from Imperial College London, and honorary research positions at the University of Oxford and St George's Medical School. So to say he has the domain expertise needed for a digital health founder would be an understatement!
Having previously co-founded the internationally acclaimed GoodSAM app (an volunteer response app for NHS emergency services), Ali has now joined forces with Nova to build NeuroNav, a platform that is working to improve neurosurgical performance through computer vision and augmented reality. We spoke to Ali to find out what excites him about neurosurgery, and how it drove him to confound NeuroNav.
I was drawn to neurosurgery even before I applied to medical school, partly because someone close to me had suffered from a brain tumour. The uncertain outcomes, the fear, the emotional and physical pain that both the patient and those around them must endure are hard to describe.
Neurosurgery is a specialty where the surgeon cannot just focus on treating the disease. The surgeon has also to attempt to preserve the patient’s identity – the most important characteristic of our existence.
One of the difficult aspects of the job is to prepare the family for what is to come and to discuss what kind of life is worth living. This is not just a matter of sickness and health, life or death. Are we, for example, willing to sacrifice a young girl’s speech and language to gain a few years of life?
Neurosurgery not only calls for excellence in emotional and physical capabilities but for a deep sense of moral values. This is what attracted me to the specialty years ago, and to be honest, was the only reason I went to medical school. I am fortunate and privileged to be able to pursue that goal now.
Can you imagine a situation where you operate on the most complex and unforgiving organ without the vision you need? Based on my experience in theatre, I was frustrated by the inefficiency and bulkiness of current navigation systems.
With minutes to spare in emergencies, we often abandon navigation and perform procedures free hand. This has consequences – according to published evidence, for ventricular catheter placements there is a 20% revision rate due to misplacement.
The current suppliers have almost a monopoly foothold in the market, and charge extortionate amounts for their solutions. As a result, there is a poor uptake in low and middle income countries, and at least 14% of their patients don’t have access to navigation. We need a solution that empowers and augments neurosurgical performance and vision, regardless of where in the world the operation is taking place.
Every day is different, each with its own challenges and opportunities to learn. I don't think there is such a thing as a typical day in neurosurgery, you start the day as early as you can on a normal day making sure your patients are ready for surgery, completing a ward round and ensuring patients are ready for discharge. The rest of a “normal” day will be either spent in a clinic or the operating theatre dealing with any cranial or spinal issue, in adults or in children. The variety of cases and breadth of knowledge you need means there is always an opportunity to keep learning.
When you are oncall, you need to be as good at operating as you are with making decisions. Which often may be life changing or life and death decisions. Whether it's 4pm or 4am, you need to be consistent and apply the same level of concentration.
It would seem almost impossible to launch a startup alongside a full-time neurosurgery training programme. However, I would say that NeuroNav has added more drive and enthusiasm for what I do because it’s aiming to solve a key issue in neurosurgery – which really is a global health inequality problem. NeuroNav and neurosurgery complement each other, and both excite me to keep going.
Simply put, we want to reduce the risk associated with performing neurosurgery “free hand” by enabling better access to navigation, both in emergency settings and globally. In addition, the surgeons will have better vision through augmented reality glasses, meaning they get 3D vision of the patient’s anatomy and no longer have to look away from the patient to focus on a secondary screen to orientate themselves. All this combined together, presents a future where fewer patients will have prolonged stays in the hospital, requiring redo surgeries and will experience improved outcomes as result of more accurate neurosurgery.
In medical school, you don't get taught anything about setting up or running a business. So it is definitely a challenge when a clinician wants to start their entrepreneurial journey. Working with Nova has allowed me to focus on giving the startup direction, focus on the problem and validating the solution. I found myself feeling less lonely in the journey, and worrying less about recruiting the right skills and general administration of a registered company.
With startups, it's hard to predict what you will be doing in a month let alone 5 years. The best way to answer this is to say what I hope – and fantasise about.
NeuroNav would have achieved CE marking by this point, and had at least a year of sales and an uptake globally with neurosurgeons who have really embraced the product. The team would have been able to build something that makes their lives easier to perform high risk operations. Regions in the world that never had navigation, would be now using it. We would have published some data on how using our system was improving patient outcomes – and we would be well on our path to help make neurosurgery safer worldwide.
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