 Hello, and good morning, good afternoon or good evening depending on where you're joining us from today. Welcome to Engineering for Change or E4C for Shorts. Today, we're very pleased to bring you this month's installment of the E4C 2018 webinar series, how the Internet of Things and Human-Centered Design enable life-saving health solutions. My name is Yana Aranda and I'm the president here at Engineering for Change. I'll be your moderator for today's webinar. The webinar you're participating in today will be archived on our webinar page and our YouTube channel. Both of the URLs for those channels is listed on the slide. Information on upcoming webinars is available on our webinar page. Any E4C members will receive invitations to the upcoming webinars directly. If you have any questions, comments and recommendations for future topics and speakers, please contact the E4C webinar series team at webinars at engineeringforchange.org. If you're following us on Twitter today, please join the conversation with our dedicated hashtag, hashtag E4C webinars. Now, before we move on to our presenter, I'd like to tell you a bit about Engineering for Change. E4C is a knowledge organization and global community of more than one million engineers, designers, development practitioners and social scientists who are leveraging technology to solve quality of life challenges faced by underserved communities. Some of these challenges may include access to clean water and sanitation, sustainable energy, improved agriculture and more. We invite you to become a member. E4C membership is free and provides access to news and thought leaders, insights on hundreds of essential technologies in our solutions library, professional development resources, and current opportunities such as jobs, funding calls, fellowships and more. E4C members also enjoy a unique user experience based on their site behavior and engagement. Essentially, the more you interact with the E4C site, the better we'll be able to serve you resources aligned to your interests. For more information, please visit our site and sign up. Now, one of the exciting announcements we have today is about one of our features, namely our solutions library. There is a real struggle when it comes to funding technical information about products developed for and used by those living in poverty. Data is often scarce, biased or inaccurate. These information gaps have had a number of consequences. For example, losses of lessons learned and reinvention of the wheel, challenges in assessing performance and scalability, ineffective implementation of solutions and lack of transparency and accountability for poor quality or unsafe products entering the market. In 2012, E4C took on the challenge of co-designing a resource with our community of development engineering experts. That resource is our solutions library. We took a phased approach and stress tested our framework for several iterations with a growing early adopter community. Today, we are very happy to announce that the solutions library is now launched as an E4C member benefit. What does this mean for you? It means that you get a much better integrated and improved user experience, a new design with related content tie-in, improved functionality in that experts and users are able to upload photos, use your experience reports and case studies on their experiences with solutions. In addition to this, E4C is supporting the solutions library with diverse content partners and a multidisciplinary network of expert advisors. We also host an annual research fellowship with a global cohort of amazing fellows who help us develop and fold the solutions library. One of our solutions library collaborators is the World Health Organization. The WHO and E4C share a commitment to transparency, informed decision making and better solutions to meet the end user's needs. We have been working together to develop a solution library framework, evaluate success and evolve our data tools. Moving forward, users will be able to access information from the WHO's Compendium of Innovative Health Technologies for their resource settings in the solution library. E4C will serve as a due diligence platform and complementary resource for solution seekers in the health sector. A really great example of a solutions library entry is actually courtesy of our current presenter on today's webinar. This is a Neopendas Vital Sign Monitor, which you'll hear more about today and you'll see here the URL listed for the entry in the solutions library. You can feel free to check out to this product in the solutions library after today's webinar. So, a few housekeeping items before we get started. We'd like to invite you to practice using the WebEx platform by telling us where in the world you're joining us from. In the chat window, which is located to the bottom right corner of your screen, please type in your location. I'll get us started. Here we go. So, let us know where you're from today. All right. And for those of you who are not seeing the chat window open on your screen, try clicking the chat icon on the top right-hand corner. You can use this window to share remarks during the webinar. If you have any technical questions, just in a private chat to the Engineering for Change admin. During the webinar, please use the Q&A window, which is located below the chat, to type in your questions to the presenter. Again, if you don't see this window, click the Q&A icon on the top right-hand corner. If you're listening to the audio broadcast and you encounter any troubles, try hitting stop and then start. You may also want to try opening up WebEx in a different browser. All right. Well, thank you for joining us, everyone, from around the world today. We really appreciate you logging in. And don't forget that E4C webinars qualify engineers for one professional development hour. To request your PDH, please follow the instructions on the webinars page or the professional development page after the presentation. All right. And with that, I am so excited to tell you a little bit about today's webinar and our presenter. There is an acknowledged need for medical solutions that are designed specifically for resource constrained environments. Wearable technologies present an opportunity to meet the cost, power, and performance constraints of low resource settings. Today, we're pleased to welcome Sona Shah, co-founder and CEO of Neopenda, a medical device startup innovating health solutions for emerging markets. Neopenda's signature product is a wearable vital signs monitor that alerts nurses when newborns are in immediate need of attention. We're excited to learn about the solution and the Neopenda startup journey. Sona really has a great background. Her past global health entrepreneurship began when she earned her Bachelor of Science in Chemical Engineering from Georgia Tech in 2011. And subsequently worked as an engineer in bio-press research and development at Eli Lillian Company. She followed her passion for service to Kenya, but in time as a teacher and an engineer without borders volunteer. Sona's interest in eating under-resourced community continued during her research involvement with Unchip, a point of care diagnostic device for HIV and syphilis developed at Columbia University. She also worked at the TB Alliance, both in community engagement and drug discovery for medications that treat tuberculosis. Sona completed a Master's in Biomedical Engineering at Columbia University before launching Neopenda where she develops works to develop impactful solutions and sustainably delivers them to the world's most vulnerable populations. With that, I turn it over to Sona to tell us a little bit more about Neopenda and her journey. Thank you. Thank you so much for the introduction and for all of you who joined. I'm really excited to share more about Neopendas and how we use their programs. So jumping right in, the overview for today, so I'll share a little bit about my background. Although, Yana, I'll dive right into what is Neopendas and what we're doing with our first product, but I'd really love to focus a lot of the discussions around the human services and how to translate projects from academia to the startup world and what the trends are in that space and what's next for Neopendas and what I think is next in just the general space as well. So throughout all of this, please feel free to send over any questions that you may have. I'll try to relate it to Neopendas and give you an overview of our process that certainly give you a landscape and what the general topic is about as well. So my story, a little bit of background that we heard a little bit about. So I did my chemical engineering degree and graduated semester early. So I thought, why not do something totally different before starting to work? So I spent three months as a teacher in Western Kenya and just absolutely fell in love with the culture and the community that I was exposed to. But, of course, spending three months there, you're naturally drawn to some of the inequities that also existed there and that kind of planted the seed for a lot of the work that I am doing now. Eventually, I did come back to the state and start working at a pharmaceutical company in R&D, so I was doing bioprocess research and development, working with bioreactors. I loved the engineering side, loved the product development and healthcare side of things. But I often found myself thinking about how the kids that I was teaching in Kenya, they would never really see the medicines that I'm helping create. And that kind of fade away at me a bit. So I thought, I'm going to take a leap of faith. I go back to graduate school, get my master's in biomedical engineering, particularly to figure out some way to combine engineering, healthcare, and international development. So I went to Columbia, particularly for a lab that was creating an HIV and SIFLIS diagnostic. So I wanted to get some of that hands-on experience, in addition to just being in New York and having all of that exposure to the nonprofit sector. And it was in my second semester in a bio-design course that I met my now co-founder, Teresa, and we ended up starting Neopenda. So what exactly is Neopendum? Well, we are creating medical devices for low resource settings, starting with a focus on newborn care. And so I'll talk about the brief overview now. But again, as we talk through some of the different topics, I'll explain more about Neopendum and our process and how we came to certain decisions. So the problem that we're trying to address with Neopendum first is why newborn mortality rates are so much higher in resource constraint settings than they are here in the US. And as we see in this image, this is a typical word in Uganda, in Kampala. There are just far too many critically ill newborns and really not enough nurses to help care for them. So some general statistics around this. Well, 3 million newborns are dying every year in low resource settings, and most of that is from preventable causes. The WHO estimates that 80% of their deaths are actually preventable with timely recognition of distress and appropriate treatment. So there's this huge global movement. It's even part of this sustainable development goal is to really understand how can we improve newborn health outcomes? Or how can we improve health outcomes in general with a particular focus on improving child health and within that a specialty of neonatal mortality rates? So in this image, we do see many different hospital beds with babies in them. Oftentimes, there are one or two nurses. And this is very common in many of the words that we've been to throughout Uganda. So we thought, what if there was a way to help identify when a newborn was actually in distress so that nurses can devote their limited time to the newborns who actually need it most? So that's what led to the creation of our vital science monitor. So let's take a step back and understand what's actually happening here in the US in the neonatal ward. Well, in the image on the left, we can see a typical NICU type setting here. And every baby in this setting, it's hooked up to thousands of dollars worth of monitoring equipment. Sometimes this equipment is donated but often fails because it doesn't appropriately meet the design constraints of a low resource setting. So in the middle image, we sometimes see devices that are created particularly for low resource settings. But oftentimes they only measure one or two vital signs or they're focusing on a specific disease state. So a pneumonia diagnostic, for example, or a way to help anticipate sepsis or hypothermia. But very few of them are actually used in continuous, in a continuous manner like it is here in the US. And so what happens is more often the image on the right where a nurse has to go around from one baby to the next and manually measure vital signs using fiercely available equipment if really anything exists at all. So there really is an unmet need for affordable monitoring and really translating that known improvement science of what exists here in the US that continuously measuring vital signs improves health outcomes, but just reimagining it for more of a low resource setting. So that's exactly what we're doing. We've created a patent pending wearable vital signs monitor that continuously measures four different vital signs, pulse rate, respiratory rate, blood oxygen saturation and temperature all in this simple headband or armband. And then the vital signs from all of these devices, all of the babies in the room wirelessly connect to a centralized dashboard on a single tablet. So a nurse can efficiently view the health status of all of the babies in the room just by looking at this one screen. And of course, if any of the babies vital signs outside of the healthy range, then a nurse is immediately alerted so she knows where to direct her attention most efficiently. So again, I'll talk more about the solution and how we came about it throughout this webinar, but I wanted to take a step back and talk about the human-centered design approach because that's certainly the premise of creating any new medical device or really any product that we strongly advocate for using HCD or human-centered design. So it's an important concept, particularly for health solutions and particularly for emerging markets where the design constraints are entirely different than what we see here in the US. As I mentioned, sometimes that equipment that is present in the hospital ward here is donated, but it ends up in what nurses call the equipment graveyard because it fails to meet the specific constraints for the users that we're designing for. So this framework really enables us to involve a variety of human perspectives throughout the problem-solving process. It lets us create much more appropriately designed products that ultimately will lead to better adoption, better products, better outcomes from there. And there are various steps involved in that process that at a high level, you iteratively involve users and stakeholders at each step of that process. So really the first step of it is understanding what the problem is and observing that within the local concept, then we transition to brainstorming and conceptualizing various ways to approach that problem, interviewing a variety of stakeholders to better understand that and then developing the solution iteratively with these stakeholders. So keep in mind that these stakeholders don't necessarily just involve the beneficiaries of the product, oftentimes the beneficiaries. So in our case, it would be the newborns. Aren't the users who in our case are the nurses who also aren't the payers? So the people who will actually purchase the product. So it is important to involve all of these stakeholders and users in every step of the process to make sure that we are encompassing a variety of user feedback. So how does this relate to what we did with Neopenda? Well, we're looking at this newborn ward and let's break down this problem a little bit more. This image on the left is what it looks like in the neonatal intensive care unit and every baby is up to thousands of dollars of this equipment, including monitoring equipment. And the patient to nurse ratio is on the order of two to three babies per nurse. Well, that's of course not equivalent to what we see in that image on the right. There really isn't very much equipment and the patient to nurse ratio is on average nine to 10 times higher than what we see here in the US. I have also been in wards where there are a hundred babies and only two nurses. So all of this really significantly contributes to why the neonatal mortality rates are seven times higher in Uganda than what we see here in the US. And that's true pretty much for any low resource setting. And of course, Ugandan hospitals or end US hospitals are extremely different in multiple different ways. So what may work here in the US may not and will likely not work in particularly in low resource settings. So for example, the this equipment when it gets donated oftentimes it fails within a month or two because it requires extensive maintenance or it's in a language that the nurses don't relate to or it requires consumables that just aren't readily available in country. And so all of these reasons make it just not proper available for nurses to use in a lot of these hospitals. So part of human center design is being able to decipher what is known in proven science through a variety of literature or clinical trials and being able to adapt that to other settings. So if we flip to the next slide, I wanted to just give you a sense of what is happening in these wards. Often times these babies are put on beds and they may be organized in a way that nurses understand or may not, but there certainly aren't enough resources to help care for all of them. So in our design process, Theresa, my co-founder and I spent significant time in Ugandan hospitals. So here's an image of what it looks like over there. We observed the nurses natural workflow, understood what they spent their time on, how they interacted with patients, really trying to get a grasp of what their normal workflow is because if we can't integrate our solution within the normal workflow, then they won't use it and the product, no matter how good it is, won't actually be adopted. So we spoke to a lot of different stakeholders in this process and on this slide, you can see a quote from one of the nurses that we work with very frequently. So this really resonated with us and then it spoke to a lot of the problem of what we're seeing in these settings. So this was, again, the first step in understanding the problem. Why are these babies dying? What types of technologies can we use to help solve that? So babies in need of immediate attention go unnoticed and then they die from presentable causes. And that was really the problem that we wanted to focus in on. It was specific enough that we could, it's not thinking of, well, how do we prevent babies from dying? But it's broad enough that we can allow ourselves to brainstorm multiple different ideas. So again, we spent a lot of time interviewing many different doctors and nurses. We actually have been to 43 hospitals throughout Uganda and interviewed over 150 nurses and doctors throughout our design process. So the solution that we brainstormed was a vital science monitor that can immediately alert nurses when nuke runs into stress. And of course, throughout this process, we received feedback at every step on what vital signs we should be measuring, how frequently, how to display the vital signs, what the device should look like, what location on the body should it be on. And that required user input from a number of different perspectives. So here you see in the image on the left of prototype, if that's putting actually this prototype on babies. And then we translated this prototype to a newer look-life model that encompasses feedback from those 150 users throughout the hospitals in Uganda. So I won't go through each of the features and benefits in this slide, but I wanted to just briefly share a little bit more on why it's important to be thinking about features and benefits and how it actually relates to it. So we're designing it specifically based on the feedback that we're getting from these users. It was based on the constraints of the settings that we found in war is like, they don't often have continuous power. Or so how do we create a solution that doesn't rely on continuous power? It can last for multiple days because that's how long babies are staying in the hospital ward. And no matter how many times you tell a nurse in Uganda that it's a single use product, they likely will reuse it. So how do we design the product to be reusable and easily cleaned using the readily available cleaning agents that are there? But it's also based on feedback, direct feedback that we receive from the nurses. So many of them indicated that they wanted to centralize dashboards so they don't have to go around from one patient to the next to look at the vital signs. They can just look at this one screen and quickly identify which babies they should direct their attention to most. Sorry, trying to switch slides. There we go. And it's really important to understand that while designing health interventions, the solution often extends far beyond the product or technology itself. And it involves thinking about how to manufacture the product, how to distribute it, how are you gonna install the product? And then once it is installed, what sorts of training and education and product support is available? And of course that is an iterative process as well. It's not something that can happen overnight. And without significant thought to all of these components, the tech itself will likely fail at some point or the nurses won't end up using it. So it really is a much more comprehensive solution. And it's important to keep that in mind. And while keeping that in mind, it's really important to build a team that has a variety of expertise in that process. So I wanted to share a little bit about the team that I have that I'm very fortunate to have because creating this comprehensive solution really can't be done alone. So we have two full-time members, myself and my co-founder, Teresa who are based here full-time in Chicago. But we also have two coordinators who are absolutely amazing and understand more as a local context and are based in Kampala full-time. So they really immerse themselves within the culture, continuously get that feedback from our users. And then we take a lot of that feedback and iteratively design a new solution or testing out a new feature here in Chicago. And then we are backed by a diverse advisory board that has expertise in a variety of areas to help us make through what those various constraints and challenges are and how we can apply some of those to the constraints of a low resource setting and the design of our solution. And it can't just be the team itself. We take pride in a lot of the partners that we've been able to develop or grow over the past several years. It's enabled us to really grow and scale much faster because we're able to leverage the expertise of organizations who are working in a variety of areas. And that can be funding partners who enable us to actually develop the technology and go out to Uganda and test out various aspects of it. But it could also be product development firms who understand how to develop that technology itself and are doing more of the coding and the hardware and software design of it. But then piloting our solution, we are partnered with several organizations within Uganda, but we really are trying to design for the constraints of every emerging economy, every emerging market. And that's where we've leveraged some of the relationships that we have with larger NGOs who already have expertise and are in over a hundred countries around the world. And we certainly couldn't do it without the mentorship from a variety of universities and incubators. And I certainly would recommend if you're a student project, taking advantage of some of those incubators or university relationships, that's certainly how we started and we'll continue to leverage the expertise that we've gained from there. So I just briefly mentioned academia and what that looks like. Well, we learned a lot about this human-centered design process and the principles behind it through a bio-design course that Theresa and I took while we were students at Columbia University. So we were getting our master's and it was a one-master course that was really amazing in helping us think through this framework. And while it seems so obvious to start with a problem first and then design a technology, I think far too often in academia, we start thinking about cool technologies and how we can develop new things and then find a problem to solve for. And that's really contrary to a lot of this process and often ends up in tech that doesn't actually benefit anything. So I would really encourage you to look at the resources available for human-centered design. If you're at a university setting, make sure you're involving some of your professors or whatever resources they may have to help you learn more about this process. So our initial idea and funding came from the work that we developed in this class and a venture competition that we applied to right afterwards. But that was really the jumpstart of the idea and brainstorming behind Neopenda. And we're really grateful for everything that we learned at Columbia and for the continued support that they're giving us today. But eventually we realized that the opportunity to create a startup and really devote our time and efforts to Neopenda, there was just so much of that opportunity and we wanted to spin it out of the university and devote ourselves to it full-time. So academia is of course really different than startup life. It's a huge risk to create a startup and then enter into a world of largely unknowns without really being able to fall back on anyone. All of our work suddenly transformed from this overwhelming feeling that our efforts are good enough to do well in school to this device is going to be placed uncritically on newborns and has to be a safe and accurate product. And we needed the funding to continue to make progress. But we were willing to take that leap of faith because of that opportunity to create appropriately designed solution that could significantly impact communities in low resource settings. And while so many of those feelings are still overwhelming honestly, there are so many resources available to help transition a student project to a commercially viable startup. And it's astonishing to us how many student projects are really quite amazing but just stay at the university level. So again, if you're a student out there or if you're a larger company, I would encourage you to work with the students because they have amazing ideas and it is possible to translate what you're doing in academia to a startup. It just requires a little bit of faith, a lot of faith and a lot of dedication and passion. And once you are a student, there are honestly are probably more resources available to you than once you've graduated. So while we were students, we had access to a number of business plan competitions that really gave us our initial funding without having to go to venture capital firms or investors that would take part of our company. We did have to think about intellectual property and how that translates from what we're doing at Columbia to being able to own that IP and maintain the rights to that even though the idea started at the university level. So every university is different but it is something that's important to think about as you transition from academia to the startup world. And I really don't think that there is a magic formula to creating a startup or how to make that transition. But one thing that I absolutely think is crucial is the team and the good idea. And if you have both of those, then everything will kind of fall in place. So just transitioning a little bit, one other thing that I think is extremely important is timing. So a lot of our decisions with the product were actually made because of trends that were occurring just generally and more broadly in the healthcare sector or in the tech sector. And over the past decade, we as a society have really focused on advancing technology and making devices more and more connected. And we can leverage so many of these advances and apply them to tech for good. So we see so many of these examples in our daily life. So here we've got a few examples of many of things or IoT devices. As we all know Fitbit, it has taken wearable tech to an entirely new level. If you don't own a Fitbit, you probably know somebody who does. And connected apps are just popping up everywhere. We've seen IoT devices, particularly even in emerging markets. On the bottom left, we have BEMPU. It's a hypothermia bracelet. And on the bottom right, we have a drone, which not only are drones a big deal here in the US, but we've seen startups actually taking drones and delivering medical supplies and blood to a variety of settings in Africa, for example. So what do a lot of these different technologies have in common? Well, they're using the basic concepts that sensor technology has advanced significantly to become smaller, cheaper and more efficient. They're also using the basic cameras that data that can be collected from the system can be used to improve health outcomes. So if we look at Fitbit, it's not just the wearable device itself. It's the data that you can glean from the app that you have on your phone. It's being able to track and trend things over time. And most likely, I can't say for certain, but most likely Fitbit is aggregating that data on some level and using that to really understand how consumers are making decisions or how they're improving their health outcomes just by walking even more. And that's really important to understand is a lot of these devices can be connected and we can glean important, valuable data that just will enable healthier systems and strengthen the health systems in the future as well. And again, this can be collected on individual levels and shared with a consumer or a patient where it can be aggregated and disaggregated to better understand the trends on micro and macro levels. So for Neopenda's product in particular, we're really interested in not only the vital signs data that we can collect with the system because eventually we can use that for predictive analytics or being able to diagnose a specific disease state, but we also can collect a lot of basic demographic information, patient information, because people don't really know what's happening in these newborn boards. Oftentimes they're still using paper charts and at the end of the month, the nurses will tell you how many newborns went through the ward, but that's pretty much the only number that gets translated. And with our system, we can very easily capture some of that invaluable data and present it in a variety of reports to stakeholders like the hospitals or ministries of health or NGOs and help them understand what's happening on local or regional or international levels to improve health outcomes in the future. And that also helps guide what our future devices may look like as well. So I wanted to go through a little bit of the prototype and product development process because these devices aren't just created overnight. They do require a very iterative process that certainly uses human-centered design principles to transition from one version of the prototype to the next version. And here we can see Neopenda's very first design in the top-left corner. It was our very first breadboard that was really fun to work on, but of course, nobody would ever want that on a patient. I would be scared to put that on myself. So from there, we leveraged a lot of the advances in IoT and sensor technology and we're able to miniaturize a lot of that into the next version of what we see with that pink hat and the wearable device. So I wanted to pop there and talk a little bit about that. Our original design was actually in a baby hat. It was a wearable device in a baby hat and then these vital signs would wirelessly connect to a tablet and then we would send an SMS message to the nurses to let them know that the vital signs were outside of the healthy range. So that was basically the concept that we had developed in the bio design course. But when we went to Uganda and interviewed a lot of our stakeholders, most of them said the hat is nice because it provides the additional benefit of warmth to the baby. But actually, we really don't like the idea of a hat because it's much harder to clean. And remember that they will reuse any type of product that you send over there. So if you can't clean the hat, then you're now introducing or potentially introducing the risk of spreading infection from one patient to the next. So we actually transitioned from a hat to the next version which is wearable band. And we are still testing that out on four different locations on the body. But I think it's really important because that decision was solely based on that human-centered design process and that feedback that we got iteratively from our users. But had we not done that, we would have created this cute little hat that actually didn't serve the purpose that we were hoping for. And then from there, we transitioned to the bottom right corner which is the new looks like model that we have right now. And that, again, is based on feedback from hundreds of users across multiple hospitals, not just in Uganda, but in other countries as well. And this isn't the final market-ready product. So we do still have a couple of rounds of design iterations that will happen after this. But it will continue to involve the feedback that we're getting. And we're excited to have a design freeze that we're targeting in early next year. And every step that we go, we're getting closer and closer to that market-ready product. So I wanted to just show a little bit more detail and talk about the features a little bit more just so that you can get the context of some of the design constraints that we're designing for. So we're designing a cleanable, reusable band that doesn't have very many crevices. So essentially the use case is that a baby would put this device on or a nurse would put the device on a baby when he or she is admitted into the ward. It would stay on the baby. For however long they're in the hospital, our battery life is designed to be five to seven days, which is the average length of stay as the baby in the ward. And if the vital signs go outside of the healthy range, then nurses immediately alerted in three different ways. On the wearable device itself, there is a flashing red LED. But then on the tablet, there's an auditory tones of nurses walking around and she can still hear it. Or if she's at the nurse's station, then it's a vital signs flash red. So all of those different alerting mechanisms and design considerations were based solely because we spent so much time in Ugandan hospitals and iteratively asking them questions and understanding how can we design this better for them? So on the bottom left, we see that there are two different sensors. So we are able to leverage their off the shelf product and we're able to leverage those advances and sensor technology to create a product to do exactly what we want it to. So all of the algorithms and microprocessing behind the device that is proprietary by Neopenda, but the actual sensors themselves, we don't need to recreate the wheel here. There are so many devices out there that are using these types of sensors. So we're excited to be able to leverage those benefits and tech. So I think it's also really important to talk about why now, why is timing so important? And it's not just advances in IoT that really were great timing for our solution, but there are just so many initiatives related to improving health outcomes, particularly for initial patient population as newborns. One of the UN sustainable development goals particularly relate to improving newborn health outcomes. And not only that, governments are spending more and more of their budgets on purchasing medical devices and equipment. So the landscape is changing within a lot of these countries and a lot of that political landscape while I didn't originally think was important, now see that the extreme value in involving stakeholders at that level as well, because it is important to understand what initiatives they have so that we can either leverage that or collaborate on some level and make sure that it's the right time for our types of product. But we're also seeing a growing interest in wearable tech from multinational organizations like UNICEF or ARM and Frog. So they actually have this wearable for good competition that they do, I believe every year, that particularly focuses on creating IoT devices, creating tech for good and largely picks solutions that have encompassed the human-centered design process. So looking forward, I wanna talk a little bit about what looking forward means to Neopenda and us as a company but also what are some of the emerging trends that we're seeing in the healthcare space and in the wearable space. So I'll talk first about our milestones and kind of recap where we've been and where we're going. So we started Neopenda about three years ago. January, 2015 is when we ideated the concept in that bio-design course and then we did a needs assessment in Uganda in August of 2015, saw the massive opportunity to create a startup around this and really created Neopenda then. That's really when my co-founder and I decided to submit ourselves full-time to Neopenda. We were still finishing graduate school so that was an interesting transition for us and would be happy to answer any questions around that. But it was in August of 2015 that we're really committed to Neopenda full-time. So we did initial fundraising, again using the resources that are available to students. We did business plan competitions. We did wireless innovation prizes, really just applying to any type of competition or prize that we could. And mind you, we didn't get every prize. We didn't win every competition. So you do have to apply to many of them and don't be discouraged if you don't get the first thing that you apply to. It is a process. But in August of that year, 2016, we did a lot of market research. So again, creating the product is really important but it is one aspect of creating a business. So it is important to understand what that market looks like and what that landscape looks like. Who will actually purchase these devices? What are the budgets around medical equipment? What are comparable companies who have tried to implement things either successfully or not successfully? And honestly, we learn a lot from the companies that have failed because we know either not to do the same thing or how they worked through that process so that we can improve upon their thesis or assumptions as well. So briefly talked about IP and the important of that and transitioning from academia to startup and having IP is just crucial because you never know what markets you'll be entering into. And while sometimes it may not be regarded as well respected in a lot of Sub-Saharan African countries, for example, you never want to close the door on any intellectual property that you may have. So we did file a PCT patent in August of last year. We spent a lot of time getting feedback on our design, letting the nurses play with our devices and we actually take around a little baby doll with us because of the regulatory constraints of working in the healthcare sector, we take around a baby doll because we can't directly put the device on a patient without regulatory approval for that. So this baby doll was kind of our proxy for letting them play around and give us feedback. And then in March, later that year in March of 2018, so early this year, we actually finalized our MVP that we're excited to launch in our immediate next steps of pilot testing. So we're doing clinical studies both here in the US to evaluate the accuracy of the product but we're also doing it in Uganda to make sure that it is appropriate for the local context and some of the environmental factors don't change the accuracy or safety of the product. In future studies with the second version of the device, we'll be launching feasibility and efficacy studies and that will not just be in one hospital in Uganda, it'll be multiple hospitals in Uganda and we're collaborating with NGOs to really expand what we're doing to other countries and make sure that we can translate the work that we're doing in Uganda to a lot of these other countries. And then we're about a year away from actually being able to commercialize the product itself. So almost as somewhat closing notes, I wanted to give you a sense of the future of IoT or at least where we see it or trends that we're seeing in IoT and tech for good. So all of this work is certainly not without its challenges. So data security and privacy, especially in the healthcare sector, that landscape is changing significantly. We see anything from the new GDPR regulations in Europe to HIPAA regulations here in the US to regulatory bodies that are actively being formed in a lot of these emerging markets. So one thing, one trend that we're certainly seeing is around data security and privacy and how do we make sure that we're protecting secure patient data, but being able to glean important information that will enable us to create future products or collaborate with a variety of partners on improving health outcomes in general. Creating medical devices are really tough. So IoT and tech for good are, it's great in practice. And honestly, I would love to see more and more people devoting their time and resources to it, but I would be remiss to not mention that regulatory hurdles are pretty significant for medical devices. If you're in the medical device sector, I'm sure you're very familiar with that. And it is a complex nature, but then the added complexity of working in emerging markets where they don't necessarily have rigid bodies and rigid procedures in place and typically fall back on FDA or CE mark. That's something that is actively changing and we're excited to see more of those bodies forming, but it's not quite formalized yet. So it is a challenge that we're working within the design constraints of, but something important to understand. And then implementation and sustainability are also two really, really important things that I would highly encourage you to think about when creating IoT and or tech for good. So it's not just the technology itself, it's how you actually implement it that will improve product adoption. And if it's not integrated within the nurses normal workflows, they won't use it. So understanding that education and training and maintenance and repair that goes behind creating any type of technology is important to embed within the company culture early on. And then the sustainability side of things. We see our type of work is often viewed as nonprofit. We often see a lot of our collaborators and other people donating medical supplies and equipment, which is great and certainly improves the immediate term needs, but is that a really sustainable way to empower these communities to have ownership over the devices and really take care of them and has the education, training, maintenance, support activities that are necessary to really keep a sustainable solution. So it is challenging, but certainly something that I would highly encourage you to think about. And then on the horizon, it's really exciting to see more emerging tech hubs in Africa and that spans across IoT and tech and wearables and healthcare, a variety of different things and most of these tech hubs, actually I think that image on the right is a little bit dated. The most recent number I've seen is around 442 tech hubs in across Africa. That's a lot of tech hubs. That's a lot of ideas. That's a lot of collaboration. So it is exciting to see more and more local Africans creating products for their context and being able to work with other companies like ours who are able to leverage some of the resources that we have here in the US that are much more readily available than what you may find in Uganda, for example. We're also excited to see that changing regulatory framework and that's not just an emerging market. CE Mark, for example, in FDA, they're harmonizing a lot more of their efforts. So that's been really exciting to see some of the changes and certainly affect the design considerations for our product. But there also are increased focus on emerging economies. We don't have to view African nations as poor countries that can't afford products. We are seeing their economies growing. We're seeing them interested in purchasing more and more medical devices. And we're seeing more and more companies or startups like ours focusing a lot of their efforts on emerging economies because there is such a large opportunity there. And then I'd also love to just end on improving methods for collaboration. So NGOs are finding way to work with small startups like us. Small startups like us are finding ways to work with the larger medical device companies and collaborate and leverage the expertise that both of us can bring to the table to really create appropriately designed medical devices. So with that, I wanted to make sure to leave the rest of the time for any questions that you may have. But thank you so much for joining and I'd be happy to connect offline or answer any questions that you may have here. But we do hope that you join us in improving newborn health outcomes and health outcomes in general and join us as we create medical solutions for where they're needed most. So thank you again. Thank you, Sona. This has been such an enlightening and overarching presentation and we're so grateful for you taking the time and being quite transparent about your experience so far. So I'd like to invite our listeners to please post your questions in the Q&A window so we can address them. We already have some questions that have come in. So one is very practical here as a startup life is tough. And the question came in is how do you financially support yourself during the three years of development as since you started this journey? Yeah, that's a great question. And that has evolved and will continue to evolve. So when we were students, I am not sure how much I should be sharing this but I was paying myself $600 a month. So it's really not enough to actually create a livable wage but we were also students and we're financially supported from a variety of means. So that was kind of from a salary perspective. Thankfully, we have increased that certainly not to what you would see at larger companies but it is a much more livable wage now. So that's great and that's important to consider for employees. From a product development perspective, tech is expensive, medical devices are expensive and you do need that funding to keep going. So in our early days, we did a lot of business plan competitions a lot of just prizes in general. And to date, we've been able to raise nearly $500,000 just from these prizes and competitions and grants. And we're still continuing to apply for a variety of those sources. So don't discount that type of work because it can help fund those initial days and those initial stages for salaries for product development, for legal expertise. Any of those things, those competitions are often a good way to start off. We have recently transitioned into raising capital. So we have a seed ground that's open and we'll be launching more of a press funding equity campaign over the next month as well. And that investment opportunity allows us to think more strategically about the business side of things as well. So grants and competitions are great for the initial days when you really are just focused on getting initial concepts out. But at some point when you're starting to transition to more of the business aspect and really learning how to grow and scale that business, that's where we value the strategic expertise that we can get from our investors. And that there are more impact investors that are interested in this space. Not a lot that are focused particularly on medical devices, but certainly a lot that are interested in tech or in health or some combination of that. And so we have transitioned to that realm as well. So I'm going to pull on that thread a little bit because this is a pain point that we hear from a number of startups that we've engaged with, especially those that are led by technical talents such as yourself and your co-founder. Engineers are not typically taught business skills or provided that kind of business insight through our studies and I include myself and this is as I am also an engineer. So given the construct of your team, how have you navigated this particular aspect of startup life which is a raising capital, the business development work? Have you engaged talent and occasion? What have you been your strategies to kind of keep that money engine going while you're trying to get also the technical side of the house in order? Yeah, great question. So I don't have a business background and a lot of people question whether I have the ability to run a business without an MBA and I think the answer is absolutely yes. So I debated for a very long time, should I go back and get my MBA or not to have more of that business expertise but honestly, starting a company you'll learn a lot along the way. You'll learn how to create the business because if you don't then you won't be a company anymore. So you'll figure it out along the way. That's not to say don't put in the effort and don't kind of divvy up the work. We're a small team and still are a small team and so we do divvy up that work very significantly although we wear many different hats. So my co-founder Teresa is more engaged on the engineering and the technology side of things whereas a lot of my focus is to really strengthen that business strategy. So that's been a really exciting shift and change in the team dynamics but a lot of the business parts of what we've been able to learn are through accelerators. So we've been through a couple of different accelerators very early on. We did relevant health in the DC area. We participated and pulled that math challenge. Right now we're part of the Texas Chicago program. So all of these different accelerators have enabled us to think about the business from a variety of different ways. And so I would encourage you if you aren't familiar with the business side of things either find a team member who is very familiar with that or participate in the accelerators and really devote a lot of your time to learning the business side. That's a really sound and concrete advice. On that note, I think a question that could dovetail into that from one of our listeners is regarding your board makeup and where did you get the contacts for your board through personal collections, through social media? Perhaps you could share a little bit of how you went about that. Yeah, so in the initial days our board was largely made up of advisors that we had when we first created the product. So two of our amazing advisors, one both are in the biomedical engineering department at Columbia, but one is very heavy on the technology side and one is very heavy on the commercialization side of medical devices. So that's how we got our initial board members. One of them, Willow Brock was my boss's boss when I worked at the TB Alliance and just really started to love the company and wanted to give us advice based on its international development expertise. So sometimes these board members just kind of fall into place because you're constantly seeking mentors and you're constantly seeking advice from people and that relationship just naturally happens. Sometimes you need very specific advisors and expertise. For example, we're transitioning into thinking about manufacturing. So we're actively looking through our networks to find an expert or an advisor, particularly on manufacturing and commercialization of these devices. So I think part of it relies on knowing where you have gaps in your team and where you need expertise and advice. And some of it relies on cold calling and randomly emailing. One of our advisors today is now an advisor. She's the very first person that we talked to. She's a clinician that works with Doctors Without Borders and I randomly emailed her when I was a student asking, can you give us an hour of your time to tell us about your experiences working in the NAO Awards? And now she's a formal advisor of ours. So I think some of those relationships don't be afraid to do any of that cold calling. Don't be afraid to use LinkedIn, perhaps to the extent of stalking and trying to find particular people and figuring out how to get in touch with them. Don't be afraid to use those networks because that will extend beyond the board and will be absolutely crucial for your business as well. I completely agree with that. And one of the things I wanna tease out from what you've said and what we've heard is also being a successful tactic is being specific in your ask. So I think you mentioned that you articulated exactly what challenge you were facing with and you bounded the time engagement for that advisor at one hour so that they knew that this is something very manageable within their particular schedule and you build on that. Start with that concrete engagement, start with that specificity and then evolve the relationship as you go. I think that's very, very practical and we've seen that be successful for other startups as well. In terms of, and we are almost at times, I'm gonna make this the last question. And I apologize for those of you whose questions we weren't able to address. You can certainly email Sona or email us and I'll put up the slide with her email here directly for questions. One aspect that you noted regarding trends and just the ecosystem at large is regarding regulatory hurdles. And particularly when we're talking about hardware, this comes into play with the IP and of course getting CE marks and so forth. So I would love to know from you a little bit more what some of those, how you navigate those challenges or how you are navigating right now. I know you guys are still in your MVP and we have a specific question from our audience here, ultra specific on how much did the PCT patent cost? So if you can maybe speak about that at large and maybe zero in on the specifics of the cost if you can disclose that, that would be helpful. Yeah, so regulatory hurdles are, they vary based on the device itself. So for us, we're lucky in that it's a non-invasive device with plenty of predicate devices. So Vital Signs Monitoring has been around for decades. We didn't invent the concept of Vital Signs Monitoring. We did reimagine the form factor and the design of that and using our own algorithms which certainly relates to the IP and what we are protecting a lot of that design and the algorithms behind it. But again, that concept of Vital Signs Monitoring has been around for so long. There are international standards that are related to those and so every design decision that we make is based on those regulatory constraints as well. So how loud the alarm needs to be, there's a standard that tells us how loud it can be and should be and how frequently it should be. So some of those things are very strictly defined and we will be going through the CE marking process and we have a regulatory consultant that's helping navigate some of that. That is for the just general regulatory landscape. But when you go to specific countries, particularly in emerging markets, we do see that many of their regulatory bodies are still forming. So even at the stage of IRB, for example, which is necessary to do a clinical study on patients, you have to get its institutional review board. You have to get ethics and safety approval on your protocol. And for that IRB approval, we're meeting challenges in emerging markets because a lot of these institutions aren't as familiar with how to evaluate the safety and efficacy of the medical device protocol. They're very familiar with health in general, but as we all know, medical devices are extremely different from pharmaceutical products, for example. And so I think that introduces additional challenges where it's a learning curve for both the IRB committee and for us as a team trying to go through that. And then just briefly on the PCT, it depends on where you want to protect your IP. So PCT enables you to figure out which countries you would like to file in after 18 months of filing that PCT. So we're working with our IP attorney to figure that out. But it can be costly. It can be 10 to $20,000 just to file that PCT patent. But again, it's 10 to $20,000 in what amounts to millions of dollars that you'll be spending on development. So I would highly encourage you to go through the IP process and find an IP attorney that you enjoy working with and that understands those constraints. We really enjoy working with ours. Fantastic. Thank you so much for that comprehensive answer, Sona. And thank you so much for joining us today. We are a little bit over time here, but this has been an incredibly fruitful discussion. For all of you who are joining us, the recording of the webinar will be available on our platform in the next few days. And for those of you who are interested in receiving professional development hours, please do submit the forms with the PDH codes listed on the slide in front of you. If we didn't tackle your questions, we do apologize, but you feel free to email us at webinarsandengineeringfortune.org. We would be happy to connect to you with Sona and get those questions answered. And we'd like to remind you to please join us as you first see members to get information on upcoming webinars and access other member benefits. With that, I'd like to close out this webinar and thank you, Sona and the Neopenda team again for sharing with us a little bit about your journey. And we wish you the best of luck in your evolution. Have a great morning, evening, or afternoon, depending where you are and we'll catch you on the next E4C webinar. Take care. Thank you, everyone.