Rutger van de Leur and René van Es want to build a marketplace to facilitate the implementation of algorithms in electrocardiograms – a solution sought after all over the world. Rutger believes that taking the steps to execute the findings of your research is crucial to be able to make a change, and that is why he has set up a startup around his PhD research topic.
Rutger started studying medicine at Utrecht University in 2012, and his interest in research and coding led him to continue with a degree in epidemiology in Utrecht and Amsterdam. Once graduated he started his PhD research on AI for electrocardiograms (ECGs) at the UMC Utrecht together with his co-promotor and technical physician René.
Bridging the gap between building and implementing algorithms in clinical settings
Can you describe your idea?
“We saw this gap between making and studying an algorithm in a research setting and then applying it in practice. The idea for the startup is that we are going to provide a kind of marketplace platform to bridge that gap – to make it possible to easily deploy your algorithm in clinical practice,” Rutger explains. The first step would be to start with a few of their own algorithms, he says, go through the whole process of regulatory approval and finally get the algorithms into their platform. “Once we have all the documentation ready to do this, other researchers or companies can also get their algorithms approved through our platform,” he adds.
Rutger continues by laughing and saying “It’s a complex procedure, but that’s at least the big end goal. The start is easier. For now, we are just going to make this platform that plugs into the ECG system and make sure that it has a good interface for the physician and that it can work with our algorithms. Then the marketplace where others can also get their algorithms approved, that’s the end goal. But that’s gonna take a while.”
How did you come up with this idea?
“The idea was born during the research process,” Rutger shares. “We didn’t really know if it was gonna work or not, because when we started this research, there was only one publication saying that you could do deep learning on ECGs and that it works nicely.” While they were researching this topic the field exploded, Rutger explains. “Now I think there are hundreds of papers every month on the subject.”
He says that the interest in the field is massive all around the world, but everyone comes across the same issues as René and he when approaching the final step – applying the algorithms in practice. “At that point, there is this big wall of regulatory steps,” Rutger explains. “We’re building all of these cool things but we can’t use them, it’s really annoying because that’s in the end what you want to do with it. So, that’s why we thought that we need to do this,” Rutger concludes.
He continues by explaining that “I think that the marketplace aspect of the solution makes it innovative and special, as you can have all of these algorithms from around the world in one place.” He says that there are many research groups with their own data sets building and training algorithms. Today it is difficult to get an algorithm approved, which limits its reach and impact. “So that’s the nice thing I think,” Rutget continues, “if we can help them as well to get their things approved. To help each other a bit, and to have a very nice platform with all the algorithms.”
Why did you decide to make a startup out of your research?
“It’s something that I really wanted to explore – the three pillars: research, clinical and entrepreneurial,” Rutger says. He continues, “and see if I liked entrepreneurship more than the other two, or together. And then I can maybe make a combination later on.” He explains that you see that many physicians, next to their medical career, spend one or two days a week either on their own company, on research or as advisors at another company. “And I think that’s also a very nice option,” he adds.
It’s something that I really wanted to explore – the three pillars: research, clinical and entrepreneurial.
What does your team look like?
“René and I are the ones for now in the company,” Rutger explains. But the interest in what they are doing is big, he says, as many doctors see the need for a solution to this problem. Rutger continues by sharing, “We had a talk from a professor from the US recently, who is also doing research on AI for the ECG. At the end of the meeting, one of his first questions was ‘So how are we going to get this? How are we going to use this?’ So, that’s the thing, many people in the field want a solution, they are really enthusiastic, but then there is nothing there yet, so that’s something we have to solve.”
The first steps in the entrepreneurial world
Since February 2022 you have been participating in UtrechtInc’s Validation Programme for science startups, how is that?
“I think it’s been super cool,” Rutger states. “It’s really nice to get this reflection all the time on your idea. I think that the most important thing about the programme is the whole validation part. All the talking with different people, explaining our idea over and over again, getting different questions and adjusting it all the time – I think that that’s really nice and the most important part of the programme. The workshops and the knowledge you need to have to have a startup are also important.”
How does it work to combine this programme with your research?
“So the nice thing about research is that it is usually flexible,” Rutger says. “You have a few things to do and a lot of meetings during the week, but you can always do it at different times and arrange everything. So it works okay to combine the two things, it works out.”
What are the differences and similarities between being a researcher and an entrepreneur?
“I think what is really similar is that you are also testing hypotheses as a researcher. It’s the same idea actually,” Rutger begins. “You have an idea or a hypothesis and you are validating it with tests to see if it is true or not – and that is actually the same thing we are doing here. But now it is a business plan or case and in research, you are validating a more fundamental idea, but the idea of thinking is quite similar. That is the biggest similarity.” He continues by stating that “What is also similar is that as a researcher you really need to sell your science. You go to a big conference and sell your study or your idea and that is similar to being an entrepreneur.” But there are differences as well Rutger explains. “As researchers, we are taught to think about everything, to see all pluses and downsides. And as an entrepreneur, you have to make it simpler for a lot of people who don’t get what is going on. In the research field, you are selling your research to people who know the same amount as you. So that is really different, to make it simple.”
What is really similar [between research and entrepreneurship] is that you are testing hypotheses.
What have you so far learned about being an entrepreneur?
“I think you have to be really convinced and work really hard. You have to be at it every day. It is a complicated decision. Do you want to combine your startup with research or get on with it full-time? It is probably going to work better to do it full-time but it is also a huge risk,” Rutger states.
Is it possible to combine research and having a startup?
“Yes, I think so,” Rutger says. “But in our case, we need someone to work full-time. We are looking for a new team member right now. I think we really need a CEO who is focused on this so that we can take more of an advisor role. Because I think we are really good at having the idea and doing that, but we don’t have a sales background, are not entrepreneurs ourselves and have no experience in that. It would work much better if we had more experienced entrepreneurs in the team, but they are hard to find,” he laughs.
Do you think you will continue your startup after the programme at UtrechtInc is done?
“Yes for sure,” Rutger says confidently. “We are doing a lot of interviews now and validating, and we just adjusted the business plan. Right now we are also talking to Utrecht Holdings [the knowledge transfer office of Utrecht University and UMC Utrecht], he says. “We want to continue, but we need that third person and we need to figure out how we are going to combine it all.”
What is the most challenging part of setting up a startup?
“The most challenging part is everything that has to do with arranging things with the hospitals,” Rutger begins. “If you want to do a spinoff from the hospital it is such a lengthy process, but we are getting there now. We have a business developer helping us so it is going quicker.” Rutger explains that they started actively working on this idea in October last year, but so far no formal steps have been taken.
He continues, “We really need spin-offs. Because, research is very good for the first steps, to investigate everything and try things, and somewhat easy because there are not a lot of rules and you can just try. But when you find something, it needs to get into the clinic and that’s the complicated part. Then the project needs to get serious and you need a lot of money which you’re never going to get from the hospital or from the funding agency. So, then setting up a startup is the only way.”
We really need spin-offs.
What is the most fun part of setting up a startup?
“Many things!” Ruger says with a smile. “Thinking about the idea, changing it all the time, discussing it. The social events are super nice,” he adds, mentioning the recent funding event as an example. “And just talking with everyone here. The good thing is that you can finetune the idea all the time, that is the fun part.”
What would you recommend to other researchers who are considering setting up a startup?
“I think you should just try it, it is always worth trying,” Rutger says. “You just have to validate your idea way more thoroughly than you think at the beginning. As a doctor or researcher, you are not always a good entrepreneur. Our ideas are usually way too complicated. If you have an idea, try to validate it with a lot of people, as fast as possible and then if you have a feeling it’s good enough – then you should really try it! This is the real change you can make. Research is a part of it, but the implementation of your research is the real change of course. So only on paper, it is not going to change a lot. That is why you should do it,” Rutger concludes.
Research is a part of it, but the implementation of your research is the real change.
Posted September 2022