Melbourne startup Nebula Health Raises $250,000 in Seed Funding For Best Perioperative Patient Care

First published June 6, 2017

What makes patients’ lives easier?

Having clear, up to date communication with their doctor and treating team.

The problem is, time pressures and administrative structures in most hospitals and clinics make this difficult both for patients and clinicians.

Australian surgeons Dr Paul Paddle and Dr Chandrashan Perera have created a solution for this. Nebula Health delivers smartphone reminders and advice via app directly from the surgeon to the patient, improving the quality of pre-operative care, post-op recovery and long-term health of their patients, in an easy-to-use and efficient manner.

 

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Nebula Health’s new patient-focused app will help patients prepare for and recover well from surgery, with clear instructions tailored to each patient’s unique needs. Photo courtesy of Nebula Health.

As Chief Medical Officer Dr Paddle explains, “The concept for this app was borne out of my own experience and frustration. As a practicing ENT surgeon, I strive to check in on my patients at every step, before and after their surgery. However, in the time-pressured realities of medical practice today, it’s often not possible. With this app, my patients receive personalised directions every step of the way. In return, I receive real-time notifications of their compliance. As a result, my patients have more confidence in my abilities, are more satisfied and have better health outcomes.”

Frustration with the limits of current best patient care are what drive startups formed by doctors, nurses and other clinicians. Perioperative medicine is a standout opportunity for healthtech innovation, given the enormous breadth of surgical patients and cases, spanning from neonatal to paediatrics and adult surgery, and the non-surgical complications that can occur (such as cardiac events) amidst the high turnover of operative cases. A precision medicine solution like Nebula’s app could potentially also help those patients on waiting lists who are anxious about surgery or wanting advice in between appointments.

 

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Melbourne Accelerator Launch Party 2016. Photo: The Medical Startup

Since completing their time with the Melbourne Accelerator Program (MAP), Nebula have visited Silicon Valley with the other MAP graduates and iterated the initial concept of their product into a helpful perioperative app. What was the journey like as a clinician and startup founder? “We tested thirty (surgical) patients using a prototype. Feedback was overwhelmingly positive, and it encouraged us to develop this concept into a market-ready product.” explains Dr Chandrashan Perera , Nebula’s CEO. “Patient testimonials from this trial turned six surgeons into early customers. From this traction, we were able to close our seed round. This funding will allow us to grow the team and scale our services to more patients.” Indeed, at least two more medical doctors have joined Nebula‘s team, and Nebula’s vision has impressed angel investors including Rod Lyle, a board member of ASX-listed medical technology company Pro Medicus.

It’s been exciting following Nebula Health’srapid journey from the Melbourne Accelerator Program (MAP).  Other medical successes include compatriots CNSDose, a pharmacogenetics company who are now part of the Texas Medical Center’s Innovation Accelerator, and other graduates of the MAP program.

Currently, Nebula Health are looking for more surgeons in hospitals and clinics who are interested in their software. For a demo or more information, please contact Li (at) nebulahealth.com.

Congratulations and best wishes to the team!

Breaking The Boundaries You’ve Set Yourself: Thoughts and Events To Inspire Your Tech Journey

First published May 28, 2017

 

How do you learn about tech as an outsider?

For awhile, before The Medical Startup became an idea, I was toying with creating something in tech.

I was a full-time doctor in a Melbourne hospital, spending all my spare time studying for fellowship.

When you’re at that stage in your career, you’re usually facing another four to six years of focusing on fellowship full-time.

I was surrounded by peers who were working towards the same goal.

It was all we knew at that time. We’d forgotten what life was like pre-training, it was deemed a “waste” if you paused for breath, and it took a long, long time to learn to breathe above water again.

So it seemed impossible.

But when you start to act towards those “strange” goals, the world opens up beyond anything you’d imagine. 

Attending events and online webinars helped tremendously. I was surrounded by others who were teaching themselves, too.

I started learning how to adapt to new environments, even more new than running a Code Blue at 3am.

I started learning the lingo of life outside of medicine.

And the love of learning I have for medicine sustained me through this journey, too.

So here’s a thought for the next time you’re thinking, “I can’t do this” or “It’s impossible, I have no background in this area.”

Think laterally about what you’re telling yourself.

Is it really impossible?

 

You’re not just a doctor.

You’re a woman in tech.

You’re not just a nurse.

You’re a father of three.

You’re not just a clinician who sees patients one by one at scheduled appointments at your clinic.

You’re facilitating their wellness beyond their current condition. How they are at home, at work, at the shops and their daily lives.

You have to stop thinking of yourself as a single job description. 

Otherwise, when you’re stuck, how will you remember who you are again?

Think about those who have the courage to uproot countries and settle in a new culture, starting from scratch with their careers again. Often, their degrees aren’t recognised at their new home.

Or think of those who graduate from one degree, then use their determination and self-belief (even when it’s down) to apply to study post-graduate medicine or another degree.

Don’t underestimate yourself.

We’re all learning, after all.

And that shiny, suited person speaking up on the big stage? They had to start somewhere, too. 

This is literally just a random post after reflecting on recent events and conversations. You have to normalise curiosity and your hunger for knowledge. 

Thinking about it, there are a ton of events coming up around the world that may help you along your journey; I’ll list them below. Perhaps you’ll find some of them useful, too.

A couple are med tech, but most are actually more general and will help you learn the vibe and get comfortable in the tech and entrepreneurship worlds, too.

Who knows what new friends you’ll make, and what skills and knowledge you’ll bring back to your usual lives? You’ll almost certainly realise that you already know more about tech than you thought you did.

Be inspired.

Let me know in the Comments or by email if you have been or end up going to any, and how you enjoyed it/what you took away from it. I’m also speaking at an AMA leadership event tomorrow, aimed at junior doctors but hopefully useful for others, too.

Below:

  • The Sunrise Conference” by Blackbird Ventures in Sydney. One of Australia’s most renowned tech venture capital firms. (Last year it was streamed online; here are a couple of tips we took from some of the talks.)

  • The Melbourne Accelerator Program Launch Party 2017. Last year, two Melbourne digital health startups founded by doctors were part of the program. Nebula Health and CNSDose have both benefited hugely from MAP, with Nebula now partnering with hospitals and surgeons, and CNSDose breaking ground as part of Texas Medical Center’s Innovation program.

  • General Assembly, a tech education company running coding bootcamps, one-day workshops and even two-hour events across their centres in Australia, Asia, the US and UK. Visit generalassemb.ly to find your nearest centre and see what’s available. I’ve found their events very helpful.

  • HIC, Australia’s premier health informatics (digital health) conference, run by HISA, the Health Informatics Society of Australia. It’ll be in Brisbane in August, and I’ll be presenting as part of the UX (User Experience) workshop, along with others interested in digital health. I really recommend joining HISA, HiNZ, HIMSS (including their APAC branch), COACH (Canada) or other organisations as a way to get access to valuable resources, networks and skills for eHealth.

  • COACH, Canada’s annual health informatics event early June.

  • HIMSS Asia-Pacific Summit, in Singapore in September. (As a member of HiNZ, you also get full automatic membership to HIMSS Asia-Pacific.)

  • HiNZ, which we wrote about last year; it’ll be in Rotorua this year.

  • The Global Ideas events in Melbourne, inspiring global health innovators with skills including tech and human-centred design thinking. (Read about founder Dr Lloyd Nash’s journey here.)

  • Vogue Codes, an Australian event running in Sydney and Melbourne in August aiming to inspire more women to take up careers in STEM. Speakers include the founders of ClassPass and Shoes of Prey as well as female members of Australia’s startup and tech communities. Being a woman in STEM who loves fashion and the arts, (even if I don’t look the part!), this event really speaks to me, knowing that although society places us into simplistic career boxes (“Medicine!” “Science!” “Engineer!” “Designer!”), we’re much more than just a “science person” or “arty person” 100% of the time.

  • Vivid Sydney’s Ideas program, coming up this week.

  • Girl Geek Academy, an Australian organisation aiming to educate 1 million girls and women in tech by 2025. It also has events in the US.

How Can Facebook’s Spaces VR Program Help Patients and Consumers?

First published April 20, 2017

Overnight at Facebook’s F8 conference, Mark Zuckerberg officially announced the launch of Facebook Spaces in beta. Using the Rift platform and available on the Oculus store, purportedly all that’s needed is Oculus Touch and an Internet connection.

 

Essentially, this means Facebook is adding virtual face-to-face interaction. This is a huge win for patients and healthcare consumers.

There are several ways in which we think virtual reality through Facebook will help patients, consumers and clinicians.

Patient communities are a burgeoning interest in healthtech. The Mayo Clinic Connect is an online messaging and education platform where patients and carers can chat with others suffering the same or similar illnesses. Australian app CancerAid is also building patient communities and sharing the burden of cancer with the millions affected by cancer worldwide, through their app for iOS and Android. Imagine the potential for communities to virtually “talk” with each other.

 

Patients can create avatars and share vivid experiences with each other, including their Facebook photos and 360 degree videos. Imagine taking a 360 video of your community hospital’s dialysis unit in Chile with your smartphoneand sharing that in real time with your friends in Norway.

 

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Screenshot from Facebook Spaces Oculus’ launch video.

The potential for healthcare education is huge. Facebook Spaces includes a drawing function, meaning that potentially, clinicians could educate patients and families in a more hands-on way, without needing to be in the same room as them. Of course, this helps students and clinicians train for procedures and study for exams, as well.  This could come in handy for rural and residential communities who may not be able to travel to the city for care so readily. Hospitals, clinics and education centres producing educational video content (such as the Royal Children’s Hospital) could potentially integrate their videos into Facebook Spaces, and nurses and staff could help teach with the added drawing function inside the virtual classroom. Imagine teaching a patient about what to expect from a hospital visit through a virtual tour on Facebook Spaces. (Or through our anaesthetist friend’s made-for-VR video!)

 

Facebook Spaces also adds another potential dimension to telehealth. Using Facebook Messenger, video calls can be made, including outside of Facebook to the “real world”. We imagine chatbots for Messenger like Amelie, the mental health chatbot, will have incredible functionality here, where the user’s virtual avatar can consult “face-to-face” with the chatbot counsellor. Sometimes it’s easier to chat to someone you can’t look directly in the eye, and we can imagine people who are too uncomfortable to talk to a face-to-face counsellor or who can barely get out of bed when in a bout of depression may find it easier to start with a chatbot. (One of Amelie’s functions is to guide the participant to further help, rather than replace a professional psychiatrist or psychologist.)

And from a global health perspective, users will be able to virtually “travel” with chatmates and experience different environments. This could help with disaster resource planning, for example sharing VR videos and 360 photos of earthquake – ravaged zones with aid organisations to help their planning for resources and deployment. Similarly, can you imagine how design of healthcare spaces will be impacted? Oculus’s YouTube video above shows a user sharing photos of the apartment she just bought. Again, the virtual tour aspect of public buildings and clinics can help plan for better patient care through architecture and design. Imagine sharing 360 pictures of your Emergency Department layout with other EDs around the world at conferences; or performing emergency simulation training through VR tours and demonstrations.

Are you an app developer or health tech startup founder? Now you have a whole new avenue of possibility to think about when integrating social functions into your product.

Of course, cautions about security and encryption of call content apply here, but just imagine the potential…

Got any ideas for how you will use Facebook Spaces in healthcare or for leisure? Comment below and please share this article if you enjoyed it. Sign up for our mailing list if you’d like more updates like these. 

Singapore Stanford Biodesign Paid Fellowship Open for Applications

First published April 17, 2017

 

If you’ve ever wanted to experience medical innovation in Asia, this opportunity is for you.

The Singapore Stanford Biodesign Fellowship gives clinicians, engineers, developers, designers, and other aspiring healthcare innovators the opportunity to be immersed in a healthcare innovation project for a year. A unique program that unites diverse career pathways, the SSB Fellowship comprises five months at Stanford in America; immersion and project rollout in a Singaporean hospital; and a three-week clinical immersion in another Asian hospital outside of Singapore. Similar to the original Stanford Biodesign Fellowship, a stipend is included for the program’s duration.

Members of the Singapore-Stanford Biodesign Fellowship team. Pic courtesy of SSB.

The clinical theme for the year is selected by SSB’s Board members, challenging participants to develop valuable experience in areas outside their usual training. New ideas are stimulated when an orthopaedic trainee is given an obstetrics focus for the program; similarly, we believe strongly in thinking outside the box to generate better medical solutions.

Some of the program’s previous fellows have gone on to commercialise their projects and been listed on Forbes’ “30 under 30.” There is an option to extend the program for a further period of time after the initial year.

Entries close 2nd May 2017. Preference is given to Singaporean citizens and permanent residents; however, it’s worth a shot if you’re passionate about healthcare and medical technology in Asia. For more information, please visit ssbiodesign.org.

To hear about other programs and opportunities, sign up for our mailing list

How Can We Be Leaders Through Healthcare Technology? Day 3 of HiNZ and the New Zealand Nursing Informatics Conference

First published November 7, 2016

This week, we’ve been inspired by the many speakers who have made career leaps: from clinician  to academic; from clinician to ICT (Information and Communications Technology) specialist; and even from accountancy to the public service in healthcare. Here are some of their insights from Day 3 of HiNZ, and the concurrent New Zealand Nursing Informatics Conference:

1) Videos of nature scenes played via app, with or without music, can help reduce pain perception and level of anxiety in the perioperative period. Professor of Nursing, Margaret Hansen of the University of San Francisco,  was inspired to investigate the power of visualisation in dealing with pain, after experiencing a severe illness herself. Her feasibility study, performed as a randomised controlled trial, has shown these promising effects, and will lead to further study- perhaps even in Virtual Reality!

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Prof Margaret Hansen of USF demonstrates one of the app’s Nature videos at the NZ Nursing Informatics Conference 2016. Pic: The Medical Startup

2) “We need to collaborate with our international colleagues,” said Lucy A. Westbrooke, who is the New Zealand ambassador for the International Medical Informatics Association – Nursing Informatics (IMIA – NI). From her diverse career in nursing, leading to executive and chairperson positions in New Zealand health informatics and telehealth, she described some of the various international meetings and opportunities helping to achieve this goal.

 

3) “You don’t design systems for the most technologically agile; it has to be for the users,” Dr Simon Kos, Chief Medical Officer of Microsoft advised. Having experienced healthcare both as a clinician and as a software engineer, Dr Kos gave insights into the future of medical education with virtual reality through Hololens. 

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Dr Simon Kos, Chief Medical Officer of Microsoft at HiNZ 2016. Pic: The Medical Startup

4) Finally, NZ Ministry of Health Director General Chai Chuah posed the question: What kind of leader are you (in healthcare)? “Today’s global leaders understand and lead the art and science of disruptive change,” he said, acknowledging the combination of both art and science in medicine, technology and healthcare.

Leadership isn’t always about being the first to present an idea, or the first to use a new technology. Leadership can occur at an individual level. As an example, guiding a patient to a tech solution enabled by a District Health Board (DHB), such as A.Prof Robyn Whittaker has done with her project with Waitemata DHB. Her research findings from a messaging reminder service for behaviour change showed that patients benefited from this service. Or coordinating an entire Australian Territory’s telehealth services, as Michelle McGuirk does in the Northern Territory; or encouraging a patient to keep an app-based symptom journal.

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A/Prof Robyn Whittaker, Medical Doctor and Digital Health lead at Waitemata DHB presents her Behaviour Change Messaging project findings. Pic: The Medical Startup

You can view sessions from 2016 and 2015 at HiNZ.org.nz with membership. Catch up on Day 1 and Day 2 highlights as well.

We thank HiNZ for providing media access to the conferences and opening our eyes up to these incredible experiences.  

The Virtual Ward Round Is Here: Highlights from Day 2 HiNZ, Successes and Failures in Telehealth, and the Global Telehealth conferences

First published November 2, 2016

We’ve been very inspired from the talks and positive atmosphere at HiNZ, SFT and the Global Telehealth conferences this week. New Zealand is a country that deserves a lot more credit for their innovation in medicine and global healthcare. Here are some of today’s highlights:

1) Virtual Ward Rounds and Consults help patients and clinicians alike feel supported and at ease with care. Dr Eddie Tan, nephrologist from Waikato Hospital, spoke about the “hub and spokes” model of care that Waikato Hospital and its satellite rural hospitals and clinics run. With hundreds of kilometres between sites, Dr Tan and his colleagues are on planes at least every fortnight for clinics that may last just a few hours before returning back to Waikato. This is problematic when rural patient emergencies develop; however, Telemedicine with videoconferencing to the satellite clinics has helped the Renal team conduct assessments, minus the hours and dollars spent on travel (and minus hours of patient/family stress). It has also prevented unnecessary hospital presentations, and brought critical patients to hospital sooner.

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Dr Eddie Tan, kidney specialist at Waikato Hospital NZ discussing Telehealth in Renal failure. Pic: The Medical Startup

Dr Tan’s colleague, Waikato District Health Board (DHB) renal nurse Jenny presented her research paper on how palliative care decisions were made easier with telehealth’s videoconferencing capabilities. This meant that difficult and time-critical family and patient conversations could be had in the comfort of the patient’s home, without wasting precious time in the potential final days of life arranging hours or even days of transport for the same consultation.

Dialysis ward rounds also help Dr Tan assess end-stage renal patients who may deteriorate very rapidly and become fluid overloaded.

Similarly, Rehabilitation ward rounds by telemedicine has helped patients in a rehabilitation ward feel happy and secure with their care. Registered Nurse and PhD candidate Sophie Gerrits’ research has so far found that rehab patients and staff at Thames Hospital, Waikato DHB New Zealand, are happy with the consults, and the elderly patients have adapted well to the new technology. The Ward Registrar goes from bed to bed with a telecart, and the Rehabilitation Physician or Geriatrician video-calls weekly in from the tertiary hospital, in addition to their usual weekly face-to-face visit.

 

Staff appreciated having a second chance during the week to ask questions and raise issues that had arisen in the days since the last visit. The main issue to overcome was “patient jitters” at not knowing what to expect from a video consult and what was expected of them. This reinforces the need to counsel patients prior to a consult; that they can speak, behave and ask questions just as they would if the clinician was in the room with them.

2) Telestroke Improves Door-to-Needle Time in New Zealand

Yesterday, Dr Chris Bladin of the Victorian Telestroke Program discussed the very promising findings from the Victorian Telestroke Program research in rural hospitals, with hopes to expand to other Australian hospitals. Today, New Zealand Neurologist Dr Anna Ranta showed that since Telestroke has piloted from 3rd June in the Capital and Coast DHB, door-to-needle median time has reduced from 80 minutes down to 54. With cerebral ischaemia being a critical matter of seconds, this is a significant early finding, and along with other positive outcomes, will hopefully help push for a Telestroke rollout in other DHBs.

 

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1,100 delegates attending HiNZ this week. HiNZ Awards Dinner at Shed10, Auckland, sponsored by Microsoft. Pic: The Medical Startup

3) The finalists for the Sysmex Award for Health Informatics at the University of Auckland have promising ideas for mobile health applications. The winner, Daniel Surkalim, was announced tonight at the HiNZ Awards dinner. By creating visually appealing, simplistic views of patient data, his project, GRID(Graphical Relational Integrated Database) will help solve the clinician bugbear of “too much data, not enough sense” that occurs in many existing EMRs (electronic medical records). The other finalists deserve commendation for their work; Frances Toohey with Dr.Doctor for clinicians and patients to track eReferrals, and Kyle Frank’s MedScript to facilitate e-prescribing solutions for patients and doctors.

4) Tele-ophthalmology in India aims to cut waiting lists for a population short of ophthalmologists. Dr Sheila John of Chennai, India has done extensive work with diabetic retinopathy and machine learning, and inspired us with her dream to help rural villages be screened for diabetic retinopathy accurately and safely without a long waiting period for an eye specialist. Dr John quotes 60 million people in India as suffering from diabetes, with nearly 20% experiencing diabetic retinopathy, a cause of blindness if left untreated.

 

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Speakers from four different nations closing the Global Telehealth conference today; L-R: Global Telehealth co-chair Dr Kendall Ho of Canada; Dr Karen Day of NZ; Dr Laticha Walters, South Africa; and Dr Sheila John, India. Pic: The Medical Startup

With four events running this week, it’s impossible to catch all sessions at once. Watch the conference on demand, even after this week, with a Virtual Ticket, including one year’s worth of membership with HiNZand HIMSS Asia-Pacificamong other benefits. We thank HiNZ for providing media access to the conferences and truly enjoyed the experience.  

Highlights from HiNZ, Successes and Failures in Telehealth, and the Global Telehealth Conference Day 1

First published November 1, 2016

We’re Tweeting live from #HiNZ2016 in Auckland this week. Follow us on Twitter @themedstartup and @journalmtm, the Journal of Mobile Technology in Medicine. We’re also on Instagram @themedicalstartup.
Virtual tickets with HiNZ membership are still available at
hinz.org.nz. 

What were some of today’s highlights?

1.Experiencing the Maori welcome ceremony. It was incredible seeing the haka and other traditional ceremonies performed to commence the event. Kia Ora!

 

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Pic: The Medical Startup

2.Learning about New Zealand’s healthcare system. New Zealand’s DHBs (District Health Boards) manage the various hospital regions in the country of two islands, supported by the national Ministry of Health (MoH). With a large rural and regional population, their DHBs have managed to put together various digital health solutions to overcome the geographical, cultural and at times, linguistic barriers that occur. (We’ve written about what Australians are doing with telehealth here, and Dr Gregory Sam’s telepsychiatry service here.)

3. Discovering what sensor wearables can do for the elderly.
Professor Marjorie Skubic of the University of Missouri’s Computer and Electrical Engineering Department, has carried out extensive research into sensor wearables, inspired by her own journey to help her parents feel safe yet independent while living a considerable distance away from her. Gait analysis using Microsoft Kinect depth cameras; sensor mats in beds that measure respiration and heart rate; and other sensors embedded in the home environment are all part of her research, giving hope for the elderly to feel supported and independent while their children can continue work.

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Prof Marjorie Skubic discusses Eldertech at HiNZ2016. Pic: The Medical Startup

4. Experts acknowledging that technology is a means to a human-centred solution for healthcare. As Lord Nigel Crisp of the United Kingdom said below during his address:

The Medical Startup@themedstartup

"Healthcare is a human contact sport" - Lord Nigel Crisp quotes his friend at @HINZ_NZ #hinz2016 @nhsdigital

8:12 AM - Nov 1, 2016

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Additionally, Homecare Medical, who won the tender for New Zealand’s National Telehealth Service, understand that citizens don’t expect healthcare to be limited by geographical boundary anymore.

The Medical Startup@themedstartup

"The Virtual world doesn't respect the boundaries of District Health Boards (&other local health systems)" Andrew Slater, Homecare Medical

9:27 AM - Nov 1, 2016

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This leads into the topic of Precision Medicine Personalised Medicine. As technology evolves, patients will feel more empowered to take control of their healthcare (as they already do by Googling symptoms and performing other forms of accessible research), and clinicians will have to evolve to understand their patients’ perspectives better. Patients will expect medicine doses and timing to be tailored; their leaflets or apps about their conditions will  be personalised; and more forms of personalisation to enable better living.

5. Learning what Clinicians think of Big Data. Big data is important, but what good is it if it’s of no use to you in future? With big data comes big responsibility, and collecting unnecessary data wastes valuable time and resources.

jMTM@journalmtm

"I thought Technology would be v important with all this,but it's actually Change ie.human behaviour-"Prof Chris Bladin @TheFlorey #Hinz2016

8:46 AM - Nov 1, 2016

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– above quote from Prof Chris Bladin when presenting his journey as a neurologist with the Victorian Telestroke program, which has successfully treated rural and remote patients throughout the state. They’re now looking to expand to other States.

The Medical Startup@themedstartup

"Elective #surgery is a great target for #bigdata but you need #goodquality data"Dr Mark Fletcher #anaesthetics #registrar#hinz2016 #ehealth

11:11 AM - Nov 1, 2016

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6. Watching the Finalists of the Clinicians’ Challenge, supported by New Zealand’s Ministry of Health. It strikes a chord with us that a national government supports and empowers their clinical staff as innovators, being the ones at the coalface of medicine. Finalists include an Anaesthetic Fellow; a Pharmacist undertaking doctoral studies; a Public Health doctor; and a Junior Doctor working in Dunedin. Stay tuned for further details, as well as updates on last year’s Ophthalmology and Surgical winners.

For more information on HiNZ, visit hinz.org.nz.