Boston
28 October 2020

Equipping Humans Versus Replacing Them: The Place for AI in Digital Diagnosis

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Dyad Medical is a digital diagnostics startup that uses Artificial Intelligence and Virtual Reality to create more advanced cardiac image analysis and diagnostic to support treatment decision making, improving patient outcome and for better patient education and collaboration across the medical community. “It’s web accessible,” said Dyad Medical’s CEO and founder Dr. Ronny Shalev. “Dyad’s goal is to provide them with “thousands of second opinions”, in real-time, making even the best clinicians even better and bringing expert level observations to all who need them. The power of machine learning and artificial intelligence is the “system” can also detect from the images what is truly invisible to the human eye and that is what gets us all excited every day”

Dyad Medical’s first product was an intravascular image analysis that reduced 6 hours of analysis time to less than 2 minutes. 

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Dr. Ronny Shalev, Founder and CEO of Dyad Medical

Dyad became a formal Delaware based company in October of 2018 and immediately after were awarded the $2.6 million by the NIH. They then applied and were accepted into MassChallenge Boston for the 2019 cohort. In September 2020, Dyad Medical closed its oversubscribed Series Seed funding round led by The Unofficial Syndicate, with participation by Social Starts L.P., and local angel investors. Along with grants from the NIH, this brings Dyad's total funding to more than $3.5M.

We got to catch up with Dr. Shalev about his recent experience closing funding during the pandemic, his approach and thoughts on the future of AI, AR, and VR for medical diagnosis and digital health, and on how his experience with MassChallenge helped push Dyad Medical forward in crucial ways.  

Congratulations on your recent Seed Funding. I believe this is following a pre-seed round as well, can you tell us more about this achievement for Dyad Medical? 

Thank you, yes, we closed it with a very specific milestones in mind, which basically defines how the company is going to be commercially ready. In the healthcare industry, as opposed to other industries, the FDA can make things slightly more complicated. So, when I say commercially ready, I mean ready to start selling the product and this is the intended use of the funds of this round. Luckily, our lead investor has had great input in terms of helping me approaching other investors and putting together this whole package, which we call together a seed round.

It was additionally difficult with COVID. Most of the pitching and discussion was done all at home.

So, you closed the round when businesses-as-usual was largely shutdown. How did you go about navigating these new obstacles?

Due diligence is even more important. One of the issues with this way of communication is we're missing body language, and this is actually a big obstacle. You can't express yourself the same way, so now you have to be a lot more thorough in your presentations. Communication is more distilled to written form or over interfaces. I had to be slightly more detailed in all of these. I had to modify my presentation because it was no longer something that I could elaborate on verbally, I had to be more thoughtful with showing an example or a demo.

From your experience, what would you advise other entrepreneurs who have to raise funding in this environment?

Well, one of the recommendations for some reason that is going around the entrepreneurship ecosystem is “Don't send cold emails,” for example. Everybody says you need somebody to introduce you, and so on. I'm not saying that’s not true; an introduction is much better. But I'd say never give up the cold email approach because my whole growth was based on a single cold email I sent. 

I did meet a few people in my MassChallenge cohort who said they don't do any cold emails. “Nobody answers,” they said. But all you may need is one answer. So, this is one thing I would definitely tell people to keep doing although when you send a hundred of them 99 will probably not answer.

I’m wondering about the digital health and digital diagnosis industry currently. An outsider's view on this is that digital health is more in demand because of COVID. Did you feel the tailwind of that at all? Even though fundraising was hard?

Yes, because honestly, it did cause me to think slightly different. As I mentioned, in-person presentations were gone, so I had to show a lot more and even start to enable them to have access to the platform so we can talk through it. Which I think really helped me, it changed the way we presented, and the other end was a bit more receptive to this type of technology than in the past. COVID indeed accelerated some of our plans.

It seems some of the biggest tech trends are starting to hit healthcare in a meaningful way. Technologies like Artificial Intelligence, Machine Learning, and Augmented and Virtual Reality – Dyad Medical is largely on the frontier of this. Can you tell us more about what you’re seeing for the adoption or obstacles of this in healthcare? 

So let's spend a little time on AI because I think one of the things that makes the application of artificial intelligence and machine learning so exciting in healthcare is its promise of helping lead us towards lower costs and higher quality at the same time, which has been elusive, particularly in the US to help healthcare system. 

I can tell you from my narrow point of view, the efforts that I have to go through in order to approach a healthcare system is a challenge by the fact that the mindset of a health care system is different from mine at this point.

However, if I'm able to find those unique individuals who actually see things the way I do. They may be my ambassadors and that's really what I’ve done and continue to look for. 

The way I try to frame these developments is, say, we focus on using medical images as a means for diagnosis, some people claim that machine learning will replace humans. I think that’s too bold a statement. I'm more focused on the concept of let the machine learning, the medical imagery, let it be your second opinion.

We have the ability to learn from the insight of experts. I have a piece of software which is able to learn from the insight of any expert. And then lesser experienced professionals, or highly experienced one, have access to a second opinion. Nobody's forcing you to use it, so it will definitely improve decision making, I think, but only as a support to the current practicing workflow. It'll take some time to be fully adopted, but I don't think it will replace a human anytime soon. It will definitely create improvement. 

We should think of it as better equipping humans and not replacing them.

In addition to educating your market, how else do you approach healthcare obstacles when presenting your technology?

There are several stakeholders in a hospital, and they all have slightly different agendas and different goals.

I have to actually prove that this solution is actually improving patient outcomes, which is really what everybody cares about. So now we have to be very creative in how we prove our recommendation.

One way I’ve been doing it is by saying, “Okay, let's say the hospital did some clinical study with some outcome. And say they had a thousand patients in the clinical study, and it took them two years to reach a conclusion.” To prove the efficiency of our application, I would ask the hospital to give me only 100 out of the thousand patient data points without their results. Then I’ll create my own results and compare them to theirs, and they’ll be the same. Now I can show the hospital that it doesn't have to use a thousand patients and doesn’t have to wait two years to roll out the product. They can do it faster. I don't want to throw numbers in the air, but I'm just saying it's more consistent. It's very reliable. We just have to prove it. That's the only major point we have to prove.

We also have to modify these approaches to the stakeholder, because they all have different considerations. We may have to go through the IT department, then the administrative director, and then maybe the head cardiologist. We try to do different demos to fit the stakeholder.

For conclusion, can you tell us a little about your experience at MassChallenge, and how Dyad Medical grew during the program?

I think MassChallenge, in just one sense, can be an entry ticket to the Boston area, and for biomedical startup that’s huge. Because Boston is so strong in this field, it can be difficult to get footing in the industry, MassChallenge was very helpful in this aspect.

Additionally, one of the more outstanding components of my experience was the mentors that I was able to select. Because I’m more on the mature side for an entrepreneur, I made a list of my weaknesses before we started. I actually made the list and I searched by those. I searched for the right mentor and I found two who were excellent. Really, they gave me everything I needed to advance Dyad Medical. We even redefined the direction of the company as a result of their input. 

And when I graduated from MassChallenge my cold emails were not as cold anymore. I was able to say that I'm a graduate of MassChallenge, and here is what I did there, and therefore, let's talk honestly. That's how I got the attention of my first lead investor.

I really think that people should make the effort to try and get into the program. If they don't succeed, they should keep going and try again. And listen to the staff at MassChallenge, they only want to help you. If they suggest “Stay here. Go to the coffee machine. Talk to people,” even though it may sound cliché, doing that is exactly where I met the most people and had some of the more informative conversations. Take advantage of all the opportunities there. 

 

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