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The Inventivity Pod
A Better Ostomy Bag
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As a kid and a young man Michael Seres, the founder and CEO of 11 Health, was plagued by Chrons disease and intestinal problems. Eventually, this required him to have an intestinal transplant, just the 11th ever performed in the UK. The surgery left him with a permanent companion, an ostomy bag. Tapping on business skills he developed creating product merchandising for TV shows like The Apprentice and Who Wants to Be A Millionaire, he created a better ostomy bag and launched 11 Health.

 

TRANSCRIPT:

 

Intro:

Inventors and their inventions. Welcome to Radio Cade a podcast from the Cade Museum for Creativity and Invention in Gainesville, Florida. The museum is named after James Robert Cade , who invented Gatorade in 1965. My name is Richard Miles. We’ll introduce you to inventors and the things that motivate them, we’ll learn about their personal stories, how their inventions work, and how their ideas get from the laboratory to the marketplace.

Randy Scott:

For those of you expecting the wisdom of Richard Miles, I apologize, but this is your guest host today, Randy Scott, and I’m here today for Radio Cade, with Michael Seres, the founder and CEO of 11 health and the inventor of the Alfred smart optimi bag. Hi Michael, thanks for joining us today. It’s going to be interesting to chat about this. So as we normally do here, Michael, we’d like to start actually with having you explain and, you know, fairly simple terms, just what the Alfred smart bag is and why it’s important.

Michael Seres:

Sure. Let me start by explaining a little bit about, an ostomy, typically, an ostomy is where part of your intestine is brought to the outside of your tummy and you have a bag attached to that part of the intestine. And that’s known as an ostomy bag. And most people I guess understand about a colostomy bag, but it’s generally after surgery that would come from either bowel cancer or inflammatory bowel disease and where your bowel either needs to rest or isn’t working. The part of the intestine is brought on the outside and those bags traditionally are collection vessels. They fill up and they leak and spill. And when you’ve had that surgery, part of your nerve endings is cut. And so you don’t actually know when those bags are filling and what’s happening to them. It’s kind of like a diaper as it feels, and you don’t necessarily know when to change it. And so what I did really, after my own experiences as an ostomy patient was to deconstruct an existing bag and rebuild it with a series of senses inside. And those senses are mainly temperature, sensors, and capacity senses that out. You understand when the bags have failed, that the sorts of senses that you would have in a car there , you know, sometimes the cars beep when you get too close to another car or when you’re crossing over a lane. And so I integrated those senses into an optimi bag, and now they will send a signal to my cell phone when my bag is filling. And so it can prevent the leaks and the spills. And what it also enables us to do is send that information to the doctors so that they can help manage mine and other people’s conditions better. As an example, if you have too much output in a day, you are prone to dehydrating and if you have too little out put in a day, it might indicate there’s a blockage or there’s some inflammation in the intestines . So your doctors need to know that data in real time. And currently the existing bags don’t do that.

Randy Scott:

So you’ve mentioned that you’re an ostomy patient yourself, so I guess you kind of come by this vention honestly, so to speak and you and I have already talked about this a little bit of course, but maybe for our listeners benefit, kind of describe where did you grow up? Cause I tell from your accent that you’re obviously not originally from Southern California, but maybe a little bit about your childhood, but then tell us how you came to become an ostomy patient the first place.

Michael Seres:

Sure. So as you can tell from my accent, I speak the Queen’s English. I grew up in Northwest London and I’ve been out in Southern California, the last two and a half years, but I’ve got a younger sister, mum and dad, and grew up as a , a massive sports fan, became interested in my late teens in politics and law. But most of my childhood was interrupted with health challenges. I was diagnosed with Crohn’s disease, which I’m sure many of the listeners will know is, is an incurable inflammatory bowel disease. And I was diagnosed with that age 12. I had my first surgery at age 14, and then I went on, unfortunately to have 25 further intestinal surgeries, or basically they will continue to resect part of my intestine and my bowl. And then I got to a point during my working life where I had intestinal failure. And basically your intestine is down to less than a hundred centimeters, and you’re really kept alive through intravenous feeding. And that lasted for about 18 months before I became the 11th intestinal transplant patient in the UK, which is why my company is called 11 health. And so,

Randy Scott:

Well that answers one of my other questions.

Michael Seres:

Yeah, I would love to tell you it was a really great branding exercise, but it was just from that. So I’ve lived my life connected to medical bags for most of it, which was the inspiration behind the company.

Randy Scott:

Going on, I guess a little bit about your history before founding 11 health, just to dig in a little bit more there and we’ll come back to the, you offered a bag and all, but it sounds like you were a natural entrepreneur from early on too . I think you started a candy business when you were a youngster, even before all of this other intestinal issues came up. Hopefully not from eating too much candy.

Michael Seres:

Yeah. I grew up around both grandfathers who were , uh , own their own businesses, one in the clothing industry, one in the o ld b ristles trade. And so I grew up,

Randy Scott:

Bristles ? Like Brushes?

Michael Seres:

Yeah. He made the shaving brushes. You put the shaving cream on and the old traditional style. And he was one of the first people to fly out to China, and those days it would be for months on end, then come back. So I grew up around relatively entrepreneurial, I guess, family, as you said, I ran the alternative school candy shop from my locker, which probably upset the teachers, but it did make me some extra pocket money. I did paper rounds . And I’ve been lucky enough and always been intrigued and interested in how business ran prior to 11 health. I then had a career in consumer product licensing and merchandising. So, television programs that , that you probably aware of, like Who Wants to Be a Millionaire, The Apprentice, T.he X-Factor my job was to commercialize those programs off there. So take the intellectual property, take the gaming format . And so one of the first commercial agreements that I signed was the mobile phone or the cell phone game for Who Wants to Be a Millionaire, which now probably feels very outdated. But at the time was one of the first games on a cell phone that you could play. So I’ve always been in and around b usiness.

Randy Scott:

So if you’re doing the apprentice, I’m guessing you’re doing Donald Trump action figures before they were cool.

Michael Seres:

Yes, absolutely. And the book and it was interesting. So in the UK, we had our own Donald Trump figure known as Alan Sugar and exactly the same thing. It’s books, it was figures. It was you name it all, all the merchandise that you’d see in traditional retail outlets . That was our job.

Randy Scott:

But then you started , uh , like a toy company or something also doing licensing. Is that right?

Michael Seres:

Yeah, that’s right. So, because I was working in and around building brands, I was lucky enough to cure the rights to various toy brands. People may have heard of Thomas the Tank Engine and Bob the Builder, little kids brands. And so at some point I took the right for myself and built a small toy company, manufacturing those products and then selling them into retail. And in fact, all those learnings have been fantastic instruction manual for , for where I am today. I’ve been lucky to have great mentors and just intrigued about how you build businesses across different countries with different rights.

Randy Scott:

And so at some point you moved over to the U.S. From the UK?

Michael Seres:

Yes . So I moved about two and a half years ago to the U.S. Really as, as 11 health was starting to expand. And I was lucky enough to be mentored by someone I’m sure, you know, by Mike M oritz Firms, S equoia Capital, and he and Mike really in a sense gave me two rules. When he first worked with me one, you need to be based in the U.S. If you’re trying to grow your business out here. And secondly, don’t run it like a British company. And so I u pped s ticks and I , at the time I left my family in the UK and I was commuting eight weeks in the U.S. two weeks in the UK, and then finally convinced them to come over just under a year ago. So now we’re all Southern b ased.

Randy Scott:

I’m not surprised he made the comment about the U.S. In part, because of course the U.S. especially in medical products is always by far the largest market in the world, but this notion of don’t run it like a UK company. Well , what did that mean?

Michael Seres:

I think to me, the big difference that I noticed here is you put more time in terms of building your technology growing a little bit more aggressively, even in healthcare , it’s slightly more opportunities for younger companies to grow. If you get regulatory approval here, you can really expand a lot quicker in the UK. The traditional model is you invest a little, make a little bit of money, put , perhaps put half in the bank and invest the rest. And it’s a slower churn and a slower build. Whereas there’s more value as well put to growing technology. And I think, I mean, you’re the expert far more than I am because of what you do. But I think if the addressable market is big enough and you’ve got an opportunity, it’s a much quicker pace here. And I think that was at the half of the lesson he was trying to,

Randy Scott:

That makes sense. Things in the UK are a bit more conservative, maybe old school in terms of how to grow the business, as opposed to the California approach .

Michael Seres:

I think you’ll braver here about trying new things, about giving an opportunity to younger companies to grow. We’re a little bit more old school. I think that’s a great phrase.

Randy Scott:

So going back, you had, as you’ve described for issues , medical problems, you’ve got the ostomy bag. And I think I gathered from the research. I did that, one of the things that may be sort of steering you in this direction and got you plugged into the ostomy community, was that you started a transplant blog that took off kind of virally, is that right?

Michael Seres:

Yes, that’s absolutely right. So an intestinal transplant, as I said, I was number 11 and sadly five of the first 10 had passed away. And actually the unit at Oxford in the UK where I had mine brought their surgeon over from Miami to run the program. And I was his first and everybody inevitably wants to know how you’re doing it . There’s an awful lot of interest and love. And actually I started the blog at the beginning, just so that people didn’t have to call and so my wife didn’t have to repeat the same stories. It was a way of sharing what was going on, but then I actually discovered that my transplant surgeon was reading it and that he was sharing it then with the medical students at the hospital. And it just grew really through luck. And then it became a story of my journey. I was very honest about the ups and downs of the journey, and it connected me with a new community and it really opened my eyes as well to the power of the role that the patient can play. And also how you can connect people on social media. And in a sense, I was late to the social media party, but it really allowed me to connect with people all around the world, which was fantastic.

Randy Scott:

Yeah I’ve noticed that 11 health habit just innovated with the product, which has clearly unique and serves a specific need, but it looks like you’ve created an entire, almost support structure around these patients that include some social network kind of elements, but also patient coaches. And you’ve got something called club 11 and in some doctor and nurse training and this kind of stuff . So maybe describe the ecosystem that you had to build there. And for that matter, why you felt the need to do that, as opposed to just, Hey, I’ve got a cool product, I’m going to go sell this cool product.

Michael Seres:

You definitely do a better job of selling less than half than I do. Thank you. But as a 16 year old, I went to see a , uh , leading gastroenterologist in the UK. He was actually the Queen’s physician and he was a quite a scary man. And as a 16 year old, I was a bit all over the place. And when I went to see him on the first day with my parents, he asked my parents to leave the room. And he said to me, here’s the deal, Michael, I will only treat you if you take as much responsibility for your care as I will, we’re going to teach each other and we’re gonna work together on this and transplant surgeon, pretty much repeated the same words all those years later. And so I’ve always grown up believing that as a patient, I have to pay as vital role in my own care as my medical team. And so the reason for sort of sharing that backstory is that when we built 11 Health, I really was plugged in and believed that actually the role of patient to patient can not only improve outcomes, but also can save money for the system, but really improve quality of life mentorship, the education side. And so we built this originally the support network that now really starts a pre-op, when you’re told you’re going to have surgery, we pair you up with an existing ostomy patient who becomes your coach and your mentor. And now with the way health coaching is growing, particularly in the U.S. we put these patients through coaching accreditation and they become your , your mentor and your guide, and they become part of the pre-op and post-op planning on what we’ve been able to see then is we can actually reduce the number of clinical interactions a patient needs to have, because so much of what they go through after surgery is actually nonclinical. It, it’s social, it’s educational, it’s hints and tips. It’s the practical things of how do you get back to a normal life? And I really value that peer to peer side of things. For me, it’s the greatest thing I can do is to support another patient. And this is just an extension of it.

Randy Scott:

It sounds like you connect with your patient slash customer, future customer or whatever, before they actually have even had their surgeries. So this means, obviously you’re really integrated with the surgeon somehow to them.

Michael Seres:

You’re absolutely right. And we’ve become part of that pre-op education. So the surgeon and often the nurse will go in and say, this is the surgery your having, this is what it means. And then 11 Health patient coach will be brought in to explain in more practical terms and be there as that support. And I think that builds that relationship right at the start of the journey. And we’ve even seen where patients perhaps have had their bag reversed. So they’re not on it anymore. They continue on with our patient coaches because they become almost a friend and a support system to them. I think that value is going to grow. And I think in a healthcare system, which is moving globally to sort of outcomes based, which is moving the term precision medicine and keeps coming out well, how do you really understand the outcomes unless you include the patient? Cause sometimes the surgical outcomes and the patient outcomes, aren’t always aligned. And so,

Randy Scott:

Yeah I think frequently they aren’t aligned exactly.

Michael Seres:

Yeah, And I know for myself that there are times when actually the most important outcome to me is to go to my daughter’s concert and not sit in hospital for three hours connected to an IV drip. And how do you facilitate those in a sensible way? So that’s really important to me, 11 Health, that it’s not just about technology, it’s about the human being as well.

Randy Scott:

No that’s great. Yeah, one of the other things that I’m curious about is even as a very young company, you’ve been able to surround yourself with a lot of impressive kind of board members and advisors and that kind of stuff. You get several pretty important surgeons. And I noticed even Joe Kiani, who is the CEO of Massimo multi-billion dollar global health care products company, how did you get Joe to agree to be on your board? I suspect there’s thousands of startups that would love to have somebody like him as an advisor and board member probably get plenty of invitations, but something about this one got him to actually sign up, is there a story to that?

Michael Seres:

Yeah. So Joe was actually instrumental in me, settling in, in orange County and stuff in California, and had advised me to come over and it was going to be traditionally in Silicon Valley. And I’ve , to be honest with you, I looked at the costs and I’m not an engineer by background. And I didn’t want to just necessarily recruit a group of people who we might be the hottest startup today, but not necessarily tomorrow. So I looked at where a lot of medical device manufacturing was going to be a nut was in orange County. And I wrote to Joe and I guess got lucky. And originally it was about the ecosystem in orange County. Is it a place that you would suggest settling or starting a business in? And he said, yes, that was how I got originally to start. And it was just some advice on the area. And then the relationship grew. And I think what we were trying to do from an engineering perspective peaked his interest, but we built a relationship and in the end he said, look, I’m happy to invest in and come on the board. And he’s been a fantastic mentor. He built his business from nothing to where it is, if we’re anywhere near as successful as Joe’s been , I’ll be over the moon. Yeah . I mean, to be honest with you, I’ve been incredibly lucky. I reached out to you and your team and we’ve connected and we’re on this call is, I don’t know whether it’s a patient trying to build a solution, opens the door. I think sometimes people don’t always ask for help. I’m learning what I’m really good at and what I’m really bad at. And I’m not frightened to ask for the help . Maybe that’s something.

Randy Scott:

Yeah probably a good piece of advice for other entrepreneurs and inventors and they listen to, don’t be afraid to ask for help. That was in my experience also.

Michael Seres:

There’s a tendency to think that you built something, it’s yours, you’ve got to know everything. You’ve got to do everything. And for whatever reason, I’ve never approached. What I’m trying to do is that I’m the only one that can do it. It’s how do I surround myself with amazing people to support me? And I’ve been lucky. I’ve learned with Joe, what a s you have with different people i s h e w ants to go straight to the nub of the problem, straight away, answer it and move on. And, u h, when you’ve got 10 minutes of p eople’s precious time trying to use that wisely is k ey.

Randy Scott:

So jump back for a moment to the Alfred bag. So you’ve got this bag and you described this , having these sensors in it and the sensors I gather tell you at a minimum, the volume of the bag, and it’s communicating that this mobile app on your cell phone, is there other information being gathered as well, or is it really just kind of volume and it’s time to change it ?

Michael Seres:

One of the main things that we look at is skin temperature change. We have sensors that effectively are picking up around the site of the wound, a temperature change, and that’s a very strong indicator for infection markers. It’s also a strong indicator that your bag is leaking. So there’s a clinical relevance to that and a patient application. And we’ve now started to pick up our first electrolyte markers so we can pick up sodium and pH. And if I had privilege of coming back to talk to you in sort of nine months time, we’ll have integrated some bio sensors. So we can analyze some of the large molecules and pick up inflammatory markers and bacterial issues. That’s sort of the trajectory to turn effectively the bag into a, almost a lab in a bag that we can pick up clinically relevant data and then help treat the patient that way. I’m very wedded to it being relevant data.

Randy Scott:

Yeah , for sure. Again, it’s I kind of looked through your website and there was a lot of description of this being technology for medical bags, as opposed to just ostomy bags . I’m guessing that means that you’ve got some long-term dreams and visions outside of just the ostomy backspace space and some applications for the technology more broadly.

Michael Seres:

Absolutely. I mean, we have started the development for urology to look at urine analysis. And so yes, I think the medical bag industry is an old established industry. And I think I view the bag as an opportunity to collect data that that can really make a difference clinically into patient lives. So , so the goal has been to really transform that whole sector. And ironically, we probably started with the hardest bag enough , an ostomy bag is not solid. It’s not stable patients move around the whole time. So actually analyzing data from an ostomy bag is the most challenging, but it stands us in good stead as we move to the next area. And , uh , one day I actually have a vision that we could take the array of sensors that we’ve built and drop them into anybody’s bathroom. And actually if you’ve got inflammatory bowel disease or you’ve got a condition that isn’t connected to a bag that we could pick up clinically relevant information, but I’m giving you my dream.

Randy Scott:

Smart toilet that we’ve been hearing about for a long time.

Michael Seres:

Absolutely. And that’s the dream into the future. I’m aware we’ve got a long way to go.

Randy Scott:

Yeah, of course. Yeah. People will have to decide whether they really want a smart toilet, whether everyone else I kind of like mine being dumb, but I can certainly understand the medical value too.

Michael Seres:

Yeah , I think you’re right. But for today and tomorrow, it’s definitely about bags.

Randy Scott:

This has been great talking by the way. And I look forward to obviously continuing to hear about the progress, but we’re just about out of time here. So any words of wisdom that you would give to other entrepreneurs and inventors you talked about, don’t be afraid to ask for stuff that’s actually think is a really great piece of advice, but any other bits of advice you’d like to share?

Michael Seres:

One thing I’d probably say, and I’ve learned, mainly from mistakes is you have to solve the problem for all the end users. And so whilst I’m very patient focused and everything is about improving patient quality of life, unless we deliver data in a meaningful way to the doctor or we integrate the right way with the system or we bill our services, that makes sense. And we provide economic value to the payers you can’t scale. And so I think one of the big things I would say particularly, I guess in h ealth c are, is u nderstand who the end users are and the solution has to solve problems for all of them.

Randy Scott:

That’s a good piece of advice. You know, there’s a book out actually in the middle of reading right now, ironically, that is kind of along this line, it’s called The Wide Lens by a guy named Ron Adner and a wide ledge, really just talking about this innovation ecosystem and making sure that it works, whatever your innovation is, works and kind of rewards everyone in the ecosystem as opposed to just the end user . I think that’s kind of what you’re talking about. It seems like you guys done a great job of hinting to that. Where there’s, you know, there’s something to be gained by everyone around while you’re doing.

Michael Seres:

I think you have to understand everybody’s pain points. Don’t you? I mean, as I said, you’ve got more experience with companies than I have, but I think that you have to solve problems for everybody that’s going to interact with it. Otherwise you just can’t scale. And I think we naively went off after the patient pain point and then realized actually we have to do everything for everyone else as well.

Randy Scott:

Well, yeah , I think that is increasingly true these days in part, because everyone has a million new innovations or whatever to think about and deal with and react to and so people are too interested in innovation for innovation’s sake. They want innovation. That’s going to somehow make their life easier, even if they’re not the user to your point. So yeah, Michael, appreciate the time here. It’s been great chatting and look forward to staying in touch with you and seeing how 11 Health continues to succeed and thrive.

Michael Seres:

Randy, it’s been an absolute privilege. Thank you so much for inviting me onto your show.

Outro:

Radio Cade would like to thank the following people for their help and support Liz Gist of the Cade Museum for coordinating and vendor interviews. Bob McPeak of Heartwood Soundstage in downtown Gainesville, Florida for recording, editing and production of the podcasts and music theme, Tracy Collins for the composition and performance of the Radio Cade theme song, featuring violinist, Jacob Lawson and special thanks to the cave museum for creativity and invention located in Gainesville, Florida.

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