A Laser-Focused Business Model, With Nir Katchinskiy and Lahav Gil
Click here to watch the video version of this podcast.
Retina specialists have limited imaging and surgical tools to visualize the back of the eye. While imaging technology has improved, the need for high-resolution precision remains paramount. PulseMedica’s three-dimensional imaging and surgical platform has the potential to deliver extreme accuracy through advanced imaging technology, artificial intelligence–based decision assistance, and femtosecond laser pulses. (For those who don’t study lasers, a femtosecond is one millionth of one billionth of a second, or one quadrillionth of a second, or 10-15.)
PulseMedica CEO Nir Katchinskiy, PhD, focused on these super-precise laser pulses during his doctoral studies. In the process, he built a system that images the eye in 3D and in real time, and delivers laser treatment with precision. For now, the company is focused on imaging for dry age-related macular degeneration (AMD), diabetic retinopathy (DR), and floaters, among other possible applications.
With executive adviser Lahav Gil, an entrepreneur with a 30-plus-year career in medtech, Dr. Katchinskiy discusses his innovation and the challenge of expanding his focus from solely research and design to device development, business, and leadership.
Listen to the conversation with Ehsan Sadri, MD, to hear:
· What motivated Gil to join PulseMedica and the qualities that make Dr. Katchinskiy an ideal CEO.
· How Dr. Katchinskiy developed a device that allows physicians to image the eye in 3D in real time and deliver finite laser pulses to treat eye disease.
· The scoop behind their newly appointed chief technology officer Geoffroy Rivet-Sabourin.
· The go-to-market application for PulseMedica. Is it dry AMD, floaters, or DR?
Click “play” to listen.
Ehsan Sadri: All right, everybody, this is Dr. Ehsan Sadri, Board Certified Ophthalmologist, your OIS Podcast host here from lovely Newport Beach, California. I’m really delighted and excited to bring my colleagues here from PulseMedica really cutting-edge technology, which they’re going to dive into and talk about, and what they’re doing and what how’s it going to, you know, impact our patients, and really what kind of unmet need it’s going to fulfill. But before then, we really want to kind of get it to dive into getting to know, Nir, and his colleague love who are joining me from Canada and Israel. Love is probably like, what time is it for you? I don’t know. It’s early in the morning, probably.
Lahav Gil: It’s coming close to midnight.
Ehsan Sadri: Commonly close to midnight. Okay, very good. Well, thanks for giving us your time. And we’re just delighted to host you as our guests. So, you know, obviously, I’ve been involved with the company just recently and you know, there’s a lot of exciting technologies as you know, you’re trying to fulfill unmet need and AMD and you know, it’s just at the back of the eye, but really just there’s a tremendous a lot of applications here. But before we talk about that, I want you guys to kind of give us an audience who don’t know you a little background about who you are, you know, where you trained and how you got here. So Nir, take it away.
Nir Katchinskiy: Yeah, thanks Ehsan, thanks for having us. It’s really exciting and great to see you. So my name is Nir Katchinskiy, I completed my Ph.D. studies at the University of Alberta in Edmonton, Alberta in Canada if somebody doesn’t know where it is. And really, during my Ph.D. studies, I focused on using femtosecond laser pulses. So femtosecond laser is 1,000,000th of 1,000,000,000th of a second. That’s how short these pulses are. So using these technologies to develop novel medical applications. Over the years, we’ve seen a lot of promise for this technology of advanced things like attaching single cells together neurons together doing novel cancer treatment using nanoparticles and femtosecond laser pulses and then started going towards the eye. And the reason we started going towards the eyes is that the eyes are perfectly or somewhat perfectly optical media to deliver laser pulses. And then we saw a big opportunity, right? So there’s a lot of people around the planet who’s got different eye diseases. And there’s a lot of opportunities to help. And that’s that essentially how we got here today to start off America.
Ehsan Sadri: Very good. Very good. All right, Lahav. How about you, you want to give us a background? How’d you guys meet? And what’s your background?
Lahav Gil: Sure. So I come from a very different background. I’m what people would call today an investor operator with most of my career as an operator. And only lately, in the last 10 or so years of my life started understanding a little bit more about investment. I started off as an industrial designer in the 80s. And that’s kind of my that’s my background trade. In the 90s we immigrated into Canada, and I’ve been operating out of Canada since then, I founded what is known in Toronto in Canada, the Kangaroo Group, the Kangaroo Group became over a period of 10 or 15 years, the second-largest contract design engineering and manufacturing for medical devices in Canada. And 2017, I believe we were acquired by our largest comparable, StarFish Medical out of Vancouver Island. And that kind of mark the second phase of my career as an entrepreneur, and a technology innovator. The last five years of the Kangaroo Group before I sold it, I started to experience an evolution of headset, I would say and I realized I’d rather invest the Kangaroo infrastructure the know-how, the work, the capabilities, I’d rather invested in companies that I believe in, rather than sell it as a service for hire. And so that so in the last five years of Kangaroo, we became almost a private incubator, and we basically used our entire infrastructure and our know-how as investment capital. I continued that journey after I sold Kangaroo only without the resources. And I’ve been working as a mentor Angel, and in the last year and a half as a venture partner for Zoic Capital in Seattle. I met Nir, I guess, probably through the CDL network because I’ve been mentoring whoever people don’t know what CDL is, is the Creative Destruction Lab Accelerator Program that is run out of the Rotman business school in Toronto. Nir heard about me there and this is credits to him, this is all credit to him. He courted me and reached out to me multiple times until I had to pay attention. And he basically convinced me to join him as an advisor first and then as a mentor and as a board member. And I continue to enjoy seeing him turn into an amazing leader that’s in right in front of my eyes.
Ehsan Sadri: Well, you know, it’s his testimony to your guys’ partnership and friendship to complement each other especially love you can tell you’re a seasoned at this, which is great. It’s always great to have a team that love and support each other. Let’s dive into technology. I know audience really wants to really kind of get to know what PulseMedical around for those of you who don’t know this technology is basically involves femtosecond and laser which I want them to kind of describe what the applications are. But really we’re talking about dry, wet macular degeneration, glaucoma, diabetic retinopathy, retinal detachment, we’re talking about vitreous floaters. So Nir, tell me about this technology. If you were describing this, how did you come about this? What excites you about it? And tell us about the applications that you would really want this to happen?
Nir Katchinskiy: Yeah, I’d like to talk about it a little bit from historical perspective how it evolved, because then it really explained the story. So the interesting work with femtosecond laser pulses is he can do things very, very accurately. Right. And so when I started the project with working with the eye, I wanted a tool that lets me visualize the eye in three dimensions and very, very accurately deliver laser pulses. And so my first thing as an engineer was, let me go see what can I go and buy out there that I can just put my laser into and target whatever I want. So long story short, I couldn’t find anything like that. So I decided, I’m going to build thing, something like that. So I’ve put my head together and essentially started building an imaging system that lets me image the eye in three dimensions in real time, so that I can deliver a laser very fast and very accurately, I got connected with a group of retinal specialists in Edmonton. So there’s one big clinic about eight retinal specialists working together and start talking to them about this technology. And I said, Look, this is what I’ve built so far. And they got really excited. They said, Look, even without a femtosecond laser, you can do so much. So in essence, what we started doing is saying, We can do a lot of things in the eye, so essentially, the concept of image guided laser treatment is the concept that we’re going after, it’s building that technology that let us image the eye and then have the computer control the treatment. So what we’ve started doing right now is saying, let’s wait a second with a femtosecond laser, let’s at least use green laser photocoagulation laser, and demonstrate that we can image the eye very effectively track the movement of the eye, and then deliver a photocoagulation laser for diabetic retinopathy patients. So targeting micro aneurisms as an example of the eye was moving and without contact. So that by itself is quite a complex piece of engineering to put together, we have a very sophisticated machine learning or artificial intelligence aspect to what we’re doing. So really combining artificial intelligence with sophisticated piece of equipment to make decisions in terms of what needs to be treated in the eye. And building the treatment plan automatically and enhance the computer and the device itself, doing the treatment very accurately. You know, over time, as we’re building this technology, we’re starting to see oh, you know, we can do so many things with it. So not just photocoagulation. But we could do things like vitreomacular traction treatments are released kind of that regional tension. Or we can we saw that, hey, we can image and detect and track movement of floaters. So why don’t we treat floaters using femtosecond laser pulses. And then the end goal, one of the goals that we want to achieve, which is where we started with was trying to treat dry macular degeneration. Right? So on dry macular degeneration, you have these drills and deposits the back of the eye. And our idea was, you know, can we go into the retina can be removed these tools and very, very accurately without causing more damage. And then you know, one see, would this prevent geographic atrophy first? And then second is would this prevent or slow down the progression toward wet stage AMD? That’s essentially a little bit of the story of where we are and really focusing on that imaging component, the AI component to bring that automation and efficiency into the clinic.
Ehsan Sadri: Fascinating! Absolutely fascinating because you know, this is for clinicians Listen to this, this is going to be I think it’s a new era because as you know, visualization has always rally been limited. And you know, the pinpoint accuracy is not been there. So, you know, that’s why I was very excited to bring you guys on because I just think it’s a huge shift in mindset, especially coupled with AI. Lahav, what excites you about working with Nir and PulseMedica specifically.
Lahav Gil: I’ll answer the more attractive question for me. So it’s, in order to build a company from an invention, the founder needs to go through a transformation or rather a series of transformations. And that transformation basically entails from seeing themselves as a builder of technology, more so as a builder of an ecosystem. And it’s not many academics that are willing to do this journey. Not even saying that can do this journey. Not many academics are willing to do the journey to do this transformation. Because you, you have to let go of many things that have been dear and close to your heart for many years. And you have to learn to see yourself in a new light. As I mentioned before, rather than a builder of technology, or somebody who’s somebody who focuses on technology and on interests in advancement of technologies, in this case, to a person that that their mandate is to build a business ecosystem in which in which technology gets built, but not directly by me. I’m now responsible for creating an ecosystem in which technology gets built, in which technology gets commercialized, in which people experience processes of growth. So it’s a really interesting and very rare, I believe, very rare kind of reinvention that the founder needs to do. And Nir, happens to be one of the people who is willing to do this journey and is just so capable in doing this. And yeah, so that’s what attracts me to this. Every day when we talk, I get reminded how enjoyable this is for me just because I can see this happening in front of my eyes. And I’ll mention one more thing about the relationship. And maybe I get motivated by feeling useful. Many people in this industry actually gets motivated by just being useful, you want to be utilized. Sometimes you feel so underutilized, and Nir is giving me an opportunity. There’s so much that he by self-declaration doesn’t know because he’s doing this first time. So he’s this is his first time as a company builder. And he basically uses my knowledge as somebody who has built several businesses built a few companies that a few companies, sold two companies is asking me simple questions that and I can provide simple answers to certain things and for things that I know. And this gives him an opportunity to focus on the real, the meaningful things on the exploratory things on the high ambiguity things which he does very well.
Ehsan Sadri: So there’s a lot there to first unpack if you’re listening. You know, you’re I think the biggest thing that you see discussing with Lahav and Nir is through their relationship. And just to experience that just sort of camaraderie, but also the chemistry and building a company, I think you can have the engineering, you can have the commercial success, but when you really merge the two, the intellectual plus the, you know, financial sort of chemistry, I think that’s really gets something special. I think you guys are on your way. Certainly, you’re building a great team. I just noticed you just had an announcement not too long ago, right? Your Chief Technology Officer, Nir? Tell me about that.
Nir Katchinskiy: Yeah, so we’ve had, Geoffoy, Dr. Geoffroy Rivet-Sabourin who just joined us as a CTO. And again, this is another thing that I think is making, you know, building this company, so awesome is bringing people with that industrial experience of doing that before so Geoffoy is going through the process of approving and going through FDA and Health Canada approvals for medical for a number of medical devices with a very, very broad background, which is really awesome. And that’s something that is very critical for us. And the other thing is, we’re building in our technology involves a mechanical engineering, optical engineering, electronics software, very heavy software, machine learning. So there’s so many things that we are doing and finding a person who is an expert in all of these is so difficult, and somebody like Geoffoy who’s got so many so much expand to so many different things. It’s really, really good to bring to lead the entire team and see the bigger picture.
Ehsan Sadri: So Nir, so you’ve got this technology, you’ve got a great team, you’re well-capitalized. What’s your biggest unmet need first? Is it gonna be vitreous floaters is gonna be diabetic retinopathy. It’s gonna be macular degeneration, obviously, a huge, huge disease states with ginormous markets tell us what are you going to focus on? What’s your strategy? What’s your go-to market sort of pathway?
Nir Katchinskiy: Yeah, so that’s actually an excellent question.
Lahav Gil: We ask this question. We ask ourselves this question all the time.
Nir Katchinskiy: Yeah, I was, just about to say that we, we’ve put together a really good and solid Medical Advisory Board, which somebody here is part of it. To help us answer these questions. I had to throw that in.
Ehsan Sadri: Couldn’t find anybody else, huh?
Nir Katchinskiy: I was looking for the best of the best. So and I found them. So you know, just to answer a bit of our strategy. So in the short term, we are interested in doing improving our concept on diabetic retinopathy, right, just because from a clinical perspective, we do not need to prove the clinically, the green laser photocoagulation lasers is effective treatment of treatment of diabetic retinopathy. It’s mostly a technological uncertainty that we need to prove that we’re able to do that. And so with that same technology, we should be able to deliver a laser to, you know, accurately anywhere else in the eye. The second thing that we really see ourselves doing right after the diabetic retinopathy, I think it’s actually floaters. And it’s interesting, because it wasn’t one of the first things that we thought to do. But as we’re building the company, and as we talk to people, we started, we’re starting to understand the need for Florida treatment. You know, first of all, I did not know that. I think 50 or 60% of the population has floaters, which is crazy to me. Yes. You know, not everyone needs my treat. Yes, me too. Yeah. For the most part, we don’t need to treat them. But first of all, there’s some subset of the population that does need an effective treatment for floaters. And the other thing that we’ve also learned is, people who undergo cataract surgery, they some of them need to suddenly have a treat and effective Buettner floaters, because of the way the optics work of the intraocular lens. And now these floaters are a lot more bothersome. Right. So they’re a lot more bothersome, then they suddenly seek a treatment for that. So that is very interesting, and also starting to realize and discovered that there isn’t a lot out there for floaters, and our technology is very, very suitable for it. There’s also a massive engineering challenge that we already overcome. In terms of floater treatment, sorry, I should be more specific, maybe floaters imaging and detection. Because if you look at images of floaters and try to detect them attract them, conventional image processing actually fails. And so we’ve found a methodology to do that, and overcome it and patenting it, in order to detect the floor and attract them. And then the next step is also to treat them as well.
Ehsan Sadri; Lahav, do you have anything to add to that?
Lahav Gil: The only thing that I would like to add, and it’s been discussed, I mean, it comes up again and again, is that the way that Nir and his team architected, the core technology of the company is what you would call a platform, which means that it would serve a variety of applications. And it gives us a lot of options. And I guess the driving force is to create meaningful impact for patients and give clinicians the tools that they need to deliver that impact, and also at the same time to run a successful and profitable business. So we’re very cognizant that in order to be able to deliver clinical impact, we need to create business tools, not only clinical tools, and that is diffused within the thinking in the entire organization, specifically towards the business of clinicians doing laser surgery of the eye, it’s about being able to be very, very efficient and effective in not just how they treat each patient, but also in the amount of patients that they’re able to treat with minimal resources, in small spaces, and so on. So we’re basically I think we were thinking very broadly and commercially.
Yeah, that’s terrific. I think the wonderful thing about this application here, you know, glaucoma in the back of the eye, and as a clinician, I’m really excited and for those entrepreneurs who try to do the same thing and starting from scratch, you know, my advice is listen to this and there’s a lot of pearls here. And we listen to this, because you notice both of them are very deferential. They’re not, you know, they’re not there’s not a lot of ego involved in their discussions. If you notice, there’s very few times people say, I, And this is a direct correlation as successful. In my opinion, someone has. I always said to my team, your ego is not your Amigo. And, you know, it’s like one of my favorite sayings, I stole up on somewhere else. But I really believe in that I really believe you guys have a lot of chemistry, we can talk for a long, long time. You know, I’m going to bring you back on as we develop the technology more, I mean, the areas and you know, laser, photocoagulation, trabecular meshwork applications, the vitreous. I mean, we can go on and on, right. I just have so much pride in with you guys, the work you’re doing. And so congratulations to both of you. Are there anything in your, would you want to pass on to people that are listening to this that are like in your shoes, but like maybe five years ago? Maybe they don’t have funding? What would you tell them about their process? Your process?
Nir Katchinskiy; I was I was thinking, Yeah, I was thinking about that earlier, you know, some of the things that that we’ve been doing, that I think works really well. And I think I wanted to share or some of the things that I’m most proud of. And so one of the things that I’m most proud of out of anything that we’ve been doing is our team. You know, just like you said, Every time I talk to anybody, the first thing that comes up to me is the amazing team that we put together, I’m really big believer that people are business builders. And if you have an incredible team, you can do anything. And so this was the one thing that we put a ton of focus on having an incredible team, and moving so so quickly, great that we’ve done so much progress in one year, from nothing to a prototype is going to be in a clinic and climb patterns, and you name it. And the other thing is that I wanted to say is if you could leverage people’s past experiences, right? So one of the reasons that I wanted so much to work with someone like Lahav is, I don’t know anything about the medical device industry when I started, right. And I knew it. And I didn’t pretend that I know everything. And so by having somebody like Lahav who’s, you know, commercialized? I don’t know, hundreds lab of medical devices, I don’t even know how many.
Lahav Gil: I would be cautious, I would say, has had a part in commercializing 200 things.
Yeah. So that’s such a valuable experience to have somebody like this to telling you listen, these are the things that you should be watching out for. And the same for you know, Geoffroy, who just joined the team and a lot of other people that we’re working with, in terms of regulatory consultants, and clinical consultants, Medical Advisory Board, and now putting together a really solid board of directors, same thing, right? Bringing people with those past experiences that we could learn from and minimize the mistakes that we make. I think that’s really a big key. Sorry, I’ll be quiet, talking too much.
Lahav Gil: Not at all. Things.
Ehsan Sadri; What about you Lahav?
Lahav Gil; There is we have ideas, right? We look at the world and we see a problem, and we have ideas of how to solve it. And that’s a natural process. That’s a natural human thing. Over the years, what I’ve learned is that I need to kind of put the brakes on the first ideas that come even on many first ideas and over the years, what we’ve seen is that the value of the first ideas, the real value of the first ideas, is that they bring us closer to the problem. So what I’ve seen is that your first ideas should be good enough to bring you closer to the problem. They don’t need to be the solution. In fact, they rarely are. But by bringing you closer to the problem, and I should say it’s not to the problem, it’s to the problem set. The problem is always multivariable, and your ideas bring you, your ideas for solutions bring you close enough to the problem set so that you can discover the real problem. And if you’re open, if you’re open, if you keep open and you don’t get too stuck on your first ideas, then you’ve got an opportunity for breakthrough ideas by because you’re now you’re with the problem. You’re so close to it. And yeah, that’s what I can add.
Ehsan Sadri: Fascinating, man. Fascinating. I got to get you on one of our Launchpad Shark Tank stuff, both of you. I can talk for a long more time. I you know, we’re pretty much out of time. I just want to say thank you, both of you guys for coming on. And I’m really just absolutely delighted to get you on here and you know, happy to get you in again. You’re gonna get up we have some progress the company. Thank you for spending some time with us.
Nir Katchinskiy: Thank you so much, Ehsan.
Lahav Gil: Yeah, thanks for giving us the opportunity. This is also just to experience how you host this. So really appreciate it.
Ehsan Sadri: Pleasure.