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With its high concentration of talented engineers, innovators and entrepreneurs, it’s no surprise innovation is thriving in Israel. Home to a growing number of biotech and engineering firms, Israel has established a thriving ecosystem for ophthalmology startups.
This week’s podcast shines a spotlight on that ecosystem as host Suzana Nahum Zilberberg, vice chair of Bio-Light Life Sciences and co-founder of healthcare advisory firm IL. Factor, settles in for a series of six-minute chats with six Israel-based innovators from the OIS Israel Innovation Showcase.
Tune in to hear emerging technology founders, industry leaders and savvy investors discuss emerging trends, product advancements and business developments in eye care. The lineup includes:
• Zack Dvey-Aharon, PhD, cofounder and CEO of AEYE Health, and Kester Nahen,PhD, CEO of Notal Vision. The two early startup founders discuss how disruptive technology can help overcome the limitations of clinic-based eye care. They also give sage advice for other entrepreneurs.
• Anat Loewenstein, MD, chair of ophthalmology at Tel Aviv Medical Center, and professor of ophthalmology, Sydney A. Fox Chair in ophthalmology, and vice dean at Tel Aviv University, and Ron Schneider, CEO and cofounder of Beyeonics Surgical. They discuss the advantages of translating defense technologies to medicine, and the key to a successful transition.
• Nahum Ferera, CEO and cofounder of EyeYon Medical, and Michal Geva, managing partner and cofounder of Triventures. Geva, the first woman to found and manage a VC in Israel, discusses the opportunities and challenges in Israel’s ecosystem. Ferera recently completed a successful first round and discusses how he made it happen—with the help of a global team.
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Suzana Nahum Zilberberg: Guys, congratulations on your very impressive presentations. It seems that both of your companies are aiming to improve diagnosis and do it in a disruptive way to the traditional clinic-based return protocol. Can you please share your views about the limitation of the clinic based eye care as we know it today? And how can your technologies improve it? Kester, would you start?
Kester Nahen: Yeah, happy to. I mean, what we’re doing in office-based eye care really is we’re taking snapshots of chronic diseases that sometimes have an acute conversion to a disease that needs treatment. And in a way, we’re not capturing the full patient journey. And by involving the home monitoring by other structural functional imaging, we’re sort of taking diagnostics, in essence, for example, all CT, from snapshots to a movie, which gives us continuous information and really enhances the way physicians can make medical decisions.
Suzana Nahum Zilberberg: Zack?
Zack Dvey-Aharon: So in our space, because we screen for retinal images, it’s quite amazing to see that currently, the high-risk population is not getting screened. So currently, many of those people are just getting blind and the current solutions don’t work very well. It’s very hard to get visits to the of the ophthalmologists. In some areas in the US like in LA with a new month to schedule a visit. And even then, you need to spare a day of work. And the current solutions to try and sending images to reading center, you know, they suffer from so many problems. Typically, you need to buy expensive cameras, you need to pay a lot of money for each read of those images. And even then, there is a huge administrative hassle by either you know, chasing for an answer or going back to the patient. In many cases, the images come back with insufficient quality, so you need to call back the patient again. And so we think AI really brings great advantages to this space, it’s truly disruptive, it solves both problems by being able to do it in a much more affordable way. Because the AI can provide the reading. And then also by being able to answer the patient on the spot, you’re saving so much administrative hassle as well. So we’re definitely seeing a lot of value and disruption in this kind of technology.
Suzana Nahum Zilberberg: Thank you Zack. Kester, it seems like when you deal with disruptive technology. There is a lot about market education. Is that an obstacle. How do you deal with that?
Kester Nahen: Yeah, absolutely. Especially when you provide the technology in a new care model. Now. We’re not a software or a box company. We’re actually a healthcare provider. And as such, we are partnering with office space, ophthalmologists and optometrists who refer their patients to us. And this is sort of a new relationship. Yeah, we don’t have an office in town. Yeah, well, you refer your patient, we’re virtual. And to build those relationships that requires a lot of trust, that we have to sort of develop not just the technology, but in the relationship with us as a provider. And of course, that’s also reflected in the account management model when we introduce us to other providers so that they can, you know, they’re open to hinders their patient forcing co management.
Suzana Nahum Zilberberg: As well as Zach, you’re not being referred to by doctors, but you’re approaching a new segment of doctors that will check these patients. How do you deal with that?
Zack Dvey-Aharon: So this technology is really built for those clinics that are outside of ophthalmology to do the screening. So that’s really built for primary care physicians for endocrinologists for retail pharmacies. And that’s really a breakthrough area where FDA really allows the AI to do the autonomous reading and we see a new CPT code by CMS to actually get reimbursed for this AI based reading. And we see great response from that target market. We also see now that the ADA American Diabetes Association has now included AI as part of the standard of care. So these are really exciting times. And yeah, we see great feedback about that.
Suzana Nahum Zilberberg: Kester since you have a lot of mileage. And there are a lot of early-stage companies that are participating this conference. What would be an advice that you will give for an earlier stage company that is entering this space?
Kester Nahen: Yeah, I think Zack hit the nail on the head there. reimbursement is absolutely key for everything we do. So engaging early with physicians, with societies, all stakeholders to make sure that when you introduce a new technology, it not only addresses the clinical need, but it also fits into sort of the business case of how physicians practice. And the physicians are key stakeholders here. And when you introduce technology, there still has to be a role for the physician. So I always like to think about sort of a physician led process, you know, that is supported by AI, but it’s not intended to replace the physician. And I think when you when you address that early in the process, you get a lot of buy in from the community, and that ultimately supports your company.
Suzana Nahum Zilberberg: And Zack says you’re almost in the market, but you’re very into the development and clinical trials at the moment. If you would meet a new entrepreneur trying to get with a great innovation to the marketplace, what would be your advice?
Zack Dvey-Aharon: Well say two things. First of all, my advice would be to build the solution in Israel, because that’s where we have the best AI experts and data scientists. So that’s definitely the place for innovation. The second advice would be to really use the fantastic ecosystem that grew up here in this space of technology. We now have also funds we sees like, like Bio-Light very much focused solely on you know, this area. So there is a lot of great connections and advice to get from this kind of, of community. So it’s a fantastic community and entrepreneurs should definitely take advantage of that.
Suzana Nahum Zilberberg: Excellent. Thank you so much for your participation in the conference. And congratulations again for your progress. I think a lot of what you said today surface the value of CEOs in our community talking to each other and learning from each other. Thank you, very much and good luck.
Kester Nahen: Thank you Suzana!
Zack Dvey-Aharon: Thank you so much.
Suzana Nahum Zilberberg: Thank you, Ron, for a wonderful presentation for the following discussion I’m very happy to have Professor Anat Loewenstein, Vice Dean of the Faculty of Medicine and Sidney Fox Chair of technology at the Sackler Faculty of Medicine at the Tel Aviv University, the Chairman of the Division of Ophthalmology, the Tel Aviv Medical Center, President of the Israeli Ophthalmological Society, and recently one of the power lists of The Ophthalmologists, as we’re doing this, well, we will keep the less formal way. And for the purpose of this discussion, we’ll use first name basis, Anat great having you here.
Anat Loewenstein: Great to be here Suzana and Ron.
Suzana Nahum Zilberberg: Anat one of the unique trends that we find in Israel is defense technologies that are translated into medical applications Bionics is one of them. But we have many more examples, and I know that you were involved in more than one. What are the advantages you see in such a trend?
Anat Loewenstein: Yeah, I think that adopting defense technologies into the field of medicine has a lot of advantages. I think the fact that it has already been tested and gained a lot of experience in extreme situation, is very helpful to us once we start to incorporate it into the management of our patients. Because for example, with the bionics technology, something that a pilot, a fighter aircraft pilot used and was able to see all the landscape and know exactly what to do. And the 3D was exercise them perception for the little details was exercise is very, very beneficial for us. And many of the things that were requested of the system, were actually very easy to perform and adopt because of the previous experience of the technology in the defense system.
Suzana Nahum Zilberberg: Thank you, Ron, being at the entrepreneur have such a transformation in bionics. Can you tell us a bit about the challenges that you have in such a process? And when did you involve European leaders in the process?
Ron Schneider: Yes, I think the biggest challenge is by taking a super detailed, high-end technology that was invested with a lot tremendous amount of effort and resources and what it was designed to pilots and aviation and adapted to the medical field. So with a maturity also found the challenge, there is a lot of temptation to take things as is, you know, because it works great for pilots. But there is obviously a game of needs that we do not fully understand from the point of view of the surgeons. And I think at that point, this is the critical point that the success is dependent on the KOL, the ability to take that technologies that is not fit, you know, to the needs of the medical field yet, and having the KOL that is creative and tolerant enough and how to direct the development team. And to make this as a medical product. And this process takes many years and requires the patience and the vision from the keyword.
Anat Loewenstein: If I can add on this one more word, I think the collaboration is the main point for and that is the key for success. Because you know, for example, the technical team or that Ron has could say, you know, I can make the movement of the system faster for you or I can make it easier for you to press on the pedal. And these things are not important for me. The main important for it may be important for a pilot, but not for me. For me the resolution, the 3d is more important. And the fact that we were able to step by step work together on the system, I think that was the key for success for this technology.
Suzana Nahum Zilberberg: And then maybe, that’s the place you can first refer to the potential of digital solutions in the ophthalmic OR.
Anat Loewenstein: Well, actually, I’ll tell you, I think that there is no way back. We’re going digital in the OR, it reminds me of the time that we started to look at digital images. And I said, Oh, actually, why do we need to leave the film, The film is so good. And my boss at my fellowship told me you know, in 10 years there will be no film. And that’s the situation today. So I think this is what’s going to happen in the OR we will be only digital the surgical world is really looking and waiting for such a transformation to actually have the abilities of digital technologies to enhance the visualization to give you a registration of preoperative data, intraoperative data, all the things that the digital systems can do, whereas optical systems cannot do in the same way. So I think it has a huge potential and I think that in 10 years, five years, we will ask ourselves, how could we operate on the eye looking at the eye, whereas compared to operate the eye looking at the image of the eye?
Suzana Nahum Zilberberg: Ron, do you hear that from many doctors around the world? Are there specific markets that are more excited towards such a chronology?
Ron Schneider: Yeah, I completely agree with Anat. First of all, I think that probably today all the markets are pretty much engaged in the digital, you know, digital solution direction, obviously, you know, we were headed directly to US and Europe, in a Western markets, but we see it globally, from the entire world. And, you know, converting also, you know, the picture and looking at it from the point of view, again, of the cockpit, because we’re from aviation originally. So wrapping it up, you know, we can say, I can say that, like, we did many years for aviation and created the cockpit, and gave the pilot and I’m dividing it to three parts, you know, visualization, you know, seeing better images, you know, in ophthalmic, control that the surgeon will have, like the pilot and control of the system, the data, and the data and the information availability and usage, you know, if it’s an existing data or guidance data, but it’s very, very critical to have all of these working together. So the idea is to have a system that will support the surgeon to perform as close as possible the surgery and a perfection level, giving all the tools that Anat needs, you know, that taking it all. So the surgeon can be concentrated 100% in the surgery, and the system will work for the surgeon. And this is the idea and the concept of not only having the digital information but making it accessible for the surgeon with not all at all.
Suzana Nahum Zilberberg: Right. Great. So before I wish you all the luck, Ron, I think we had, you have a great dynamics here. That is very, very unique, today’s really ecosystem in which you can, and leaders can really become partners of the company. Sometimes we push them a bit too much, but they are always very welcoming. And that’s great to have people like you’re not on board. So good luck with launching your product. And thank you very much for participating in this discussion.
Anat Loewenstein: Thank you for the opportunity.
Ron Schneider: Thank you for inviting us. Yes, thank you.
Suzana Nahum Zilberberg: Thanks.
Suzana Nahum Zilberberg: Thank you Nahum for your presentation. For our discussion. I’m happy to have also Michal Geva with us. Michal is the Managing Partner and Co-founder of Triventures. Michal has 25 years of executive management experience in medtech. And in digital health startups in Israel, and in the US. She’s the first woman to found and manage a venture capital fund in Israel. And also in 2017, Michal was recognized as one of the 50 most influential women in Israel by Globes, which is the Israeli leading financial journal. Michal we’re happy to have you here.
Michal Geva: Thank you very much. I’m very glad to be here.
Suzana Nahum Zilberberg: MichaI would like to turn the first question to you. Although we have a lot of innovations in Israel and a variety of interesting opportunities, the number of VCs and investors is quite limited. Can you start by referring to the Israel investment ecosystem from the eyes of the investors? What are the opportunities? What are the challenging and also maybe you can speak about companies that are seeking for investment?
Michal Geva: Sure. So first of all, it is true, you know, the landscape has changed in the healthcare environment, if I need to put it in categories, I think we had the biotech, we have the pharma, we have the medical devices, which I was part of, and we have the digital health. We at Triventures we are focused more on digital health and medical devices. But interesting enough, it is interesting to see the development that has happened in the past decades in devices versus digital, a lot of the investors unfortunately, got out a little bit of the medical devices. And there is much less capital available not only in Israel today, but in the world for devices. And we see a huge dramatic change and a dramatic entrance into the digital health space, by the way, which ophthalmology is also playing a major role in that sector. But you know, Suzana there’s never a vacuum. So yes, we still have several different medical device VCs that are investing here in Israel. But one of the interesting things that we’ve seen is the entrance of the strategic of the corporate VCs. I don’t know if you know, but we at Triventures are great believers in working with a companies on one hand and with the industry on the other hand, so we have about 1213 different strategic VCs, on our fund from Johnson and Johnson, Medtronic all the way to Samsung, and Nikon and everything in between. And we’re very, very fortunate to have that. But on the other hand, we see those type of organizations entering much more forcefully today, not only into funds, but actually into investing directly in companies we’ve seen with Nahum’s last round, which was we had a larger strategic participate, we see more and more often. We’ve seen it with several other symbology companies that we are investing in we see very often nowadays.
Suzana Nahum Zilberberg: Thank you. Maybe that’s the time Nahum to say congratulations on your very successful round. That was done in a difficult time worldwide, can you refer to that a bit, Triventure took part of that. And Michal mentioned a strategic, I guess it wasn’t easy. Can you talk about some of the challenges? And how did you overcome them?
Nahum Ferera: Yeah, so first of all, to raise funds is never easy. And it was even more challenging during the COVID pandemic. Actually, that’s a result of a long-lasting relationship with some of the investor that I met there, you know, back then five or six years ago, and was not ready to invest back then. But you know, the long relationship became fruitful eventually. So I think that’s how. On the other hand, actually, you know, everybody had time to meet and to speak and to learn more and to dig more so that made the due diligence process even harder. And I needed to take into account the time difference because an if something which is in a way unique to Israel, because in the recent town with investors from China, from Japan, from Canada, from Israel, of course and even sales in a way as a bridge between those countries, so I needed to have like three time zones in my mind all the time. And I saw you know, the kids of my investors, are they so my that came suddenly into the course. It was challenging, but eventually you know, because I’m going to college. I’m very, very successful point with the clinical data with the NBR. That is a real game changer, that eventually led the reason for the successful arm. And I’m really happy that it is actually oversubscribed. So yeah, I’m very proud of it. And then we just started a new airline, a lot of other extensive work for the company have folded.
Suzana Nahum Zilberberg: Sounds like a big happy family. And I know the Triventure is escorting the company and invested not only in this round, now what would you ask both of you? How do you see the advantage of having an Israeli investor as part of the round?
Nahum Ferera: The information style, I think, especially in that kind of found that done remotely with people that actually never been to the company, having a great partner like financial, which is, you know, not just an investor, if I may say smart money and really involved in the company, day to day activity that serves as an ankle, I believe, for the other investors. All of them wanted to speak with the existing investors that are ongoing and can really know that I’m not only an avatar with the real person, and there is a real company behind us with all the achievements we’ve got.
Michal Geva: Yeah, Suzana, I think.
Suzana Nahum Zilberberg: Yeah, go ahead. Sorry.
Michal Geva: I think what Nahum is describing is very, very accurate, we seek very often where external investors meaning investors that are not based at the country where the company is, are interested to see buy in, are interested to see mentorship, are interested to see close clinic connection and work with the company that is on one hand validation. And on the other hand, a true support, I would say to people that, you know, today, the world is kind of flat with zoom, right? We’re even doing this conference in zoom. But we usually like to work with people in a more intimate way. And I think being with the company, seeing being with the team, not just the management is important. And, you know, when we invest in companies outside of Israel, I always would like to see a local partner and it goes both ways. So I think that is helpful. And on the other hand, Lapham has done a tremendous work on really building partnership, not just investors, but partnerships with different markets, different ecosystem players, from strategics, to financial investors, but they all bring a lot of value added, but in different sectors. For example, we have Rachel from Relaunchy, which is an investor that specializes in in ophthalmology. And the amount of value that she brings to the table with her team on the ground working with Nahum and his teams, on the regulatory on opening doors in China on the clinical work is invaluable. We have investors from the US that are working on the board and off the board with Eye-Yon and the team. We have investors now from Japan, we have investors from Israel, and I think the way that Eye-Yon his build its infrastructure is extremely helpful for the growth of the company.
Suzana Nahum Zilberberg: That’s exciting. So guys, thank you so much. I wish you both a lot of luck. And thank you for sharing your opinions with us.
Nahum Ferera: Thank you.
Michal Geva: Thank you.