Health Innovators
Health Innovators

Episode 92 · 3 months ago

Patient co-creation: How to play the long game with novel tech in healthcare w/ Robert Niichel


Bringing about game-changing solutions in the healthcare and pharmaceutical space can be a daunting and difficult endeavor.

It takes patience, drive, determination, and the canny ability to play chess with marketing - you really need to look at the long game.

Robert Niichel is a master at playing three steps ahead and, on this week’s show, he sits down to discuss what it’s like to play that game with a product you know is going to change the market.

From development to commercialization to marketing, Robert has the scoop on timing and focus that could be the game-changing combination other entrepreneurs are looking for.

So, stay awhile and listen as he touches on many key steps in the commercialization process that could help your company successfully bring a solution to market.

Here are the show highlights:

  • Why it’s the patient that drives the market (2:22)
  • This is how patient co-creation can keep you on track (4:47)
  • Ways COVID acted as a catalyst for changes in how we co-create (7:33)
  • Invest early and often - an education in marketing (10:43)
  • Need to get the word out? Podcasting is where it’s at (14:22)
  • When raising capital, be sure to fund for the long haul (19:22)

Guest Bio

Robert Niichel is CEO and Founder of SmartTab, a digital medicine company developing wireless ingestible drug delivery technologies to dramatically improve patient outcomes.

Both a healthcare entrepreneur and visionary, Robert is the host of the digital health innovation podcast “Who Would Have Thought”.

In addition, he has leveraged over 20 years of experience in leadership and management of Pharmaceutical R&D to acquire numerous pharma/delivery system patents.

Robert earned his MS in Biochemistry from the University of Colorado, Boulder, and his BS in Finance Economics from Iowa State University.

If you’d like to reach out to Robert, you can find him on LinkedIn at Robert Niichel, on his webpage at, or email him at

You're listening to health, innovators,a podcast and video show about the leaders influencers and early adopterswho are shaping the future of health care on your host doctor roxey movie. Welcome back to the show healthinnovators on today's episode, i'm sitting down with robert nicholl, whois the ceo and founder for smart tab. Welcome back to the show robert. Thank you very much grit to be here so for our audience. If you could justtell them a little bit about your background and what you've beeninnovating these days, that'll kind of set the tone for today's conversation- yeah very nice. So my background is inthe pharmaceutical space historically directing projects that have beendesigned around drug delivery, time, release, drug delivery, etc. About tenyears ago, moved out of that space started a company nano pharmaceuticallaboratories with the idea to bring these high tech types of pharmaceuticalapplications to the consumer, healthcare, digital health care andconsumer healthcare space from there as that company grew and we started a newdivision called smart tap, and that was brought online about three years agowith the idea of now adding in wireless drug technologies to cutting edge platform. So today thatbrings us to smart tam, an oral injustibly capsule with which is a drugdelivery platform very, very exciting, some very noveltechnology in solutions that you're bringing to the market yeah exactly- and you know really whatstarted as an idea a few years ago with one particular application for targetdrug delivery has expanded into a platform. Now we have different typesof capsules that deliver different types of applications, they're all centered around a platform,so each capsule has a very similar type...

...of electronic architecture inside andthen from there to delivery applications do change. On the first one, we have completedpreclinical animal studies already. That was last year getting ready forour filings with the fda, and then we have two more platforms that are comingonline heading into pre clinical animal studies next month with our inject tab,which will have the studies completed with insulin. That was going to be my next questionof where are you in the innovation process? So as we as we kind of think about whatyou're bringing to market you know, it is something that's very revolutionary,very, very much novel. What would you say are some of the differences in yourstrategies or the commercialization decisions that you're making versus,maybe when in the past, when you've maybe brought something to market thatwas more incremental, yeah, exactly good question and really on this one inthis draws from on experience on other companies. Building companies in thepast is really have it patient focus. So because of that we hold focus groups we bring inpatients or last one we had about twenty five krones disease patients andreally try to build these products that are very patient centered. You knowsometimes companies will come up with a good ideas and then hope that themarket or the consumers will be there this one where, on the opposite, end of that we'relooking at the consumers first or the patients first see what is important tothem, and then you're talking about our digital hub here in denver, coloradoworking with us health to see what they're, looking at they've beenprogressive with telle medicine. How do we perform the drug deliverythrough our smart capsule? How do we collect data? I e vital signs after thedrug has been deployed, and then how do...

...we analyze those data to make real timedecision? So i think the biggest key to answer your question specifically. Iswe're really completing a lot of market research,very patient driven and, as you can imagine, this is much more complex and thehealth care industry. You have insurance involved, you have pairsinvolved. You have very you know, high end individuals who deploy thistechnology through the hospitals. You know they're very highly trained, i'mvery specialized, so we're looking at that strategy that platform firstversus a lot of consumer products. I mean this isn't a consumer product, butnonetheless you come up with this. One is kind of cool you sprinkle some moneyon it for marketing and you're. On your way, this one we're v being verystrategic in obtaining what the market is, after what the patients are. Afternow, the engo with all this is better patient outcome, so the patients havebetter drug delivery platforms and have better patient outcomes. So what ithink is so important. I've talked about this a couple of times on theshow is you know a lot of brilliant innovators. Like yourself, you know,you've got an idea that you want to bring to market and a lot of times,people kind of fall in love with that idea, and stay really closed and makesure that all that rnd comes from within the company. So i really reallyadvocate for what you're saying i call it: co creation, where you're co,creating with your target customers- and you know not just doing that- thatcustomer discovery at a particular moment in time, but on an ongoing basis,but it's part of the culture, it's part of the dna of the company. It's notsomething that you just do it's, who you are yeah, that's exactly right and it'sbeen surprising with the patient focus groups. You know some of the learningsfrom those you know. It seems simple enough thatyou know one of our platforms is to do away with the syringe in a needle andbring that to a capsule platform. So now, instead of once a week, if youhave to self inject a...

...syringe in a needle and to your leg,now you take a capsule and that performs the injection into the stomachvascular matrix. How you know that would affect people and then really,you know just seeing what the desire is for that and a lot of stories wherepeople have to drive fifty miles. I have to go to a hospital. They have tohave their injection completed because they can't do it by themselves. Maybethey have to have their roommate complete, an injection or their spouse,etc, and you really discovering some of the non visual cost. You know the drivetime the time in the hospital so on and so forth. So so they have been very eyeopening it's just fantastic, and i hope thatall of our audience is kind of taking heed to that a lot of times wheninnovators are starting out. You know they might not think that they have thetime or they have the money to invest in this type of customer discovery upfront, and i'm always advocating that you can't afford to not do this upfront. So it's great to know that you guys are on the right track. Yeah yeah,thank you and will stay on that track as we move forward and you no more inthe commercialization is really today. You know we're working through theclinical studies. The next step will be the fda approvals, and then we go tomarket and as we get closer to going to market, you continue with focus groups.You know what resonates with the individuals of the patient beyond justthe product, but how do you deploy the technology? How do you interface thiswith a an app on your phone? How does this platform then become driven withdifferent software attributes? So those are important things also as we move tomarket yeah. So when i, just if you don't mind tying to just talk aboutthis co creation or customer discovery with the patients as you've gonethrough them process, you know, have you come across any challenges withgetting patients to participate and...

...engaging them, especially you know inthis post coved climate that we're leading into, and maybe, if you have,how have you, how have you worked through them? Yeah good point, so youknow the first thing is with the ovid very limited on in person meetings youknow prior to ovid, we would have visitors to our facility. We are in anewer building catalyst, health. It's a a mix of startup companies, midsizecompanies in the digital health care space we would have visitors come intalk with them, show them what we were working on. What we're doing ovidstopped all that so then we had to migrate to these these sessions. So the focusgroups the last couple that we've done they're all online right, so you havethirty people on your zoom call, and that is effective. It does create adifferent type of dynamics. You don't really get to know the people as wellor have that you know in person interaction. So that has been it's beena challenge i think. Sometimes it has allowed us toget people from different parts of the state different parts of the country toparticipate. So that has been a benefit you know so so covin nineteen had itschallenges as well as some positive things as well. We have been expanding the reach withyou know: the focus groups you know, like i mentioned outside of the stateand more on a national level. We've been able to talk to some moreinternational communities. What this would look like as well. Now,post coid, it's been interesting, tell medicinehas really increased. You know the use of zoom calls is really increased, so ithink those conversations now sometimes go better because you're actually seeing theperson on video you're actually getting a little bit more interaction with them. Pre coid, you know zoom calls are notas popular now they're everywhere, they're every day, so you know i'm kindof the eternal optimist and now he's looking for the good things and youkind of like im the you know. The glass... always full. It doesn't even havefull it's all the way full, but so i kind of looked up to pregar the ovidnineteen. If you looked for opportunities with that, you know, ithink we can come out of that better and it's certainly with our focusgroups, it has been a ben, has been a benefit. Yeah yeah. I couldn't agreemore a lot of times. Those things that wethought were challenges turned into really incredible opportunities thatcan be an changing for our business and i like what you're saying to reallybeing able to go. Go outside of your local market gives you kind of adifferent population for which is, you know, i'm sure you're going to beselling nationally, maybe even globally, so being able to broaden that samplepopulation. For that co creation is so important because you could potentiallylearn something different from you know. Patients in the new england area versusyou know more in the colorado market. So it's great. So one of the things that i find is soamazing about you guys is your investment in marketing and prpre launch. So i've worked with a lot of health innovators over the years andmany times i'm pushing and advocating and and kind of presenting a case ofhow important it is to invest in these strategies early on and you guys aredoing it so just kind of share about that journey. What was your motivation? Was it past experience? Is it someoneon your team, a combination of things, what motivated you to make thoseinvestments early on a great question, so i wouldsay there are two things number one: it's the t t what we are working on isreally to an extent educating patients on a better platform of betterapplication. The second thing is that prior experience is that you need toget the word out on what we're working on so inasmuch to an extended marketing.

This is really a mission for us. Wehave had successful companies before were driven by really bringing a gamechanging technology to the market. So when you think about that, you knowmost people in the united states today. If you would say in three years fouryears you will be taking a capsule instead of using a syringe and anneedall, i never heard they've never heard of its crazy idea. However, youcan look at other industries that have started out and have moved prettyquickly to a new paradigm shift and that's what we're working on so part ofthat requires marketing. It requires what we're doing today, you know beingon the show, but you know on the podcast being on. You know, with themarketing to educate people that it's out here, so that not only has benefitsto drive potential to our focus groups, to focus on this patient centeredapproach, but also you know, with the working on strategicpartnerships with farman companies or strategic partnerships with medicalinstrument, tech types of companies and you know, raising capital etcetera. Soa lot of this is about educating and when you're working on something aslarge as this. So were you look at a pharmacy today, it looks basically thesame way it did fifty sixty years ago, so we're talking about going into apharmacy and changing the way the medicine is deployed. So when you walkinto a pharmacy say five, ten years from now, virtually all capsules tableave, some type of a tracking mechanism, electronic delivery mechanism etc. Soyou know because of that we need to get the word out and we need to provideeducation to patience as well as the marketing piece of it. Yeah. Well again,big kudos to you guys, there's another company, that's in the similar spaceright in the digestible medicine, drunk delivery market that i'm very familiarwith, and you know their perspective of of their commercialization strategy wasthey were waiting all the way until...

...they got fda clearance waiting tillthey had all the clinical evidence before they were investing any dollarsand marketing, and i think it's a huge missed opportunity, and- and so i meanjust fee like- i said- kudos to you guys for making that investment andseeing that vision, because i think it's going to be a game changer,because you're right, it is a long hall with being able to educate the marketaround something that is so novel and that way when you're ready to go tomarket it's already there yeah. So let's just talk about podcasting.You know when i think about some of the objectives from from a marketing acommercialization standpoint, around pre launch, i think, of building anemail list, building a social media presence, testing marketing messages, having early conversations withperspective customers, and these are all things that you can do. Throughhe,producing and hosting your own podcast show. So when did you guys start yourshow and how is that that been beneficial to the company yeah exactlygreat point, so we started about a year and a half ago and we've done it indifferent segments. So the first segment was to focus on health care ingeneral. How that's changing, then? We have a second campaign where we talkmore about the technology specifically and then you know different types ofpodcast. We've been guessed on, you know where there's been talking aboutthe deployment of the technology, commercialization, etc. So to answeryour question about a year and a half ago we got started, and then it hasreally helped like again back to this education to where, almost, if you lookat these industries to where people are like i've, never heard of such a thing,you mean you can actually take an electronic capsule swallow it trackdata you inject to balls, multi days, etc, and you can look at some of theseindustries. That start i before and...

...since i vention this a couple times.Some examples take take things that are electronic. Like a microwave oven andwhen that started in the late s, nobody ever heard about it and it very fastpeople heard about it. They started using it now. Forty fifty years later,it's like every house every place has a microwave oven. You can look at thecell phone industry in the early es, nobody ever heard of cellphones. Theywere nowhere and then all of a u e thousand nine hundred and eighty fiveor so they came out with the big motor roll of bricks. If you remember those,and then you know her, we are thirty years later and they are everywhere andwe truly believe i'll, be it a long hall like you mentioned that getting out there with the podcasteducating the people and letting people know that thistechnology actually exists is key to what we're working on so like we'vetalked about here is like get started early get the word out: it's notopportunity to educate people about the technology, but, more importantly, let people know that the technologyactually exists. Yeah yeah, hey it's dr roxy. Here with a quickbreak from the conversation. Are you trying to figure out what moves youneed to make to survive and thrive in the new co vid economy? I want everyhealth innovator to find their most viable and profitable pivot strategy,which is why i created the co. Vid proof your business posited. The pivotkit is a step by step framework that helps you find your best pivot strategy.It walks you through six categories. You need to examine for a three hundredand sixty degree view of your business. I call them the six critical pivotlenses. As you make your way through this comprehensive kit, you'll be armedwith the tools, tips and strategies you need to make sure you can piv it withspeed without missing out on critical details and opportunities, learn moreat legacy: hyphen daco back kit.

You know, content pr promotion, youknow and as we talked about co creation and customer discovery, you know whatbetter way to do that with with then consistently having interviews withyour target audience on the show and create content, while you're doing it,yeah yeah exactly right yeah. So what is what is? What is on the future? In the futurefor smart tab, what are some of the key milestones that you guys are focused onboth in the short term in long term, yeah great question so short term. Wehave an upcoming preclinical animal study using the inject tap with insulinthat will be happening starting next month. That's a key milestone target top. Wehave clinical studies completed. We will be bundling those data to submitit to the fda for in a clearance medical device, you get a clearanceclass to medical device and then from there we bundle that with a farm, aprescription drug- and that would be a five ib, two so kind of give you anidea. The timeline is it within the next six twelve months obtain the classtwo medical device clearance on two of our smart tabs, and then we need tobundle those with prescription drugs about twenty four months to have to doone human clinical study, then the next mile stone be commercialization. So, as we grow, one of the things we'reworking on right now is building now a mid size have a pilot, midsizemanufacturing facility. So we can measure the so we can build thecapsules at a measured right. Keep that internal, keep the controls tight thereand then commercialization within thirty six months, so we're in a prettyshort time frame to wear in three years...

...o. If all goes well, you will see thefirst smart tabs in the market in the pharmacies for our patience to use. It's very exciting. I mean it's yourhard press these days to not have someone that you know in your circle.That's taking some type of injection medication, or that is non compliantwith their medication regiment, and you know how it's impact in their lives andand so it'll be really exciting to when we have some of these innovationsactually in use. So one of the things i think is really interesting is you knowyou've been at this for what three years yes and then you're talking aboutanother thirty six months before you get to commercialization and that takes money right, can't build a company for five or sixyears without having some type of funding. So talk to us about what thisfunding journey has been like for you yeah exactly, and this you know drawhis own experience of building companies in the past and beingsuccessful is that you know you start out with individual investors. Some ofthose investors have been prior investors and prior companies, soindividual investors, you know to date. We have a very clean balance sheet: nodebt, no preferred stock, o liquidation preferences and we continue to growwe're, starting now on our series of capital rays. We were going to start inthis a little bit earlier, but things were slowed with covin nineteen etc. Sonow we're embarking on that journey to raise additional capital for the growth ahead. So, yes, we doneed to raise capital. However, with that capital it continues to, youknow now will work through the clinical studies build out this pilot manufacturingfacility, launch activities etc. So today i would say: we've been very frugalwith the dollars that we've raised. We know how to you know, present the company exactlywhere we're at present a very solid... team and also there's thisidea that we are on a mission. You know we will see this through andyou know so. People like myself, we've had other companies, we've beensuccessful, but you know this is one. That's a mission and we're not going toyou know get twelve months here as or you know, we're out of money where i go.Raise more capital go, do something else this. This is a mission and wewill see this through to get these products to market so with that itgives people confidence as the investors to invest dollars and see thehorizon of what we're what we will be bringing to market. So how is thatjourney? It may be evolved before ovid during ovid and kind of now is we're ca.You know kind of the post, coved economy or the post cun ovid fundinground. You know i hear a lot of mixed messages about money, drawing up andthen money being a free for all and kind of every place in between yeah i mean for us, it's really aboutto fit. You know this is more cutting edge technology, so we'renot a real good fit for an investment firm that is looking to invest, and youhave a very clean line of side for nexi in twelve months. All right, yeah ours,it be longer, were you know, probably three or four five years out. Some people get scared off by the fdaprocess, but that's just the way it is we've been through that before and willmigrate through this one successfully as well. There's plenty of money outthere for the right ideas and if it's the right fit, i think a lot of timeswith you know you hear the money has dried up. That's probably becausepeople are running into a situation to where it isn't a good fit. They don'thave a good strategy. They are trying to build something and take it tomarket, but they have no idea of what the market is. We've talked throughthat already ill being patient centered, so the money is out there. It has to be.You know it has to be invested into...

...good teams, good strategies etc. So itis a process and i think, covin nineteen- it certainly slowed thingsdown, but now we're kind of moving out ofcovin and things seem to be now speeding back up again: yeah yeah. Idefinitely agree- and you know to your point- you know it's very different. Ithink trying to raise funds for you know they all have their theirchallenges in their opportunities, but i think it's very different when you'reraising money for something that's really never been done before orcontributing to a new category, yeah you're exactly right- and you know soagain. This is a mission for us. We will bring these things to market, butit is game. Changing m y. If you start looking in the numbers, fifty billioninjections last year globally, i mean imagine if you could have some of thosepeople taking a capsule now for an injection instead of a strange needleyou're talking the ability to have you know, market valuations that areextremely large or tarn about you, revenue streams that are extremelylarge. This is a game changing technology that we're bringing tomarket so yeah, you're, right, you're, exactly right. Some people may view therisk too high the money, return, etc, but it willwork we will bring in things to the market and because of that you know, your returnswill be very high. Oh ever some people's, you know it's too risky thelines site isn't. Quite there dvd scares some people off like we wetalked about, but but i think to your point. That is correct. If, if it's too new,if it's too unknown people get scared away, and then they obviously don'tenjoy the returns when it does come to market well and they're the ones thatmissed out right, they weren't a good fit for you anyway. So it's nice thatthey can. You know self select out self top out right yeah.

So what are some of the most importantcommercialization decisions? You think entrepreneurs are need to make,especially bringing you know something like a med device solution to market yeah. That's a great point, so one ofthem that is near and dear to our heart is to keep the development, keep theearly stage manufacturing in house many times, and people will get sold on thisvery easily many times. As a start up, is you need to contract, manufactureout, bringing the experts and many times those don't go very well, becauseit isn't a house, maybe the people that are contract manufacturers they're, noton the same mission path that you are, and you know me prior experience, we'veseen those play out so very important to us and i was suggested otherentrepreneurs take a close look at this is when you're developing something t,certainly the more proprietary that it is, keep a very close eye on how it'sbeing developed, how it's going to be manufactured and then what thosecontrols look like, because many times you can spend a lot of money oncontract manufacturers and then it doesn't work out as well. So i wouldsay that is one key point to really take a hard look at beyond that, thenis kind of this moving scale of investment right. We talked about thisa little bit already. How much do you market early? How much do you marketwhen you launch there is a direct function between marketing and yourrevenues, but you know you do have a diminishing scale there. As well, sohow do you optimize that? How do you optimize the marketing dollars, however,being cognizant of the different marketing streams that exist todayright? So you market, a new product, whether it's me devise farm ofprescription is quite different today than it was ten fifteen years ago,twenty years ago, when we only had three channels on television and mindto deploy were now, we have multiple...

...channels, multiple streams, the two waycommunication is much better right, so we can hold focus groups. We can havemuch better interaction with our potential patients than we could twentythirty years ago. So that's been a big boom things like what we're doing today,you get the word out. You get almost real time feedback and then from thereyou can adjust to your marketing. How is farma reacted to this idi in this new category e andbrought to market by guys, yeah, so large farm of companies? We talk tothey like it. It's a game changer. I believe everyone we've talked to wouldlike to be a part of this. At some point. Large farming companies, largecompanies in general. They do not innovate necessarily very much or atall or very quickly, so they, some of them, take a wait and see approach.Others have signed it up for strategic partnership, so we know that you knowin the farmer space it is a little bit of a longer hall. We understand that,but i mean in general everybody likes it. Everbody knows it will be a gamechanger. We have seen some of these things. Youknow medical devices have have improved or you have have had some niceadvancements over the lise decade. So we see that continue. Yeah just seem tofind those two drug manufactures that have complimentary products that aregoing to be competing against each other right and find the one that wantsthe lion, the competition exactly exactly so. What are is. Are there any additional lessonslearned you know doesn't have to be through smart habit can be some of yourprevious companies. Are there any other lessons learned around thiscommercialization journey that you would want to share with our audiencebefore you wrap up, i think for commercialization again,you're really looking at what the market is. After you know, a lot of these products willcomedown to what the market will bear...

...or what the market desire so be verycognisant of what you're building fits into that and also be aware of thepricing, because if you have really great products but they're price toohigh or too low, so we can achieve decent margins to really promote them.You know those are issues as well, so those will be the two things that iwould really point out and then the third thing isjust make sure you have control, make sure that you're not farming out toomuch of your activities, so you lose control yeah. I definitelyrecommend that anything that is coming close toyour competitive advantage, that you've got to keep those resources andcapabilities internally and only looking for strategic partners oralliances with those things that you that aren't tied to your competitiveadvantage, otherwise you're in big trouble exactly right, yeah good pointgood point: well thanks! So much for joining me today, robert. How do folksget a hold of you if they want to follow up with you after the show yeah exactly so. We have our web page,which is smart tab, co, notam, but cos a smart top dot co and we have a linkthere and then we can email as well, so that would be robert dot initial atsmart tab com. Thank you. So much, it's been greathaving you here today, yeah thank you enjoyed it my pleasure. Thank you so much for listening. I knowyou're busy working to bring your life changing innovation to market, and ivalue your time and attention to get the latest episodes on your mobiledevice automatically subscribe to the show on your favorite podcast app likeapple podcast, spotify and stitcher. Thank you for listening, and iappreciate every one who shares the show with friends and colleagues, seeyou on the next episode of health innovator,...

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