Future of Healthcare: How Exo is Relentlessly Moving the Needle for Imaging

We talked to Sandeep Akkaraju of Exo about Unleashing the potential of technology in modern medicine.

First of all, how are you and your family doing in these COVID-19 times?

Sandeep Akkaraju: All things considered, we have made the most out of summer, and I have been able to enjoy quality time with my family at the beach. We have been very fortunate with our health, and my daughter has even returned to school. However, I have family living in India, where the COVID-19 situation is much worse, and I feel some trepidation around my elderly parents living there. I am also missing the office in general and really yearn for the regular connection to the team.

Tell us about you, your career, how you founded Exo.

Sandeep Akkaraju: I am originally from India, and healthcare has always been a part of my family. My grandfather and grandmother founded a hospital in India, re-building the Indian health system in the post-colonial era. As such, I have always had a passion for both healthcare and startups, which led me to Silicon Valley after I finished my university studies. Before Exo, I was a part of the team that grew a DARPA-funded garage startup into IntelliSense, a MEMS technology powerhouse that was eventually acquired by Corning for $750 million. After IntelliSense was sold, I decided to venture on a backpacking trip through Africa, and it was there that I saw first-hand how the lack of healthcare infrastructure can severely affect impoverished communities, causing treatable and preventable illnesses to spiral into life-altering diseases.

Clearly, the contrast between these rural African villages and Silicon Valley was starkly different, especially when it came to access to medical care and technology. This inspired me to re-immerse myself in the technology world with a desire to tackle true transformational challenges that would impact the lives of people around the world. I returned to the U.S. and re-acquired IntelliSense from Corning, and then went on to launch and sell Jyve, a sensor company pioneering the early technology of Augmented Reality, to a large semiconductor firm. These experiences led to the launch and growth of Exo with my co-founders Janusz Bryzek, Yusuf Haque and John Kokulis, born with my vision to redefine medical imaging and diagnostics for patients worldwide. It is my goal to have a direct impact on West African villages and rural communities in the U.S. where hospitals and clinics are hours away, or where imaging may be unavailable. 

How does Exo innovate?

Sandeep Akkaraju: You are likely familiar with the traditional cart-based ultrasound systems that require a sonographer to operate. Until very recently, this was the primary way to complete an ultrasound. The process is limiting — too slow for point of care diagnostics in emergency rooms where an immediate diagnosis can be the difference between life and death. Legacy ultrasound brands still operate in this model. However, Exo is leading the change in this landscape by reinventing the point of the care ultrasound device.

At its core, Exo is a health information and devices company, and we are all about equality, access, innovation and solving real-world problems. We aim to provide a window into everybody, no matter the challenges they have. We are proud to be at the forefront of reinventing the way healthcare practitioners use high-quality, affordable and intuitive technology to triage, diagnose and treat patients at the point of care around the world. 

Now, how exactly do we plan to do this? 

First and foremost, we listened. Our team has been listening and learning from physicians and other healthcare professionals for years about the challenges they face in their day-to-day patient interactions. 

Then, we learned. What came to us very quickly was the notion that the lack of interoperability and cumbersome documentation slow down patient care and distract physicians from critical medical emergencies — especially in emergency medicine where time is of the essence. Over-complicated ultrasound systems make triage and interpretations difficult. With Exo’s workflow app and ultrasound depth-penetration power, medical practitioners will have access to high-quality, point of care ultrasound imaging that can shave minutes from the triage and interpretation processes, equipping providers with immediate answers and a rapid pathway to care.

We are creating solutions that work for the whole hospital and beyond.

How the coronavirus pandemic affects your business, and how are you coping?

Sandeep Akkaraju: Unfortunately, the COVID-19 pandemic has wreaked havoc on the U.S. We want to help healthcare practitioners diagnose COVID-19 patients in a more efficient manner for faster healing. As COVID-19 significantly affects lung performance, we are poised to be at the forefront of point of care lung ultrasound, which has become critical in the treatment and diagnosis of coronavirus-related lung problems, especially COVID pneumonia, due to its non-invasive imaging technique. 

On top of dealing with the ramifications of the pandemic, many COVID units nationwide do not have enough ultrasound devices to pass around for timely scans, resulting in delays in diagnosis, especially if the unit relies on cart-based systems that need to be cleaned and sanitized before they can be reused. Point of care ultrasound devices like ours will fit in the clinicians’ pockets, circumventing the need to wait for a cart-based system to become available, and are easy to sanitize. Therefore, more ultrasound devices at the point of care means quicker treatment for COVID patients leading to more accurate life-saving diagnosis.

Did you have to make difficult choices, and what are the lessons learned?

Sandeep Akkaraju: Exo has decided to take a risk in changing the ultrasound landscape by being ahead of the game as the industry takes on an inevitable evolution through technology. We are placing a huge emphasis on our vision of ultrasound being in the pockets of caregivers worldwide – this is going to live or die by how simple we can make it for clinicians. As it stands today, many ultrasound machines are cumbersome to use. This is clearly holding the industry back, and as such, we have created an intuitive solution to bring the industry forward. We are ready to prove to clinicians how simple and non-cumbersome it can be to achieve high-quality imaging, therefore vastly improving patient outcomes.

How do you deal with stress and anxiety? How do you project yourself and Exo in the future?

Sandeep Akkaraju: I have an amazing team at Exo which allows me to take breaks and maintain a balance of work and family. This goes a long way, especially when there are many external stressors around COVID-19. I also have the type of personality that relishes tackling challenges, and I look at setbacks as an opportunity to improve. I typically do not dwell on things and can quickly learn, adapt, and move on.

Exo has a bright future, and we are investing big. We just completed a Series B+ fundraising round, which has allowed us to attract top talent and further develop our technology. This is a truly exciting time for our company.

Who are your competitors? And how do you plan to stay in the game?

Sandeep Akkaraju: I would compare handheld medical imaging to the early days of the digital music market or the early mobile phone market. There are a number of players with parts of the solution. Each of the players have solved parts of the problem but no one has created a solution that solves the entire problem.

There are a few products with adequate image quality but are bulky or expensive, others which are inexpensive but have poor image quality. Each of these products makes compromises on image quality, ergonomics, or ease of use. More importantly, these products do not adequately fit into the workflow of physicians. None of them provide an end to end solution that can go from imaging to billing without hair-pulling. 

At Exo, we are reinventing the future of ultrasound. Our proprietary Piezoelectric Micromachined Ultrasound Transducers (pMUT) – the only chip technology of its kind – which will deliver reliable, high fidelity imaging at the price of a modern laptop. We are also creating an informatics platform that allows for seamless data transfer from imaging to documentation, billing and patient records. We’re hard at work at computational sonography algorithms that make medical imaging as easy as using a camera on your phone. Our goal is to deliver unparalleled image quality, ease of use and seamless integration into a physician’s workflow. 

Exo has a deeply experienced team with high-level knowledge of all elements of the business. We have an incredible leadership team behind our company and technologies, coming from companies like Apple, Google, GE, Medtronic, and Siemens, among other prestigious companies. They’ve applied their years of experience in developing and bringing patented technology solutions to market to develop a trailblazing new technology in ultrasound that retains the quality of a larger ultrasound machine at a fraction of the size and cost.

That is what has allowed Exo to develop medical imaging technology unlike anything else on the market — making imaging sharper, more reliable and more affordable than ever before.

Your final thoughts?

Sandeep Akkaraju: Exo has channeled semiconductor and nanotechnologies toward one of the most urgent needs around the world — the lack of affordable, reliable high-quality medical imaging technology that can be carried in the palm of a doctor’s hand. We don’t just predict this is a need in our market; we know, based on market research, that this is an urgent need. According to industry analyst Klein Biomedical Consultants, the worldwide point of care ultrasound market is forecast to reach $1.5 billion in 2024 and grow at 9.5 percent annually. Handheld ultrasound is forecast to lead the industry’s growth, and Exo is poised to become a leader in the industry.

But we aren’t stopping there – we have ambitious next steps for the company. Beyond Exo’s software and medical device launch, we have plans to create a platform for medical technology convergence — where a variety of diagnostics and therapeutics can all be administered through a multi-functional device. We have an aim to facilitate advanced surgical robotics and endoscopic procedure, and could enable therapeutic modalities in non-invasive neuromodulation and drug-delivery. We like to let our products do the talking – they will speak for themselves. Keep an eye out in quarter four of 2020 and quarter one of 2021 for our exciting product announcements, because Exo is going to change the world.

Your website?

www.exo.inc