One of the state’s goals is the creation of new science and technology companies from research at its universities. That’s what has happened with a company in Greenville called Perfusio.
Perfusio, which started up with research more than a decade ago at East Carolina University, has created a device that can let surgeons monitor perfusion – the rate at which blood is delivered to tissues – in real time, on a monitor.
The big benefit, the company says, is that the machine can help reduce complications that endanger patients and require additional, costly surgeries. The surgeon can see and correct problems causing inadequate blood flow to tissues in the initial procedure.
I talked about the company with Monte Tucker, a veteran of nearly 40 years in medical imaging and health care marketing, who became CEO of Perfusio in 2020.
Tucker talks about “the uncomfortable truth,” which is that up to 15% of major surgical procedures have complications. “And a lot of those complications come from suboptimal blood flow in critical tissues that is unrecognizable by the surgeon and by visible light.”
Perfusio’s Certes surgical imaging technology uses what is called “multi-spectral imaging” and “laser speckle contrast analytics” and – in Tucker’s words, “an artificial intelligence algorithm that runs the information of what comes back from the lasers.”
Essentially, an imaging arm attached to the machine is moved over the patient during surgery, and feeds back to the software what’s reflected from light penetrating the tissue.
The system’s software is looking pixel by pixel. It has been trained to know whether tissue in and around the surgical area is getting a flow of blood, and it displays perfusion on the monitor. This means surgeons don‘t need to use dyes, which are time-consuming and limited in how many times they can be used, says Tucker. With the Certes machine, tissue imaging can be done as much as needed during surgery.
Data from the imaging goes into the servers maintained by Perfusio’s partner, Silicon Valley-based ARMUS, an advanced data analytics firm. As more procedures are imaged, the data enhances Certes’ machine learning. It gets better at recognizing what it is seeing.
That’s why it was significant when Perfusio announced last month that it had reached a key milestone: Certes had been used in surgery for its 100th patient. One of the challenges facing researchers working on this technology is getting enough data from actual surgeries. Perfusio is working with 25 physicians in nine surgical subspecialties in its current multi-site outcome study.
Perfusio was co-founded by Dr. Bruce Ferguson, a cardiothoracic surgeon, and Dr. Cheng Chen, an optical physicist. Their team of cardiothoracic surgery, optical physics and engineering experts started developing a process known as “Multi-Spectral Physiologic Visualization.” They formed a company, originally known as RFPi (Real-time Flow and Perfusion Imaging), and spun out of ECU in 2014. In 2015, they licensed the technology from ECU, and in 2016, raised $4 million in Series A financing.
The past five years have been filled with prototype design, clinical outcome studies, getting FDA clearance and securing a manufacturing partner. They also landed $1.75 million in grants from the National Institutes of Health.
Commercializing new medical technology means, primarily, pitching large health care systems to lease your equipment and pay hundreds of dollars every time it is used. This is a daunting task for a young, 10-employee company that has primarily been focused on research and development.
Tucker, 70, spent the first part of his career selling medical imaging equipment and the second part running a health care consulting firm; many of the largest health care systems have been clients. In January 2020, what was then RFPi brought him to Greenville to do a strategic analysis of the company. After delivering his presentation in mid-February, and offering to do some consulting, he was offered the CEO position.
A Houston resident, he was preparing to visit as CEO when COVID hit. “I ended up taking over by Webex,” says Tucker.
That wasn’t a big deal, because most everything was happening virtually. In June 2020, the company was able to move out of ECU and into new offices, and Tucker was able to make his first visit in September of last year. Last January, Perfusio reorganized its board of directors. One of the new members was David LaVance, formerly chairman of Boston-based Hologic, a medical device and diagnostics company. LaVance is now CEO of Surround Medical Systems, an early-stage imaging company in Morrisville.
Tucker believes Perfusio can make a compelling case to hospitals that Certes can save money by reducing surgical complications – often an unreimbursable expense. “All the repeat secondary surgeries cost the hospitals. You’re spending thousands and thousands of dollars that the hospital has to put up.
“Hospitals are only running single-digit margins. They don’t have big margins,” says Tucker.
But there will also be an economic benefit, he says, to having a patient back to work earlier.
“It’s like a generational leap forward. Doctors have been doing amazing jobs with what they had. I have so much respect for surgeons. But it’s time.”
He sees the company remaining independent for three to five years, or even longer. “There’s a lot of big companies out there, so I’m not foolish to say we wouldn’t look at an offer to incorporate into other technology. One of the things we are looking at is licensing our technology to other, larger organizations. So, I could see multiple paths of what this company would look like with relationships with a lot of larger organizations.”
Perfusio is a big deal for ECU because it doesn’t have the big research budgets of say, a Duke, UNC-Chapel Hill or N.C. State – the kind of investment that leads to spinout companies. From 2015-2017, N.C. State averaged 13 spinouts a year, with nine each at Duke and UNC, according to the most recent Tracking Innovation report published by state’s Office of Science, Technology and Innovation in 2019.
The last couple of years, ECU has averaged two to three, according to Marti Van Scott, director of licensing and commercialization in ECU’s Office of Innovation and New Ventures.
“We exceed many universities in terms of spinouts per million dollars in research expenditures,” says Van Scott. “The total numbers are a bit more modest, but in terms of the investment we have into it, we get a pretty good bang for our buck.”
“We’re thrilled for them,” she said of Perfusio, “and looking forward to their first product hitting the market.”
One interesting project launched by Van Scott and her colleagues to find more Perfusios is the I-Corp Innovation Ambassador program. The program trains graduate students and post-docs in a paid, part-time internship to identify and assess innovations with commercial potential emerging in work being done by ECU researchers.
“We’re a small office. We just can’t see it all,” says Van Scott. The students can also help familiarize researchers with the resources available to help them turn an innovation into a business.