Limburg digital solutions ease the burden of care for diabetics

Solutions are being sought in several areas to reduce the pressure on healthcare. Erik Duijsens, for example, is working with Chipmunk to develop reliable data for remote care. Ernest Lempers and his colleagues are developing a simpler alternative to the orthopaedic shoes that diabetes patients with foot problems often have to wear. Both companies receive financial support from the regional development agency LIOF to help them enter the market. We spoke to the entrepreneurs about how their products are easing the burden on healthcare.

Most expensive ailment

Patients with type 2 diabetes can suffer from foot problems. Ernest Lempers, CEO of Procs Medical: "Uncontrolled sugar in your blood causes your veins to clog up," he explains. "The further away from your heart, the worse it gets. The nervous system in the legs dies off, as it were, causing the muscle tension in the foot to decrease. The foot collapses. This eliminates the foot's cushioning function and allows the collapsed foot bones to protrude through the skin from the inside."

He continues: "Foot problems are not the most common ailments associated with type 2 diabetes, but they are the most expensive." If a patient has an infection in their foot, constant care is required until the wound has healed. This can take a long time and the patient has to visit the hospital regularly. In addition, patients with foot problems are often prescribed orthopaedic shoes, which come with a high price tag. What's more, fitting such shoes takes a lot of time. "That's a problem, because the feet of a type 2 diabetic patient become increasingly vulnerable over time," says Lempers. If patients are less mobile, it also means they are at greater risk of complications affecting the heart and eyes.

Silicone foot protector

Procs Medical is developing a foot protector called Procs. A 3D printing process developed specifically for Procs prints an exact copy of the foot from silicone. This silicone mould completely encloses the foot and provides targeted support. Procs helps prevent sagging and reduces the risk of blisters. Patients wear the foot protector in a semi-orthopaedic shoe. Fitting such a shoe takes much less time than a fully orthopaedic shoe. "So we already have an advantage for both the patient and the specialist," says Lempers.

Originating from the Netherlands Antilles

The idea for Procs originated from the work of Thomas de Windt, an instrument maker who spent 15 years handcrafting foot protection for diabetics in the Netherlands Antilles. "It took us almost three years to industrialise and digitise the manual process," says Lempers. The team developed the material at the Brightlands Materials campus in Geleen. The product is now ready for clinical testing.

Eliminate human error

The idea for Chipmunk also originated abroad. Erik Duijsens, founder and CEO of Chipmunk, moved with his family to Canada in 2010, where he learned to look at remote care in a different way. To this day, he is surprised at how little attention is paid to the reliable collection of data from patients, even though healthcare is becoming increasingly digitised.

Together with his partners, he therefore developed the Chipmunk. A smart box that connects the patient to the internet at home. "This creates a secure tunnel for data from the living room to the GP's consulting room." Various measuring devices, such as scales, glucose meters and blood pressure monitors, automatically transmit the necessary data. The patient does not enter any data themselves. "This eliminates human error," explains Duijsens. The data is made available to the healthcare provider and the patient via Chipmunk's medical cloud.

Duijsens and his partners deliberately chose Limburg as their testing ground. "Because the demand for care is relatively high in Limburg," he explains. "There is also a lot going on in socio-economic terms. For us, it's the best place for product development, because if it works here, it will work in other regions too."

Complex market

Both entrepreneurs agree that bringing a medical innovation to market is a long process. Duijsens: “Everything has to be scientifically substantiated. In addition, it is a complicated market where the user is someone other than the payer. That makes it very difficult.”

Golden move

A golden move in the development of the Chipmunk was the collaboration with a large group of general practitioners, Meditta, which focuses on the Sittard, Roermond, and Weert region. This group of general practitioners consists of around 200 GPs with approximately 350,000 patients. "We immediately gained access to five GP practices that provided us with 50 patients with whom we could test every step we took."

The test group grew to 200. That was when health insurer CZ showed interest. "CZ wanted to know what would happen if it were used by a larger group." Duijsens and his team then scaled up to 600 patients and agreed on a rate with CZ. This makes it the only insurer to reimburse the application for the time being. Other insurers are expected to follow suit soon, says Duijsens. In the meantime, Chilpmunk Health is scaling up to other regions. "We have already started in Utrecht and will be launching in Eindhoven this autumn."

Expanding into other markets

This expansion is also taking place in a completely different market. Duijsens: "We take measurements in people's homes, so a housing association asked us if we could also measure air quality. With our Chipmunk Home label, we are already measuring the quality of the indoor climate in the rental properties of a number of associations."

Simplicity

Where Chipmunk has already been validated and is entering the market, Procs Medical is still in the phase just before clinical trials. Over the next 12 months, the start-up will be working with UMC+ to get this process underway. The researchers are designing the tests in such a way that the results can also be used for the Health Technology Assessment (HTA) that will be required later on to substantiate the value, effectiveness and possible reimbursement of Procs. "We want to work as efficiently as possible," says Lempers.

The expectations are promising. "The lead researcher at the UMC+ spent half an hour looking at our foot protector and said, 'This is going to be the solution.' He was simply amazed by its simplicity."

Together with LIOF

Both entrepreneurs have noticed that having LIOF on their side gives them a solid image in the eyes of other parties. "Thanks to the financial support, others quickly see that everything is in order. They are more likely to do business with you," says Lempers. Duijsens adds: "Once you're in, LIOF really acts as a partner to the entrepreneur. I'm noticing that now that we're growing into a scale-up. It helps that LIOF is a shareholder."

During the conversation, Lempers comes up with the idea of connecting the Procs to the Chipmunk in the future. It's not there yet, but both men are driven to find solutions to structurally relieve the burden on healthcare.

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