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Medical care, anywhere and always

Innovation

Provide the best medical care when there’s no doctor around. That’s Walther Boon and Remko Huigen’s mission for their start-up, MedAssist.online. Their apps support crew at sea and in other remote places to perform medical procedures in emergency situations. MedAssist.online was included in the 2017 PortXL accelerator programme. This programme provides new contacts with potential clients, investors and partners to enable the implementation of new innovations. Everything is geared towards one thing: helping people. ‘After all, that’s in our doctors’ blood.’

In the galley of a cargo vessel, the chef momentarily loses his balance and cuts his hand with a knife. It’s a deep cut with heavy blood loss. The wound needs to be stitched, but there’s no doctor on board. The vessel is 1,000 miles from the coast and the nearest emergency station is far away. There’s only the first officer available. He opens the MedAssist.online skills app on his tablet, which leads him precisely through the process, step by step, using a video and photos. After around twenty minutes, the stitches are finished and the patient has been helped!

The MedAssist.online office is on Maashaven, with a panoramic view of the Rotterdam skyline and passing vessels. ‘Look, that’s a client vessel,’ said Walther Boon (founder and director). ‘And there, in that large white Erasmus MC tower, that’s where we started,’ pointed out Remko Huigen (strategy & development manager). Walther and Remko, both originally doctors, explained the origin of MedAssist.online and the so-called skills app with which important medical skills can be learned and performed immediately.

Walther: ‘Vessels are obliged to carry medical equipment on board. The captain or first officer will have followed medical training and is able to carry out basic treatments. We’ve been giving this training at EC-MT, the Rotterdam maritime-medical training institute, for years. However, crew members only need to follow the training once every five years. When something happens on board, the training they followed is then usually years ago. During the training stories came to light of crew members who felt uncertain as to whether they would be able to carry out the medical treatments correctly. Suddenly you’re confronted with a real patient, a colleague you’ve known for years. They receive radio support from the Radio Medical Service. But after that they need to carry out the procedures themselves. They miss having guidance.’

Pig skin

We can organise this better, thought Walther in 2015, and the idea for a digital tool quickly formed. He got to work, together with John Pieterse, who produces e-learning applications for the maritime and offshore sectors. Walther designed a studio where he took the photos and videos himself. ‘We copied a vessel’s hospital so that it looked as real as possible. That’s why when stitching in the video, we’re really stitching the skin together. But we did use pig skin for this. Of course we couldn’t have done this with a real person’s skin.’

The MedAssist.online Skills app became a reality in mid-2016. The app handles frequently occurring medical situations, such as poisoning and shock, injecting, neck stabilisation, anaesthesia and inserting a drip. The app works online and offline and guides the crew member to carry out the medical procedure safely and successfully. Step by step, with photos and video. The app also satisfies the internationally agreed STCW Code, an international treaty regarding the minimum requirements to which seafarers on merchant vessels must meet regarding training and certification. Walther: ‘We help companies meet this standard.’

A bullseye. When Walther approached maritime companies, Stena Line was immediately interested and became an important test partner. Walther: ‘Stena Line transports thousands of people a week with their ferry services; this is more than an average GP practice. That’s why they are extremely open to innovation and their feedback was and is extremely important.’

Learning from young guests

Things are progressing rapidly with MedAssist.online. The interest from companies across the world is increasing. In November 2016 the company was one of two finalists for the KVNR Shipping Award. Two weeks later it won the Lloyd’s List award from the Australian Maritime Safety Authority. PortXL is also including the new company in the accelerator programme. Remko, who is now strengthening the start-up team, said about the impact: ‘We learned so much from PortXL. We were given a kind of mini-MBA programme, with which we could raise our company to a higher level. We were offered mentors, experienced people from the maritime sector and a network. This has enabled us to develop a strong pitch and a good business plan. We were also challenged by the programme to deliver things quickly, go that extra mile and think bigger. And of course what is very important is that PortXL and the Port Authority have made it easier for us to come into contact with large companies in the sector.’ Walther added: ‘We were able to give presentations to Vopak, Van Oord and Boskalis. But we also learned from the other start-ups and vice versa. I thought it was great to learn from young international guests, for example about how you need to make slick presentations. We also have a lot to tell; we’re just not good enough yet in expressing this to the outside world. Others are also often doing much more on social media than we are.’

About PortXL

PortXL accelerator is a 100-day programme for innovative start-ups in the maritime sector. The selected start-ups receive intensive coaching from experienced mentors from the business world and are prepared for the market. Participation in PortXL opens doors to the national and international business communities. Another PortXL will take place in 2018. Registration is possible until 15 January 2018.

The two gentlemen have learned another important lesson. Remko: ‘And that is to have patience. It happens in business-to-business that quotations are sometimes left for months. Large companies particularly need time to make decisions. In our enthusiasm as a new company, we of course want to get everything done quickly so that we can expand rapidly and reach as many people as possible.’ But we have increasingly more new clients registering, with the latest being Nederlandse Loodswezen (Dutch Pilot Organisation).’

New ideas and innovations

Walther: ‘Companies see that they can make considerable cost savings. When there is a medical problem, the crew can intervene quickly, and a vessel does not need to turn back or deviate unnecessarily from its course. And that also saves a lot of money. We have received positive responses from everywhere and the interest from companies is growing.’

This interest and these contacts in turn lead to even more new ideas and innovations. For example, the two men started with an app that can take an echocardiogram on a tablet: the ‘Heart App’. Remko: ‘Cardiovascular disease is one of the most common conditions among men from 25 to 65 years of age. With a new app, crew members who suffer heart complaints do not need to wait until they are on land for a fast and better diagnosis than what is possible right now. An echocardiogram of hospital quality can be taken using the tablet. This ECG is then sent to a shore-based doctor. We are developing and testing the app together with Stena Line and Boskalis.’

Two other innovations that Walther and Remko are investigating are the use of augmented reality and the secure sending of medical information. Remko: ‘We are operating at the cutting edge of medical knowledge, shipping and IT. We are looking for ways to bring doctor and patient together virtually. So that a shore-based doctor can use specially developed augmented reality to cooperate on the care of a patient on board. We have submitted a patent application for our solution. We are also investigating how you can securely collect, encrypt and offer medical data using a connection at sea. Of course you are not permitted to simply send medical data. We are investigating a way that makes this possible and is permitted. Data protection and patient data legislation are clear. But it is not easy to comply with this at sea. Via PortXL we have met a partner that wants to investigate this with us in order to develop a service.’

About the MedAssist.online founders

Walther Boon and Remko Huigen are both doctors, trained at Erasmus MC. Boon worked in accident and emergency for a period of time before he started work as medical adviser in the maritime sector. In 1996 he developed the ‘medical care on board’ training, commissioned by the Ship Owners’ Association. He is also a member of KNRM’s Radio Medical Service committee.

After studying medicine, Remko Huigen followed an MBA training in marketing and IT and worked as manager for Shell across the world.

Innovation

Rotterdam aims to be the world's smartest port. To maintain our leading position, we need to keep on innovating. Innovation is a crucial means of realising the envisaged changes in energy transition and digitisation in the port of Rotterdam.

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