Circle CVI: Changing the Global Conversation about Heart and Stroke Care
Cardiovascular diseases are the number-one killer of adults on Earth, taking nearly 18 million lives globally every year. Diagnostic imaging—including such methods as ultrasound (an echocardiogram) and CT (computed tomography)—is the most common and important tool that we have to determine the nature and magnitude of the problem and to designate an appropriate treatment.
And the undisputed gold standard of cardiac diagnostic imaging is Magnetic Resonance Imaging (MRI), which has the best capability and accuracy and provides doctors with detailed quantitative analysis. Historically, it’s also the least used of the imaging technologies. First off, it’s always been complicated to accomplish: not only are you taking an MRI of a moving organ, but it’s difficult to get high-quality images from an MRI machine. In fact, patients have to be in the scanner between 20 minutes to an hour, making the economics of cardiac MRIs problematic. Throw into the mix the need for special scanner sequences and trained technicians and you begin to see why adoption of Cardiac MRI has been slow.
But that was before Calgary’s Circle Cardiovascular Imaging (Circle CVI) simplified and automated the Cardiac MRI post-processing procedure, reducing the time involved from at least an hour to less than 5 minutes. Coupled with advancing scanner technology, adoption of the gold standard as represented by Circle CVI is accelerating. Greg Ogrodnick, CEO of Circle CVI, aims to have cvi42 in every hospital worldwide.
Circle’s cvi42 software features fully embedded artificial intelligence, which improves visualization, analysis and reporting in a single platform. The AI component removes or reduces the need for highly trained professionals to engage in time-consuming post-processing work; as a bonus, computer vision can often detect what the human eye doesn’t see and help identify abnormalities and tissue properties, for example, improving the quality of diagnoses. Patients benefit from a speedier, more accurate diagnosis and hospitals benefit from reduced cost and improved outcomes.
WHY YYC?
According to Ogrodnick, Calgary is a natural environment in which medical tech companies can flourish, because the city boasts three important strengths: Science, Business, and Capital.
Science. In order to develop the innovative ideas and technology that are the foundation of successful med-tech companies, you need to have a supply of clinical vision and expertise in a particular field. That starts at the level of advanced science—and that means universities and other institutes of higher learning. Calgary has an eminent research university (University of Calgary), teaching hospitals, SAIT, and a variety of other schools. Science education, innovation and experiment are well-established and well-funded in the city. Ogrodnick notes that, in terms of product development, Calgary’s engineering school has a strong reputation and attracts students from all over the world. Specifically, the UofC has a growing biomedical engineering faculty, from which the company draws when hiring product managers and Quality Assurance professionals.
In terms of cardiac innovation, the University of Calgary has one of the finest cadre of scientists in the world, thanks to the Stephenson Cardiac Imaging Centre (one the five largest cardiovascular magnetic resonance imaging centers in North America) and the Libin Cardiovascular Institute, which houses some 200 researchers and clinicians.
Business. Ogrodnick was Executive in Residence at Innovate Calgary (the innovation transfer and business incubator at the University of Calgary) when he met the cardiologist Dr. Matthias Friedrich, who is now Circle’s Chief Design Officer. He and Friedrich started discussing the need for a software company that would serve advanced cardiovascular diagnostic imaging—and thus Circle CVI was born. They worked with Innovate Calgary to build the company from the ground up through the Company Creation program. Ogrodnick observes that without a robust infrastructure that collides entrepreneurs and researchers with investors and industry partners, the kind of applied innovation that Circle CVI represents would not take place—or at least not as readily.
Capital. Calgary has a deep and broad philanthropic and investor network—historically based in the oil and gas sector—that has provided seed capital for many of the city’s great startups, not to mention research facilities such as those mentioned above. Calgary is also gaining reputation in the venture capital community as well, with firms like Yaletown Partners and Inovia Capital establishing important beachheads in the city.
There’s a fourth factor, too, of course, in the success of Circle CVI in Calgary: people want to live here. It’s relatively simple to find—or relocate—talent because, unlike Silicon Valley, unlike Boston, even unlike Vancouver or Toronto, Calgary enjoys an enviable quality of life that is also affordable. People who could live and work anywhere are drawn here because Calgary is consistently at the top of the list of the world’s most livable cities.
GLOBAL BY NATURE
Circle CVI has always been global by nature. Matthias Friedrich, the Chief Design Officer, and Philipp Barckow, Chief Science Officer, were both trained in Berlin (where the company now has an office). About 60% of the company’s employers are in Calgary, and the rest are in Montréal, the USA, UK, Europe (France, Germany, Italy, Netherlands, Portugal, Spain), Brazil, Japan, Singapore, and China. The company has a small office of developers in Berlin and in Utrecht, as well as an R&D lab in Montréal.
Circle’s first product was adopted by 125 leading hospitals in 25 different countries; the company currently has customers in 50 countries, and regulatory approval in 40. Global distribution is achieved through machine manufacturers like GE and Siemens and through agreements with other software companies, such as IBM Watson.
TECH ECOSYSTEM
Ogrodnick notes that Calgary's relatively young tech community is strong, supportive and growing. He himself has been involved in the A100, a group of experienced Alberta tech founders that supports, mentors and advises new entrepreneurs, including through board membership and accelerators. He's also on the steering committee of Calgary Economic Development’s Life Sciences group and meets monthly with an informal group of life sciences CEOs. He points to Creative Destruction Lab—Rockies, located at the Haskayne School of Business at the University of Calgary, as an example of the ambitious tech infrastructure that’s helping seed capital and business prowess grow rapidly in the city.
The missing ingredient? For Ogrodnick, it’s “more”: more success stories, more tech companies that get to scale, raise significant capital, experience solid domestic and international growth, and have a high enough profile that venture capital courts them.
EXPERIENCE COUNTS: StrokeSense™
Two years ago, Circle was approached by the world-renowned Calgary Stroke Team to develop software IP by that team of physicians. The result: a subsidiary, Circle Neurovascular Imaging Inc., which has created exciting new software called StrokeSense. StrokeSense leverages Circle CVI’s 12 years of experience to use in stroke care. Circle Neurovascular was formed about 9 months ago, and has recently made FDA submission for its product, which should come to market in September 2020.
Ogrodnick is excited about bringing a commercialization team to stroke and stroke care—every year, more than 62,000 strokes occur in this country, according to Heart & Stroke Canada. Circle Neurovascular will bring its innovation to market quickly, thanks to the Circle team’s business experience, existing sales and marketing team, and roster of 1500 client hospitals who are currently Circle CVI customers. This is life-saving, life-improving technology that will benefit millions of families around the world.
Circle Neurovascular provides a great example of the principle that building experienced companies can help generate innovation that will grow and scale much more quickly than the first generation of tech startups could.
MOBILE CMR
In February 2020, Circle CVI announced a global partnership with Berlin-based diagnostic imaging company medneo. Cardiac MR (CMR) is the best-in-class diagnostic imaging tool, but many hospitals do not have access to scanners or appropriately trained specialists and technicians, or they don’t have the number of patients required to make such investments feasible.
To counter such obstacles, Circle and medneo will be offering pay-per-use CMR-as-a-service—diagnostics on demand, in other words. The partnership will also sell fully equipped diagnostic franchises that make it possible for hospitals, physician teams and researchers, to access state-of-the-art CMR technology without the need to actually own that technology. A fleet of mobile cardiac MR systems will bring diagnostic services to smaller or remote communities. Circle’s post-processing and reporting automation will help make the service quick, accurate and informative.
WHAT’S NEXT
“At Circle CVI, we are all driven every single day by making the best possible diagnostics available to patients,” says Ogrodnick. “What we do helps people around the world. And that’s why we keep innovating, simplifying, automating, and displacing other modalities of imaging (such as nuclear) that carry risk. If we can do it better—faster, easier, cheaper and safer—that's a good thing.”
The company is growing rapidly because the modality it offers is the best and it is widely available. Training programs are full, and we’re really busy” says Ogrodnick. “Use of our technology has moved beyond academic medicine and into community hospitals all over the world. Big things are on the horizon.”