The Future of Healthcare: “Kill bacteria with robots and not antibiotics that create antibiotic resistant germs” with Xenex CEO Morris Miller

As a part of my series about “The Future of Healthcare” I had the pleasure of interviewing Morris Miller. Under Morris Miller’s leadership, Xenex has become a world leader in automated room disinfection. Through the use of xenon technology and innovative hospital disinfection protocols, the company is helping healthcare facilities achieve significant infection reduction results. As CEO, […]

As a part of my series about “The Future of Healthcare” I had the pleasure of interviewing Morris Miller. Under Morris Miller’s leadership, Xenex has become a world leader in automated room disinfection. Through the use of xenon technology and innovative hospital disinfection protocols, the company is helping healthcare facilities achieve significant infection reduction results. As CEO, Morris is responsible for the company’s overall business strategy and oversight of day-today operations. Originally from San Antonio, Morris is a graduate of the Dedman School of Law at Southern Methodist University, The University of Texas at Austin, and Phillips Exeter Academy. He is the co-founder of Tectonic Ventures, formed in 2016 to advice founders, start-ups and established technology companies. Prior to co-founding Tectonic Ventures, Morris founded Sequel Ventures and Cutstone Ventures, which invests in/acts as an advisor to numerous start-ups such as Inventables, Adometry, and Golfballs.com. He started Curtis Hill Publishing, the first company to publish Texas case law on CD-ROM, and he was also the co-founder and President/CEO of Rackspace (NYSE: RAX). Morris is a member of APIC and BioMed SA.

Can you tell us a story about what brought you to this specific career path?

I started my career as an attorney at a law firm, and launched a company that was the first to publish Texas case law on CD-Rom. After selling the publishing company to Thomson Reuters, I wrote the first check and co-founded Rackspace. Eventually I started my own venture capital firm, which brought me to Xenex.

When the Xenex founders approached me about their Germ-Zapping Robot technology, I consulted with my father, a retired physician who specialized in Internal Medicine, about the technology’s potential. I was shocked when he told me that being able to stop healthcare associated infections could have more of an impact on humanity than his service to his patients throughout his entire career. The Xenex founders, Dr. Mark Stibich and Dr. Julie Stachowiak, had a focused mission — to stop the needless pain and suffering and over 100,000 annual deaths caused by healthcare associated infections, which was something I was proud to get behind and help grow.

Can you share the most interesting story that happened to you since you began your career?

I’ve been fortunate to meet some incredibly smart people and invest in a variety of exciting technologies. A story that resonates with me is one that happened recently where we were able to convince a skeptical Infectious Disease doctor about the efficacy of our LightStrike robots.

I think it’s important to understand the enormity of the epidemic facing healthcare facilities today. Nearly 100,000 people die in the U.S. every year from healthcare associated infections. That is more than 300 people dying every day from an infection they acquired during their hospital stay. Everyone knows someone who went to the hospital to have a hip or knee replaced, seek treatment, or have a baby, and contracted a scary (and sometimes deadly) infection. These infections are caused by microorganisms like C.diff (Clostridium difficile), MRSA (Methicillin-resistant Staphylococcus aureus), and CRE (Carbapenem-resistant Enterobacteriaceae) that remain on hospital surfaces, even after a room has been cleaned. They linger on tray tables, bedrails, doorknobs, OR equipment, wheelchairs, and IV poles. Some of the really scary ones — like C.diff — can live on surfaces for up to 5 months. It’s happening every day. Hospitals need more than 2 hours to properly disinfect a hospital room with traditional methods, but the germs that make people sick are becoming resistant to cleaning chemicals and antibiotics. In addition, financial pressure only allows hospitals to give cleaning team members 28–45 minutes to get the room ready for the next patient, which is a 2+ hour job (for proper disinfection).

That’s what is so frightening — the germs have become resistant to antibiotics and we don’t have the time to properly disinfect the rooms or the drugs to treat the diseases they cause.

Back to my story. Peer-reviewed outcome studies published in journals are the gold standard in the medical device world. I visited an Infectious Disease doctor at a world renowned hospital and I presented 4 peer-reviewed outcome studies from hospitals that saw their infection rates plummet after they added our LightStrike room disinfection technology to their cleaning protocols. The doctor crossed her arms and succinctly told me “I don’t believe you.” Despite the evidence, she didn’t believe that our robots could kill the germs that make people sick and help bring down the facility’s infection rates. She was willing to give the LightStrike technology a chance, however, because other interventions weren’t working. Nine months later, she conducted her own independent, controlled trial. The results, which were recently published in the American Journal of Infection Control, showed that C.diff infection rates fell 47% on the units where our robots were used for room disinfection. C.diff infection rates INCREASED on the units that were not disinfected with our robots. The hospital deployed 12 robots and have continued to see reductions in their infection rates. While the story has a happy ending, it feels like we have to repeat the same process in every hospital.

Can you tell us about your “Big Idea That Might Change The World”?

Antibiotic resistance is responsible for the deaths of 700,000 people each year. That number is expected to skyrocket to 10 million deaths by 2050 unless action is taken. These deaths are caused by antibiotic resistant pathogens — like methicillin resistant staph and vancomycin resistant enterococci (VRE). We no longer have antibiotics to treat the infections they cause. The only way to combat this epidemic is to reduce the number of cases where antibiotics are needed. If you destroy the pathogens before they are transmitted to people, then infections are prevented. It’s a paradigm shift in the way we think about antibiotic resistance and superbugs. Kill the pathogens before they make people sick and then you don’t need antibiotics to treat the infections.

And that’s what LightStrike Germ-Zapping Robots accomplish. The robots use intense pulsed xenon ultraviolet (UV) light that quickly destroys pathogens so they can’t reproduce, mutate or cause infections. The robots are operated by a hospital’s cleaning team and have been proven effective against the most dangerous microorganisms (like Ebola and anthrax) as well as the most common (MRSA, influenza). Hospital employees still clean the rooms — remove trash and visible dirt/fluids, change the linens — and then they bring in our robot to destroy any pathogens that you can’t see but may have been missed during the manual cleaning process. Right now we are focused on healthcare — hospitals, surgery centers, long term acute care facilities and skilled nursing facilities, but there are certainly other places where our robots could have an impact (professional sports locker rooms, cruise ships, airports, etc.).

How do you think this will change the world?

Our mission is to stop the deaths and pain and suffering caused by healthcare associated infections. If we can stop the infections and reduce the risk of antibiotic resistance, then we can change the world. Right now, 300 people die in the U.S. every day from an infection they got in the hospital. Hospitals using LightStrike robots are reporting 50, 75 and even 100% reductions in their infection rates. Adding LightStrike room disinfection to a hospital’s comprehensive infection prevention strategy (hand hygiene, antibiotic stewardship, etc.) will make a difference.

LightStrike Germ-Zapping Robots have run more than 17 million cycles in hospital rooms. Using CDC statistics, that means that over the past 5 years, the robots have helped hospitals prevent 340,000 infections — and saved 37,000 lives. Conservatively, the average cost of treating a MRSA, C.diff or surgical site infection is $11,000 (per infection), so hospitals have saved $3 billion as a result of fewer infections.

We’ve talked a little about the financial impact of infections but it’s worth repeating. Infections are devastating for the patients who suffer them, but they also can have a negative impact on a hospital’s bottom line. Preventing just a couple of infections pays for a robot. Most hospitals report ROI in just a couple of months.

There’s also the PR value, which can’t be overlooked. Hospitals are now required to report some of the infections they cause — such as C.diff,MRSA and some surgical site infections. Consumers can go online and check out the infection rates for the hospital where they are going. You don’t want a loved one going to a hospital with high infection rates.

Keeping “Black Mirror” and the “Law of Unintended Consequences” in mind, can you see any potential drawbacks about this idea that people should think more deeply about?

Preventing infections in a hospital requires teamwork — the facility’s Infection Prevention and Environmental Services (EVS) team members must work together to develop and maintain a successful Infection Prevention program. Our Germ-Zapping Robots are not replacing human jobs and they need to be part of a comprehensive infection prevention strategy. It’s a huge misconception that the robots can do the work of the hospital’s EVS team members. The robots are tools (very powerful tools!) that enable the EVS team to do a great job but they are operated by humans. Successful infection prevention requires a comprehensive strategy — hand hygiene, antibiotic stewardship and LightStrike room disinfection.

Was there a “tipping point” that led you to this idea? Can you tell us that story?

When we launched LightStrike robots, we were optimistic that we could help hospitals bring down their infection rates by 5–10%. I was visiting with a customer one day and their Infectious Disease doctor told me an amazing story that served as our “tipping point.” The hospital was using 2 of our robots to disinfect rooms. Based on historical trends, they expected 16 Clostridium difficile (C.diff) infections during Q1. After they began using our LightStrike robots to disinfect rooms, they only had 2 C.diffinfections during that quarter — and those were on rooms where the robot wasn’t used!

It established that there is a direct correlation between using Xenex disinfection robots and the number of infections patients will suffer. When a hospital reduces infection rates by 5%, they have paid for the robots. That hospital experienced a 73% reduction in infections, which showed us the huge potential for the technology. We realized we needed to get LightStrike robots in hospitals ASAP.

We believe so strongly in the technology that we offer hospitals a “No Risk” program where they can evaluate our technology in their facility at no cost. We will provide robots and training for hospital employees at no cost, and then track utilization. We guarantee the hospital will see a reduction in infection rates or they can send the robots back. They only pay us when they’ve seen the agreed upon reduction in infection rates. We did this for a hospital in New Orleans and they recently reported a 70% reduction in infection rates since they have been disinfecting rooms with LightStrike robots. That facility is using 16 of our robots and has expanded the program to other facilities in their system.

What do you need to lead this idea to widespread adoption?

We need hospitals, physicians and the public (patients and their families) to realize that the majority of infections are preventable. Hospitals don’t like to talk about their infection rates because in the past they have been powerless to prevent them. Doctors want to believe that the OR where they are operating and the patient recovery rooms are properly cleaned and disinfected.

Unfortunately, the peer-reviewed studies have established that this isn’t the case. Studies have shown that less than half the surfaces in a hospital room are properly disinfected when it’s being prepared for the next patient. It may look and smell clean, but pathogens remain. Contamination exists — even after a thorough cleaning — and it’s enough to cause deadly infections. We need people to demand that the hospitals properly disinfect their rooms — or seek treatment elsewhere.

Remember, nobody can see these microscopic pathogens! A room that looks clean and smells clean gives the occupant a false feeling of safety.

What are your “5 Things I Wish Someone Told Me Before I Started” and why. (Please share a story or example for each.)

  1. When we started the business, we were hoping we could help hospitals get a 5–10% reduction in their infection rates. We were astonished when hospitals began reporting greater than 50% reductions in their infection rates — with some experiencing more than 75% reductions. We knew the technology had the potential to make a huge difference, but we had no idea about just how enormous an impact it would have.
  2. When we began to get traction inside hospitals, I called upon the CEO of a for-profit hospital. As I explained how the robot works and how it can be easily integrated into the hospital’s cleaning strategy, he told me that I was naïve. He said, “it’s not flattering, but we make money even when we make people sick.” Learning that hospitals profited from infections was something I never expected.
  3. Be patient. Selling technology to healthcare facilities is complex and time-consuming. Many industries embrace innovation — like creating a better shopping site (Amazon.com). But in hospitals, even if you offer a technology that is statistically better than what they are doing AND it can save them money, they may still take YEARS to adopt it.
  4. Infections happen to everyone. I thought infections only happened to elderly people or people who are immuno-compromised or weak. They can and do happen to everyone, even healthy people who are in the prime of their lives.
  5. Patients must be responsible for their own safety. Check out the hospital where you or your loved one is going. If the hospital isn’t using pulsed xenon UV disinfection technology, then find a facility in your area that does. My sister recently needed an operation and the hospital where her doctor operates doesn’t use LightStrike room disinfection. We offered to disinfect her OR and recovery room at that hospital at no charge, but the hospital decided that they wouldn’t allow us to do it. My sister switched doctors and hospitals so she could go to a facility that properly disinfects its ORs and patient rooms.

The future of work is a common theme. What can one do to “future proof” their career?

LightStrike robots have specific functions and extraordinary capabilities but the point of care in hospitals is delivered by humans. Providing a germ-free environment is a preventive measure. What people remember is their doctor, the nurses and the people who cared for them during their hospital stay. People matter. Whether you are a doctor, lawyer, EVS team member or teacher, when you care about others then you can future proof any job.

Based on the future trends in your industry, if you had a million dollars, what would you invest in?

Most people have no idea of the risk they face when they go to the hospital. Everyone knows someone who went to the hospital to have a joint replaced, seek treatment, or have a baby — and unfortunately contracted a painful and sometimes deadly infection. Most people have no idea that the hospital environment — microorganisms that you can’t see that are lurking on bedrails, tray tables, door knobs and OR equipment — caused their infection. With $1 million, we would create a consumer education campaign to raise awareness about hospital acquired infections because that’s not happening today.

Which principles or philosophies have guided your life? Your career?

  • Always be good for nothing. Do the right thing because it’s the right thing to do, not because you expect to gain something from it.
  • Non-Sibi. Do everything you can to make the world a better place.

Can you share with our readers what you think are the most important “success habits” or “success mindsets”?

The most important question to ask yourself is ‘why not me’? You have to believe in yourself. When I started my first company, I was rejected 168 times before I found my first investor. Be willing to be rejected, whether it’s by an investor, customer, etc. It’s not a coincidence that the harder you work, the luckier you get.

Some very well known VCs read this column. If you had 60 seconds to make a pitch to a VC, what would you say?

My VC fund and I have invested millions of dollars in Xenex since discovering how effective the technology is. I invite similarly-minded individuals and their firms to join us in our mission — which is to stop the deaths and stop the pain and suffering caused by hospital acquired infections.

Many VCs sit on the boards of hospitals and foundations. They can influence hospital decision-makers to invest in room disinfection technology — it’s good for the patients and it’s good for the hospital’s bottom line. Stopping the infections means we can preserve the efficacy of antibiotics, and protect our children, grandchildren and future generations.

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