As a part of my interview series with leaders in healthcare, I had the pleasure to interview Martin Burns, who is the CEO of Bruin Biometrics (BBI). Martin is a rigorous, analytical and highly structured business transformation leader, sharply focused on eliminating unnecessary patient suffering and waste in healthcare systems via novel technology and data-enabled strategies. Martin works with payers and providers to modernize out-of-date care pathways to make prevention and associated cost savings a reality. He is also a published author, speaker and inventor on six issued and registered patents.
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
In my career as a management consultant in the US and Europe, I lead corporate strategy, innovation, operations quality and regulatory M&A for global medical device and life science companies. My goals are to help save patient lives while also eliminating wasteful spending.
Can you share the most interesting story that happened to you since you began leading your company?
It is hard to pick just one story since we are continuing to grow and make an impact on prevention in healthcare. Within six months of joining BBI as chief operating officer, I transformed the business, reset strategy to focus on two medical devices rather than eight, restructured the management team and rapidly accelerated the execution of regulatory approval for the devices. I also led the company to ISO13485 Certification, CE Marking in 2013, FDA authorization this year and also the National Institute of Health and Care Excellence’s (NICE) Medical Innovation Briefing (MIB) process.
Can you tell our readers a bit about why you are an authority in the healthcare field?
I am leading the conversation about prevention from the front. The team at BBI and I have done data analysis to show how prevention can be achieved at scale in a year, all while saving costs instead of increasing them. We have analyzed the care pathway, the economics, existing clinical strategies, academic research and spoken with practitioners, guidelines-setting groups (NPUAP, CMS etc.) and companies in this space. Our analysis leads us to the conclusion that the prevention of pressure ulcers is stuck, is in crisis, and lacks a clear definition of prevention and a winning strategy to achieve prevention. We have the answers.
What makes your company stand out? Can you share a story?
BBI has the most innovative, proven solution to aid in the prevention of the number one reported patient harm in the USA: bedsores. It is a systemic failure. The SEM Scanner is the world’s first FDA-authorized device to objectively alert clinicians to specific anatomical areas of a patient’s body at increased risk for developing pressure damage. Patient risk assessments are performed with the SEM Scanner before visible damage manifests at the skin surface — a world and clinical first.
Let me give you the case of George.
George is a 77-year-old man. He’s fallen over at home — broken his hip. He’s been admitted to orthopedic trauma for hip replacement surgery.
George is assessed for his pressure ulcer risk as part of the standard intake procedure. Given George’s conditions, the answer to the risk assessment process is, “Yes, George is at risk for a pressure ulcer.”
Pressure ulcers occur over bony prominent areas — e.g. heels and sacrum — accounting for more than 70 percent of pressure ulcer incidents.
So the nurse now knows that George is at risk for a pressure ulcer and he or she will do a scan of
George’s body using what’s referred to as “a visual and tactile skin inspection.” But unless George’s skin is observed as red over those areas, George is deemed to not have a pressure ulcer. So although he is at risk, the nurses don’t know where on his body.
Risk assessment tools and visual and tactile skin inspection are notoriously unreliable in being able to predict and detect pressure ulcers. So much so that the goal of prevention is mathematically impossible to achieve. Too many developing pressure ulcers are not detected early enough to allow preventative actions to be truly effective.
George’s problems get worse, because although the nurses know he is at risk, and they apply “universal preventions” like turning, those interventions are total body in nature. Pressure ulcers don’t occur over the whole body; they primarily occur at bony prominent areas, which for George, are not yet receiving targeted interventions.
Targeted interventions for George will only begin once his skin turns red. And that is too late. The SEM Scanner answers the question of “Where?” Now we know where George is at risk of a pressure ulcer because the Scanner tells you so.
Now, after doing the risk assessment for George, the admitting nurse scans the areas most susceptible for pressure ulcers, and receives an SEM Scanner score.
An abnormal SEM Scanner score — we call it the delta — tells the nurse that George’s left heel is at risk of developing a pressure ulcer, even though skin redness is not yet evident.
So what does the SEM Scanner enable the nurse to do now? Intervene on George’s left heel and confidently take action there, even before the skin turns red.
The overarching point is the gap between patients being at risk, and when they receive targeted, anatomy-specific, interventions.
That gap is a critical danger zone for patients like George.
The SEM Scanner closes that gap.
Can you share with our readers about the innovations that you are bringing to and/or see in the healthcare industry? How do you envision that this might disrupt the status quo? Which “pain point” is this trying to address?
With the SEM Scanner, we are equipping nurses with information that they can’t get anywhere else. This information about those historically undetectable changes in skin and tissue prior to redness appearing is new for nurses and is groundbreaking, actionable clinical insight.
Without factoring in the use of the SEM Scanner, pressure ulcers kill almost the same number of people in the US as opioids and it costs a whopping $26.8 billion. It’s absurd when you consider the fact that 95 percent of pressure ulcers are avoidable.
Why are the costs so high? Well, the average cost to treat a pressure ulcer is $43,000 and given the prevalence, that results in $25 billion annually. Then, there are 17,000 lawsuits on average each year with the average settlement of $250,000.
So there is clearly a need to focus on prevention. By way of example, the CDC has a budget of $187.5 million to prevent the flu. And a pressure ulcer prevention budget of $0.
What are your “5 Things I Wish Someone Told Me Before I Started” and why?
1) A startup can never have enough money, nor enough data.
2) Understand the importance of committing to success. As I learned through my hobby of mountaineering, you don’t go up a mountain unless you know that you can get to the top and back down again safely. Have the mindset to set yourself up for success.
3) Having a background in business, accounting and data analysis can translate to making an impact in healthcare.
4) The healthcare system in the US does not emphasize prevention as much as you might expect.
5) Every CEO absolutely needs a mentor to coach you along the way.
Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly? And can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
The incidence of pressure ulcers alone is a perfect example of a systemic failure of healthcare in the United States because 95 percent of pressure ulcers are avoidable, yet it is the most commonly reported “never event.” We now have a device that can make it mathematically possible to achieve true prevention. But there are still hurdles to overcome:
- The US needs to emphasize the importance of prevention.
- Small companies need to be given a voice and need to be heard because they are truly the ones that are innovating most rapidly and are disrupting the status quo.
- Healthcare providers need to understand that technology is not a threat to your intelligence or the care you provide. The right technology will not make things more difficult; rather, it can help provide even better care.
- The government needs to understand where there are major gaps. We have been making an effort to show how terrible pressure ulcers are in the Department of Veterans Affairs (VA) healthcare system, for example. But these initiatives take time.
Thank you! It’s great to suggest changes, but what specific steps would need to be taken to implement your ideas? What can individuals, corporations, communities and leaders do to help?
At BBI we are focused on making sure our prevention insights are heard, understood and acted on. We want policy makers, payers and decision makers to resolve to make the change away from a failed, expensive clinical strategy to a smarter, modern, less-expensive strategy that achieves the outcomes that they want at scale. The request is very simple: get serious about prevention. Incentivize prevention as well as penalizing incidence. The request is no different than Elon Musk’s request to have the conversion from combustion engine-powered cars to electric cars to be codified in policy and incentives. Healthcare has a lot to learn from other industries about how change like this is possible.
At a grassroots level, patients and caregivers should ask: “What are you doing to prevent pressure ulcers? Can this institution ensure that there is the most advanced protocol in place to make sure this ‘never event,’ which is all too common, does not happen to me or my loved one?” It is important that patient and caregivers are able to express their concerns and advocate for themselves.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
Brene Brown: The Call To Courage. I loved one of her quotes: “The days of engineering smallness and playing it safe to avoid criticism are over.”
Thomas Kuhn: The Structure of Scientific Revolutions.
How can our readers follow you on social media?
@bbi_ceo on Twitter
Thank you so much for these insights! This was so inspiring!