Innovfusion personalises pain relief for childbirth

LOCAL medical technology company Innovfusion has created an effective way to manage labour pain. Epiva, the pump they created, in collaboration with KK Women's and Children's Hospital (KKH), matches the amount of epidural analgesia administered to the demand of the patient during labour.

The patient presses a button connected to the Epiva pump to administer the first dose of epidural, and when she feels a new surge of pain, she can receive another dose by pressing the button again.

Using its own algorithm system, depending on how often the button is pressed, Epiva will recalibrate the amount of epidural to discharge in subsequent doses to meet the patient's need for pain relief.

Epidural analgesia is typically administered to relieve pain during childbirth. In Singapore, more than 60 per cent of mothers opt for epidural during labour. However, despite being widely used, it is not always effective.

According to Innovfusion project director Gabriel Tan, even with epidural, a quarter of patients still suffer breakthrough pain during labour. Furthermore, there has been debate on the ideal dosage and regimen of epidural, yet there is no commonly accepted dosage that works for every patient.

This gave KKH medical board chairman Alex Sia back in 2009 the idea of creating a computer program that allows patients to determine themselves the timing and frequency of the epidural drug delivery.

"Prof Sia saw that one size does not fit all and that we needed the ability to personalise (the administration of epidural) on a larger scale," said Mr Tan. "He wanted to give his patients a safer and better experience than existing tools and systems could."

Innovfusion was later founded in 2013 and incubated by The Biofactory in order to accelerate the development and launch of a smart infusion pump for pain management during labour. In January 2015, Innovfusion turned Prof Sia's computer program into its current compact model, Epiva.

The Biofactory is a leading biomedical incubator in Singapore that has launched several medtech companies such as SG Meditech and TNR Diagnostics.

"The idea behind Innovfusion was to use the technology developed by KKH and embody it within the right design to deliver on its potential," said Mr Tan.

"There is still a catheter and drugs involved, except that we deliver it faster and better because of our engineering and software," he added.

Innovfusion is continuing the development of infusion systems, particularly with the help of Dr Sng Ban Leong, deputy head of anaesthesia at KKH.

Epiva is currently running large clinical trials in KKH. According to Mr Tan, clinical trails have been going on for over a year due to the positive response from previous trials.

In the first clinical trail, over 3,000 first-time mothers with full-term pregnancies were assessed on the degree of maternal satisfaction, quantity of analgesia used, as well as the wellbeing of the newborn.

Innovfusion's next-generation infusion systems will allow hospitals to upgrade their existing patient-control infusion system and consumables. In addition, they intend to sell the infusion device as well as a disposable set.

Mr Tan added: "We've spent quite a lot on our infusion systems and we think that in order to ensure that we deliver consistent quality, we need to provide a specialised, proprietary one-time-use disposable set."

Still, the journey for this medtech startup has not been painless. In its initial years of incubation, Innovfusion faced the challenge of hiring people with specialised skills set in product realisation and engineering to join its team.

"We needed to find the right people and key executives required to roll up their sleeves to deal with issues pertaining to product realisation," said Mr Tan.

Despite several challenges encountered along the way, he said, Innovfusion has been fortunate to be an incubatee of The Biofactory. Its leadership, headed by director Theodore Tan, has added value to Innovfusion and its products.

Looking forward, Innovfusion is focused on staying ahead of its competitors. Mr Tan concedes that there are large American and European companies that have a long tradition in the field of epidural anesthesia. But he is certain that Innovfusion's technology sets it apart, and its management is always focused and nimble enough to stay ahead of competition.

"The company is focused on pushing personalisation of medicine through these infusion systems," said Mr Tan.

Innovfusion believes that, as hospitals look to upgrade their infrastructure and systems, they will require systems like the ones developed by Innovfusion to provide patients a better experience.

The startup is also currently developing other infusion systems - called Intrava and Diva - focusing on easing labour pains.

Intrava is used for the delivery of intravenous analgesia, while Diva is used for the management of blood pressure during elective Caesarean delivery under spinal anesthesia.

"We are very excited about our pipeline," said Mr Tan. "I think our next devices Intrava and Diva are well positioned to provide better and safer drug infusion for other applications besides epidural analgesia."