Harrison Brown (CEO and Co-founder, HEADCHECK Health)

Can you explain your job to a five-year-old? 

I have a four year old niece, so I can imagine that I'm gonna have to not use big words here. I guess the way I'd start off is: In sports, sometimes people will hit their heads, and if their head gets hit hard enough, it can lead to an injury to your brain, and there's a lot of bad things that can happen when that occurs.

So in sports, where this injury happens frequently, the organization—so the team or the league that the injury is happening underneath—will try to protect the player. And so what they do is they come up with these things called concussion protocols. And those concussion protocols are the foundation of safety for the players when they're followed.

And so if they're not followed, then the injury is not managed properly. It can be really bad for the athlete and the organization. So for the athletes, if they continue to play, they might have a more serious injury. In extreme cases, they can even die. And for the organization, if they have a player that has this injury and they've not taken care of them, it can be catastrophic because they could be sued, they could get in trouble. And there might be a news article about how poorly they take care of their players. And so it's catastrophic for the player and and for the organization. 

So what we do at HEADCHECK is we are on a mission to eliminate that from happening. So we want every single time that somebody gets hit in the head and they're injured, we want them to be taken care of when they're playing sports. And for elite sports organizations and others who want to stop this from happening, they want to stop players from having that risk. We provide a digital platform to execute those protocols in a way that makes sure that they're actually followed properly. And so what we do here is we provide the way to actually run those protocols properly. And then we also provide the mechanism for people to check, to make sure that it was done properly. 

What excites you most about your job?

I would probably say the outcomes that we're seeing. So just as a background, as an organization, we work with roughly 6,000 teams which are mostly North American. On those teams, there's about 70,000 athletes. And we've got a formula to do this, but really the way that we've, you've calculated it is that, in the last 12 months for example, we believe that we prevented almost 13,000 head injuries from being mismanaged.

And so, you can do the math on just the impact of that economically. You can also just think about it even down to a single individual playing in a single sport in a single league. We've prevented a catastrophic event from occurring to them. That’s impacting their families, but also the organization that they play underneath.

So I think that is the biggest thing that excites us is that our company was started in a research lab. And so everything that we do is very metric focused and very data driven. And so being able to actually see the impact that we're having in the real world and be able to put a number to it I think is really motivating.

Which trend will change the future of medicine? 

The ability of digital health to improve outcomes, improve speed, and contribute back to the research world, I think, is understated. 

Obviously there's very specific niches of digital health, but I guess the way that I would explain it is with a little bit of our background. We came from a research lab. I was a concussion research student in a graduate research lab. And we would follow around, for example, the football team in our university, and we would collect data on all the players. We would have them with sensors in their helmets and sensors in their mouth guards. And we would run all these tests on them. And we were trying to do what really everybody was doing in the industry for concussion, which was figure out how risky is it to receive head impacts and which tests are most accurate in diagnosing concussion.

But the problem was, is that just the scalability of that type of research was really poor. We did this for, I think, two or three years where we just followed around this football team. Every single game we had to follow them around—every single practice. And we didn't even have enough data to publish that study in the top journal in the industry.

Thinking back to it now, the problem was the quantity of data available to advance the science just wasn't there. And so I think the problem that we're seeing in digital health or in the concussion space relative to digital health is that there's not enough high quality data to be able to make quicker changes in the industry.

So I think back to that now what we do at HEADCHECK, and basically what happens is people, leagues, and teams adopt our products. They use HEADCHECK to execute their protocol. And then, we're able to use a digital health tool to be able to ensure the quality is high. So we're going to put people between these rails, so they're not collecting values that are too far beyond what's normal. And to date, to give you perspective, we have 120,000 tests that have been done on our system. And going back to that research example, when I was in the lab, we ended up having something in the range of 18 concussions. 

All I'm thinking about now is we can take these data that we have as a digital health company, and we can in some way take give that back to the research world. And I think back to when I was a student, if I was given 120,000 concussions’ worth of data, not only would it have saved me a couple of years of data collection, but I think the advancements that could be made in the industry as a whole would just be a lot quicker.

So what I'm saying here in terms of the trend is that, technology can scale the data collection technology and can improve the data quality. And then that can complete the feedback loop where, if you're trying to research, for example, in our data set, you wanted to know: Why is it that female volleyball players typically have a higher concussion rate than male volleyball players? And so, if that was a research question that you wanted to run at a university, it would take you probably 10 years to do that study. But we could actually isolate that data in our database right now, de-identify it so that nobody can figure out who the people are. You could probably get ethics to be able to get access to the data, and you could actually start to answer that question now.

And that's what we're starting to see, is that in some of our more advanced clients, like our professional sports leagues, they're actually doing that internally, as opposed to getting a grant for a research study and waiting six months for the grant to get approved. So, I think the speed in which digital health will be able to change the future of medicine is that it's going to make it quicker to see the progress that that was hindered by the ability to access quantity of data and also quality. 

Looking back, which trends have you missed or underestimated? 

I would just say solving the right problems. As an example, for HEADCHECK, when we started our company, we were doing something completely different. In a standardized concussion test, like what most organizations do, you test all these different functions of the brain, like memory, balance coordination, symptoms, all these sorts of things. And we picked out one of those areas, which was balance. And we said, this is poorly done right now. We're going to create a medtech device that's a wearable that will actually increase the fidelity of that test. So that, when you're looking at balance in respect to all these other brain functions, at least it's going to be accurate.

And so we began solving that very niche problem. And when we went to market, what we realized was that there's only a very small number of people that were ready to solve that problem. And so we underestimated the size of the bigger problem that needed to be solved first. And that was that the policy as a whole, the concussion policy was just very poorly followed. So everybod in the sports world, as they began to recognize that concussion was a real thing, it was a real injury, their first reaction was, ‘Okay we'll solve it with policy and this is going to go away because we're going to say, yes, this is real. We're going to do all these different things.’ But then they just didn't end up doing those things. They didn't follow the protocols. And so when we came in and we were like, ‘Hey, in that protocol, there's a test that you run and there's a component of that test that is for balance and it's really inaccurate. Here's a way to make it accurate.’ We thought people were going to be like, ‘Oh, wow. This is going to change everything.’

But in reality, they were like, ‘That's nice, but that doesn't really solve the real problem here.’ And so we had to go back to the drawing board and design something that was going to fix the real problem, which was that this whole protocol as a moving piece was not getting done. And we had underestimated, and I guess we missed that that was a possibility. We had just assumed that if you have a concussion policy on your website, or you give it to the insurance company to get insurance, or you give it to the parent when they drop their kid off, that you're actually doing it. 

So I guess what we're trying to say is that, if I had known at that time that when you drop your kid off for football and they hand you a concussion policy, I never even thought to that there's a chance that policy was not getting followed. And if you had known that, would you still drop your kid off? I probably wouldn't, but that was something that we missed. And I think we were coming from a research background. We just had all these assumptions about the real world where you know the problems that needed to be solved were very small niche problems, when in reality, the problem was actually much, much bigger.

Which MedTech initiative or startup deserves more attention? 

I'm pretty biased in this because I live in a very niche world. But yeah, I would just say we don't necessarily brand ourselves in this area, but there's definitely a component to what we do that is in this area which is technologies that increase compliance to policy.

I think it's been shocking to me how significant the gap is between policy and execution. And coming from a research world where a lot of medtech originates, I think a lot of people aren't aware of that. And when you're thinking about designing technologies that are addressing specific problems, like I think the translation of that technology into the real world, a lot of times it just fails. And part of the reason behind that is compliance.

Going back to our example of that balance tool, if we had commercialized that, it really wouldn't have made an impact at all. And the real problem was a compliance problem. And once we solve the compliance problem, once we get everybody to the point where everybody follows their policy, because it's so risky that you can't not follow it, or it's just common practice that everybody has a culture that if you say you're doing something, then it actually gets done, then you’re solving those other problems. Now we can say: The balance isn't that accurate. Okay, now we can actually tackle that. 

So I would say maybe an underlooked initiative would be compliance technology. But it's been very eye opening to us that that's the real problem in our industry, and we're really excited to be the ones that are getting to solve it. 

Where would you put a million dollars? 

Honestly, I'd probably split it into 50,000 and I'd give 50,000 each to early stage startups. 

I think a million dollars, unfortunately, isn't enough money that if you gave it to one group it's going to mean that they're successful. But I think a lot of companies die early on because they can't get that first check. And that first check gets them to a point where they can do a proof of concept that allows them to then raise more money or get a grant or start working with the military if that's what they're doing.

I think one of the problems in the food chain of innovation relating to med tech is that a lot of really good ideas and a lot of really talented people can't get off the ground. And just thinking back to our case: We bootstrapped for quite a long period of time, but if there had not been an early injection of cash, we for sure would have given up and looked elsewhere. And we never would have landed on the problem that we're solving now. So I think helping people get off that ground, if you give a bunch of 50K checks out.

What's the best advice you've ever received? 

Knowing what size problem that you're trying to solve will help you figure out the different plays that you can run to achieve it. And so I think it's really important to know what size problem you're solving. Because otherwise, you might run the wrong play. And I guess the way that I've described that is not every single med tech innovation is a venture funded, billion dollar or bust company. I think there's a lot of really good innovations that are not those. I think the majority of them are not those. And what ends up happening with some of those companies that don't go that route is that they end up having great impact on health outcomes, and maybe they end up getting aggregated with a bunch of other tools that they get bought or, and then somebody else scales it.

But I think, yeah just that concept of: if that's not what you're going for, or if the market doesn't dictate that's what you should be, it doesn't mean that's what you should be going after. And I think there's a lot of messaging that comes out across social media and just in the startup world in general, where it's like the holy grail is receiving venture capital. And I think in a lot of cases that actually can work against the innovation. Because the innovation doesn't dictate needing that sort of capital or being put under those pressures for growth. So, I think knowing the size of the problem and understanding that, that the plays will look different depending on the size of the problem will help people figure out which play they should run, which is the best play they should go after.