Megical brings black-box thinking to healthcare

Two Finnish airline pilots take their seats in the cockpit of an aircraft set to take off to Milan, Italy. They exchange pleasantries, this being the first they meet, but as the aircraft advances toward its destination their conversation veers to the safety and risk management systems in aviation.

This is not the setup of a delicious – and oddly specific – joke, but a defining moment in the history of Megical, a Finnish developer of a platform for improving the safety of clinical care.

“We started working on a better risk management system for aviation until we realised that aviation is already relatively safe,” tells one of the pilots and current chief operating officer at Megical, Jussi Kajovaara.

“But there was a need for our ideas in healthcare. So I changed the subject of my thesis to safety and risk management in medical care, and the company turned its course towards healthcare.”

Airline safety has improved considerably over the past couple of decades. To70, a Dutch consulting firm specialising in aviation, has estimated that the fatal accident rate for large commercial flights stood at 0.06 per million flights in 2017. Although the rate rebounded to 0.36 last year, the year was the third safest ever in terms of the number of fatal accidents, according to the Aviation Safety Network.

Kajovaara and Mika Pyyhtiä, the founder and chief executive of Megical, attribute the positive long-term development to the fact that flight data is monitored and analysed continuously, not only in the event of an accident.

“This is the thinking we’re bringing to healthcare,” says Kajovaara. “The industries are different, but there’s no reason why you couldn’t introduce a similar system to healthcare.”

Half of adverse in-hospital events are preventable

Although obviously not directly comparable, statistics from the healthcare industry do indeed seem strikingly different.

The World Health Organization (WHO) has reported that an adverse in-hospital event occurs in roughly 10 per cent of the over 420 million patients who are hospitalised annually around the world and, more importantly, that at least a half of the events could be prevented.

Even though roughly two-thirds of the events occur in low- and middle-income countries, patient safety is a concern also in Finland: One estimate suggests that around one per cent of hospital patients suffer a serious health detriment due to an adverse event and that a fifth of the one billion-euro costs of the events could be avoided.

“The healthcare system hasn’t really kept pace with medicine. The idea of our platform is to make sure it does catch up,” views Kajovaara.

Thinking outside the (black) box

The platform consists presently of two separate elements: A checklist that can be customised for each care pathway and medical professional, and covers the entire care pathway of patient – from admission to post-operative recovery at home. A reporting tool that has been shown to result in an over tenfold increase in reports submitted by medical professionals.

“We started with the components that create the quickest benefits to customers,” tells Kajovaara.

“But we’re already on our way to creating a more comprehensive platform that’s based on a dashboard and that tells concretely what has happened in terms of care at both the individual and statistical level. Any data that’s of operational importance will be visualised and presented to the management.”

“We’re not just building a dashboard that siphons data from others, but we’re able to provide tools that support care and gather data.”

A safer future for patients

Megical announced recently it has completed a 1.2 million-euro funding round with participation from Ilmarinen and the founders of Small Giant Games, Timo Soininen, Otto Nieminen and Markus Halttunen. The funding will enable the company to both recruit new employees and realise its vision of the clinical pathway platform, according to Kajovaara.

In the future, he envisions, the platform will include an app that tells patients who have undergone an operation what exactly was done to them, when and why. Another idea on the drawing board is a microchip-fitted bracelet for patients that ensures, for example, the surgical team has all the necessary information before administering anaesthesia.

“It’s important that the transfer of critical patient data is seamless,” underlines Kajovaara.

Megical has also begun exploring ways to utilise artificial intelligence to analyse the data generated by its platform throughout the care pathway and determine the efficacy of different medical procedures on certain types of patients.

“We’ve looked into how the data we produce can be stored in a format that can be rummaged by artificial intelligence,” he tells. “At its best, artificial intelligence could enable you to monitor medical procedures in real time and tell both what are the possible outcomes if someone makes a mistake and how to move on after the mistake.”