Testing the S-Case prototype in the Slovak Republic.

A year ago, Martin Pekarčik and Slavomir Hruška won Forbes 30 Under 30 festival. This year, their S-Case device has been nominated among the Top 10 Innovations in the Vodafone Idea of the year and Reflect Impact Awards 2020.

The S-Case is a small, portable point-of-care medical device combining smart sensors with predictive analytics and a patient database for healthcare professionals and physicians working in remote areas of low-income countries. It’s also suitable for doctors and healthcare professionals in developed countries for telemonitoring patients with chronic diseases, immobile patients and patients and after one-day surgery.

The initiative is financed under Slovak Challenge Fund, implemented by UNDP in Europe and Central Asia with funds from Ministry of Foreign and European Affairs of the Slovak Republic.

We talked to them to find out more about their innovator’s path.

1) Where did the idea came from? What problem were you trying to solve?

Martin: The idea to make the S-Case came recently, but its original form was very different from the current one. As a medical student, I had a problem identifying veins of my overweight classmate under a layer of fat on his arm. I was thinking about how to ensure trouble-free blood collection in patients like him, and the idea of a “veinseeker” arose. But my idea of helping people was different from helping those in real trouble.

The impulse to make the S-Case arose for the realization of three important shortcomings often found in health care in economically less developed countries: a noticeable lack of trained medical staff, quality medical devices and an impractically managed patient database system.

After many discussions with doctors and medical staff came the impetus for a practical device that contains basic sensors, and thus the development of the S-Case began.

2) What challenges did they face in getting the idea off the ground?

Martin: To be honest, there were many challenges and obstacles we faced from the beginning. I often asked myself whether we could actually create the solution I carried in my head and transform it to the real world.

I would not be able to do it myself. Since the solution combines both hardware and software, I had to find equally passionate people in the medical and technical fields. As a student, I have access to various lectures or events where students come together. I contacted many of them or asked if they knew anyone who would be interested in becoming a member of the S-Case team. Step by step, we assembled an experienced team of experts.

Slavomír: We also worried about the validation of the idea itself. We visited many doctors and paramedics, asking their opinion and if the device and platform would make their work easier. After many positive responses, we started looking for investment.

Unfortunately, investment in hardware is often questioned. Right now there is an online boom and the development of many applications, but support for the development of something tangible is being pushed to the background. Nevertheless, we managed to raise enough funds from smaller donors to produce the first working prototypes.

Simultaneously, we had to look for ways to pilot it, as the question of whether the solution would really be able to help in the field was key. To our surprise, there was such an interest in the prototypes that we currently have a problem with figuring out how to get them to everyone. We have pilot projects signed in Albania (a Slovak NGO collaborating with the government’s public healthcare system), Serbia (a non-profit and foundation working with the homeless) and Slovakia (the Žilina Department of Health Care). Often our partners do not want to return the prototypes.

Martin: Financing was a huge issue. Once we had the prototype, after many unsuccessful meetings, we found some synergies with an investor whose telemedicine platform will be implemented in the S-Case facility in Slovakia.

S-Case tested its first prototypes in Kenya.

3) In your first test missions, what mistakes did you catch or realize challenges to making the product work "in the field"?

Slavomír: During the testing of prototypes, we encountered several problems from our testers. We worried whether people would be able to work with the S-Case or if it would be too complicated to use. And some of our concerns were confirmed.

On the usage side, the sensors were not very "user friendly". For instance, the location of the thermometer sensor, located on the back of the device, was okay for medical staff, but in the hands of the patients themselves, this sensor was essentially unusable - the patient must enter the command to measure on the screen and at the same time have the sensor aimed at their own forehead.

Martin: Also, the blood pressure monitor can only measure flawlessly if the cuff is correctly positioned on the patient's shoulder. On the data side, exporting from the device is difficult for the average user at the current stage. Files are of different types and in several separate sheets and the patient data itself is subject to coding to preserve identity.

So through this testing, we found out a lot of useful information, which we are currently using to update and finetune the hardware, software application and platform. In May 2021, S-Case will be ready to roll out as we begin a pilot in North Macedonia with the first iteration of the final product.

4) You received funding to develop pilot projects in North Macedonia. How do they intend to roll it out?

Slavomír: We applied to and received a grant from UNDP’s Slovak Challenge Fund to test S-Case in North Macedonia, where we are now launching two pilot projects/partnerships. We wanted to test in a country with a higher standard of health care, and I had already been in touch with local innovators to build a cooperation.
The first is with a state-of-the-art clinic in Northern Macedonia that offers a wide range of medical services specializing in cardiac surgery, but also focuses on modern procedures and solutions to help prevent 21st century diseases. The Zan Mitrev Clinic will use S-Case to remotely monitor twenty patients with cardiovascular disease associated with diabetes.

The second collaboration will be with the Health Education and Research Association (HERA), founded by medical students to address the lack of education or care for HIV/AIDS patients in the country. These patients often do not even have access to basic medicine. The association currently provides free and confidential services in the areas of sexual and reproductive health and gender-based violence, educates in the field of sexual rights & strengthens marginalized societies. Through S-Case, HERA will monitor pregnant as well as non-pregnant women and mothers, especially in socially disadvantaged families, through mobile teams consisting of a gynecologist, a nurse, a driver and community leaders.

Martin: Through these pilots, we can test the cooperation with partners and find out whether our S-Case solution will be beneficial and suitable for future mass use in North Macedonia. We are not yet able to pinpoint the initial and specific challenges we will face in the country. We did not test S-Case directly, either in the ZMC clinic or in remote parts of the country where HERA operates, this phase will come next in April next year.

5) So what are the next steps, and what is your goal with S-Case?

Right now, our biggest goal is the production of a fully functional and certified device. With S-Case, we plan to expand to middle- and low-income countries that are “under-regulated” and work with governments, community health workers or even private clinics.

We are currently starting with the monitoring of patients with cardiovascular diseases, but later we would like to move on to the monitoring of oncology patients, patients with respiratory diseases and the like. Our goal is also to set up headquarters and distributors within countries in this region to employ more people in the field of sales, maintenance and supply chains.

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