FundamentalVR: accelerating the fundamentals of surgical training

A technologist at heart, Richard Vincent, CEO and Co-Founder of FundamentalVR, set out with fellow Co-Founder, Chris Scattergood, to revolutionise medical training through the use of virtual reality.

A curiosity, turned company

After taking a short break from the realm of tech entrepreneurship, Vincent was ready to hop back into the space in 2015, becoming fascinated with the potential of immersive reality technology such as virtual and augmented reality and what it could bring to various industries.

This is where the inception of FundamentalVR took place, “we strongly believed, and still do today, that immersive technology has only just started to have the impact that it's going to have on the computing interfaces of tomorrow, moving from 2D to 3D spatial. That was the space that Chris and I were passionate about and wanted to pursue,” explains Vincent.

After analysing where immersive technology might have the most impact, the duo quickly realised that the medical sector had some of the best use cases and greatest needs – particularly surgical education.

Rising to the challenges the medical sector wrought, FundamentalVR focused on the specific needs and desires of the industry. “We really set about that process of aligning the technology to the use case of medical education and particularly surgical education. We discovered, after deliberation with experts, surgeons, and educators across the world that there was an excitable need for this sort of technology within the space,” notes Vincent.

However, the team realised early on that if the technology was ever going to be truly useful, it had to implement the sense of touch. Vincent expanded: “That realisation took us down a whole other technological journey, building touch into the system and haptics that are good enough to enable skills transferability. That was the real starting point of FundamentalVR and our platform, Fundamental Surgery.”

With the concept set in motion in 2015, the team spent another year refining the approach and code behind it and moved out of bootstrapping by mid-2016. It was finally time for Vincent and Scattergood to push towards building the business, taking on its first investments and writing up the business plan.

From concept to reality

Starting off in orthopaedics with areas such as knee and hip replacement surgeries, FundamentalVR has since continually expanded. “After working with some fantastic educators and experts, we’ve really been able to broaden out. Since then, we’ve moved into cardiovascular, robotic surgery, urology, and neurology, and we discovered that the platform capabilities are pretty much ready to handle any and all disciplines and procedural requirements,” elated Vincent.

Currently, FundamentalVR is focusing on the big growth areas that benefit the most from its hardware-agnostic product, including image-guided therapy, robotic surgery procedures, cardiovascular, interventional, and EP. Primarily, the company operates within the educational sector, providing junior nurses, surgeons, and tech staff with the opportunity to train virtually following medical school, but before the real thing and throughout their career. Partnerships with large medical device and pharmaceutical businesses, as well as hospitals directly, have allowed Vincent and his team to refine the product and get it in the hands of those who need it most.

“We provide the virtual version of that high-volume experience that medical workers so crucially need. We’ve seen the direct correlation that the more a hospital system is performing a certain procedure, the better the outcomes,” says Vincent. FundamentalVR can offer an effective solution that allows medical staff to train before the real thing, ensuring confidence, minimising risk, and opening up more time and space for training to take place.

At its core “accelerating the learning curve” is what Vincent describes FundamentalVR’s purpose as being. “We provide a virtual reality system that combines simple off-the-shelf hardware with our platform software that aims to accelerate the acquisition of knowledge and skills for surgeons, tech staff, and the ancillary/auxiliary nurses that support them.”

The fundamental team behind FundamentalVR

FundamentalVR has quickly grown from the two founders and their idea, to a growing combination of full-time employees and medical advisors at their side. “We’ve gone from the two of us in 2015, to 135 full-time employees currently. We’ve then got around another 20 part-time consultancy-type people for support along with a 30-strong medical panel consisting of full-time surgeons, educators, and medical professionals,” described Vincent.

Together, this team works through operational, business, technical, and strategic challenges to deliver precise virtual procedures that professionals can utilise in training. “We are busy executing our current objectives and we strongly believe we have barely scratched the surface of this market; growth is certain to come over the next few years!” enthused Vincent.

Trials, tribulations, and triumphs

There have certainly been challenges to overcome for FundamentalVR, but for Vincent and his team, it's all par for the course. Vincent noted three key areas of dilemma the company has had, and sometimes still needs, to overcome to deliver its product, these being market, technology, and people.

“Market inertia is one of the biggest challenges,” admits Vincent. “The healthcare market, for all the right reasons, is a very conservative market. Trying to push any changes is very hard. Everybody may want to innovate, but nobody wants to go first!” Overcoming this resistance to change and persuading people that this is the right path has been a key challenge for FundamentalVR. As for technology, it was all about the challenges regarding haptics. “So, haptics are just hard,” Vincent said plainly, “they take a continual investment and arduous research just to deliver something functional.” Add the precision needed for medical training into this equation and the challenge becomes clear, however, that this is something the team at FundamentalVR worked tirelessly to deliver. Finally, when scaling up rapidly, as Vincent and his team did, it’s a challenge to ensure you’re always bringing the right people on board whilst being quick about it. Ensuring that these people fit the culture of the company, bring the right skills, and feel comfortable has been quite the task, as Vincent put it: “It’s sort of like building a Formula One car whilst driving it.”

Despite the plethora of challenges for Vincent and the team, it’s all been worth it to see the product working as intended, accelerating training, and improving patient outcomes. “It’s all about the impact we’re having, when you hear the patient cases and see the impact it's having on real people in the real world, seeing the stats, it’s incredible,” elated Vincent.

Vincent also noted that he has concerns over the looming medical training crisis seen across the globe. “You can’t train surgeons quick enough, and that lack of trained surgeons will become a real problem in the next three or four years. We can impact that.” Seeing his product used to tackle this problem not just in the UK, US, or Europe, but also in areas such as India has been an incredible achievement.

Fundamental Core: an SDK toolkit

On top of FundamentalVR’s self-made offerings, it also provides an SDK toolkit to simplify the creation and launch of other companies'/ individuals' surgical simulations, Fundamental Core. With the sheer number of procedures out there, it would be hard for FundamentalVR to do it all themselves. Thus, instead of attempting the impossible, they are working to provide others with a software-agnostic tool that can plug and play into other people's frameworks.

“There’s just so much to do, unfortunately, we can’t do it all. So, what we wanted to do was enable people who perhaps don’t have all the resources that we’ve been able to build up to be able to create credible simulations and release it in a way that is safe for them and rewards them if they then decide to commercialise it – they can use that model,” explained Vincent.

Fundamental Core works as an all-in-one simulation development Unity toolkit as well as operating as a distribution platform. Simplifying it, Vincent said: “The SDK has a combination of some of our haptic developments, activity building tools, various building blocks, security, online tools, and data analytics.”

FundamentalVR hopes that through Fundamental Core, other creators can utilise virtual reality features such as multi-user virtual environments, assessment/educational frameworks, and pre-built haptic interaction building blocks to create realistic and effective simulations with a simpler development and distribution process.

Finished Vincent: “Our mission is all about increased human capability through precise simulation, and we don’t have to make all that simulation, we just need to ensure that it’s well-made, solid, and reliable so that it can be deliverable.”

Looking to the future

To put it simply, there’s plenty to expand into for FundamentalVR, “it’s all about widening the scope, there are over 2000 procedures out there that we haven’t even glanced at, focusing on the most crucial of those first,” explained Vincent. Key areas of expansion currently lie in robotics, cardiovascular, and heart-connected surgeries which the team at FundamentalVR are already hard at work on.

This article originally appeared in the November/December issue of Startups Magazine. Click here to subscribe