Develop a Marketing Plan: In our case, the patient is the number one beneficiary of this new technology. Typically, a patient would hear about this from their surgeon. We did not expect how much the X10 and its benefits would be spread by word of mouth from former patients who had seen success. Due to this, patients who did not have insurance coverage were willing to pay out of pocket to use the X10.
In recent years, Big Tech has gotten a bad rep. But of course many tech companies are doing important work making monumental positive changes to society, health, and the environment. To highlight these, we started a new interview series about “Technology Making An Important Positive Social Impact”. We are interviewing leaders of tech companies who are creating or have created a tech product that is helping to make a positive change in people’s lives or the environment. As a part of this series, I had the pleasure of interviewing Paul Ewing.
Paul Ewing is a serial entrepreneur and has formed two startup companies, one of which was sold to SPS Technologies (a leading aerospace company) and the other was sold to IBM. Currently he is the founder and CEO of Halley Orthopedics, LLC, which has developed X10 Therapy, a revolutionary rehabilitation system and patented “smart” in-home machine that helps knee recovery patients regain their range of motion and leg muscle strength faster than any other known method. All of Paul’s endeavors have helped revolutionize various industries.
Thank you so much for joining us in this interview series. Before we dive in, our readers would love to learn a bit more about you. Can you tell us a bit about your childhood backstory and how you grew up?
I was born into a middle-class neighborhood in Northwest Detroit and have three younger brothers. As a kid, I was highly energetic with a passion for sports and music. I attended the University of Detroit High School, which was known for high academic standards, where I excelled in math and physics and was named as an All City, All State, and Parade Magazine All America football star. I graduated from the University of Michigan College of Engineering and obtained a master’s degree in finance from U of M. I was president of my fraternity and was chosen as the Dean of Men’s number one choice to lead a Michigan group of Newsboys on a sponsored two-week trip to Italy. After graduate school, I declined many lucrative job offers in order to help my father manage a failing manufacturing business.
Can you share the most interesting story that happened to you since you began your career?
Several years ago I met with Dan Loepp, the CEO of Blue Cross Blue Shield of Michigan, one of the largest companies in Michigan. Mr. Loepp agreed to meet with my small Michigan technology company that had just developed the X10 knee recovery machine.
At a time when the industry was slashing costs with no regard to quality, Mr. Loepp took another route. He was interested in providing the most advance technology and best therapy to his members because he understood that technology would help drive down costs while increasing the quality of care.
Mr. Loepp and his staff quickly realized the patented technology of the X10 could revolutionize knee replacement surgery recovery and saw opportunities to apply it in other areas such as stroke rehibilitation. Mr. Loepp recognized that without coverage from an insurance provider, the public would never realize the benefits of the X10 technology. After several months of meetings and testing, Blue Cross Blue Shield of Michigan granted coverage for the X10 to their PPO groups of patients.
Mr. Loepp is a CEO who aligns his company’s goals with the needs of his members. He believes the way to lower costs is to increase patient satisfaction by achieving superior outcomes. He realized that the X10 would help him achieve this goal and he had the courage to move forward and provide member coverage for the X10. Thanks in a great part to Mr. Loepp and his team’s vision, the X10 was voted the startup company of the year in Michigan the following year.
None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?
Even though my parents were separated, I was very fortunate to have two loving parents who really cared about me and my brothers. On a family trip to Washington D.C., we were on a bus that was involved in an accident which threw my mother out of her seat and caused a lifetime back issue. My mother received a $10,000 insurance settlement.
Several years later, when I started my manufacturing company and was experiencing some early business development financial problems, my mother insisted I take a $10,000 check from her. As a result, my company thrived and became one of the most technologically advanced companies in our industry. Without her loving help, I don’t know if I would have succeeded and be where I am today.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
“Life is a daring adventure or nothing at all”
For me, an adventure begins when I am about to do something new and I get that excited feeling in my stomach. It might be a new idea to solve a problem that I think could work. It might be a new marketing idea or a hospital that wants to talk with me. In all of these cases, what makes it an adventure is that the outcome is never certain.
X10 Therapy may be the most important adventure of my life because it has the potential to help so many people all around the world. When people lose their mobility, they also lose their freedom. They become observers instead of being actively engaged in life. My passion for the development of the X10 has never waned because I am continually rewarded by the gratitude and positive feedback from the thousands of people the X10 has already helped.
One of our patients, Kevin, was sidelined for two years after having knee replacement surgery and emergency bariatric surgery. He was unable to walk or go back to work and was facing long-term disability and the loss of his job. He was depressed. Workers compensation insurance covered his use of the X10 and after only several weeks Kevin and his wife met with his orthopedic surgeon and Kevin got a clean bill of health and was able to return to work. This link tell his entire narrative:
You are a successful business leader. Which three-character traits do you think were most instrumental to your success? Can you please share a story or example for each?
- Empathy — The number one trait that your co-workers, friends or family want to know about you is, do you really care about me? If the answer is not a resounding yes, then you cannot lead people and you should not be a CEO. Great CEOs find a way to align their goals with their customers, employees, suppliers, and communities. For example, at my former company, we were running three eight-hour shifts. The second shift employees began at 4 p.m. and ended at 12:30 a.m. These employees were working when their children left for school, came home from school, and when they went to bed at night. Work was causing them to miss seeing their children grow. Because we cared for our employees and understood their problem, we changed the entire work schedule and went to two 10-hour shifts, which was 7 a.m. to 5 p.m. and the second shift was 10 p.m. to 8 a.m. This allowed the employees to spend quality time with their families and resulted in a happy, grateful and loyal employee base.
- Empowering and Recognizing Others — A CEO should encourage his or her employees to take risks without fearing retrobution. I have always believed that everyone can contribute to a team’s success if they are placed in the proper job suited to their strengths. I remember when our janitor was honored at our quarterly meeting for his documented process breakthrough. We had many large machines that had oil tanks located beneath them. The janitor’s job was to remove the oil weekly. Often the heavier sludge would mix with the oil during clean up and cost thousands of dollars to repair or replace the vacuums. Our janitor and his friends in the machine repair shop installed all machine tanks with pipes just above the sludge but beneath the oil, which allowed the vacuum to extract the oil without disturbing the sludge below. This eliminated costly vacuum replacements and increased efficiency. We honored this man in front of his 150 fellow employees who all gave him a standing ovation. I wish I could have been there as he proudly described his success to his wife and children. Recognition and reward helps employees feel valued and appreciated.
- Working ON the Company, not IN the Company — A successful CEO must be willing to listen to their employees, customers, and suppliers. I always strived to hire competent employees who could make decisions based upon their own skills, judgements, and the company culture. This allows me to have time to work on other areas of the company that need my help. For example, in my current position of CEO of Halley Orthopedics which developed the X10, I became aware of a problem that patients had been struggling with for over 50 years — the protracted time it took to regain lost quadriceps strength. Even at one-year post-surgery, the average patient suffered a 30% quadriceps strength deficit which greatly affected their ability to engage in activities of daily living and returning to a quality of life. Because my team was competent to handle the day-to-day operations, I was able to focus my energy to develop a solution for this very serious problem. As a result of technology we developed, patients are now able to regain their full quadriceps strength in one-month post-surgery. This is a major medical recovery breakthrough. This would not have happened if we did not have a competant staff of professionals. We are currently faced with an uphill battle to change the old recovery model used by physicians and convince them there is a better solution for their patient’s recovery.
Ok super. Let’s now shift to the main part of our discussion about the tech tools that you are helping to create that can make a positive impact on our wellness. To begin, which particular problems are you aiming to solve?
There are several major problems that X10 Therapy is addressing:
- It takes a long time for patients to recover. Using conventional methods, it takes a knee replacement patient at least three months to recover lost range of motion (the ability to bend and straighten the leg) and six months to a year to regain lost strength, according to the American Orthopedics Association.
- Recovery is extremely painful because conventional therapy involves a physical therapist manually manipulating the patient’s leg. This often results in overbending which causes severe pain and increasing fluid. Patients need a day or two of recovery from overbending. Meantime, underbending doesn’t remove the fluid and is useless. Manual manipulation is so imprecise that it can never work in the optimuim zone which is just below the patients pain tolerance.
- Therapy is not frequent or long enough with conventional therapy. Because of the pain associated with manual therapy, patients can only tolerate a few minutes of bending, three times a week.
How do you think your technology can address this?
- The X10’s patented technology works just below the patients pain threshold. This enables therapy to be done in half hour sessions, three times a day, seven days a week. This is a major breakthrough with the X10. What has not been well understood is that the fluid generated by surgery cannot be allowed to accumulate in the joint. An outstanding outcome must begin with rapidly removing the fluid from the joint and keeping it from reaccumulating. Patients who use the X10 machine can completely regain full range of motion and full quadriceps strength in one-month post-surgery. The X10 is set-up in a patient’s home so they can engage in consistent and convenient therapy sessions which significantly expedites recovery.
- The X10 is a “smart” machine in that it extends the leg and senses when the patient is approaching their pain threshold, pauses to protect the patient from experiencing pain and to let the fluid escape, and then reverses direction.
- Removing the fluid lets leg strengthening begin far faster. Strengthening has several components. First, the brain-muscle connection must be reconnected which is done by the X10’s biofeedback. Secondly, fluid must be removed from the knee to partially restore the nerve connection to the muscle. Thirdly, to fully restore the brain-muscle connection, the muscle must be contracted to failure. The X10 accomplishes all three of these requirements by using special modules that are safe and effective for knee patients.
Can you tell us the backstory about what inspired you to originally feel passionate about this cause?
In my prior manufacturing company, many of my employees were on their feet all day. As they aged, some required knee surgery with varying degrees of success although many never returned to work. This bothered me greatly, but it was not until I formed a friendship with Dr. David Halley, a successful orthopedic surgeon in Columbus, Ohio, that I realized how common this problem was. Dave was one of those special doctors who was very passionate about his patients and their quality of life after surgery. To stay in contact with his former patients, he held annual picnics so he could follow their recovery, no matter how long since their surgery. Dave was disappointed with the high variability in the patient post-surgical outcomes.
Dave knew that my company was very creative and technologically advanced and had many patents. We talked for years about what he perceived as the problem and how he wanted me to use my engineering expertise to solve it. Once I sold my company I was able to concentrate on understanding the medical issue and begin working on a machine design.
I found in my research that there was a machine, the continuous passive motion (CPM) machine, and it was commonly used, in addition to manual physical therapy following knee surgery. The CPM was used around the world. When I brought this up to Dave and his colleagues, they all agreed that the CPM was useless, and they did not utilize it unless a patient demanded it. The uselessness of the CPM was later confirmed by the world-famous Cochrane Review in 2014. They reviewed all the randomized controlled studies up to that point and concluded that the CPM added no value. This validated what Dave and his colleagues had known for years, yet some surgeons continued to use it because they had nothing else.
I then began to explore what the real problems of knee recovery were and discovered there were several well-known issues that had never been resolved. I believed the root cause of this neglect was that the CPM was developed when surgeons were putting patients’ legs in a cast for six weeks following surgery. The CPM had become a habit and surgeons continued to use it even when they stopped casting the leg. I found it odd that after all this time that nothing had been done regarding these problems and I began to investigate. I was open to radically new thoughts which opened my mind to the challenge.
How do you think this might change the world?
The scale of this problem is growing. Approximately 50.8 million people in the world suffer from disabling knee pain, and only 2.6 million have knee replacements each year (PRNewswire, 2019). Even the 2.6 million who are fortunate enough to have the surgery are not assured a good outcome. However, if they were to use the Halley Orthopedics’ X10 recovery system, they would have a great outcome, and be able to do the activities they love.
Additionally, the cost of rehabilitation using the X10 is far less costly than home care or outpatient physical therapy, resulting in more insurance money being available for people in need of other surgeries. This cost savings is significant because X10 Therapy has been shown to replace home care and outpatient physical therapy. The X10 is also cost-efficient because a telehealth therapist works remotely with the patient while data is transmitted to the therapist daily — they no longer need to travel to and from the patient’s home. Patients also no longer need to go to the physical therapy clinic, which was hugely beneficial during the COVID-19 pandemic.
Keeping “Black Mirror” and “The Law of Unintended Consequences” in mind, can you see any potential drawbacks about this technology that people should think more deeply about?
After utilizing the X10 successfully on more than 5,000 patients, we have seen no unintended consequences related to the patient or their treatment. Some have suggested the demand for therapists for post knee surgery recovery could decline, however, the use of the X10 does not replace the need for a therapist, it simply redefines their function.
Here is the main question for our discussion. Based on your experience and success, can you please share “Five things you need to know to successfully create technology that can make a positive social impact”? (Please share a story or an example, for each.)
With any business venture, you must:
- Identify a Problem Exists: Due to my friendship with Dr. David Halley and his orthopedic surgeon colleagues, we identified knee surgery patients and their need for a better recovery as our targeted market. The outdated medical device, the CPM machine, had been discredited not only by studies but by doctors themselves who knew it did nothing to improve their patient’s recovery. Yet, this was the only device available on the market when we began our journey to develop the X10.
- Understand the Root Cause of the Problem: We discovered that post-operative fluid was not being elimated and kept from reaccumulating. The build up of fluid greatly impeded the speed in achieving range of motion and strengthening.
- Explore and Develop a Resolution: We asked ourselves why so little time was spent on removing and preventing fluid from reaccumulating in therapy sessions. The answer is because it’s a manual process done by a human that can be extremely painful. We found it necessary to build a user-friendly, computerized machine that would be more precise in its movements with “smart” technology that could sense a patient’s pain threshold. We built the X10 with the ability to give progress results in real time, which highly motivated the patient to continue with X10 Therapy.
- Collect Data on the Solution: To ensure your solution is working, you must show results. Since the X10 has the ability to collect and analyze data with every patient, we have shown and can prove the machine accomplishes its mission to dramatically shorten recovery time, while improving outcomes and lowering costs compared to other methods.
- Develop a Marketing Plan: In our case, the patient is the number one beneficiary of this new technology. Typically, a patient would hear about this from their surgeon. We did not expect how much the X10 and its benefits would be spread by word of mouth from former patients who had seen success. Due to this, patients who did not have insurance coverage were willing to pay out of pocket to use the X10.
If you could tell other young people one thing about why they should consider making a positive impact on our environment or society, like you, what would you tell them?
Unless we change the world, it will become increasingly more difficult to successfully inhabit it. We should all be looking for opportunities to make the world a safer and better place to live for ourselves and our society as well as for those who will follow us. You should always look for an opportunity to find a cause that you feel passionate about and one in which you can contribute. In doing so, you will find purpose and enjoy life more.
Is there a person in the world, or in the US with whom you would like to have a private breakfast or lunch, and why? He or she might just see this, especially if we tag them. :-)
Ken Langone exemplifies my business philosophy and how I have acted in my business ventures. He took a chance to radically change an industry against all odds just like we developed the X10 to upset the accepted rehabilitation model. He kept the customer in mind and created a service that was lacking and one that has helped people everywhere. He bucked the status quo and in doing so, delivered a quality product that has improved people’s lives. Since his “retirement” he has involved himself in programs that continue to help people. Without hesitation, Mr. Langone is who I would enjoy meeting.
How can our readers further follow your work online?
They can subscribe to our email series, podcast group or click on one of the links below.
Thank you so much for joining us. This was very inspirational, and we wish you continued success in your important work.