Despite its history of inspired creativity (lobster phone, anyone?), Spain was among the countries hit hardest by the financial crash of 2007 and 2008, and the youth unemployment rate remains the second highest in Europe. Yet the Mediterranean approach of innovating for the sake of survival, combined with a highly educated and digitally savvy population, has created a hotbed of Medtech innovation within Spain, as Ewen Legg discovers
Spend a little time in any cerveceria or bodega and you will find that Spaniards are not afraid of grand ideas. Innovation is a key part of the ‘anarchic and individualistic’ Spanish character, says Dr Rafael Pinilla, co-founder of the online medical consultation platform QooLife. ‘But beyond that initial momentum we need to collaborate, negotiate and reach agreements’.
Spanish entrepreneurs are fostering such collaboration from the ground up. ‘Four years ago we founded Health 2.0 [Catalonia] which has been the incubator for six other chapters in Spain,’ says Dr Fredric Llordachs co-founder of Doctoralia, an mHealth platform connecting patients with local physicians. ‘We have about 2,000 people interested in medical startups and innovation in healthcare… that’s a lot of people willing to change the way the patient is seen and to improve their quality of life through technology.’
The continuing presence of strong regional identities in Spain has been a boon in creating multiple digital hubs. Madrid, Barcelona, and Valencia are all within the European Digital Cities Index (EDCI) top 50 for both startup and scale-up of digital companies. Barcelona stands out in particular as the only non-capital city within the EDCI top 10. The city authority’s goal of making Barcelona the world’s ‘leading digital city’ has supported growth in digital infrastructure within an urban environment which hosts more than 200 co-working spaces. Alongside smaller tech hubs, the flagship Barcelona Tech City’s waterfront location brings together startups, incubators and accelerators at a single 10,000m2 site.
Europe’s first startup accelerator, Numa, was founded in Barcelona and has since been joined by numerous others, including Startupbootcamp and SeedRocket. ‘Catalonia is an active region for innovation because of the mind-set of the Catalan people,’ says angel investor and medtech entrepreneur Cristian Pascual. ‘Entrepreneurship is in our DNA.’
As the home of the European Health 2.0 Conference for the past three years, and the Mobile World Congress for the past ten, the Catalan regional capital knows how to attract worldwide attention. Local medtech talent has plenty of opportunity for international exposure and the potential for further growth is clear, with the startup-dedicated 4YFN (Four Years From Now) conference expecting to attract 20,000 attendees in 2017, a 60 per cent increase on 2016.
The rivalry between Barcelona and Madrid, which sits just outside EDCI top 10, is a major driver of innovation within both cities. Madrid is home to over 60 start-accelerators, more than 100 health, biotech and R&D startups, as well as the Google Campus Madrid. The Parque Científico de Madrid has been supporting scientific entrepreneurship for more than 15 years and is home to intriguing startups like Protheus Technologies whose µFlow micro-extraction lab-on-a-chip aims to be a step up from the Fitbit in personal wellness tracking.
The ability to recognise a problem waiting to be solved has been the key to a new wave of Spanish medtech companies says eHealth journalist and Spanish industry expert, Javier J Díaz. Psious, a startup using VR technology to treat anxiety disorders; the Fesia neurostimulation rehabilitation system, and 3D scientific and medical illustrators Innevapharma, offer a flavour of the variety to be found within Spain today. Single companies like health gamification startup Health App, whose co-founder Jordina Arcal is one of MIT’s Innovators Under 35, and Wake App Health who have created more than 10 patient- and physician-directed products, are finding multiple solutions to meet real needs.
Yet the Spanish scene is not without its challenges. According to industry body Fenin, over 70 per cent of the €7 billion medical technology market is subsumed by the public healthcare sector. This may not present an issue for industry behemoths like Grifols, but the small companies making up over 80 per cent of those involved in R&D can struggle to make inroads into the public health system.
While public sector dominance is a common challenge for small medtech companies and startups in Europe, the same regional structure that helps balance the Spanish medtech ecosystem creates an added layer of complexity. Difficulties in negotiating a system of seventeen, often locally blinkered, autonomous health authorities has led many Spanish startups to employ a patient-centred approach. Fredric Llordachs, of Doctoralia, sees this as the logical business model. ‘For a startup I think that it’s natural… it’s better and it gets faster results.’ For Dr Llordachs, the Spanish population offer the ideal test bed for this model with over 90 per cent internet connectivity and a higher proportion of patients making medical appointments online than any other European Union country.
Mediktor, a symptom checker app, has used this patient-centred approach built a base of over 300,000 users since launching in 2011. Mediktor uses a text-based interface the simplicity of which is typical of the Spanish approach to medtech. ‘We believe that expressing how you feel in your own words is the best way to gather symptoms. The system understands colloquial words, there is no need of medical knowledge at all,’ says co-founder Cristian Pascual.
Mediktor’s parent company Teckel Medical has used their proven product and customer base to launch a more commercialised digital triage system, securing contracts with European insurance companies, and has recently incorporated in the United States ahead of further expansion.
Spain’s position at the linguistic and cultural nexus between Europe and Latin America offers an ideal opportunity for other companies seeking to expand internationally. ‘The fact that our system is in Spanish is important but my impression is that, beyond the language, the cultural factor also matters,’ says Rafael Pinilla of QooLife. ‘Currently, our biggest growth in users, patients and consultations is in Mexico.’
‘Spain is developed enough to have projects which can be exported around the world,’ continues Fredrick Llordachs. ‘Doctoralia now has a greater presence in Latin America than in Spain. We’re very proud of that.’ With their recent merger with Poland’s DocPlanner, Doctoralia epitomises the advantages of having a foot in both Europe and Latin America.
The Spanish medtech companies forged in the crucible of financial calamity and the mobile technological revolution are now very much a presence on the world stage. ‘In my opinion,’ continues Dr Llordachs, ‘Spain and Europe in general are good enough to compete on equal terms with any company in the US…. If you’re able survive here, you can survive wherever you want.’
Recommendations on how we should use AI, genomics and medtech in the NHS – click here for 98 pages to guide us to the future. ‘The greatest challenge is the culture shift in learning and innovation, with a willingness to embrace technology for system-wide improvement. An ambitious drive “towards the NHS becoming the world’s largest learning organisation”’.
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