My Startup: Hy-genie, Liverpool

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Hy-genie was founded to tackle the scourge of infections spreading through hospitals known as HCAIs - or healthcare-associated infections.

HCAIs can be caused by medical treatments and surgery, but also simply from being in a hospital setting. Their prevalence is made worse by poor hand hygiene levels in hospitals.

With improved hand sanitisation, these infections would be harder to spread - so Hy-genie has created hardware designed to monitor the usage of sanitisation products across hospitals, and let medical professionals accurately measure their own levels of hand hygiene. Based on existing NHS infrastructures and undisruptive to implement, Hy-genie has set out to improve hygiene in hospitals and save the health service millions.

Founded: 2017

Founder: Dr Richard Cooke with Nova

Website: hygenie.io

We talked to Dr Cooke to learn all about Hy-genie.

Why did you start Hy-genie? 

I’ve retired from clinical practice as a consultant medical microbiologist and Director of Infection Prevention & Control at Alder Hey Children’s Hospital in Liverpool, where I was responsible for minimising the risks of patients acquiring healthcare associated infections (HCAIs).

Most people are surprised to hear that hand hygiene is actually quite poor in hospitals and is a recognised problem in clinical settings worldwide. There have been many attempts to solve the issue at an operational level, adding more sanitation units throughout hospitals like hand gel dispensers and washing basins. But they are not necessarily effective in improving the hand hygiene compliance of clinical staff as it is difficult to capture this information accurately.

I’m not from the startup world - I’m a medic at heart. I got into startups through Alder Hey Children’s Hospital and their partnership with Nova. I came to them with the problem of hand-hygiene compliance in hospitals, and they helped me to find a solution, provided me with the technical team to build it, and are helping me to scale it into a viable business. 

Tell us more about the tech behind the product.

Hy-genie is an active monitoring system that provides staff with personalised hand hygiene performance goals and allows hospitals to continuously detect usage of hand hygiene stations. The system provides real-time insight into hand hygiene behaviour, with an aspiration for 100% compliance in hospitals.

It consists of three distinct hardware components: a beacon incorporated into the NHS staff ID badge, a sensor adjacent to wall-mounted hand gel or soap dispensers, and a centrally located base station. 

When a hand sanitisation event occurs, the system senses the user’s hand and communicates to the closest available beacon via Bluetooth Low Energy (BLE) connection. Once the identification of the user is attributed to the hand hygiene event, that information is transmitted over a Zigbee network to over central hub or base station. This information is uploaded to a dashboard for users to view their own performance and to see how they are progressing towards their own performance goals.

Fundamentally, the system is able to fit into a typical clinical environment, without any disruption to the existing workflows of very busy NHS staff.

Where are you at right now?

The Hy-genie team is making huge advancements in product development. We’re currently refining the hardware components (staff ID badge, wall-mounted sensor and centralised database) with a view to conduct a 'proof of concept' clinical evaluation on a neurosurgical and orthopaedic specialist ward at Alder Hey Children's NHS Foundation Trust later this year. 

The investment and support I’ve received since cofounding with Nova has really helped to accelerate the development of Hy-genie. I’ve been able to work with a variety of people, all of whom work in completely different fields to me, and learn from them. It's been great fun - I've really enjoyed it.

What are your aims for the next year?

We want to be commercially ready by the end of the year. With this in mind, we’ll be looking to further strengthen the business model behind Hy-genie to ensure that we have the right financial model in place that is cost-effective for NHS Trusts.

The team will also be working on the software component of Hy-genie to ensure that personalised feedback to individual members of NHS staff on their own hand hygiene performance is objective, realistic and motivates them to achieve their personal hand hygiene performance goals. 

What's been the hardest thing about getting Hy-genie off the ground?

Senior NHS managers recognise that HCAIs are very costly. Very few organisations are able to quantify the actual cost of HCAIs for their own Trust. Furthermore, most NHS trusts rely on ward-based self-reporting of hand hygiene compliance rates which typically give spuriously high rates of greater than 90%.

As a result, there is an understandable reluctance to consider investing in this type of technology if quality data on both hand hygiene compliance rate and HCAIs costs are not readily available. We’ve had to conduct a lot of our own primary research in conjunction with Trusts to really demonstrate the full extent and repercussions of the problem.

Why should more people be using Hy-genie?

Poor hand hygiene in clinical settings is a historic problem and still continues to be a crucial problem to date. Hand hygiene is a key component to preventing the spread of germs and bacteria in hospitals. This is currently highlighted by the new coronavirus that been identified in China.

However, from 2009 data, over 300,000 patients still suffer from HCAIs each year, creating an annual cost of at least £1 billion to the NHS. This figure is likely to have increased for 2020.

Additionally, the progress of hand hygiene improvement initiatives have been typically short-term and are often not sustainable. As a result, hand hygiene compliance rates are unfortunately poor for healthcare workers, at best around the 50% mark when assessed by independent audit. Hy-genie has a unique value proposition by putting the ownership of improving hand hygiene compliance back into the hands of NHS staff, while having zero impact on their day-to-day activities. 

How much will it cost users - and why is it worth the investment?

Hy-genie isn't a simple capital investment, something that you'd buy and install and then leave running. If your aim was to improve the fitness of your staff, this would be equivalent to building and kitting out a gym for them - it doesn't mean that they will use it!

Hy-genie is more akin to buying FitBits for your staff - so they take ownership of their "fitness" (that is, personal hand hygiene) and are motivated and engaged, with personalised targets and rewards. This is the most likely route to achieve sustainable, long term success for high hand hygiene performance across all the NHS workforce.