Tech pioneer Hocoma has long been pushing the boundaries of innovation in rehab. Now marking its 20th anniversary, it plans to step up its ability to drive better patient outcomes, as Deborah Johnson discovers in conversation with Clemens Muller, global head of clinical and scientific affairs at the company.
Back in 2000, the world was a very different place, particularly in terms of technology.
Many of the high-tech innovations we now accept as standard were not yet launched and healthcare remained one of the most traditional markets around.
Yet into this climate, Hocoma launched the prototype of its pioneering Lokomat, a robotic medical device which provides repetitive and highly physiological gait training to patients, enabling even some of the most impaired to learn to walk again.
While it has gone on to become one of the world’s leading robotic medical devices, in 2000, it was a significant and controversial disruption into a long- established and relatively low-tech rehab scene.
Clemens Muller, global head of clinical and scientific affairs at Hocoma, says: “Twenty years ago, gait rehabilitation was completely different.
Therapists had to physically move patients’ legs – a manual task that can be very tiring and requires huge effort, particularly when you are doing it many times a day.”
Gery Colombo, a trained electrical engineer with an interest in neural rehabilitation, founded Hocoma alongside Peter Hostettler, an economist, and Matthias Jörg, a biomedical engineer.
“The founders realised the need for a change to this way of doing things and to find a better solution,” says Clemens.
“They wanted to establish a venture which could use their specialist knowledge and go in a particular direction, with a purpose and intention.
“The goal was to change rehab as it was known. This was absolutely new; in fact so new and innovative that the world of healthcare rehabilitation wasn’t really ready for it.
“This was a challenging phase but one in which Hocoma needed to be really entrepreneurial with a very clear vision and focus and to keep on going.
“It did take a little while until it was accepted and it was a long journey for the founders.”
Despite the initial challenges of launching such a high- tech product, over the past two decades, the Lokomat has become one of the most widely used gait rehabilitation devices in the world.
It has helped to set an industry standard in rehab products for people with brain injury, stroke and other neurological disorders.
Hocoma recently installed its 1,000th Lokomat.
But it has also built on the success of its flagship product by launching an array of other devices.
Among its product portfolio is the Erigo, which assists with patient mobilisation in the earliest stages of rehabilitation; its Armeo range, which supports the recovery of arm and hand function; and its Valedo products that targets back pain.
The business is headquartered in Switzerland but works in 27 countries worldwide – and believes it is changing the lives of people in clinics across the globe.
Clemens says: “I think there are three drivers behind innovation in healthcare – social aspect, which includes demographic changes and the shift from using products which are based on evidence rather than just experience; the technology changes in the world as a whole; and the clinical changes, which are moving on quickly and have changed dramatically to encompass robotics and exploit the previously unused potential of this way of therapy.
“These drivers have changed, and continue to change, the landscape of the world in which we work. Hocoma has always been at the front pushing the boundaries and helping to change the resistance there was at the beginning of our journey.
“When you went to a rehab conference 15 or 20 years ago, there was only one tech provider there, which was us.
“But if you compare that to now, there can be anything up to 20 companies at an event, including start-ups that are working in technology fields like robotics or sensor-based equipment, offering products for inpatients and outpatients, for acute needs. So there is a huge selection now available.
“There is also the demand from the market to integrate technology. The key for us has always been how to integrate this technology into a routine of therapy to use it to its full potential.
“It is about not only being engineering-driven but understanding how to use that to make a bridge to the rehab world and understand the link to the human world – bringing the know-how and capability and opening that up for the needs of patients.
“As a market, we do need to do more homework in that area.
“Lots of clinics already have integrated the technology they are using very successfully, and with our products it makes us proud to see how the patient is being supported to the highest level.
“I have seen this happening in many clinics around the world and it gives me goosebumps to see how happy patients are with how it is working for them. It also makes a huge difference to the work and demands placed on the therapist, and that is something that also makes us so proud.”
Now celebrating its 20th anniversary, Hocoma’s ambition for the future is to continue changing lives and reaching out to millions more around the world.
A strategic move in achieving this came in 2017 when Hocoma joined its now-parent company DIH – bringing it under the same roof as other rehab technology developers including Motek.
“We have always been a pioneer since we were established so we will continue this with new and better solutions to benefit people’s lives.
“Our focus is on bringing solutions which are innovative, high quality, effective and efficient.
“The future for us will of course be affected by the healthcare market in general. We are seeing a rapid demographic change around the world and this will mean a change in the healthcare approach.
“There will be a search for solutions.
“With the huge move towards digitalisation through the Industrial Revolution 4.0, there will be a greater role played by artificial intelligence and virtual reality.
We will continue to develop as a business so we can continue to be at the front of what is happening.
“Traditionally, we have come up with a new innovation every year, which could be a new product launch, or else new features or a new version of an existing product, but we are always developing what we have to make it the best it can be.
“We are always learning by doing and have a network of research and academic partners all over the world and this enables us to come up with great products which deliver solutions.
“We are planning heavily in our development team and are continuing to develop our launch plan and product road map.
“We hope the global coronavirus outbreak and the shutdown we are seeing around the world does not affect our plans too much in the short-term, but we will have to see how that develops and adapt to that as we need to.”
As a business which has helped to change traditional practices and approaches in rehab globally, one area in which Hocoma would like to push for further change is in widening patient access to its own products, and other high-tech solutions.
“At the moment, it is not a given that all patients and all clinics will have access to our products. Of course technology has its price, but we need to address that at some point.
“We need to work with clinics and insurance companies to try and find a solution here and to shape the future of rehabilitation.
“It is important to find optimal solutions which increase access to technology, to improve the quality of rehab, while looking at the cost effectiveness of such products.
“Over the next five to 10 years, there are going to be more stroke, cerebral palsy and traumatic brain injury patients who are needing innovative solutions and our goal is to develop more solutions which will benefit them and the therapists.
“When money and costs are involved it can often be a long journey, but we believe if all stakeholders got together to find a way of best dealing with this, together we could deliver the best rehab to patients, and this is something we would like to be involved in delivering.”