Digital Solutions to diabetic foot ulcers – Interview with CTO

Interview with Dr. Christos Kapatos – CTO of HCi Viocare.

Dr. Christos discusses the background and technology behind HCi Viocare and his view on the digital health landscape.

SD – Hi, could you please introduce yourself ?

Dr Christos Kapatos , a Greek and British national-  I am the CTO of HCi Viocare a start-up company developing solutions to help prevent, monitor and alleviate complications across different patient and athletic populations.

SD – Where do you live ?

Dr CK –  I divide my time between Athens, where the company’s HQ is and Glasgow were the company’s R&D centre is located.

SD  – What is your background ?

Dr CK – I have a degree in Mechanical Engineering and a master’s and PhD in Bioengineering from the University of Strathclyde, specialising in Prosthetics and Orthotics technology and the diabetic foot. I also have a master’s degree in New Venture Creation. I have worked in a number of healthcare R&D posts in organisations such as the University of Strathclyde and the Kelvin Institute in Glasgow, as well as in companies such as Scotsig in Glasgow and Diolab ltd in Athens.

SD – Please tell us about HCi Viocare ?

Dr CK – I founded HCi Viocare with my partner Sotiris Leontaritis, our CEO over a year ago to capture the opportunity presented by a growing and correlated  population of the obese, diabetic, amputated and/or movement-impaired. We are setting up a chain of prosthetic and orthotics clinics in Europe and also have an R&D arm which is working in Digital Health and other medical devices.

Although the company is young, some of the technologies that we have, I have worked on for nearly 10 years informally with my scientific advisory panel who are experts in biomedical engineering and diabetes.

Our first finished development is pressure and shear sensing technology, for which we filed patent applications, and we have incorporated it into insoles. You see, our technology is the only one that is suitable for a hot and humid environment like the shoe. The technology can also be built directly into a shoe, for example a smart athletic shoe. And because of our bioengineering expertise we’ve been able to turn a simple insole into a lower leg gait analysis system, which can even give you information about the impact of your running on your knees.

SD – How does it benefit patient and clinician ?

Dr CK – Closest to my heart  is the application of the technology in insoles for diabetic patients. By monitoring the pressure and shear experiences by their feet in real-time, we can alert them about risky behaviour or bad footwear and if recommended thresholds of pressure over time are exceeded. Clinical studies have shown that as long as patient are focused on their feet and have a good management regime, they can prevent ulcers without any other intervention. We want to provide that focus.  The insole is also a handy tool for blood glucose monitoring needs: it can record your activity better than writ worn devices, tell you your weight and give you a much more accurate reading of calories expended.

The benefit to clinicians is that they will hopefully not see the patient at all because no ulcers have present! For perspective, the NHS in England spends £600m per year on diabetic foot complications. This could almost completely disappear if diabetics with even the slightest indication of neuropathy would monitor their feet with our insole.

SD – What is your route to market ?

Dr CK –  Because our technologies cover a wide range of health and wellbeing sectors, including diabetes, athletics, prosthetics, orthotics and surgical assistive devices, we have adopted an IP Licensing model.  We know from having watched and worked with other start-ups that have tried to build a path to market for a single sector, that trying to do this for multiple sectors is a folly, even if it does mean giving up some of the value.

So we build the prototypes and do the testing and then look for established players in their respective markets to collaborate towards the final market product, which they then launch. We are in discussions with a few interested parties currently, and are delighted that our technology has passed the myriad of technical tests thrown at it.  The key for diabetic insole is to find a partner who understands that diabetes is more than blood glucose monitoring, and that actually, if you are going to provide monitoring devices to diabetics then it makes sense to monitor the other parts of their anatomy also, thereby creating a greater loyalty to your brand. Watch this space..

SD – What do you see are the biggest healthcare challenges in in 2015 ?

Dr CK  – Diabetes, without a doubt. Diabetes is the greatest epidemic of our century with more than 383 million people suffering from diabetes worldwide and this is rising rapidly in all areas of the Globe.

Many complications can be associated with diabetes and generally people are aware of the blood sugar monitoring requirements but little else. But diabetes disrupts the vascular system, affecting many areas of the body such as the eyes, kidneys, legs, and feet. People with diabetes should pay special attention to their feet; about one in five people with diabetes enters the hospital for foot problems. Specific foot problems include calluses, ulcers, loss of feeling (neuropathy), poor circulation, and this ultimately results in amputation more times than people care to think!

In fact, it is reported that every 20 seconds an amputation is taking place somewhere in the world due to diabetes, and this figure is expected to rise as more and more people are diagnosed with the disease. In the UK alone 61,000 people have foot ulcers at any given time  and more than 125 amputations occur every week due to diabetic foot.

SD – What do you see as the biggest opportunities in Digital health in 2015?

Dr CK – Digital health and new, wearable, technologies can now really make a difference; they can improve the standard of living of millions of people and help them combat and control health conditions, such as diabetes.  And it doesn’t have to be expensive: our insoles uses off the shelf components that can be sourced cheaply. The magic is in the configuration and algorithms.

I believe smart wearable devices that can provide really important and meaningful information, more than just how far has a person walked, heart rates and/or estimates of calories burned.

Digital Health shows opportunities both at the consumer/patient side but also institutionally. Our pressure and shear sensing technology, for example, is intended to also be used within the hospital or home care environment to prevent bed ulcers. There are plenty of remote monitoring opportunities to reduce hospitalisation needs and the cost of home care.

The next big evolutionary step is using Digital Health in real-time diagnosis. Low cost, home imaging for example, which is another thing we’re working on in the context of the diabetic foot.

SD – thanks for your time


Paul Budd

Co-Founder and Business Development Director

Paul is an experienced sales & marketing leader within the healthcare sector and is a Co-Founder of Salus Digital. He is a Digital Health enthusiast with a passion for extending the reach of technology to improve patient’s lives and reduce the strain on healthcare services.

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