“It wasn’t until I had the stroke that I realised just how much of our daily social life revolves around eating and drinking. Just simply not being able to go out with friends for a meal or a coffee was having a real impact.”
This is life with dysphagia – difficulty swallowing. Dysphagia is unseen but is not uncommon. Although its frequently associated with patients who have had a stroke or have Parkinson’s Disease, it can be a consequence of many conditions across the lifespan, from cerebral palsy in our youngest to dementia in our oldest. Professor Maggie-Lee Huckabee and her team at the University of Canterbury have a solution.
Huckabee was in clinical practice for many years, before leaving patient care to broaden her clinical impact through research. Her key interests are in using innovative technologies to solve this complex problem of dysphagia. She is the Director of the University’s Rose Centre for Stroke Recovery and Research.
Recent research has documented that the attributable costs of Dysphagia to the New Zealand economy are approximately $111 million each year, taking into account all costs of diagnosis, management and quality of life. There is also the cost of lost income for those still working.
“Our first effort was the original Biofeedback in Strength and Skill Training (BiSSkiT) software. We developed it as a research tool using an off-the-shelf surface electromyography (sEMG) device to detect and display muscle activity with wired sensors under the chin,” says Huckabee. In 2016, they made the software available to clinicians in the European Union, Australia and New Zealand. This enabled rapid translation of their research into clinical practice. Clinicians loved the treatment approach but reported being under-resourced to provide intensive one on one treatment.
Skip forward a few years, and BiSSkiT is now also an app - BiSSkApp. “We found there was more interest than we expected, so we began the commercialisation journey, spinning our expertise into a company called Swallowing Technologies, or SwalTech for short,” says Huckabee.
“BiSSkApp is a great solution for dysphagia rehabilitation. It can be used in hospital or at home with remote clinician supervision. And that’s a huge step forward. In some health systems, a patient with dysphagia may get only around 10 rehab sessions across all disciplines. That’s probably two sessions on swallowing. It isn’t enough. Putting it bluntly, with BiSSkApp, clinicians can get the biggest bang for the bucks – intensive rehabilitation without intensive use of limited public resources,” says Huckabee.
Emma Hayes joined SwalTech with seven years of experience in the medical devices market. As COO, she overseas SwalTech’s great team of 6 full-time employees and is responsible for day to day operations of the company. An integral member of the SwalTech team is Eric Knapp, who guides development as our Human Factors Analyst, having experienced dysphagia due to stroke a number of years ago.
Hayes and Huckabee both talk about the benefits stemming from the Canterbury healthtech ecosystem and the KiwiNet Healthtech challenge. “We were really surprised at how much support was available for people going down the start-up route. Many clinical academics don’t have expertise in commercialisation and we really need that sort of support,” says Huckabee.
“Our new healthtech centre is trying to bring this whole ecosystem together which will create a fantastic resource. It offers a central hub, with local and national support. There are fortnightly breakfasts on subjects ranging from IT to health economics. We can benefit from those who’ve made this journey before,” says Hayes.
She says funding has been critical to SwalTech. “Funding from Callaghan Innovation, for example, means we can continue developing our product with a summer student. NZTE is helping us target the right investors.”
“Networks like these are so important,” says Huckabee. “You can get buried in your own pathway and that can be lonely. Those breakfasts are a wonderful way to connect with others who know your pain. You can learn from them and they can also learn from us.”
SwalTech is running clinical trials through the University of Canterbury, but also in partnership with the University of South Florida, which was looking for technology-based apps such as this to facilitate at home rehabilitation. They’re now looking for commercial partners in New Zealand, Australia and the US to get the BiSSkiT app to market in 2024.