Osteoporosis is often referred to as the “silent thief”. The disease is caused by low bone mineral density (BMD) and can occur over a number of years without any symptoms. It is often diagnosed when the first fracture occurs and the disease is already fairly advanced and less treatable. At least one in three women and one in five men will break a bone due to osteoporosis in their lifetime.

Artificial intelligence screening tool, Rho, was developed by 16 Bit inc., a Toronto-based medical device company founded by Canadian radiologists Dr. Mark Cicero and Dr. Alexander Bilbily, radiologist and affiliate scientist at Sunnybrook Health Sciences Centre. The company’s mission is to create trusted AI-based medical software to improve the quality and accessibility of health care for all. Rho automatically screens patient x-ray scans for low BMD and alerts physicians of increased risk of osteoporosis which allows patients and physicians to work together to create preventative treatment plans.

We recently sat down with Dr. Bilbily to chat about how Rho is shaping the future of health care.

What inspired you to become an inventor and create Rho?

I enjoy my clinical work, but its impact scales linearly – I can only help one patient at a time. What excites me about software is it can scale exponentially, creating value even while I’m asleep, camping in the backcountry, or chasing after my toddler.

We created Rho because our health-care system urgently needs smarter, more sustainable solutions. With an aging population, rising costs, and limited resources, we have to find ways to improve care while reducing expenses. Rho identifies patients at high risk for osteoporosis using x-rays they’ve already had without extra imaging or added cost. This enables much earlier intervention which prevents devastating fractures for patients and reduces cost to the health-care system. We have successfully built and deployed the first tool of this kind which has already impacted the lives of over 300,000 Canadians.

What skills or traits have helped you the most in your journey as an inventor and entrepreneur?

Curiosity, the ability to learn quickly, and empathy have all been essential. As a physician, transitioning into entrepreneurship meant learning an entirely new language – product development, branding, market strategy and, regulatory affairs. My curiosity pushed me to dive in, and years of medical training helped me to quickly learn and adapt.

Empathy has been a key strength because it has helped me build a strong partnership with my co-founder, recruit a mission-driven team, and deeply understand the needs of our customers and patients.

What advice would you give to someone interested in launching a health-care company to commercialize their discoveries?

Start with something you think the world needs – something you’re willing to spend 10 years of your life building. Healthtech is hard. It comes with all the usual start-up challenges, plus regulatory, clinical validation, and compliance hurdles that increase cost, risk, and time. If your motivation is just financial, it’s hard to weather the storm. But if you’re mission-driven, that purpose will sustain you and attract others who share your vision like key teammates, advisors, and early customers.

How has Sunnybrook and INOVAIT enabled you to make your technology a reality?

INOVAIT, [Canada’s image-guided therapy and AI network led by Sunnybrook], has been essential at every step of Rho’s journey. Through the Pilot Fund in 2022, they helped support our AI model development, early user testing, and Health Canada approval. That funding and visibility gave us a critical boost to land our first customers. More recently, the FOCUS Fund has supported our commercialization efforts which included helping us expand Rho’s capabilities, build evidence through publications, and grow into international markets.

Sunnybrook has also played a pivotal role – from running Rho’s first prospective clinical trial with CAN Health Network, to supporting bold new research in my lab. That includes exploring next-generation AI use cases in medicine – some of which are admittedly a bit out there, but might just shape the future.

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Vitreous hemorrhage is a leading cause of severe vision loss worldwide. This condition, commonly caused by diabetic retinopathy, occurs when diseased retinal blood vessels rupture, rapidly filling the eye with blood and rendering someone blind within minutes. The traditional treatment for this condition involves a period of watchful waiting to allow for natural resolution, which can take many months. Patients suffer while waiting, facing limitations in physical activity, reduced work productivity and the fear of impending surgery or permanent blindness. If the hemorrhage does not clear, surgery is the only alternative.

Dr. Gary Yau, ophthalmologist and affiliate scientist in Physical Sciences and the Hurvitz Brain Sciences Program at Sunnybrook, is developing a non-surgical, office-based solution that uses the power of sound to restore vision loss caused by vitreous hemorrhage. The technology applies focused ultrasound waves deep within the eye to fragment the hemorrhage and accelerate its clearance, all without the need for incisions.

Partnering with SRI, Dr. Yau founded Vitreosonic, to accelerate the technology and its potential to transform the current treatment paradigm, having a significant impact on how patients may recover from this blinding condition in the future.

Dr. Yau sits with the Vitreosonic technology, which applies focused ultrasound waves to the eye non-invasively.

How did your training as a physician help you as an inventor?

Medical training is, understandably, centred around learning the craft of clinical care. While it may not explicitly focus on invention or product development, health-care professionals are uniquely positioned to contribute to innovation. We work on the front lines, encountering real-world clinical challenges and observe firsthand where current solutions fall short. Our research background trains us to think critically about evidence and improvement, and as end-users of medical technologies, we bring valuable insight into what works in practice, not just in theory.

What knowledge or skills do you need to become an inventor?

Perhaps the most essential skill I’ve observed in successful inventors is simply the ability to get things done.

Invention is about bringing an idea to life. It requires you to be both a dreamer and a doer.

As an inventor, you’re stepping into new territory, so you’ll inevitably hear phrases such as “this isn’t how things are usually done.” The ability to push forward despite those barriers is a necessity.

I certainly am early in this journey, and still have many walls to navigate, but this pursuit has been one of the highlights of my professional life. True invention doesn’t just advance care—it has the power to redefine it. I would encourage those that have a compelling idea to take this less travelled path, as its impact on patients can be profound.

What advice would you give to someone interested in launching a health-care company to commercialize their discoveries?

Absolutely go for it. Inventing and entrepreneurship aren’t the most common paths for health-care professionals, but they offer an incredible opportunity to make a lasting impact on patients’ lives.

I didn’t initially set out to start a company. It began with identifying a compelling clinical need, one that resonated deeply with me. Over time, it became clear that the only viable path to bring this solution to patients was through commercialization.

In that sense, forming a company wasn’t the goal, rather it was the necessary vehicle to move the solution forward.

Translating an idea into a real-world solution often requires knowledge beyond traditional medical training, such as intellectual property, regulatory strategy, and product development. For clinicians interested in innovation, being involved more upstream in the invention process not only broadens our perspective but also allows us to shape the direction and real-world impact of new solutions from the start.

As a health-care professional, your unique clinical insight is a major advantage that can help propel an idea forward.  Just as important, though, is knowing where your expertise ends and being resourceful in filling those gaps. It’s rare these days, especially in health care, to develop an impactful invention entirely on your own. I’ve been fortunate to collaborate at SRI with Dr. Kullervo Hynynen and an outstanding engineering team, Bohao Ning PhD and Christopher Hu MSc, whose expertise and partnership continue to be essential in moving this technology ever closer to the bedside.

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All inventions come from asking a question. In their lifetime, two in five Canadians are expected to be diagnosed with cancer, a disease in which abnormal cells grow and invade other parts of the body. But what if we could reprogram the body’s own cells so they could fight cancer cells?

Dr. Juan Carlos Zúñiga-Pflücker, senior scientist in the Biological Sciences and Odette Cancer Research Program, is researching T-cell development and Notch signalling and its therapeutic implications in the treatment of leukemia. T-cells, made in the thymus — a small organ in the upper chest, are a type of white blood cell that play a vital role in immune response, targeting and attacking viruses, bacteria and importantly, cancer cells.

Dr. Zúñiga-Pflücker is the scientific co-founder of Notch Therapeutics, an SRI spin-off company designing and manufacturing off-the-shelf chimeric antigen receptor (CAR) T-cells from pluripotent stem cells, which can be used as therapies to target and fight cancer. Notch Therapeutics’ CAR T-cells are genetically modified so they can be used by universal recipients, and act as a tumor-targeting mechanism in patients with leukemia. These therapeutics have the potential to provide a more precise treatment to cancer patients, with less side-effects than current therapies like chemotherapy and radiation. The name Notch Therapeutics comes from the technology’s foundation in Notch signalling research. The Notch signalling pathway is critical in cell-to-cell communication, helping to control organ and tissue development and gene expression.

What inspired you to become an inventor and create new medical technology?

All inventions arise from basic scientific questions and endeavours. My inspiration for Notch Therapeutics came from doing fundamental discovery work in developmental immunology and from finding out how things work.

In my case, I had questions about how we could generate T-cells from stem cells, like how the thymus makes it happen. We then applied that knowledge into developing clinically relevant tools for fighting cancer with CAR-T cells.

What advice would you give to someone interested in launching a health-care company to commercialize their discoveries?

Start by focusing on a key biological question and pursue fundamental discovery work. This will lead to new opportunities to apply the research into something that can be commercialized and serve more communities.

Many people are interested in the final stages of launching companies, but none of it can happen without the initial discoveries. The interest and focus should be in creating new knowledge, the rest follows from this inventive step.

How has Sunnybrook enabled you to make your technology a reality?

Pursuing commercial goals is not what discovery research is about. Without discovery, you cannot have the new knowledge required for turning new technologies into a reality, which serves to validate the process. I am grateful that SRI supports this entire arc, from discovery to clinical translation to commercialization. SRI provides the infrastructure and climate to enable fundamental basic biological discovery research, which plays a key role in making the initial findings that lead to technological advances that can later be commercialized.

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Dr. Hon Leong, scientist in Biological Sciences and the Odette Cancer Research Program at SRI, emphasizes the importance of translating research into clinical practice. Using ideas from his lab, Dr. Leong and Dr. Gobi Thillainadesan, research associate at SRI, co-founded SRI spin-off company, Yex, a sustainable, ethical and cost-effective alternative to currents method used for growing cells needed to make biologic drugs. Yex can also be used in research applications to fuel discoveries in regenerative medicine, antibody production, clinical diagnostics and drug discovery and screening.

What inspired you to become an inventor and create new medical technologies?

There have been lots of leaders in my life that inspired and fostered my passion for research and innovation. My dad is incredible at making things and creating solutions. He was a welder and I grew up watching him and his colleagues do research at a government facility in Northern Alberta, where he successfully developed an alternative to open pit mining for oil extraction. Watching my dad showed me that I really loved using my hands and a creative process to discover things and create solutions. I also think that’s why I loved university, and later grad school, so much; There was a plethora of different disciplines and topics to discover.

I became inspired to research medical technologies when my father had a heart attack and fortunately survived. When learning about how he was saved, I began to see and appreciate how so many different worlds came together to forge medical devices and drugs that would save patients like him.

I also had a previous supervisor who was ambitious and focused on biotech entrepreneurship. He helped me realize that everything we do in the lab has to mean something to patients, and in order to do that, you have to reduce that work into a type of product or service.

What impact can Yex have on patient outcomes?

Yex has the potential to accelerate the development of life-saving medications, making them more affordable and accessible for patients. Yex lowers costs, helping scientists perform more research, leading to more advancements in health care and patient care.

Yex, Dr. Leong’s alternative to fetal bovine serum (FBS) and serum free media (SFM).

What knowledge or skills do you need to become an inventor?

A good first step for becoming an inventor in biotech and medtech is to pursue a Bachelor of Science. The type of material and topics that are taught in these types of courses today is incredible, and scientists around the world have made leaps and bounds just from discussions that have happened in a classroom. Soak up everything you learn in science class because one day one of those lessons may lead you on your own path of discovery.

Public speaking is another important skill to have if you’re interested in becoming an inventor or entrepreneur. I wasn’t very good at it as a student, but one of my colleagues urged me to join a Toastmasters group and it changed my life. I became more confident, was able to truly understand the needs of an audience, and it taught me to better communicate my ideas and solutions.

Lastly, you need to be able to listen. Whether it’s listening to the needs of a patient or a colleague, if you aren’t actively trying to understand their needs, you’ll quickly lose focus and waste a lot of time and resources.

How did Sunnybrook enable you to turn your invention into a reality?

Sunnybrook is a place where world-class talent and expertise are coming together to invent the future of health care and serve the needs of the patient; this includes coming up with new scientific discoveries and commercializing them. I think Sunnybrook has an amazing track record of taking lab-grown ideas all the way to market and my experience so far makes me want to do more of it.

Inventing something that has clinical impact is a gargantuan journey and you need the right kinds of people and relationships to help chip away at the marble. It’s more than just scientists, but a team of experienced professionals that will help guide you and advise you on the path to success.

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Maria Plummer is an oncology nurse in the Odette Cancer Program and founder of Yewtwist, a tool that helps nurses disconnect tight intravenous (IV) and feeding tube connections safely and efficiently. She named the tool after the Pacific Yew tree because compounds derived from the tree’s bark are used in chemotherapy treatments to inhibit cancer cell growth. Yewtwist is currently available to help nurses deliver better patient care across North America.

Maria demonstrates how Yewtwist is used to disconnect a line.

What inspired you to develop Yewtwist and how has it impacted patient care?

I’ve been an oncology nurse for more than 30 years and have looked after thousands of IV lines. Nurses disconnect IV lines and feeding tubes multiple times a day and many of these lines are difficult to handle due to overtightening, their small size, or lack of grip. My experience inspired me to create a solution that would help my colleagues and I provide better care for our patients.

In my research, I found that nurses could lose anywhere from three to 30 minutes trying to disconnect a tight IV line. Nurses across North America often resort to using metal forceps or pliers, which could cause stress fractures that can damage the line and increase the risk of infection among patients.

Yewtwist addresses the many concerns that nurses have when disconnecting tight lines. Lines can often be disconnected in less than 10 seconds, and the tool adapts to different sizes and shapes. Yewtwist is made up of thermoplastic elastomer materials which won’t damage lines and provides additional grip. It’s also designed as single-patient use tool, which reduces the risk of infection and cross-contamination.

What advice do you have for nurses and other health-care professionals who want to launch a medical device or company to commercialize their offerings?

We are a very creative profession; we experience and feel the pain points in our job, see where there are inefficiencies and have a deep understanding of how improvements can be made. If there is an area of your role that you feel strongly about improving, you just need to go for it. When you get amazing feedback from colleagues and patients who benefit from your invention, the rewards are worth the challenges.

How did Sunnybrook enable you to commercialize Yewtwist?

Sunnybrook encourages innovation throughout the organization. Whether it’s through one of its manufacturing resources, or in my case, the invaluable support and guidance from my fellow nurses and Sunnybrook educators and supervisors, Sunnybrook played a critical role in getting Yewtwist into the hands of nurses around the world.

There are so many aspects to inventing a medical tool to bring to the market, and you often feel a lot of self-doubt while you’re going down this path. Sunnybrook’s commercialization landscape and drive to innovate patient care gave me fuel to keep going and turn my ideas for Yewtwist into reality.

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Dr. Nicole Look Hong is a surgical oncologist and associate scientist in the Odette Cancer Program, and her work focuses on improving cancer care through economic efficiencies and new technologies, and evaluating new techniques for tumour removal in breast cancer. Dr. Look Hong’s research interests led to the development of MOLLI®, a wire-free and radiation-free technology that works like a stud finder, enabling surgeons to locate breast cancer lesions with more precise accuracy.

The device, developed at Sunnybrook by Dr. Look Hong, and former Sunnybrook employees Dr. Ananth Ravi, and Mr. John Dillon, inserts a tiny magnetic marker into the tumour and during surgery, using a small wand, surgeons then identify the location and exact depth of the marker helping them determine where and how deep to cut. This flagship device led to the founding of MOLLI Surgical, a SRI spin-off company, and now MOLLI is being used in hospitals across North and Central America and the Caribbean, helping more patients. In 2022, TIME Magazine named the device as one of the best inventions of the year and more recently, MOLLI Surgical was a 2024 recipient of INOVAIT’s Focus Fund program.

MOLLI^® 2 Wand Detecting Marker. Photo: MOLLI Surgical

What inspired you to invent MOLLI and later commercialize it?

I think the best inventions are created when there is a genuine desire to solve a problem that has no other effective, creative alternative as the foundation. When we initiated discussions about the idea that would eventually become MOLLI, there were very few options available in Canada for breast lesion localization. We sought to develop a simple and intuitive solution, that also overcame many infrastructure limitations. There was also a need to create an alternative that would be cost-effective within the Canadian healthcare ecosystem, as most commercial products abroad for localization were quite expensive at the time.

The inspiration for commercialization started to emerge once we saw that the prototype products for MOLLI worked to localize breast tumours and were successfully and safely used in a phase I clinical trial.

What knowledge or skills do you need to become an inventor?

I think the most important skills needed for invention and commercialization are collaboration, humility, and patience. During the processes of idea generation, building, testing, and trial for a new invention, there will inevitably be many wrong turns, useless ideas and failed attempts.

Medical device creation and commercialization is a very interprofessional process and it is critical to recognize that no individual team member is skilled in all aspects of the process. It may be uncomfortable at first, but relying on each other, and trusting the judgement of others is essential to moving forward with your invention. The ability to fully commercialize a product requires a significant time and financial investment, and a lot of proper oversight. Partnership and collaboration can help make these challenges much more manageable.

How did Sunnybrook enable you to make your invention a reality?

When MOLLI was first invented, myself, Dr. Ravi and all the engineers involved in its creation were working at Sunnybrook. Because of this, we were able to meet in-person regularly and utilize the laboratory and operating space within the hospital. Through Sunnybrook, we were able to access its advanced machine shop, a state-of-the-art facility equipped for the design, fabrication and testing of medical devices, which played a crucial role in developing the product and its prototypes.

As a premier academic and research health sciences centre, Sunnybrook provided our team with the academic atmosphere to apply for innovation grants and advance the work, and to conduct clinical trials in an ethically sound and peer-vetted environment.

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Dr. Brian Courtney, interventional cardiologist and clinician-scientist in the Schulich Heart Program, develops new medical innovations with a focus on imaging and therapeutic catheters for minimally-invasive cardiovascular procedures. While working at Sunnybrook, Dr. Courtney invented the world’s first catheter-based system that combines ultrasound and optical coherence tomography imaging, enabling doctors to guide coronary angioplasty and stenting with greater precision. Dr. Courtney’s technologies help physicians better visualize disease in the arteries, potentially reducing complications in common procedures like angioplasty. In 2007, Dr. Courtney co-founded Conavi Medical, a spin-off company that commercializes the technologies he initially invented at SRI.

Dr. Courtney also used his knowledge and experience developing and commercializing medical technologies, to help create Medventions, a program founded by Sunnybrook, that drives medical innovation in Canada by nurturing talent and equipping young medical professionals and entrepreneurs with the knowledge, experience and networks they need to translate their ideas into products with life-saving impacts on patients.

What inspired you to become an inventor and create new medical devices?

I’ve always been someone that’s liked to build things, and this is one of the reasons I originally pursued engineering in my undergrad. I was inspired to take this interest and use it in a way that could help people. I discovered my passion for medtech after working for a company that designed digital healthcare devices, and I realized that in order to truly understand the real problems facing healthcare I would need to gain clinical exposure.

How did your training as a physician help you as an inventor?

My work as an interventional cardiologist plays a crucial part in identifying subtle ways that new technologies could influence care. Working in a clinical environment, I experienced these opportunities for improvement first-hand which helps fuel my understanding of the challenges facing clinicians and patients.

My experience as a physician enables me to more easily communicate the benefit of new technologies and demonstrate their impact. I have the knowledge to speak to the medical concepts required to design the device and am aware of the policies that may support or impede advancing the device in the system.

What advice would you give to others wanting to develop a medical device or healthcare company to commercialize their inventions?

Above all else, you need to be motivated by curiosity and the desire to help and work with people. There are many stakeholders involved when it comes to designing and commercializing a new medical technology and you gain a lot of insight when working interprofessionally with these different groups. Given the collaborative nature of medtech, networking is a powerful tool when looking to invent a new device. Learning from individuals that have gone through the commercialization process can help you avoid common mistakes and move you in the right direction.

There are several resources at SRI that help support inventors during the commercialization process. The Technology Transfer Office at Sunnybrook bridges the gap between scientific discoveries and their application in the real world by collaborating with its network of partners to enable further development and commercialization.

There are a number of communities that connect seasoned and aspiring medtech entrepreneurs. INOVAIT, a platform hosted by SRI, is a network dedicated to advancing and commercializing image-guided therapy technologies by bring together medical science companies and institutions of all sizes. These networks play an integral part in fueling innovation that will ultimately advance the future of health care and patient outcomes.

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