Unknown to many, a deeply personal commitment to rehabilitation therapy was the powerful driving force behind the creation of SWORD Health's game-changing digital physiotherapy device.
The company's co-founder and CEO Virgílio Bento was unaware of the dearth of physiotherapy services until his brother was involved in a car accident and spent six months in a coma. Thankfully his brother recovered, even though he had received only two hours of physiotherapy per week instead of the recommended two hours daily at a Portuguese state healthcare facility.
The experience spurred Bento to do some research and create SWORD Phoenix, the industry’s first digital physiotherapist. “At the moment, there is a failure in our capacity as developed nations to provide physiotherapy of a high quality and intensity,” Bento commented. “Our digital therapist permits the democratization of healthcare to enable patients to easily obtain high-quality physiotherapy in the comfort of their homes. It represents a new paradigm that will define the next 50 years of physiotherapy worldwide.”
Together with CTO Márcio Colunas, Bento founded SWORD Health in 2014. Private therapy is still unaffordable to many all over the world. It is estimated that China has only one physiotherapist for every 100,000 citizens, compared with the UK’s one physiotherapist per 2,000 inhabitants, still woefully inadequate. Coping with long-term care issues, where patients require two to three hours of daily therapy and endure long waitlists, seems like a losing battle.
SWORD Phoenix is an AI-powered device and the first truly scalable solution for delivering high-quality physical therapy remotely, just as demand for such highly labor-intensive services is soaring. The global physiotherapy market is forecast to grow at a CAGR of 5.34% to reach US$165.73 billion by 2023 from 2018.
COO André Santos has said that the essential challenge for the startup was to “go big or go home.” But reinventing the wheel in the healthcare industry requires lots of time and patience, especially in traditional sectors that rely heavily on highly trained, qualified professionals. Now, five years since the founding of SWORD Health in Porto, the company's flagship product Phoenix is being used by healthcare practitioners in the US, Canada, Australia, South Africa, Mexico, Japan, Norway, and Portugal.
In April 2018, the company's first seed funding round raised US$4.6 million for expansion abroad. International investors included the US developer of biological technology Green Innovations and Luxembourg's Vesalius Biocapital III, a €150 million medtech fund. SWORD Health's clients include Genesis Rehab Services, the largest physical rehabilitation provider in the US, and the Central Hospital of Leiria, the startup’s first partner in Portugal’s state healthcare system.
The Portuguese hospital started rolling out the Phoenix therapy program in early 2018, with up to 300 patients receiving treatment for aberrant ventricular conduction (AVC). They need daily treatment but live a considerable distance away from the hospital. “SWORD offers two things that Portugal's state healthcare provider SNS loves: maximized results with low costs and constant monitoring – everything the patient does, the doctor knows about,” Bento said.
Affordable physiotherapy for all
Critical to driving greater adoption is persuading physiotherapists and other healthcare professionals to trial the Phoenix digital system in their local communities. SWORD Health has focused on sharing its technology with the medical community, securing favorable peer reviews in well-respected journals. Earlier in 2018, the scientific research journal Nature concluded that SWORD Health had conducted “the first study to demonstrate that a digital rehabilitation solution can achieve better outcomes than conventional in-person rehabilitation, while less demanding in terms of human resources.”
The Phoenix system is currently used for private treatments at a monthly cost of €50 and above. Prices vary according to the problems being treated. Nevertheless, it is still more affordable than other private options – up to five times less than similar treatments by human therapists – thus democratizing physiotherapy to a level never seen before.
Phoenix can be used to treat around 90% of musculoskeletal disorders, producing 25% better outcomes than the current systems in terms of efficiency, the company says. In addition, a higher proportion of patients adhere to the treatments because they can perform the exercises when and wherever they choose. Most importantly, it is easy to use.
“People aged 90 used the application and gave great feedback because the interface is very simple and intuitive, largely working on the basis of voice and colors,” Bento said.
The patients first learn their exercises from their own physiotherapists. Then, they wear an extendable band lined with sensors placed on the body parts being treated during the exercises. The sensors communicate with the Phoenix program on a tablet to check if the exercises are performed correctly. The sensors also give feedback about the speed and efficiency of the exercises. The programs are monitored by SWORD Health staff who send progress reports to the therapists who can change the prescribed exercises as needed.
SWORD Health got its first break in 2014 when it became Portugal's first startup to join medtech accelerator program Aging2.0 in San Francisco. This early experience and connections gained in the global healthcare industry eventually led to a partnership with Genesis Rehab Services that treats 45,000 patients daily.
Six months later, SWORD Health also became the first Portuguese startup to be selected for the European Commission's Horizon 2020 SME Instrument Phase II program for innovative and highly scalable SMEs. The startup received €1.3 million in grants to expand operations and grow its team from five to 15. Today, the team of 29 is busy gearing up for more commercial collaborations and clinical validations across Europe and the US.
SWORD Health recently won the Nos Prize for Innovation, Portugal's main prize for innovative startups, as well as the Innovation 2018 prize from the International Society of Physical and Rehabilitation Medicine.
“In Portugal, you can get clinical validation, but the biggest value for a company is to go outside of Portugal and your comfort zone,” commented Santos. “For us, it means everything to be able to say to our friends in a bar that we are working somewhere that really is changing the lives of people.”