Scaling with purpose: Intellijoint’s strategy for redefining surgical innovation in medtech

Scaling innovation in a competitive landscape

Intellijoint operates in a MedTech environment where many players are well-established. How has the company successfully carved out space and scaled amidst legacy competitors?

You are absolutely right. Intellijoint is only 15 years old, but we are competing against companies that are decades-old—in some cases over a century old—with billions of dollars at their disposal. In this market, we’ve been able to achieve deep market penetration by remaining focused on solving real problems that customers have and building elegant solutions that they want. We don’t just focus on the clinical problem either; we consider the environment that our solution must be successful in and optimize its performance for that environment. Internally, we refer to this as being “Intellijointy.” We don’t build a cool solution first and then try to find a problem it fixes. We instead identify a cool problem to solve first and then build a solution in a way that addresses real adoption challenges that customers have. 

In the orthopaedic industry, the real problem surgeons have is how to achieve the key clinical targets during a hip or knee replacement without error. Without technology, the standard of care is for surgeons to use their eyes and judgement to restore a joint, which is difficult given how hard it can be to see the joint. So, we help to eliminate any mistakes by providing surgeons with a device that provides them with real-time data for these targets. What’s more, we didn’t just look at the clinical side of the problem, but also the environment in which the surgery is delivered. In the operating room, a solution that is small, fast, and affordable is paramount. Other technologies exist, but they often cost too much, add too much time to surgery, require surgeons to change their workflow, and limit surgeons to just one brand of implants. For us this is part of the problem, and we aim to fix it.

The future of surgical precision

How do you see smart surgical tools and integrated planning ecosystems transforming patient outcomes in the next 3–5 years?

I ultimately see two futures for our industry. The first is a “closed ecosystem” that incumbents are already pushing on providers where they make their implant exclusive to their robot and bundle the two together to lock customers into long-term contracts. In the next 3-5 years, this trend will likely continue—not only into other surgeries beyond hip and knee replacements, but also the tools and technologies themselves. The robots will become smarter and more integrated into the operating room, but at the expense of surgeon choice of the equipment they want to use. If this becomes the dominant model of the industry, it will limit competition to just a few closed ecosystems that will drive prices up.

Alternatively, we are building a future defined by an “open ecosystem” where surgeons are empowered to choose the tools, technology and implants that best serve the patient. We are similarly turning our technology into an integrated platform to enable surgeons to plan and deliver their surgeries to achieve their best outcomes, but we do not require them to change their surgical workflow, tools or implants. They can use our planning and navigation platform, any implant and a wide range of tools that provide unique value rather than only those that are exclusive to their robot. A number of other smaller companies share our open ecosystem approach, and we are working on partnerships to provide a range of effective, affordable and easy-to-use technologies and tools that surgeons love to use and are easy to adopt. 

Data privacy meets personalisation

As precision medicine continues to evolve, how does Intellijoint balance the opportunities of personalised care with the responsibility of safeguarding patient data?

Every patient is unique and deserves a personalised approach to their care so that they have the best chance at a healthy and fast recovery post-operatively. Our R&D efforts over the last 4 years have been focused on this goal by prioritising a pre-operative planning technology for hip and knee replacement surgeries. Intellijoint VIEW incorporates the patient’s unique hip-spine relationship into the planning for their functional cup placement, while for a knee replacement, VIEW enables surgeons to easily explore and customise different coronal alignment approaches for the patient. All of this is done with the x-rays taken before the surgery, making it easier to build a technology that can safely store and analyse the patient’s data, since no additional patient data is required.

Leadership through transition and growth

As CEO, what leadership lessons have been most valuable during periods of rapid growth or change?

As entrepreneurs, risk-taking and failing is inherent to the job. Success only comes with taking risk, but not every bet is going to work. So, since the very beginning of founding Intellijoint, my co-founders and I have prioritised learning how to take risks and being resilient as we inevitably make mistakes and learn from those lessons. For example, when we first developed Intellijoint HIP, we deliberately tried to open ourselves to failure by asking surgeons early and often about our product and what, specifically, was wrong with our approach. And surgeons were not shy about their opinions! But those conversations were essential. They not only built a network of surgeon champions—most of whom remained engaged with us on our Scientific Advisory Board—but also gave us a foundation of resiliency. Especially as I reflect on the last five years, our ability to be resilient is what has helped us navigate from being the top of the Deloitte Fast 50 in 2020 to having nearly every hip and knee surgery cancelled or delayed during the pandemic to more recently managing the uncertainty of US tariffs while seeking new international partnership opportunities. In these times of great uncertainty, preparing for the worst, while hoping for the best is a useful approach. A blend of optimism and paranoia is healthy for any entrepreneur. Every year for an entrepreneur and their team is different – embrace change because it is the only constant.

Looking ahead

What are some of the major shifts you anticipate in the MedTech landscape, and how is Intellijoint positioning itself to stay ahead of the curve?

Around the world, health care is becoming more expensive and reimbursement levels are going down. Whether it’s North America, Europe or Asia, there are increasingly fewer dollars for innovation at a time when more demands on the health system require innovation to solve problems. In our industry in particular, the majority of orthopaedic surgeons have not adopted enabling technology in their practice. Why? We believe surgeons see the clinical value in the technology, but that it is too costly at a time when every item in the budget is already going up – let alone the uncertainty and costs that tariffs place on hospitals and surgical centres. 

So how do we get ahead of this trend and convince new surgeons to enter the market? Well, we need to provide exceptional clinical and economic value to customers. If we are just solving their clinical problem, that simply isn’t enough anymore. We must help surgeons, care teams and administrators bend the cost curve and create efficiencies. We need to provide an exceptional user experience that makes working with Intellijoint as easy as possible. And we must enable our surgeons to achieve their best outcomes – for the patient, for the provider and for themselves. I don’t think this is a radical approach, but it’s a mindset shift that we are gearing our entire business behind so that we do not simply play in the market but win it. 

Navigating the Canadian market

Canadian MedTech startups often encounter hurdles when trying to sell their innovations within Canada, despite being homegrown. Has Intellijoint’s experience in this regard changed since this article from March 2022, and what changes would you like to see to better support Canadian HealthTech companies in their domestic market?

Compared to three years ago, we are feeling real momentum in our home market of Ontario. In addition to Humber River Hospital mentioned in the article, we have added Brampton Civic Hospital and Waterloo Regional Health Network as customers and are in active discussions with multiple hospitals across the province as well. This, needless to say, is incredibly positive news and we’ve found success by focusing on what’s called direct anterior hip replacement surgery where we are able to replace the use of fluoroscopy during surgery, providing savings back to the hospital.

The challenges I spoke about in 2022 though—namely the lack of a scalable model tied to provincial reimbursement decision-making—still exist in Canada and are a leading factor that contributes to a slow rate of adoption for homegrown innovation in Canada. The Government of Ontario, however, has taken a leading role over the past two years by working on a new Innovation Pathway Program to address this exact problem. This program would help to test, scale and reimburse the adoption of new health technologies throughout their commercialisation journey, making it easier for the government to identify its health system needs and match them with made-in-Ontario innovations. This can be a true game-changer for the province and, if connected to other provincial health systems, the whole country as well.