Thank you, Mr. Chair.
I'd like to extend my sincere thanks to the committee for the opportunity to discuss my company and our journey.
I started Emovi, which stands for emotion, movement and vision, in 2007. When you start a business, all three of those elements come into play. Emovi emerged from university research and technology. In fact, three Canadian universities—CHUM, École de technologie supérieure and École Polytechnique—jointly developed a tool to observe and assess a knee in motion.
People can experience knee pain when they move, play golf, ski or go down a flight of stairs. And the only knee assessment tools doctors have right now are their hands, eyes, x-rays and MRIs. Imaging produces static pictures that provide little or no information on what is causing the patient's symptoms. It's akin to assessing a patient's heart just by listening to the heartbeat, as was the practice years ago.
The same goes for the knee, so doctors don't necessarily have all the tools they need to understand why the patient is experiencing pain. And patients end up in a vicious cycle. They see a doctor, who prescribes them pain medication or something else. If the patient goes back to the doctor, they will undergo an x-ray or MRI before being seen by an orthopedist. And many of the patients waiting to see an orthopedist aren't candidates for surgery. When they finally see the orthopedist—if they do—some six or eight months later, if not a year or two later in Canada, the orthopedist sends them right back to their doctor. So patients suffering from knee pain have a very hard time.
In the early 1990s, the three Canadian universities I mentioned set about examining the issue. Only a few university research teams in the world have studied the problem and been able to acquire a solid understanding of knee joint function. They researched all the symptoms related to knee injury, osteoarthritis of the knee in the aging population and femoral-patellar syndrome, which is common in soldiers and those between the ages of 20 and 40.
I acquired the technology, and together with four hospitals, we started to gather conclusive data in order to obtain approval for the system and the ability to sell it. From 2007 to 2010, clinical trials were conducted, and the technology was tested in a real healthcare setting. In 2010-11, we received regulatory approval from the FDA and Health Canada, as well as CE marking in Europe.
Given that the technology is a medical innovation that represents a new practice for the medical community, it means that doctors have to change their approach to knee assessment. In order to build credibility in the medical community, we had to engage opinion leaders so that they would publish data on the technology and endorse it.
So, not only did we face regulatory barriers, but we also had to overcome credibility issues and the difficulty around integrating the technology into the care continuum, with respect to front-line healthcare providers. After receiving the necessary regulatory approvals, we began marketing the technology in 2011. We called it KneeKG—a nod to EKG, the heart assessment tool.
Our first buyers were opinion leaders from around the world. That process was largely facilitated by Canadian trade commissioners, who introduced us to David Hunter, an opinion leader from Australia in the field of knee osteoarthritis. In 2011, he did a literature review on the subject that appeared in the journal Nature.
Having his support is important for us, knee osteoarthritis being our main market. But the fact of the matter is that, for a Canadian start-up, knocking on the doors of opinion leaders isn't exactly easy, and the trade commissioner service did a lot for us in that regard. Today, we have 20 sales under our belt, including in Australia, thanks to Mr. Hunter, who introduced us to an Australian distributor. So now we have a distribution company in Australia. And we've also made one sale to China. We've sold the technology to buyers in the U.S., France and Canada, as well. Opinion leaders have helped with our initial sales, and that's largely thanks to the help we received.
We have a small team, but what we do requires a lot of funding and investment. In our first few years, until 2012, I provided a significant part of the funding, myself. In 2012, the process of marketing the technology for export became very cost-intensive, so we sought out venture capital.
We applied for BDC funding, but we didn't get it. We did get funding from Fonds Bio-Innovation, which is mainly supported by Quebec's Fonds de solidarité FTQ and the Royal Bank of Canada. We didn't meet the BDC's criteria, but we did meet the Royal Bank's requirements, with a guarantee provided by EDC. That was a major boost for us.
At the same time, we continued our R and D work to keep innovating. We worked on our technology, a product to diagnose the causes of knee symptoms. We took the technology to the diagnostic level. Our system makes it possible to diagnose whether a patient has osteoarthritis and a partial tear, patellar syndrome or another problem. From a regulatory standpoint, diagnosis is a more refined step. We received a lot of support from the NRC through IRAP. That gave us the momentum to obtain a critical mass and to introduce our product to frontline health providers. Market demand exists for this kind of diagnostic tool.
So that gives you an overview of what Emovi does. Our team continues to innovate and engage in R and D, but our primary focus is commercializing our system. Commercializing a medical innovation requires a change in medical practices, and that's a big challenge for us. We have to work with medical associations to incorporate information about the new technology into continuing education activities. The Quebec government gave us funding for a major clinical trial involving 2,000 patients. The trial has merely confirmed all the evidence gathered to date. It's being done in a more formal context so that we can incorporate the technology into Quebec's public health system.
In the U.S., we've been able to have Medicare cover the cost of the assessment. That's been a problem in Canada, given that each province has its own plan for reimbursing expenses. In Quebec, it's RAMQ. The U.S. health insurance plan is universal, so we have access to the entire market.
Something that could go a long way towards helping medical companies like ours would be an initiative to harmonize the integration of medical innovations in the public healthcare system. That could be covered under interprovincial agreements, for example. It would make our job easier, because we wouldn't have to duplicate the same process in every province. Right now, we are putting a lot of focus on the U.S. and European markets because, in Canada, we have to follow the same process ten times. It's a tremendous burden that requires a significant amount of time and money.
As far as companies like mine go, I have a hard time wrapping my head around the BDC's criteria and what it's looking for. Traditional banks gave us funding, but not the BDC. The BDC's view was that our company represented too great of a risk. That's an area that may require some clarification.
I have a recommendation. We have a lot of support for R and D and a number of funding opportunities, but when it comes to—
