A quartet with a brain monitoring mission

Timo Koskela, Eero Väyrynen, Ilkka Juuso and Jukka Kortelainen are developing AI tools for the analysis of brain function in intensive care – and they are enjoying their journey as entrepreneurs.

A few years ago, Dr Jukka Kortelainen was doing his residency at the Department of Clinical Neurophysiology at Oulu University Hospital. His work included research with intensive care patients and he realized how little we knew about the brain function of these patients. Brain monitoring has been complicated and not well-suited to the intensive care area where clinical evaluation might be difficult due to the disease, or sedation, and where no reliable laboratory tests are available to measure brain function. In addition, the information provided by imaging, such as CT or MRI, is also limited and transferring the patient for these examinations is time consuming and laborious. One of the few and best ways to measure brain function in an intensive care unit is electroencephalogram (EEG), but its application here is limited.

One reason is the practical difficulties in carrying out the measurement, but this part of the problem is about to be solved as several easy-to-setup solutions suitable for intensive care with minimal training have entered the market. Another reason is that intensive care personnel usually are inexperienced in interpreting the EEG, and getting an opinion from an EEG expert might be difficult or impossible, leading to compromised treatment of the patient.

Together with his colleague, Eero Väyrynen, an artificial intelligence specialist also from the University of Oulu, Kortelainen started to develop a solution to this problem. The goal was to create a technology that would provide EEG measurements in an easy-to-interpret form.

From a spark to an invention

The two researchers carried out a pilot study with comatose cardiac arrest patients, in collaboration with Oulu University Hospital. They found that specific EEG features revealed healthy brain function despite the patients being unconscious and sedated.

This finding gave was the spark for an invention that was further investigated in a commercially-oriented research project, called BrainICU, which was funded by Business Finland (at that time, Tekes).

“During this project it became evident that there is a clear end-user-driven need for a practical brain monitoring solution in the intensive care environment. The invention also raised a strong interest in the companies providing equipment for intensive care. These two things, together with our strong belief in our unique technology and our team, formed the basis for the decision to establish Cerenion,” says Timo Koskela, CEO and co-founder of Cerenion.

The company’s patent-protected solution utilizes artificial intelligence to compress the complex EEG signal into a single parameter, C-Trend, revealing the status of the brain. This easy-to-interpret parameter (ranging from 0 to 100) helps doctors in utilizing EEG in their everyday work to provide the best possible care to the patients.

The long-term goal for Cerenion is to make C-Trend a globally adopted solution for continuous brain monitoring in intensive care

From scientists to entrepreneurs

All four co-founders of Cerenion have research experience from the University of Oulu, and some of them have spent almost two decades at the university, so in many ways the founding of Cerenion was a big but an exciting change, according to Koskela.

“First of all, everything is now more dynamic. We have a lot of freedom to choose how we run the company and how we conduct our daily work. But we also have a greater responsibility for ourselves, our employees, our investors and other stakeholders that we do it well,” he says.

Some of the co-founders possessed previous entrepreneurial experience, for example from the company MetaVisual, founded in 2005. MetaVisual still exists and provides centralized, full-stack online publishing solutions to SMEs, organizations and discerning private customers.

“This company has provided us with good practical experience in running a small company. Some of the founders have also worked for some other startup companies for short periods of time,” says Koskela. Nonetheless he says that the learning curve has been very steep over the past two years. “But this has mainly been a positive thing, if you take the right attitude. Of course, a small team is also much more flexible, so implementing a change is much faster (and easier) compared to the university. I also feel very privileged that we have been given a chance to build the company from scratch, including the team, the company culture and the processes. You can experience some of this at the university, but not all of it. ”

Jukka Kortelainen is still working half-time at the university as an academic research fellow, so he is still involved in research on a daily basis. The co-founders also conduct research at Cerenion, but they are currently commercializing their first product, so research has not been the highest priority, but will have more emphasis in the future, according to Koskela.

Cerenion’s solution utilizes AI to compress the complex EEG signal into a single parameter, revealing the status of the brain

Drawing the roadmap to the IPR

Founding a company of course teaches you a lot and you gain important insights. Timo Koskela advises that if you are planning to spin-out from a university, start the negotiations for the IPR transfer in time.

“It may be that your home university does not have a clear process for the IPR transfer, or you may enter into difficult negotiations about the valuation of your company (which affects the percentage of shares the university will get once the IPR is transferred, and further, may affect the investors’ interest in your company), and therefore it may take a lot of time – reserve at least half a year. Luckily for us, the IPR transfer from the University of Oulu was rather smooth.”

“If you are raising your first funding round, I would recommend that you reserve 6 to 12 months’ time depending on the maturity of your investor materials (business plan etc.) and your current connections with the VCs, angels, etc”

Also, try to attract the interest of several potential VCs, angels, etc., to create some healthy competition, is Koskela’s advice. This may help optimizing your valuation and speeding up the process in general.

“If you are raising your first funding round, I would recommend that you reserve 6 to 12 months’ time depending on the maturity of your investor materials (business plan etc.) and your current connections with the VCs, angels, etc.,” he advises.

When you draft your roadmap, Koskela would also recommend leaving room for delays. It is always better to “under-promise” and then “over-deliver” than be delayed.

Koskela says he thinks Finland provides good conditions for a high-tech medical start-up when you apply for the seed funding. However, the challenge is that it takes a lot of time and effort to develop a medical device and bring it to the market due to all standards and regulations to be followed, which are of course definitely needed.

“Therefore, I believe that the seed funding is rarely enough for the commercialization of a medical invention, and therefore typically another funding round (late seed/pre-A) is required. This is much more difficult to get, as you do not yet have any revenue, and consequently any proof that the upcoming product will actually sell,” he says.

It’s still people who make the deals

Another important aspect of founding a company is networking, he continues. “It is a must for every founder or co-founder. If people know you or know at least a (trusted) person who knows you, it is much easier to start discussions on collaboration or other business activities. Even in B2B, it is still people who make the deals.”

“Our long-term goal is to make C-Trend a globally adopted solution for continuous brain monitoring in intensive care”

Koskela also emphasizes the composition of the team. You must have all the essential pieces in place, or you need to recruit the missing talent and/or buy the services. “Also take good care of your team, both the co-founders and particularly the employees, because you have extremely talented and motivated people, but they are only a few and you cannot afford to lose any of them.”

Koskela and his colleagues are currently finalizing their upcoming C-Trend software product and will soon start the certification process. The first C-Trend enabled EEG product is expected to be out on the European market this year.

“Our long-term goal is to make C-Trend a globally adopted solution for continuous brain monitoring in intensive care. But before we get there, let’s enjoy the journey!” states Koskela.

Timo Koskela, Eero Väyrynen, Ilkka Juuso and Jukka Kortelainen