➤ Proximie, an augmented reality system intended to iron out variations in clinical care in the operating room, has supported 8,000 live procedures and was selected by the U.K. Ministry of Defence in 2019 for front-line soldiers' care.

➤ Investors include former Uber Technologies Inc. executive Curtis Chambers; venture capitalist Tim Draper; and Henry Engelhart, founder of insurance group Admiral Group PLC.

➤ About 5 billion people lack access to safe surgery, while an estimated 140 million people need life-saving surgical procedures and 80 million more who receive poor quality surgery are subsequently impoverished, according to the Royal College of Surgeons in Ireland’s Institute of Global Surgery.

Proximie CEO Nadine Hachach-Haram Source: Proximie Ltd.

Proximie Inc. uses machine learning and artificial intelligence to create a virtual and borderless operating room, enabling a surgeon in Seattle to virtually scrub-in and assist in an operation taking place in London or Benin, according to founder, CEO and majority shareholder Nadine Hachach-Haram.

Hachach-Haram, a consultant plastic surgeon and head of clinical innovation at Guys and St Thomas' NHS Foundation Trust in London, is embarking on a series B fundraising for the company. Before creating Proximie in 2016, Hachach-Haram advised medical device companies on new techniques and product launches, and volunteered with charities to help build surgical expertise and address inequities in clinical care globally.

S&P Global Market Intelligence: What brought you to set up Proximie?

Nadine Hachach-Haram: I trained to be a surgeon and my area of focus was largely reconstructive plastic surgery — so how to improve quality — and I was working on breast and pelvic cancer patients largely.

In 2014, I was sitting in an operating room on one of those footstools taking a bit of a break as the others scrubbed in, and I started to look at the operating room, I started to think about all the things I was trying to achieve. It became clear to me that it didn't really matter how many planes [I got on] or how many operating rooms I visited, the fact is, it's very analog: we don't digitize it, we don't capture information, we don't create insights to influence the future of surgery. So that was the moment that I decided every OR should be connected, collaborative. Whether you're in a third-world country, the U.K., or in the U.S., it's the same problem everywhere: variation in quality. I set [Proximie] up initially and evaluated it with some global health charities in austere environments because I really wanted to understand how far we could push the technology. But our core business is focused on Europe and the U.S. We launched in the U.S. in April of last year, with close to 50% of our business now. And we're in over 250 hospitals now in about 35 countries.

How has the pandemic changed your business?

What was really clear, even before COVID, was this direction of travel…this idea of [a] digital operating room that's more connected, more data-driven, and more collaborative. That was the vision behind Proximie: Operating rooms all around the world connected, allowing clinicians to virtually collaborate, scrub-in, and to start to curate data insights and learnings that can feedback into that. Because if we look at other industries, they do operate in a more data-driven way, and why not in healthcare as well?

But of course, that was happening pre-COVID. Those challenges that we were facing in surgery, around variation in care, variation outcomes and variation access, were crystallizing and palpable, and people were frustrated and starting to use solutions like Proximie. But undoubtedly when COVID came, [it] just accelerated.

Can Proximie be used in any type of surgical procedure?

Proximie has been used across all therapeutic areas. But in 2019, we focused on minimally invasive surgery and orthopedics. And in 2020 in Europe, we launched into interventional cardiology and interventional procedures. In 2021, we're looking at ophthalmology and bariatrics.

The shortage of medical professionals in the U.K. has been compounded by the pandemic. To what extent can Proximie be used as an educational tool?

The beautiful thing about the way we designed the platform was because I didn't want this to be a siloed product offering, I wanted it to extend across the whole surgical industry, or ecosystem within the hospital. Traditionally, we've always described surgery as see one, do one, teach one. It's how we train; it's how we deliver care.

Proximie has changed that model to prepare, perform and perfect because we believe that it should be a digitized continuum. And, therefore, your user could be a first-year medical student or could be a senior consultant at the top of his game. But throughout that the whole ecosystem of learners, care delivery, and extending workforce is all connected.

We've partnered with groups like the Association of Surgeons in Training to help deliver and hopefully accelerate the opportunities so that we can get doctors and nurses trained up faster. Because the training pathway is long, and we need more workforce, the deficit of surgeons available, and the [number of] patients who need it is growing.