Listen to this episode to learn about the Ibex by Axtion Independence Mobility Inc., a walker, rollator-walker, and mechanical lift in one and winner of the RESNA Developers' Showcase AT IMPACT Award 2022. Co-Founders Tracey McGillivray and Liam Maaskant join Dr. Mary Goldberg to talk about their innovation that is bound to change the game for aging-in-place or even those needing a little help with mobility.
Host: Dr. Mary Goldberg, Co-Director of the IMPACT Center at the University of Pittsburgh
Guests: Tracey McGillivray, Entrepreneur/Co-founder & CEO at Axtion Independence Mobility Inc.; Liam Maaskant, Mechanical Engineer; Co-Founder & CPO, Axtion Independence Mobility Inc.
Tracey McGillivray | LinkedIn
Liam Maaskant | LinkedIn | Email
Action Independence Mobility Inc. | Twitter
IMPACT Center | Website, Facebook, LinkedIn, Twitter
Full Transcript | PDF
Key Mentions
www.Rise4Access.org
www.RESNA.org
SPEAKERS
Tracey McGillivray, Liam Maaskant, Mary Goldberg
Mary Goldberg 00:04
The IMPACT Center at the University of Pittsburgh supported by the National Institute of Disability, Independent Living and Rehabilitation Research, proudly present ImpacTech. Today's episode "Solving everyday challenges with simple designs," features our guests Tracey McGillivray and Liam Maaskant, entrepreneurs and co-founders and CEOs of Axtion Independence Mobility, Inc. Recorded remotely from my soundproof bedroom closet in Pittsburgh, PA, this is your host, Dr. Mary Goldberg, and welcome to our 17th episode of the ImpacTech podcast series. Welcome Tracey, and Liam, could you please introduce yourselves for the audience?
Tracey McGillivray 01:01
Sure. I'm Tracey McGillivray. And one of the two co-founders of Axtion Independence Mobility, Inc.
Liam Maaskant 01:08
I'm the other co-founder, and my name is Liam Maaskant, and I'm a mechanical engineer. And Tracey and I have been together on this venture for about two years now.
Mary Goldberg 01:18
Excellent. We really appreciate you being here today. And we'll get into your technology in a minute here. But you recently won the IMPACT Award at this year's RESNA conference. This is based on our center's goals, which is supported by the National Institute for Disability, Independent Living and Rehabilitation Research, to make sure that technology gets to its intended users. We selected you all for the IMPACT Award based on the technology that we felt would make the biggest impact for people with disabilities. We found your technology to be very innovative, creative, and your dedication to assistive technology was very clear. So can you please talk a little bit more about your technology?
Tracey McGillivray 02:00
Sure. So you know how it came to be was, it all started with with my parents who were then at the time, 82 years of age 82 and 81. I had retired at the end of June 2019 and decided to go back to school, which was away from home, my parents actually live here with us. So I was away at university. And I know that sounds funny. And my husband was working outside the house and my dad started to fall repeatedly. And mom was unable to help him back up. And so nobody was home or nobody was around, they'd end up calling 911. So I scoured the market looking for something and couldn't find anything that was really helpful. Any of the lift devices out there. They were all they all weighed, like 50 plus pounds, they all needed to be brought and assembled, and then operated, which was just far too complex for mom to do. And so I thought I'm gonna have to build something and figure this out. I knew it was the fastest growing age cohort out there. Certainly across the developed world. Liam and I'd known each other a couple of years at that point. We've common undergrad alma mater, and through our athletics department. That's how we got connected. And I knew he was in mechanical engineering. I also knew he was somebody I could really, really work with. And so I sent him an email one afternoon, I said, I got an idea I want to run by you. And he said, Sure, I'll call you when I get off the ice. He was captain of our hockey team at the time and sure enough, he did and basically described what I just described to you all and took them about 30 seconds. And he was crazy enough to say yes, to go on this journey. So Liam go ahead.
Liam Maaskant 03:42
Yeah, so basically, I'll pick up where Tracey ended, but basically, we, we came together. And at first we were like Okay, fall recovery, fall recovery. And so we just started building, kind of lifting seats and and at first, I told Tracey, okay, I want us to go away for two weeks. Don't share any ideas. And then we'll come together and we'll share what we're thinking anything that we could incorporate into the device. And we came back and we really settled on the idea of a lifting seat built into a rollator-walker. And so that's where it all began two and a half, almost three years ago now. And so we started, I guess I was out in Halifax. And this is right at the start of COVID. So that didn't help either, but, but we were able to find space where I could start building some mock ups and I was using two by fours taking apart drills, some car jacks for lead screws and I was able to build kind of a lifting seat just built within a frame and powered by a drill and a lead screw. And we were still unsure where to go from there. So then we were lucky enough that Tracey had a mutual connection through our academics. And we brought on an occupational therapist who LingLong, who basically steered the ship, the product right from the start, and just gave me some checkpoints to reach. And I wasn't sure how low I needed to go as I was thinking, you know, what, as low as as low as a step, or, you know, six inches, and the first Ling said that “No, it has to be flush with the ground.” So that was the first thing we had to design into, into my mock ups. And so Christmas of 2020, we finished our first guess, somewhat functional prototype. And it was more of a proof of concept, but it really showed how the lifting seat can be used. We started meeting with other clinicians, and physiotherapists, occupational therapists, physicians. And what really surprised us was, okay, this isn't just a fall recovery device, it's going to be used for fall prevention. So you're really able to avoid the vulnerable positions. Living alone living at home, when you need to go down to the lower shelf, when you need to transfer from a chair, you can avoid some positions that might have been a fall risk in the past and has really made our device into a fall prevention device as well. And we tried for another prototype that next spring, it worked well. But it didn't really meet the requirements of what we wanted. And then finally, we got to our our most recent functional prototype. And that really includes a lot of features that we're looking to have on the final product. So foldable frame, rotating seat. So the foldable frame, you can traverse through narrow doorways. The folding seat allows you to walk within the frame, almost like a Zimmer frame rather than a typical rollator Walker, where the seats fixed in position. So you have more stability, more balance when you're when you're using it as a mobility aid. And yeah, and it works. It works very well, especially to demonstrate how this device is going to be used. And and so we're still continuing through through product development, and we're, we're working our way to the market. That was the long-winded answer hahaha.
Mary Goldberg 07:14
hat was great. It was great. Thank you. I can I can see it. And it's helpful for our audience. Of course, you do not have the benefit of the visual here, I saw that your tagline is solving everyday challenges with simple designs. Can you describe a little bit about what makes this design simple?
Tracey McGillivray 07:33
I guess from my perspective, it's starting with something that people are already familiar with, it's been out there for, you know, 40-50 years is the whole idea of a walker and a rollator-walker. So it's something that can go everywhere with you. So it starts with that. And I think, you know, the individual pieces of technology, there's nothing novel, but I think the novel was in the design. And you know, we've certainly come across some mechanical and design and technical challenges there. But you know, Liam, and with the support of the research and mechanical engineering community at Dalhousie, and particularly, one of the professor's who's the Academic Director in the incubator, has been able to solve and overcome most of those are probably a couple of minor ones. But I think we have a pathway to get those solved as well. And so I think it's, it was starting with something and I gotta give all credit to Liam on this, but starting with something that people are already familiar with, and then seeing what is it we need to add. And his creativity, I think was in just three in reimagining the rollator-walker. You know, my my dad before he passed away actually called it, you know, he was referring to it as a personal utility vehicle because of and this is where we really started to embody this notion. It's more than just fall recovery that goes everywhere with you. It's really about fall prevention and liberating and enabling you to kind of continue the things that you'd like to do, because dad used to describe that he said, “This will be great, I'll be a basket on it, I can put my tools in there and the sprinkler head parts so I can we went out to the sprinkler heads and the you know, the underground irrigation system that we have, and he said I can lower myself down, replace the sprinkler head and raise myself back up.” Mum still talks about it, she's dying to use it to get out into the garden she said “I just can't get down low anymore. I can't even get down to the low bench to plant the flowers in the flower bed. So I want to be able to take this out use it to get down and plant my flowers and and get back up.” So getting back to the kinds of activities that bring people joy and a sense of independence. You know, everything from my parents literally stopped cooking certain meals because they can no longer get the heavy cast iron frying pans that were on the low shelf because of their weight back up to the stove. So you know certain things go by the way side, because there's a there's a trade off and leaves to say, now we can, we can actually put that frying pan on our lap and raise ourselves back up. So it was really about continuation of activities that bring people joy and a sense of independence and dignity. I mean, it could be as simple as lowering yourself down to play with your grandchildren on the floor, you know, it, there's a whole host of things. And it doesn't have to be just for seniors, there's lots of other cases of people with some, you know, some physical impairment or disability of some sort, whether that be hemiplegia, whether it be pots, whether it be you know, there's a host of things even recovering from knee or hip surgery, but so that they can continue to be independent.
Mary Goldberg 10:51
Thank you got a clearer picture of the technology but not as clear on the status of your business. Can you describe a little bit where you are now with raising funds and whether you have any products currently on the market?
Tracey McGillivray 11:04
Sure. So we are a new company, we don't have anything else currently on the market. This is our first one. But it's not envisioned to be the only one we also have a pretty extensive product roadmap for this particular product. So we'll be complete with our new commercially viable product, the summer of 2023. But that's only the first model of the product, we have three more models envisioned after that, that will take us out to 2025, including the ultimate intelligent autonomous device that will be summonable and can autonomously navigate its way to an individual if they have fallen Earth, they do need it. And so that will come out in 2025. So we have a couple of models in between that. So we have a pretty extensive roadmap. And then we also have two or three other product ideas in the hopper waiting to kind of enter our product development ecosystem that we've been able to build up through this whole process. So in terms of the status of our business and what we've raised in terms of funds, we've been extremely blessed through the support of a lot of different organizations, Nova Scotia Business Inc, and Oba Corp both are organizations within the province of Nova Scotia, your Mitacs, which is a Canadian federal government, research-oriented organization funded by both the provinces and the Federal Government of Canada through AGE-WELL which is a national Canadian National Center for Aging, Aging2.0, which is a global organization. Volta which is a small incubator in Halifax, BioNova Park, Nova Scotia. And then we've been working with with two universities, both Dalhousie University and the Faculty of Engineering and Department of Mechanical Engineering specifically, and then with Acadia University, both their school of business and they're both kinesiology and we've also been working with and partnered with Northwood, who are the largest not for profit continuing care provider east of Montreal in Canada. And then they crest who are a very large continuing care provider focused on cognitive impairments in the Toronto in southern Ontario region. So we've been able to raise a lot of non dilutive non repayable funding through the graciousness and generosity of those organizations. And then I've been able to invest to fill any gaps that we have. So at this point, we are still non diluted, it's still 100% owned by Liam and I. So there's no dilution in the organization so far.
Mary Goldberg 13:47
That's awesome. I'm familiar with some of the organizations that you described, including AGE-Well, and they actually were past guests of the podcast. I can't wait to see what's ahead for you all. And you've obviously learned along the way, I'm curious about what challenges you've encountered and how they've helped to shape your design process.
Liam Maaskant 14:07
Yeah, sure. Technical challenges are, they're always fun. But that's that's kind of been my challenges out here. I've been building mockups prototypes, and I'm a newly graduated mechanical engineer. And this is kind of my first time going through a full design process for a device that someone else will use. So I've really leaned on my professor, Dr. Cliff Johnson, the idea the main idea of lead engineer Graham Muirhead, and they've been able to steer me in the right directions when it comes to the actual mechanical design, but really, at its core, it was trying to find a way to meet the benchmark of a typical rollator Walker and something that people are already using while incorporating a seat into that design and the lifting seat. So it's really just lifting a person up from zero inches above the ground to around 24 inches. And that's been kind of where the the most issues have come about. But it's also the core of our design as well. And we've been able to design around them and to, to really meet those requirements, so that someone isn't using a brand new device for the first time, it feels like they've already used it before, and it feels familiar to them.
Tracey McGillivray 15:24
Yeah, from a, from a business standpoint, we haven't had too many business challenges. I don't think so far, because of following some, you know, the incubation and acceleration programs, we've gotten a lot of really good advice and really good support. It really does take a village, especially if you're in the medical device space, it's not an undertaking for the faint of heart. That's for sure. And so we knew we had to get some professional help from, you know, regulatory experts. And in addition to solving the technical challenges, is it is a regulated product. And so we do have to go through regulated processes, both here in Canada and in the US. And so we brought in a regulatory consultant on very early in the process, and he stuck with us. We've been a little over two years in the actual product development cycle so far, starting with the two by fours and plywood and car jacks and drills on that Liam described earlier, through to now having, you know, pretty fully functional prototype, and we're moving into working with our contract designer manufacturer. And so that that's all gone relatively smoothly, because we do have the right community around us, we're very, very blessed and very, very fortunate to have the support from literally dozens of people around us. And I think that's what it takes. It's not just about one or two people or three people even, it takes dozens of people and their individual expertise and abilities and experiences to bring something like this to fruition. Even as you know, as far as we are, we think the kind of the biggest upcoming challenges are really going to be, you know, when we launch in the market, but it's about reimbursement from the traditional payers. In, you know, in Canada, it's done provincially. In the US, it's primarily through for those 65. And over through Medicare Part B, or Veterans Affairs, US, the US VA, or Medicaid for those who you know, who are unable to afford it, because the price point will be somewhat high. Not unaffordable, but it will be certainly more than your typical rollator-walker. And at present, you know, if you look at the Centers for Medicare and Medicaid Services, the coding and we've gone through all the HCPCS codes that are out there, there really isn't one that fits our device. So we'll be looking for a new code, but also the policy around how those codes are applied. For example, there is such a code out there as for power patient lifts, but the application of that code says, well, first of all, they really only pay for manual. And second, it needs to be a two-person assist required otherwise, the person will be bedridden, well, our typical user isn't going to be that fit that profile. And so we you know, we've seen recently the the advocacy that RESNA does for things like the elevating seat in powered wheelchairs and the stand the powered standing assist in powered wheelchairs, ours would be adjacent to that, but the need for new codes, but also adjusted and updated policy. Which, you know, from a pure mercenary dollars and cents business case, in the case of our device makes perfect sense. Because we can avoid 911 calls, we can avoid and help avoid significant hospitalizations. You know, in the US I think the average hospital stay was 11.6 days for somebody who had fallen seniors over the age of 65, who had fallen for 40% of all admissions to long term care and assisted living are because of falling, the fear of falling, 40% of hospitalizations for those over the age of 65 are because of falls. And so there's a whole bunch of cost avoidance that comes into play, not to mention the savings on the individual themselves. And aside from that, you know, from a quality of life standpoint, 90% of us, you know, go back and look at the AARP study. 90% of us want to remain in our own homes or living with family. We don't want to go into assisted living or long term care or skilled nursing facilities on a long term basis.
Mary Goldberg 19:52
Thanks Tracey. So RESNA and other advocacy groups have been key in pushing through promoting change to these different reimbursement mechanisms or policies. What can our listeners do to help this cause and help get this product into the end users hands that would need it most?
Tracey McGillivray 20:11
Well, there's currently actually, and this doesn't necessarily apply directly to our product. But it applies to those that are adjacent. And you can immediately see the benefits. But there's the Rise4Access.org, which is currently got a soliciting inputs and comments from Americans coast to coast code, you know, coast to coast in the US. And so I would encourage folks to go out and look at Rise 4 Access, and it's R I S E, the number four access.org, or go to RESNA.org and look at they've got it advertised or published on their website, and sign that petition to promote and lend your voice of support to the cause as the Centers for Medicare and Medicaid Services, and kudos to them for opening up the comments period to actually accept inputs from Americans. And they do want to hear the voices of Americans. And so I would certainly go sign the petition and add your comments to that, the more we advocate for helping people get back on their feet, whether they're in a wheelchair, or whether they're just simply in need of a little bit of mobility assistance. I think it's all a good thing because it helps with independence and with dignity. Which ultimately helps prevent admissions into hospital and long term care and extends not only lifespan, but the quality of life. And that lifespan, which I think is really, really important.
Mary Goldberg 21:40
So that's rise 4 access. That's the number four.org and RESNA.org. And as I mentioned, this company was the winner of our impact award, they participated in the RESNA design competition as a part of the annual RESNA conference. And you can find more information about the conference as well as membership to RESNA and become an advocate yourself. So thanks so much. And Liam, could you let us know where to find more information about your company and how to contact you?
Liam Maaskant 22:18
Right now we've we've kind of been focusing on first things first, the device, so hopefully into the fall we'll be launching our website and having a bigger social media presence. You can find us on Twitter at Axtion Independence Mobility Inc. Myself, I can be reached at Liam.maaskant@axtioninc.com. So as of right now we our brand we haven't done a launch publicly however, that's, that's coming. It's it's in the works. Yeah.
Tracey McGillivray 22:53
And our Twitter handle is @axtioninc.com And it's A x t i o n. That's how we spell action. So Axtion Inc is our Twitter handle and anybody is welcome to reach out to either Liam or I via email.
Mary Goldberg 23:12
Excellent. Thank you so much. Thanks again to Tracey and Liam from Axtion Independence Mobility, Inc. On our next episode, my guest host, Dr. Michelle Zorrilla and Nancy Augustine from the IMPACT Center interview the People's Choice Award winners from another RESNA design competition, this one for students. I'm proud to share that this winning team affectionately known as Toothbrush Buddy were in a class I co-teach at Pitt as part of our Master of Rehabilitation Technology Program. Kudos to them and please join us to hear more about their inspiring story. Until then continue to make an impact in whatever you do. If you like ImpacTech, please review us on Apple podcasts or wherever you listen to podcasts. Thank you again for tuning in and continue to make an impact in whatever you do. A quick note from our sponsors. IMPACT initiatives are being developed under a grant from the National Institute on Disability Independent Living and Rehabilitation Research. NIDILRR is a Center within the Administration for Community Living, Department of Health and Human Services. IMPACT initiatives do not necessarily represent the policy of NIDILRR, ACL or HHS, and you should not assume endorsement by the federal government and the same goes for the University of Pittsburgh. We would like to thank our ImpacTech guests and our production team led by Dr. Michelle Zorrilla at the University of Pittsburgh Department of Rehabilitation Science and Technology.