Ghent-based MedTech company FEops warms people's hearts worldwide

Suppose you’ve got a heart valve that isn’t functioning optimally. Your heart specialist will want to place an implant in a catheter lab or even suggest open-heart surgery. CT scans will be ordered, checks will be made and, based on experience, the doctor will make an assessment of which implant might offer the best solution. However, there’s never a 100% success rate. This process is based on an estimation and there’s still a margin of error.

That’s where FEops detected a margin for improvement. Their technology allows doctors to convert these CT images into a so-called ‘digital twin’. In doing so, they create a virtual copy within their platform, which also makes use of AI, so that the doctor can make a better assessment. Last year, they got to take home the award for Scale-up of the Year 2022. Safe to say they’re doing great!

This MedTech company fits perfectly into Ghent’s healthtech ecosystem. After all, we cherish the bold ambition to become the Technology Capital of Europe and in doing so, we’re also betting on the medical miracles of tomorrow. We spoke to the spiritual fathers of FEops, Peter Mortier en Matthieu De Beule.

Hello gentlemen, first and foremost congratulations on your win at Scale-up of the Year 2022. How does that feel?

Matthieu: Thank you! That award was especially nice for our crew. I saw big smiles on their faces that night. We’d never thought we’d win! To get that recognition, that was truly gratifying. You’re validated in your belief that you’re building something unique.

But how did this unique idea actually come about?

Matthieu: Well, I'm afraid I’m somewhat to blame. I studied engineering, and then I started doing research at Ghent University, about the use of computer simulations for medical implants, at that time still an unexplored field. That's where I bumped into Peter, as a student. I was lucky enough to pick some brilliant students to help me with my research, and Peter was one of them.

During our research, we’d noticed that there was a very strong interest in our knowledge of computer modelling and developing implants in a cost-effective way. So in 2009, we decided to set up a spin-off. At first, we only gave advice to other companies, but Peter saw an additional opportunity in the creation of a 'digital twin' based on medical imaging of patients. That digital representation of how an implant will behave in a patient's body offers great added value.

Matthieu: At a certain point, you can find your company at a crossroads: are you going to raise money to take your product to the next level and get ready for certification, or are you going to stay at the current level? We decided, back in 2014, to raise capital, which we found from PMV and Capricorn, two venture capital funds. In 2017, our investors suggested we add a partner with more knowledge of the cardiovascular domain.

Then we travelled all the way to Silicon Valley with our backpack and spoke to at least 50 investors, who mostly gave us a hard ‘no’. That’s because what we do falls between the domain of implants and imaging, and that was new in 2017. So people didn’t really believe in it yet. But perseverance wins, and eventually we found the right partner in London. There, Jan Pensaert has a venture capital funds called Valiance.  Another Ghentian, by the way! Thanks to their support, we were able to recruit people with the right expertise and went from 15 to 40 employees.

Now, healthcare is a very interesting sector, but certainly not an obvious one. You have to jump through an amount of hoops, so to speak, before you can move on. What’s your experience with this process?

Peter: Indeed, it takes several years before you can and lay enter the market, and before you can demonstrate the clinical added value on paper. We’ve had to be patient. But if you’re supported by the right people, and keep going strong, you can really reap the benefits, at some point. After all this time, when we look at what we’ve achieved, I think we can be quite proud! After 3 years, for instance, we’ve gained admission to the US market. Since March 2022, we have full FDA approval. And in Europe, our products are covered by the new MDR regulations, one of the first.

Matthieu:  That long process was also partly down to ourselves, to be honest. You can choose to launch a less innovative product and demonstrate that it’s similar to an existing product. Then you’ll get approved faster. We just didn’t feel like doing that. We wanted to set the bar very high for the competition from the get go.

Just how innovative is your process?

Peter: We construct a 3D anatomical model on the computer based on CT scans. We use computer simulations for this, which are also used in engineering, by the way. So instead of relying on a measurement based on a scan, which only shows a fraction of the problem, you can virtually perform much of the procedure in advance.

Matthieu: Doctors today need an average of 1,2 to 1,4 implants per patient. That means that there’s a chance that the implant may not fit properly and the patient may need a second implant. Of course, this also increases the risk of complications! We’ve conducted a clinical study on 200 patients at the end of last year, and the results were remarkable. Thanks to our procedure, doctors only need 1,03 implants per patient. It hardly gets any better than that!

Peter: That study really made a difference. Doctors weren’t always convinced they could benefit by the insights from some engineers in Ghent. But now, we’ve got proof.

How do you take that step towards a clinical trial? How do you start that process that, once again, requires time and resources?

Peter: Together with some top doctors, we worked out a protocol. The approach was ‘investigator-driven’, which brought the cost down quite a bit because the doctor was the instigator. However, this also meant that we were outsiders to the entire process, and had no idea how we’d done up until the results were revealed. We were pleasantly surprised to see such a serious improvement across the board!

Matthieu, you mentioned earlier that you’d gone abroad to attract investors. How do you not only start the process of going abroad, but also of contacting the right calibre of investors?

Matthieu: We started from the network of our current investors, and we also went to events abroad where we knew interesting people would be. And it’s those physical contacts that add a different layer onto your story, because you get to convince a lot of people.

Now, once you’ve convinced an investor, there also needs to be a click. Everyone has a different style, and eventually we do have to work together for quite some time, literally a number of years, given our domain. When you build a company, some things take longer than planned, and you need people around you that can see through that. In addition, they need to bring something to the table. Their knowledge has to be an added value. They need to have characteristics that you don’t yet have within the team.

You say that those funds mainly enabled you to recruit the right people with the right knowledge. How easy or difficult is it to find them, as a Ghent-based company?

Matthieu: Honestly? Pretty smoothly! I think that’s due to a number of factors. Firstly, we’ve got a stable intake of students thanks to Ghent University. I was able to select the best students at the time, which resulted in a core team of 15 employees. I’ve literally plucked these people out of a lab, and I’m still shocked by their abilities, every day.

Secondly, we work within an interesting sector, where people see the added value of their contribution every day. We also recruit quite internationally. And there are quite a lot of people who want to move to Ghent, especially for this job.

Peter: Absolutely! Young, international people love living here. Over the years, we’ve seen this close-knit community grow quite a bit.

What does the future hold for your company? What are the next hoops to jump?

Matthieu: At the moment, we are working with the manufacturer of the implants. They’re currently paying for our product. An implant costs somewhere between $10,000 and $30,000, which is still quite hefty. The advantage is that we only need to work with a small amount of manufacturers, operating from Ghent, and still serve a very large market. We train someone at the manufacturer, and they then explain this further to the doctor in the catheter lab.

Peter: As a service provider, we do have a very big advantage. After all, everything can be found on our cloud. Our competitors still use software that has to be physically installed on the computers in the hospitals. Moreover, every update has to be performed physically, and that takes time. For our technology, our customers only need a web browser. That way, an expert and a doctor can look at the same clinical picture at the exact same time, from a different location. When we perform an update, company A in Australia and company B in Boston are on the same version within 15 minutes. Our cloud is also one of the reasons we can continue to do all of this from Ghent.

Finally, can I infer from our talk that Ghent will remain your headquarters?

Matthieu: Absolutely!

Peter: If you look at the growth in recent years, in terms of digital tech companies operating within this city, it’s immense. All those companies strengthen themselves and each other. That does make recruiting a bit more difficult (laughs). But it’s also a truly inspiring environment in which to do business.