What it takes to commercialize an invention, use a 15M Series B to achieve 400% YoY Growth (during a pandemic), and change the standard-of-care for knee health

Invention and entrepreneurship are inextricably linked. You can have one without the other, but throughout history we often remember them as happening in parallel.

Despite this, there are likely thousands of examples of inventors who were the only ones that ever used their invention! And perhaps other examples of people who we thought invented something just because they are responsible for making it available for many.

If the inventor solves a problem, the entrepreneur brings the solution to the world. The world changes when invention meets entrepreneurship.

Enter, Michelle LaFlamme.

Becoming An Entrepreneur

Michelle LaFlamme always knew she wanted to have her own company someday, but despite coming from a family of entrepreneurs, her parents suggested she go to school first. To appease them, Michelle completed a law degree, and afterwards was invited to do her Master’s degree in the law and biotechnical area, learning about the path from invention to market.

Armed with this education, Michelle began working to bring new technologies to market. One of the first technologies was bringing new blood filters with the American Red Cross.

“It was an amazing journey that confirmed my desire to do it again with my own values and own journey. Highly demanding, but I needed to do it again for me.”

Finding The Problem & Solution

In 2007, she stumbled upon a painful problem that affected a lot of people. Many people experienced knee pain, but very little existed to help doctors understand it. At that point, it was a bit of an art — trying to understand what is going on by observing what is happening with walking and moving, or by simply using static images.

The story begins when Michelle was working as a business advisor for the development of the KneeKG system, where she became engrossed in the problem of knee pain, and offered to acquire the IP. The system used video data and artificial intelligence to dynamically understand knee function, providing an entirely new and more accurate way to diagnose knee pain.

In 2008 the acquisition was finalized, and Emovi was born.

The Journey to Clinical Significance

When a technology has the potential to change the standard of care, the road to market can be long and extremely daunting. In the case of Emovi’s status as a medical device, bootstrapping to revenue just wasn’t an option. At every step, data was necessary to prove efficacy, cost savings and get to the next step in the regulatory pathway.

Emovi was tested at a single clinic in 2008. Using real doctors they were able to complete a real world study on the tool, generating the data, analysis, and publications necessary to move forward. The initial data were incredibly encouraging, and gave Michelle the courage to keep going.

In 2012 everything was finalized with the help of the first private angel and the Ministère de l’économie et de l’innovation, and one year later, in 2013, Emovi closed its first Series A round, having achieved sufficient clinical data to begin pre-commercializing the product. At this point the company would sell mainly to academic institutions in order to be able to continue to publish the necessary data to obtain clinical endorsement and reimbursement by third party payers.

In 2014, Emovi applied for a grant with the Quebec government supporting the biggest study in Canada on knee osteoarthritis, and was lucky to be selected.

Knee osteoarthritis is often caused by stress on the cartilage of the knee resulting from a mechanical misalignment due to a sport injury, which leads to inflammation and loss of the cartilage. Emovi provided a new solution to identifying the source of any stress/impact on the cartilage causing knee pain through the identification and correction of bio-mechanical markers.

If the company succeeded, the technology could change the care pathway for knee pain and injury in a way that would lead to lasting health and cost benefits to the individual. Close to 1000 patients, 300 doctors, and 90 clinics participated in this study.

“The results were amazing — not only did it show the ability to correct misalignment with 2 exercises that patients could do at home, but pain was reduced by close to 50% and knee function greatly improved.”

Parallel studies demonstrated delaying the need for surgery led to huge cost savings, and that the results could be applicable to other knee problems and ligament issues.

In 2019, the results were published.

Finally On Paper

Michelle explains how she knew the journey would be worth it.

“When the MRI came to market it took easily 10 years to create early adoption. In the beginning doctors had no idea what findings on the images meant. We knew we had that challenge of correlating findings to meaningful information for doctors. In 2008 the researchers began to work with artificial intelligence and machine learning to understand the KneeKG output at which point real world application and impact became possible. We needed to invest in artificial intelligence (AI) or else it would take thousands of surgeons and images to understand the meaning.”

Today, the MRI is an extremely powerful tool that tells you exactly what the white dots mean and what should be done; 20 minutes, in and out. But it was not an overnight success.

“When you come to the market with a disruptive technology, others find it very attractive but no one knows what to do with it. Changing the care pathway is difficult. It’s different from a drug. In the area of medical devices, you need to demonstrate cost savings, show that a better care pathway can exist, and reorganize the delivery of care.”

Evolving as a Solo Founder

We asked Michelle what it was like to be a founder throughout the many different phases of Emovi’s long journey.

“In a certain way, I was transformed.”

In 2018 Michelle recalls a conversation with her son, an elite athlete, when he was feeling a bit off one day. She asked him what was going on, and how he felt on a scale of 1–10. He said 7. When she asked what would make it a 10, he answered simply: the absence of doubt.

“This put into words what I was feeling. In the beginning, you have a vision, and a lot of people tell you what to do. And because you don’t have experience, you tend to listen to them. Although I started my journey experiencing doubt, with everything I learned the doubt just went away. Then I started to say — ‘Look, if you think you can do better, just do it.’”

Although she had many people supporting throughout different phases of Emovi’s journey, Michelle has mostly been a solo founder.

“I cannot tell you how hard it is. You cannot talk about the difficulties you go through because it scares people.”

Incredibly, the name of Emovi is inspired by the strength of persevering through challenges.

“Emotion, Movement, and Vision — Emovi. These attributes are at the core of who we are as a healthcare innovation company.”

Michelle believes that mentorship played an important role for her. She was lucky to have different ones at different stages of the journey. She explained how some of her mentors didn’t know they fulfilled that function for her. Sometimes they were just someone who helped her get through a problem without knowing it and every bit of support received along the way counted.

The Challenges of Covid-19

When we asked about how Emovi approached the challenges of Covid-19, Michelle reminded us that Emovi began during the economic meltdown of 2008, and so was no stranger to crisis.

She spoke about how helpful it has been to speak to other entrepreneurs and understand what they were going through, something Michelle McBane organized for StandUp‘s portfolio at the beginning of the pandemic.

Emovi had a few strategies to keep up employee morale — including opening a virtual office every day at 9am, where anyone on the team can meet to have a virtual coffee, spontaneous meetings, and Happy Fridays. At the time we spoke to Michelle, the ‘virtual office’ had been open for 340 days in a row. It’s been over a year now. The team also had virtual gatherings every 2–3 weeks.

The business needed to transition as well. Pre-pandemic Emovi created a funnel of leads by attending in-person conferences — all of which became cancelled almost overnight. They also previously had Emovi personnel travel to different sites in order to install the systems on site and train people to use them.

“Everything had to be changed. We needed to pivot quickly to adapt to this new reality.”

Emovi began selling using webinars for healthcare professionals on Zoom. In a series of 9 webinars they were able to reach close to 2000 participants, which is more than they would have reached at in-person conferences. Along with investing more in digital marketing, the team was able to create an even stronger sales funnel than pre-pandemic.

They also began to support installation and training entirely online. Emovi team members would unpack the equipment with customers via live video. What used to take 2–3 days was now taking 6 hours, done entirely within one day, without the need to travel.

It’s clear that Michelle’s son (a competitive hockey player), along with the athletes that Emovi has helped, also inspired her to persevere through difficult times.

She tells the stories of a famous national hockey player in Quebec who succeeded against all odds. Waking up at 5am to work on the farm, starting skating with a pair of skates that were 2 sizes too big at the age of 13.

“He had nothing to lose. When you have nothing to lose, you don’t overthink it. You just go!”

Series B to Hyper-Growth

In 2019, Emovi raised a 15M Series C, led by TVM Capital, with participation from Desjardins and StandUp Ventures, with a financing from Investissement Québec totalling 20M. She speaks to the importance of developing relationships with investors far in advance — in the case of TVM, the journey took 3 years.

She also spoke to having investors with a personal tie to the company. One investor in particular had an objective to climb Kilimanjaro, but could no longer jog due to a knee injury. With the support of KneeKG, the investor could go back to jogging, climbed Kilimanjaro, and consequently invested in the company.

She talks about how her investors took the time to understand the business, the market, and supported them with Emovi’s objectives and milestones. At the time the Emovi financing was one of the biggest high-tech women-led investments made in Canada.

Despite Covid-19, the financing supported an incredible 400% growth last year. This year, Emovi will grow another 2x.

Partnering with Laurent Duvernay-Tardif

If you’re at all saavy with Canadian sports, you’ll know exactly who Laurent Duvernay-Tardif is. As the Kansas City Chiefs starting right guard for the past 5 seasons and Knight of the National Order of Quebec, Laurent is one of Canada’s most decorated athletes.

But what really makes Laurent stand out is that he is a medical school graduate, and during the 2020 NFL season he chose to opt out in order to work at a long-term care facility in Montreal supporting the needs of the coronavirus pandemic.

In January of 2019, Michelle Laflamme knew she needed to work with Laurent.

“Not only is he a professional athlete with 2 knee injuries, but he has a medical degree and could actually understand what we were doing.”

Michelle sent emails to everyone she knew looking for an introduction.

When she finally tracked him down, Laurent wanted to get the test done. He had been experiencing some lingering knee pain when he met Emovi in 2019.

During the KneeKG test, mechanical markers were identified aligning with the pain he was experiencing that could explain his pain and how his performance was affected.. After just 3 weeks of doing the 4 exercises provided to correct his knee dynamic alignment, he was back to the season in August pain free. When asked about it, Laurent says he is 100% back at his peak performance.

He soon became Emovi’s official spokesperson.

“We like to say he won the Superbowl because of us,” Michelle laughs.

Long-term Vision

To say Michelle has a big vision for Emovi is an understatement.

After bringing the knee pain diagnosis product to market, the company is continuing to innovate the standard of care for knee health. Two products currently in the pipeline include a surgical planning solution for knee replacements, as well as a product for sports teams and athletes to prevent injuries and better understand knee function for return to play.

Michelle believes that AI is the key to creating better healthcare in the future. And although the road is long, that the journey is worthwhile.

Thank you Michelle, for persevering for the benefit of so many. You are an inspiration for entrepreneurs everywhere!