Cemoh119: The Story of Maxwell Plus with Tom White

It takes a lot of work to trust an online service with your health. Simon Dell speaks to Tom White Co-founder and Chief Operating Officer at Maxwell Plus about the challenges and lessons with marketing an online service using AI and specialist doctors to detect prostate cancer early.

Transcript

Simon Dell: So, welcome to the Cemoh Marketing Podcast. Videocast, whatever it is, it changes every week. I can never remember what I’m actually doing here. And it’s Friday afternoon. I don’t have a beer, but you have a coffee because Tom White is with us today, and he’s all the way from England. So, how are you today? How are you doing today, Tom?

Tom White: I’m good. I’m good. Thank you. I’m standing here in a – what is looking like it’s going to be a lovely day in London, which is rare.

Simon Dell: Cool, it’s 6:00AM with you as well. You’re on your first coffee of the day?

Tom White: It is. It is. It is the first of many. Yes.

Simon Dell: Now, I will… I’ll ask Tom to tell us a little bit about his company in a minute. I’m just going to explain that I met you guys through a Queensland mentoring session. So, if people are wondering why I’m talking to somebody in London, it’s because you’re part of a team that’s actually based in Brisbane, isn’t it?

Tom White: Correct.

Simon Dell: So, tell us what the company does. And perhaps whilst you do that, also tell us how the hell you’re involved whilst you’re in London.

Tom White: I just… The simplest is I just love – I love getting up early. That’s the reason. No. So, my name’s Tom, I’m co-founder of a company called Maxwell Plus. We’re a local Brisbane startup. And it’s very soon, I think we’ll be able to claim we’ve shed our startup wings and moved into a local Brisbane company.

And we do prostate cancer diagnosis. The way we do it is we combine artificial intelligence and specialist expert clinicians to help better diagnose prostate cancer earlier. So, it’s a virtual healthcare company, so it’s direct to the patient. They can sign up online. It’s all managed remotely, except a few things here and there. We haven’t figured out how to do… Haven’t figured out how to do the infamous digital rectal exam in person virtually yet, but we’ll get there.

Simon Dell: Yeah. And so, how did you get involved? Why are you in London and the rest of the company is in Brisbane? I presume some more of them might be virtual as well.

Tom White: Yeah, so I joined the company… I’m just coming up on three years, just as it raised its seed round. And I joined the company as Elliot and I went to university together, and we actually founded a company in university back in the day.

So, I’m a mechanical engineer by trade. So, market – oh, well, let’s just say marketing is self-taught for me. So, Elliot is a… Elliot and I were doing a project at university for cystic fibrosis, which is a terrible, terrible disease that children get. And they have to do this exercise every day, which is imagine blowing up a balloon and letting it out, but doing that 10 times in a minute, and then doing that for an hour a day.

And imagine getting a – for those people who have kids out there or no children, imagine getting a 2-year-old all the way do that for the rest of their life. So, it’s very tough to – very, very, very burdensome condition. A tool that kids could do their exercise, and we connected it to a tablet, and turned it into a game for the kids. And we won a few prizes for it, and we won a little bit of money to run a few medical trials on it, which was… Which was a lot of fun. So, that’s how Elliott and I met. And we were we did that for a few years. Ran the medical trials, got some good results, and then we were caught up with life, moving on.

So, Elliot, Elliot finished his PhD and I was actually down in Sydney doing some management consulting. And we just continued to stay in touch. And then a couple of years later, I got a call out. I knew Elliott had started what would be Maxwell Plus.

I get a call from him saying, “Look, got some money together. There’s a space in the company for someone to help me grow this thing and turn it into what we want it to be. I want you to come do it with me.” So, I moved back from Sydney up to Brisbane and joined Elliot at the start and became a medical device AI regulatory expert for the first year of the company as we got the device approved. And then once we were in market, I switched over to helping to grow the company.

The reason why I’m physically standing over here in London at the moment is that this is where we’re looking to grow as well. So, it’s pretty exciting times. So, we’ve got some large research collaborations going on over here with University College of London, and we’re trying to convince the NHS to kick off a couple of pilots with us.

Simon Dell: Right. How’s that going, then? What do you have to do to convince the NHS to pilot with you? You don’t obviously walk in the front door and ask them. How does that process work?

Tom White: No, no. And so, we’re really lucky in that we’ve been in market for about a year and a half. So, when I say in market is there’s been real people using our medical software for about a year and a half. And we’ve gotten really, really good results and we’re starting to release those results. So, that makes it a little bit easier.

And we work with prostate cancer. We work in the world of urology. And so, we’ve got some great contacts over here from our research and also our affiliated urologists in Australia. So, we have about 25, 30 urologists that we work quite closely with in Australia who helped manage our patients and help us publish research alongside us as well.

Simon Dell: So, there’s talk about the success because obviously, the point of you doing this is that you can presume to detect prostate cancer earlier. Tell me how that’s going. What sort of success are you saying?

Tom White: I’ll start off with how it actually works a little bit, because I think that will help explain it. So, guys go online, they go to our website and they determine their eligibility for testing. So, they determine whether they should be getting tested for prostate cancer, and they get to make an informed choice about it because there are risks and benefits associated with prostate cancer testing. And they go through a bit of an education module at that point.

So, once they do that, we send them for a test, if they’re overdue for their test, if they haven’t had one recently. And we gather all their previous results, if they’ve been tested in the past. We get all of that information, including all the information we talk about them. So, the usual stuff you’d fill out at a doctor’s surgery. You know, your age, your family history, etc. Any prior… Any medical history.

And we put that together and we run it through our AI algorithms, and we come up with a risk score. And that risk score, we present to our clinicians who have been working in prostate cancer for 20 years. And that clinician will view that risk score and review all that patient’s data alongside their clinical knowledge and expertise and come up with a recommendation for the patient.

So, for a lot of guys, the good news is, “Look, you’re looking good, nice and low risk. But keep on top of it and come back in a year, two years,” whatever is appropriate for that individual. For those guys that are looking a bit higher risk, we then send them for another test, a follow up test, and we get those results again. Those results are run through the AI.

And generally, once we get another result like that, we’ll probably use a second AI model. So, we might look at something called the free to total ratio, which is another blood marker or something like that. And that keeps on happening all the way through a couple more blood tests, an MRI, all the way through to a physical diagnosis for those men that end up at that stage.

So far, we’ve detected about, I think as of today – no, it’s 32 cancers of which I think the number is about 40% would have just been completely missed by the best clinical guidelines in Australia. Another 40% probably would have been detected another 6 to 12 months later, but we can’t… It’s a bit hard to say on that one. What we’ve also shown is that our service is able to detect about 5 to 7 years younger than the median age in Australia.

So, if you compare Australia to us, we’re about 5 to 7 years younger. We do it at PSA levels. Sorry to get a little bit technical, but PSA being the blood marker, that is the predictor of prostate cancer. We do it at PSA levels about 60% lower than the Australian median. And the other thing is we do it with less unnecessary biopsies. So, prostate cancer, and when we get into the marketing, we’ll talk about the challenge we’ve had of overcoming the stigma associated with prostate cancer testing.

But the problem with prostate cancer testing is it’s got a bad rap for over testing in the past. And we’ve shown that we can do it with 50% less unneeded biopsies, which has also been a great result for us. So, I said a lot of words there, but we catch it in men when they’re younger. We do it at low PSAs, and we do it with less unnecessary biopsies.

So, that’s what we’ve been able to show. And this week, we’ve just released all that information as well, and it’ll be a paper later this month. And so, to answer your question a very long way, that’s our results.

Simon Dell: Well, let’s talk about the marketing side of things because you are dealing with a target market here who are at best, reluctant to go and see a doctor for anything. You know, the sort of target market that might lop their hand off with a chainsaw and then, you know, sit there and tell everyone that it’s absolutely fine and there’s nothing wrong with them.

So, how do you tackle that marketplace? What’s your messaging? Aside from the “don’t die” messaging, you know, how do you persuade that marketplace?

Tom White: Yeah. And I’ll throw in another challenge that we’ve found as well. So, not only are men about 60% less likely to go for testing, and the numbers are about 25% of men are getting tested for prostate cancer, and about 70% of women are getting tested for breast cancer, so it’s quite a bit lower. Obviously, there’s a national screening program, so women are more encouraged to go for breast cancer, but men are just a bit tougher to get to the doctor.

The other thing in this as well is that we are trying to sell prostate cancer testing at the end of the day. And on the internet, when you do that from a virtual healthcare and a telehealth point of view, we do get accused of literally selling dick pills quite a fair bit. So, we have to we have to overcome the, “Are you a scam?” Every now and again.

And I never want it to be this nebulous person that just said, “Oh, we need to focus on trust.” But like, what I’ve learned over these last eight months is we’ve actually had to really focus on trust. And I promise I’ll give some like, actionable, granular things on what I mean by that. But our biggest thing is being, can we be a trusted source of information, healthcare and peace of mind for men? Because if we’re not, then there’s no point in doing this. That’s been our biggest focus.

Simon Dell: So, all right. Well, how do you build that trusting relationship with… Well, what would be your target market? Men at a certain age, 50, 55? Where’s your…

Tom White: Yeah. So, we look at men 40 or over. And especially men with a family history. The reason being is they are higher risk than the average person. So, if you have a family history, your risk doubles compared to the average man.

Simon Dell: Yeah, okay. So, how do you build that relationship with those men? Because I can probably list 100 different challenges with that demographic. But you know…

Tom White: Two or three broad areas that we’ve focused on is the first one being focusing on producing quality results, and have people hear about those results from other people other than us. That’s the first bit. And I’ll jump into that in a bit.

But the second one is promotion of the category rather than promotion of our specific service. And then the third area that I think we’ve learned and done very well onto in this area is just above and beyond service and response. Like, customer service and response.

And I think those three areas have worked quite well together for us to produce trust. Trust enough to hand over a credit card on the internet, trust enough to hand over medical information on the internet, and trust enough to listen to our doctors when they say, “You need to go for more tests because the machine says so.”

Simon Dell: Right. So, just on one thing you said, you know, trying to promote the category. Explain to me what you mean by that. I think I understand, but you know, do you mean sort of medical testing in general or men’s health in general?

Tom White: So, we take an approach of promotion of the use of AI and deep analysis in medicine. So, when we say category, we talk about that, and we obviously put a nuance of prostate cancer in that as well, most of the time. But we are promoting that generally, we are promoting that there needs to be the use of deeper, deeper technology and AI in medicine, and we promote that as a category.

We find that no one likes to be sold to, but people like to have the best quality in medicine. And so, when you’re trying to sell them a better version of something that they actually begrudge to go and get, it gets a little tough. So, we like to let them understand that there… We believe that there is a better way to get tested, to have your health looked after, and that is more accurate. It’s more detailed, it’s more thorough, and it’s based on the latest science and evidence.

And then we also let them discover for themselves that that is actually available from three clicks away for one part of their health. And that’s what we focus on. And we do that a lot through… We do a lot through – and we’ll probably talk about this a bit more as well. Generally, I’ll say PR related content. So Elliot, myself or our chief medical officer, Peter Swindle, will be on the radio, in the paper talking about what AI can do for health.

Simon Dell: Okay. Well, let’s talk about that then. So, that PR focus for you, which obviously strikes me as the obvious one. You know, newspaper, radio, TV. Have you guys engaged a PR agency to help you with that, or is that something that you do in-house?

Tom White: So, we use a PR agency, and they’re wonderful. Happy to do… I’m not sure whether plugs are a thing, but –

Simon Dell: No, go for your life.

Tom White: Yeah. So, we use Janine in the media PR. So, it’s Janine and Arianna who run it, and they’ve been fantastic for us. They’ve been great because they worked with the bowel screening program a number of years ago, so they get the space. But we do quite a bit of effort of producing stuff for them. So, we don’t sit on our laurels, waiting for them to magically pluck stuff out of the air. We have made a very, very active choice to feed them with content to the point that Janine tells me to stop emailing her sometimes.

So, that’s been our strategy. And it works quite well when we – especially for focusing on the producing quality results. So, we are able to give them our results and they are able to have a number of stories written about us. And we have a lot of great individuals within the company as well, individual patients that have been involved with us who are willing to tell their story.

And what our strategy has turned out to be is get the news out there in whatever format, usually. So, through a reputable. And we let people interact with that themselves and hear about us that way. It’s much more effective for people to hear about our results from a trusted source, whether that’s a friend, someone from work, or even in the newspaper than whatever ad that we could write. The best content is hearing it from someone else for us.

Simon Dell: Well, that was going to sort of bring me on to that kind of weird conversation about influencers because, you know, the sort of social media space in the last 5 or 10 years has been horrifically overrun by influencers. You know, when someone talks about influencers, they often think about, you know, Gold Coast girls in their bikinis and all those sort of things.

And I know this is almost a terrible thing to say. But from your perspective, an influencer who would be a famous person being impacted by this disease, coming forward to talk about it would probably help you guys enormously, I guess.

Tom White: Absolutely. And I saw you cringe a little bit there, and that’s one thing that we’ve had to… That’s what we’ve had to also battle with ourselves internally, is mixing marketing and healthcare. And there’s just an ingrained part of every human that doesn’t want to be marketed when it comes to healthcare, except when we realize that our results… We’ve become comfortable with this when we realized – when we were able to definitively show that our results are better than the current system.

And what we found is that many men, no matter how famous they are, if they are affected by this disease, are very willing to come forward and very willing to share their story. We had a story in The Canberra Times and the Daily Herald this week about a gentleman called Danny, and we diagnosed him with prostate cancer.

And Danny is just so passionate about helping people now. He’s so, so passionate. And that goes right up the chain no matter the level of fame. We’ve actually experimented with this as well, and with influence-based marketing, we’ll call it. It’s a bit hard to call it that because for us, because it’s actually just people wanting to help. So, then they just happen to have influence.

So, a good example of that is with Mark Webber. So, Mark Webber, he hit the age of 40. He wanted to get checked out and he gave us a call. And we sorted him out and he’s all good. And he was very kind enough to do a few promotions and pieces for us about it, and it was hugely effective for us, we will say.

People see Mark Webber and people go, “Wow.” It obviously helps with all of the trust and everything like that. But he obviously has such a great reach. And also in Motorsport Australia, the demographic is obviously the one that we’re after.

Simon Dell: Well, exactly. That kind of macho… Yeah. I think most people in motorsport think they’re indestructible. Well, a lot of men think they are anyway. Talk to me about the – because I do remember when we first spoke, we had a conversation about the name and the branding and where all that came from, because that’s probably one of the things I still kind of look at and I’m like, “Yeah, I don’t quite get that one.” But just, you know, give us the quick story behind that.

Tom White: So, we were originally called Maxwell MRI back in the day when we were just going to do AI for MRIs. And we were going to do AI for MRIs across all of the medical – all of the medical issues in the world possible. We realized very quickly that from a regulatory point of view, that is highly burdensome. You need to get approved for every single thing you look at from a medical point of view. We also realize from a data point of view, it’s highly burdensome. You need thousands and thousands and thousands of cancer cases across every single type of cancer to do that. And it took us about three years to build our database in prostate cancer.

And we think now we’ve done pretty well with that. We think we’ve got the biggest database in the world. We’ve got over 250,000 cancer cases that our AI has trained and uses. And then we met our chief medical officer, Peter Swindle. And he has been a huge, passionate advocate of early detection of prostate cancer for many years and seeing the issues that men go through, and seeing that there is a better way through deeper analysis of the information we already have.

We don’t need new tests. We don’t need new inventions or something like that. We just need to be better at analysing the data we have. And we’ve hit the point that humans can’t do it because there’s so much nuance and so much – so many moving parts that it’s very hard to juggle in your head. And so, that’s how we ended up in the prostate cancer world. And because we now did more than MRIs, we did blood tests, we had to put the word “Plus” instead of MRI on it.

Simon Dell: Right. Got you.

Tom White: And the word Maxwell comes from James Maxwell, who is the kind of like, father of electromagnetic theory, which is where the MRI came from. So, James Maxwell.

Simon Dell: Oh, there we go. Well, nerdy little reference there.

Tom White: Yeah. You know, like, only the best companies do it. Tesla and Maxwell Plus. Like, that’s – yeah, of course.

Simon Dell: You guys have raised quite a bit of capital investment, venture capital, whatever you want to call it. Where’s the exit for you? I mean, or is there an exit? Who would be in the marketplace to potentially come in and buy a company like yourself? What’s the kind of long-term plan?

Tom White: It’s always tempting to think about like, you know, the day you get to put your feet up and look out over the beach with a cocktail in hand and give yourself a pat on the back. But we don’t often think or talk about exits, and the reason being is we’ve hit milestone one. We’ve got about 10 to go before we consider ourselves a success.

And the fact is that – so, we’ve got a little while to go, but I think from a strategic point of view, there is definitely a very close overlap with us and other companies, other cancer care companies that are at the, I’ll say, the treatment end of the spectrum.

I say strategic in that – and it could result in an acquisition at some point. But I think we’re not ready to do that personally because we still want to maintain control to develop the AI in a way we want in the next coming years. But there’s cancer care companies out there like Genesis and Icon Cancer Care that do a lot of the treatment. And I think there is a very… There’s also a strategic overlap with what we’re doing in terms of getting men early and funnelling them through the process, and getting them a good diagnosis if they end up at that stage.

And then, where we’re actually expanding into next with our own AI is decision making around treatment. So, there’s a number of different options at the diagnosis for treatment, and these cancer care companies do treatment. And so, I think there is a very, very good overlap with at that end of the spectrum, potentially, as we get further down the chain.

Simon Dell: You mentioned building your own AI. Is that something you’re doing, or that’s something you’ve done, or what?

Tom White: So, we have… We’re all – we have about four AI models in market looking at blood tests, looking at imaging for our current users. We’re looking at building the next wave of AI that we will be building is on around treatment and monitoring of diagnosed cancer.

So, there’s actually a form of treatment called active surveillance for prostate cancer. And it’s getting – it’s growing quite a lot. And that is you have cancer, it’s low grade. We don’t think it’s going to do anything too nasty, so we’re going to keep an eye on it rather than treat it. Because obviously, with cancer treatment, is treatment can be a very tough subject.

So, we’re going to be working in that space next with around treatment decision making. What is the best treatment for this individual and knowing what we know about them so far. And also then, monitoring of active surveillance patients.

Simon Dell: All right. Tom, it’s been an absolute pleasure. What’s sort of left for you guys for the rest of this year? What are the sort of little milestones that you have for the rest of 2021?

Tom White: Yeah. So, the big milestones for us is to get this paper published with our results. So, we’ll then be approaching… We’re working with the Prostate Cancer Foundation and the… To be working with the Prostate Cancer and the Urological Society about what we can do with these results to getting them to basically every man in the country.

This is what we want to be doing for the rest of the year. Hopefully, we’re also going to be starting our Series A, a fundraising round, which is exciting. So, we’ll be able to get some cash to start growing the company so we can start focusing on our growth strategy beyond that, which is going to be a lot of content, a lot of SEO related. Rather than have PR companies produce the content for us, we’ll be focusing on producing ourselves.

Simon Dell: Awesome. Mate, I wish you guys absolute the best. I am clearly the target market and clearly the stubborn kind of, you know, ones that won’t go to them.

Tom White: Are you on yet? Have you tested yet?

Simon Dell: No, I’m not. No, no.

Tom White: Oh, I’m not doing my job properly. You’re going to be bombarded by me. We’re very good at reminders. People say we’re very annoying in a good way.

Simon Dell: Geez. Well, you’ve got my email address. Add me to some sort of database. No, my wife ended up booking me in to get my COVID vaccine because I was like, “Yeah, I’ll get around to it. I’ll do it, I’ll do it, I’ll do it.” And eventually, she stole the Medicare card out of my wallet and put me in. I’m sure that’s illegal or something, but…

Tom White: This is you’d be surprised. This is one part of marketing that I really want to crack in the future. We’ll get there eventually, is targeting the wives. 

Simon Dell: That is one of the key demographics. And in some ways, probably a better demographic to tackle than the men because, you know, the men have to be dragged, kicking and screaming. And the only people that can really effectively do that is often the wives and the partners and all those kind of ones. So anyway, mate, thank you very much for your time. Enjoy the rest of your Friday down there in London. And yeah, look, we wish you every success in the future.

Tom White: Fantastic. Thanks, Simon. Have a good weekend.

Simon Dell: That’s pretty much it for Episode Number 119 with Tom White. Thank you very much for tuning in. It was an absolute pleasure. We hope you enjoyed it, and we hope you listen in to the next episode. Thank you.