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Level EX, Just Out of Stealth, Brings High Level Video Game Tech to Surgical Training



I look over Sam Glassenberg's shoulder as he carefully weaves a fiberoptic scope down the throat of a patient. He's trying to get it around a tumor blocking the airway, and through practicing the procedure dozens of times he knows to look for the air bubbles because that's where the tumor isn't attached to tissue. Pop, pop, pop--the scope bursts through the air bubbles and into the airway.

Perfect score. Game over.

We're not in an operating room, or even a hospital. We're actually in a conference room at MATTER and Glassenberg is performing this surgical procedure on an iPhone.

Glassenberg is also not a doctor. He's a veteran of the video game industry, who's previously worked on Star Wars video games at LucasArts, led the DirectX team at Microsoft in pushing the realism in video games and was most recently CEO at Funtactix, a startup that created mobile games for Hollywood films such as Hunger Games and Hot Tub Time Machine. Funtactix was sold to Playtech in March.

He's now bringing that video game industry expertise to the operating room with his new startup Level EX, which creates realistic, virtual surgery mobile apps for physicians to practice skills in minimally invasive surgical procedures. The startup, which Glassenberg has been working on for a year and just launched out of stealth Wednesday, has already raised a $2.15 million seed round from San Francisco's Jazz Venture Partners, and is backed by Pritzker Group Venture Capital. Now Glassenberg and a 20-person team of game designers, artists and engineers working out of the West Loop are focused on scaling Level EX.

"Doctors can learn not from just watching a video or attending a lecture, but from actually performing a procedure on a virtual patient," he said. "And you can do it on your phone or tablet."

Glassenberg grew up in Chicago amidst a family of doctors, but he chose his passion for video games over medicine, studying computer science at University of Illinois Urbana-Champaign, then computer science graphics at Stanford. He spent the next decade at LucasArts and Microsoft "pushing the cutting edge of video game realism," he said.

But his video game talents came in handy to his family members in medicine: They would occasionally ask him to create simulators for training physicians, residents and medical students on specific procedures. It became a hobby for Glassenberg, and as time went on, he realized the disconnect, and opportunity, between the industries.

"Simulators that I would build using obsolete game technology in 2002 would win prestigious medical education awards in 2007," he said. "It wasn’t to say that what I was building was any good, it just shows there’s this huge gap. The video games industry is a decade or more ahead of surgical training."

The turning point came when an iPad app he developed for his father went viral in the medical community--it garnered over 100,000 downloads and was the most popular medical app at the time. Efficacy studies also proved that it enhanced doctor performance, Glassenberg said.

With that in mind, Glassenberg started developing Level EX. The startup creates hyper-realistic simulations of minimally invasive procedures, with mobile controls that mimic the movements and perspective of a doctor performing that procedure, all accessible on a smartphone or tablet. Doctors are scored on their performance, based on metrics created by physicians consulted for each procedure. If a doctor moves too fast or erratically, a patient will cough and bleed (and the player loses points). Slide along an airway the wrong way and secretion might blur the lens.

Their first product is Airway EX, a suite of 18 airway procedures. They're starting with the airway because it is likely to be used by the most physicians (from anesthesiologists to pulmonologists to emergency room doctors), but will be adding gastroenterology and other specialties in the future. They're starting out targeting practicing physicians, so the procedures are more specialized. And if a doctor comes across a unique case, they can submit it to Level EX and potentially see it on the app in a matter of weeks.

The app is free for doctors, and Level EX plans to make revenue in two ways: in-app purchases, where doctors can buy additional content that could be used toward Continuing Medical Education (CME) credits, and medical device product placement. Glassenberg said there is traction on the business side, but declined to offer details on deals thus far.

They're onboarding doctors largely through word of mouth, Glassenberg said. But the benefits are there: Access to sim labs, essentially large "arcades" where doctors can practice these procedures, are extremely expensive to build and expensive for outside doctors to access. Level EX declined to share user numbers thus far.

Level EX has also not yet done objective studies to measure the effectiveness of their apps--Glassenberg said that is to come. However, to build the apps, they worked with focus groups and interviews with doctors in several hospitals in Chicago, Dallas, and New York.

“Level EX addresses roadblocks that hold physicians back by offering an easy-to- use, realistic mobile application that provides them with an edge in learning procedures through detailed patient scenarios," said Errol Gordon, a doctor at Mount Sinai Hospital in a statement. "The use of the application enables physicians at all levels to maximize learning and improve surgical outcomes.”

Though he's lived all over the country, Glassenberg came back to Chicago to launch Level EX because he said it has the unique talent to support a hybrid video game/medtech startup. In addition to Illinois' robust hospital networks, the games industry in Chicago has produced everything from the first pinball machines to Mortal Kombat to Bungie, the company behind Halo. 

It’s pushing pixels to save lives

"There’s amazing game talent here including people who are doing really cutting edge stuff," he said. "It’s been so refreshing, because you’re able to get such talented people here."

And though he was worried about convincing video game talent to make the transition from commercial games and other specialties, he said that the opportunity to help improve medical care has resonated with his recruits.

"Game developers found it extremely fulfilling; it’s a higher calling," he said. "It’s pushing pixels to save lives."

Note: Updated to reflect Jazz Venture Partners and Pritzker Group Venture Capital's role in Level EX funding.


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