Meet Avera's physical therapy leader turned prolific inventor

Nicolle Samuels is a problem-solver.

And because her background is in physical therapy, that has meant solving problems for patients.

“I feel like I’m naturally able to take a look at what’s going on and solve a problem, either for an individual patient or for something bigger that affects patients organizationwide,” said Samuels, who oversees rehabilitation services for Hegg Health Center, an Avera affiliate in nearby Rock Valley, Iowa. “I think I’m wired to solve problems.”

In her world, where she specializes in wound care, that involves looking at how to teach, treat and prevent issues related to wounds.

“In physical therapy, we’re trained to take a look at all the issues someone is dealing with and how we can impact or solve that,” Samuels said.

“For me, I was always the one saying, ‘OK, here’s what we need to invent.’”

But seeing opportunity and turning it into actual inventions isn’t something most front-line physical therapists are able to do. It’s a complicated process to go from an idea in your head to an actual product for patients.

However, thanks to Avera’s partnership with the broader Innovation Institute, it’s a path Samuels has been able to travel multiple times.

Avera joined the Innovation Institute in 2015. It’s a national network of health systems committed to bringing ideas from concept to market through its InnovationLab.

“Avera is an partial owner-member of the Innovation Institute, which operates similar to a venture capital growth fund that supports research to commercialization,” said Dr. David Erickson, who leads innovation at Avera.

“We support and promote a culture of innovation, and in part this is out of necessity. There are problems we try and solve that don’t have readily available solutions, so this provides us a way to work to try and develop something.”

That means Samuels – or any Avera employee – can submit ideas, go through a process that looks at commercial potential, protect intellectual property through patents and ultimately potentially pursue commercialization.

“It was everything I’d been wanting,” Samuels said. “Without that support, it’s hard to get your ideas off the ground.”

And she has plenty of ideas. One, an AFO, or ankle foot orthosis, with superior offloading developed for the bottom of the foot, is designed to help patients with diabetic foot ulcers but also can be used for those with foot fractures or orthopedic problems.

“It’s suspending someone in a brace, so they don’t bear weight on the bottom of their foot,” she explained. “That’s different from most boots that distribute weight. You bear the weight up to through your calf, and it takes the stress off the bottom of your foot.”

The Innovation Institute accepted her idea, and it’s now patent pending and entering the commercialization phase. The product is trademarked under the name Elevate™. The Innovation Institute is in early talks with licensing partners, and there’s a plan for clinical trials in the second quarter of 2022.

“It’s still in the development phase, so we’ve only been able to utilize a prototype, but I’m super excited to put this on patients and utilize it clinically,” Samuels said. “Having a diabetic foot ulcer means you have a higher mortality rate than most cancers, and people don’t realize what a huge problem it is. I’m looking forward to saving people’s lives with this device.”

She also has worked through the Innovation Institute to develop an educational playbook available to others in health care that shares her innovative approaches through an online education platform.

“We focus on health care solutions — health care and clinician technology with a specific focus on speed to market,” said Jay Meyers, senior client engagement executive for InnovationLab at Avera. “We even have product development engineers who focus on devices and health information technology.”

A team from the Innovation Institute held a planning session with Samuels before the pandemic began.

For instance, during the pandemic the InnovationLab has dispersed medical devices used to assist in switching ventilators from manual to mechanical to health systems across the U.S.

“We can do the licensing, the product development and the whole IP and commercialization process, whatever needs to be done,” Meyers said. “We facilitate the process, and if it comes through Avera, Avera retains the IP. In the case of an invention like Nicolle’s, some future earnings would go to the Innovation Institute, some would go to Avera, and Nicolle as the prolific inventor also receives part of that.”

The ability to access something like the Innovation Institute is significant in growing the local biotech industry, said Joni Ekstrum, executive director of South Dakota Biotech.

“The medical device field is part of our industry we know we are positioned to help support and grow in South Dakota, and health care technology is an especially good fit given our higher education partners. This Innovation Institute encourages innovative approaches to both for employees based here,” she said.

“Beyond that, from a workforce perspective, we want to attract and retain innovative individuals. Here, they know they have a direct pipeline to the support they need to make their ideas a reality and become entrepreneurs within their health care organization.”

Since Avera began submitting ideas to the Innovation Institute, the health system’s employees have offered more than 500 ideas and four have been commercialized.

Data from the InnovationLab shows that 2 percent of idea submissions have the potential to make it to market. Upon learning this information, Samuels immediately thought, “I’m going to play the numbers game and set a goal of submitting 100 ideas!”

“I keep a running file of new concepts that I gather from working with patients and refine them through a process prior to proposing,” she said. “I had lost track of my goal progress awhile ago, but it turns out I’ve submitted 76 to date. I’m excited. I’ll definitely get there.”