Musings & Inspiration

Spotlight on Cosm Medical, a Major Emerging Player in FemTech

Sam White
Sam White February 16, 2021 • 0 min read

How Cosm’s team is using human-centric design to improve outcomes for a disease that affects one in four women — and one you’ve probably never heard of. 

Suppose there’s a disease that will affect up to one in eight people on earth over the course of their lifetimes. This disease has a major impact on quality of life, and becomes more likely with age. Existing treatments are either a surgery costing $10,000-$50,000 with no guarantee of success, or a $50-150 device that’s fitted with trial and error, and hasn’t been updated in fifty years. A third of patients never find a device that works for them. Half stop using these devices in a year. Half will get complications from long term use. 

You would probably agree that this problem represents an opportunity to improve the quality of life of a major fraction of the human population, and a huge medical design opportunity- not to mention, a major potential market. 

We’re not talking about heart disease, stroke or dementia. We’re talking about a disease you’ve probably never heard of: pelvic floor disorders, which affect a quarter of all adult women, and half of women over 80. These disorders are caused by age, activity, vaginal birth, and certain genetic conditions. They affect the vagina, bladder, and bowels and cause incontinence, pain and discomfort for millions of women around the world.

And existing treatments suck. 

You’d be forgiven for not knowing about pelvic floor disorders until now — or how out of date the treatment is. Most people don’t — but the story of why you don’t know about this disease is a part of the larger story of FemTech. It’s a massively burgeoning industry, predicted to post a 16% CAGR and become a potential market of almost $50 billion by 2025. 

It’s also an area of focus for Cortex as we seek out new areas to apply human-centred design and fulfil our mission of giving people a better experience. 

Today, we’re highlighting Cortex client Cosm Medical, and its place within the larger emerging market of FemTech — personalized health and wellness products designed for women. As part of our ongoing engagement in the space, Cortex will highlight the product visionaries who are redefining women’s health and innovating to provide personalized treatment for a historically underserved market: women. 

Cosm Medical founder Derek Sham is one of those visionaries. “I watched my grandmother go through her pelvic floor disorder and saw the negative impact on her quality of life,” he says. “I had worked ten years in urology, and I knew some of the best doctors in the world for her issues, but we still could not get her the care I thought she deserved.”

Derek founded Cosm Medical to develop Gynethotics™, which is a personalized platform for treating pelvic floor disorders through a combination of digital urogynecology, 3D printed made-to-measure gynecological prosthetics, and an AI platform to centralize gynecological ultrasound data and create a prediction model from measurement to design. He also assembled an all-star science and technology team including CTO Aye Nyien San and Chief Scientific Officer Goli Ameri. 

 “I ended up putting my own money into the company to get the ball rolling,” Sham says, “and I didn’t do so until I talked to a bunch of doctors. The vast majority said, ‘if you do what you say you’re going to do, that’s amazing.’” Two urogynecologists, as motivated customers, have invested early into Cosm Medical.

Today, the main alternative to surgery for pelvic floor disorders is a pessary, which is a medical device that is inserted intravaginally to support pelvic organs. To find the right pessary for a patient, the doctor uses their fingers as a measurement method. Then various pessaries are tried, potentially more than a dozen devices, often over the course of multiple fitting sessions, to find the right fit, if there is one. This treatment, unsurprisingly, has a massive failure rate. Gynethotics™ seeks to take the guesswork out of this process, using ultrasound measurements and a dataset collected in a HIPAA compliant Cloud platform to design a made-to-measure pessary that’s fitted to the patient’s body. 

“I’m confident that if this was a men’s health issue, this technology would already exist,” Sham says. 

According to TechCrunch, women spend $500B annually on medical expenses, but only 4% of healthcare R&D is focused on women’s health issues. “The change in our society’s view on what it means to live a good life and women’s view on their own health drives the growth of the FemTech market,” says Sham. “That’s in parallel with the recognition that women control over 80% of household healthcare expenditures. They’re the decision makers when it comes to health and wellness. That recognition has brought a large influx of growth in this market.” 

Historically, the FemTech market has focused on reproductive health. But this rising awareness is broadening the market to address a huge swath of women’s health issues including endometriosis, menopause, and sexual wellness. The FemTech industry brought in almost $600 million in venture capital investment in 2019, and that’s growing. Cosm plans on leveraging this growth alongside the growth of the larger boom in personalized medicine, which is expected to become a $3.2 trillion industry by 2025. 

Personalized medicine demands human-centred design. That’s where Cortex comes in.

When it comes to pelvic floor disorders, as Sham puts it: “women are relegated to surgery or to trial and error, or told to just deal with it as a normal part of aging.” 

That’s unacceptable. That’s why we’re thrilled to be working with Cosm, and to be delving deeper into women’s health as a design space where the human has historically been an afterthought. That goes for patients, but also healthcare practitioners administering treatments who are — in this case — expected to make do with trial and error, off-the-shelf designs, and zero centralized data. 

That’s unacceptable too. 

“We are transforming the art of pessary fittings into the science of Gynethotics™.  As you can imagine, our system is fairly complex,” Sham says. “Our goal has to be to make it easy to use for both clinicians and patients while improving their quality of life. Cortex is helping us refine and develop a scalable technology platform, analogous to that of custom dental (Invisalign), where any urogynecologist, nurse, medical practitioner or physical therapist will end up being the user. How do we ensure that it’s easy to use, with the highest quality possible while capturing all the necessary data? That’s where user-centric design, and Cortex, come in. Working through the discovery, understanding those users’ pain points, and designing an elegant solution is critical.” 

Cortex has partnered with Cosm to provide ethnographic research and concept development towards creating a solution that’s deeply integrated and easy to use for this variety of clinical settings. We’re working with senior members of Cosm’s team including Chief Scientific Officer Goli Ameri (PhD in biomedical engineering with expertise in ultrasound imaging) and Alli Blokker (MSc in biomedical engineering) to: 

  • Identify pain points in Cosm’s current proof of concept in terms of hardware designs for the measurement system and other areas,
  • Deliver a concept that integrates Cosm’s complex workflow in an all-in-one mobile idealized solution, 
  • Provide design direction for ultrasound software UI,

Among other tasks. 

“The process is different with Cosm,” says Andrew Lowe, Cortex’s design manager on the project. “This is a medical product, and we’re medical device designers but not doctors – so there’s been lots of back and forth, having live discussions, taking their feedback, and iterating. It’s been a process of adaptation as Cosm’s needs evolve.” 

In our design and engineering practice, we’re always seeking out new areas to improve human experiences in any walk of life. Whether we’re designing a device to help firefighters see through smoke, or a completely new musical instrument, or a medical device, the principle is the same: design should serve people, rather than the other way around.

As Derek Sham puts it, “we are human beings, not robots.”


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