From Adviser to CEO: Morris Miller on Xenex’s Disinfecting Robots
When Xenex Disinfection Services was first launching, Morris Miller was an adviser to the company’s founders. Given his experience as a co-founder and former CEO of Rackspace, (NYSE: RAX), the San Antonio, TX-based cloud computing giant, Miller would provide insight into building a business from Xenex’s key product, a robot that uses pulses of xenon-based ultraviolet light to disinfect hospital rooms.
Miller, who has friends and family in the medial field, was intrigued by the product’s potential for improving patient safety, so much so that he helped the company with funding, too. Xenex expected that cleanings performed by its robot could reduce infections in hospitals by 5 to 10 percent.
Then, results started coming in: After using the Xenex machine, the rate of hospital-associated Clostridium difficile infections dropped by 53 percent in 2012 from the year before at Cooley Dickinson Hospital in Northampton, MA. The company’s robots, which cost around $100,000 each, emit pulsating UV lights that wipe a room clean of microbes that kill about 70,000 people annually and infect about 1.4 million from diseases such as MRSA and C. Diff., Miller says.
Other studies tout its effectiveness. At Trinity Medical Center in Birmingham, AL, the number of infections on knees and hips that had undergone surgery fell from seven to zero over the course of 12 months, according to a study published in 2015.
Miller says the results were so promising that he dedicated himself to Xenex as its CEO because he believes in the tool’s infection-preventing, life-saving potential. I caught up with Miller for a discussion on Xenex and its robot in San Antonio in September.
Xconomy: People seem to have adapted to the mindset that if you go into a hospital, you might get an infection.
Morris Miller: OK, yes. You do not have to get sick when you go to the hospital. If there’s a theme of what I want to let the public realize, it is you do not have to get sick if you go to the hospital. You now have a choice: to potentially get sick or to not. It is a completely individual choice.
X: You can say it works, but how do we know it does?
M.M.: We now have seven peer-reviewed studies. There are 60 companies that compete this market, us and (makers of) mercury light bulbs. They’ve had zero. They’ve never proven that they work. Nobody would deny that they can kill something on a glass slide. That’s different than producing results in the hospitals themselves. We just had one study that was a 100 percent reduction. Basically the hospital had no infections. We had another one that was a skilled nursing facility, a 90 percent reduction. The only person who had the infection was one
man who refused to be removed from his room. We had another 56 percent reduction in C. Diff. You ever had the stomach flu? You know how uncomfortable it is. Imagine your discomfort multiplied by 20. Something like 30 percent of patients who have this intestinal discomfort, like you’ve never had, and I can’t imagine, they end up having to have their intestines removed for the rest of their life and they have to walk around with a bag. Another 10 to 15 percent die. It’s unbelievable.
X: When you say drop in infections, you’re not talking about contamination?
M.M.: No, no. That’s 99.9 percent-plus. This means that the infection rate dropped. Last year, take Lowell Hospital: They said they had 46 surgical infections. They used Xenex at the end of the day. This year, they had 23. That means that 23 people didn’t get the infection. When (Trinity Medical Center) said they had a 100 percent reduction, that means they had zero infections. The year before, patients in the hospital had 7 infections on their joints, knees and hips. That doesn’t sound like much but let’s say you just got your hip replaced. Now they say, “Hey, we’re really sorry but you need to come back in for that infection. We have to put you out, and we’re going to remove that hip. You’re going to be immobilized for the next three weeks. We’re going to start treating you with high-dose antibiotics, try to get rid of the infection in your body, and figure out a new implant to put in. It’s probably going to be another three to five weeks.”
X: How are you getting greater adoption?
M.M.: When you think about a missionary business, I can look around and I can say, anyone that is going into a hospital, I am fighting for them. They need someone that’s going to insist that the hospital buy these things. Quite frankly, you shouldn’t go into a room if it hasn’t been disinfected with Xenex. You shouldn’t allow them to operate on you unless the room has been disinfected with Xenex. The only thing that prevents the doctors from making the decision to actually do that is awareness. I’ve met with eight CEOs of hospitals in the last three weeks that, each time, they go, “Wow, this is interesting. I’ve never heard of it.”
X: How did you hear about it?
M.M.: The technology was brought to me by an Austin entrepreneur named Brian Cruver. He had come across these founders, two epidemiologists. He said, “Hey you’ve done Rackspace. Would you mind coaching me on this?” That’s how we started, with a coaching, mentoring relationship. Then after a while, he said, “Would you help us fund this?” I said, sure, I’ll help you with funding. Later on, he said, “Hey would you help us run it?” Somehow, it kind of got into my bones. When we started it, we thought we might be able to get 5 percent reductions in infections, maybe 10 percent. Once we saw it was 50 percent to 60 percent, you’re talking about saving 70,000 American lives a year, preventing 1.4 million Americans from suffering. That is a worthwhile endeavor.
X: How many hospitals are you in?
M.M.: We’re in just over 300 hospitals. It’s a matter of going and educating somebody, sitting down with them, walking them through the sciences. In the latest service of the machine, we rolled one million room treatments. We’ll treat 3, 3.5 million rooms this year.
X: You received $25 million in funding this year, partly for expanding staff, including sales?
M.M.: Yeah, it was for expansion here and we went international. Last week, we sold 35 robots in Africa. We never just ship a robot. We go to the hospital. We work with them. We help identify their problems.
X: You have plenty of competitors. What would they say they do better than you?
M.M.: Their only argument is that they say they can put out more UV fluent. The market is confused. UV fluents are light. We’re about intensity. It’s the difference between a hose and a power washer. A hose will put out a lot more water. But a power washer, at 18,000 pounds per square inch, will clean your sidewalk in the way that a hose won’t. A mercury light bulb is about the average intensity of a fluorescent light. Ours is 400 to 1400 times more intense, depending on where the disinfecting spectrum is. The answer is, intensity makes all the difference. You don’t have to take my word for it; I have seven peer-reviewed, published outcome studies that prove it.
X: Isn’t there anything on your competitors’ effectiveness?
M.M.: If we took all of the peer reviewed studies that had ever been published on a mercury device versus us, how do we do? Against C Diff., we’re 2.29 times better. That means that, if in ours we had four colony forming units per square inch, they had 10. It is literally math. They had ten pathogens. If you’re over ten, the room is infectious. Below that, it’s not. [We have] 3.16 times better against MRSA; 3.89 times better against VRE. Those are their studies on real hospitals versus us. This is kind of what I need to walk (hospital executives) through, as exhausting as it is.
X: What problems are there with the device that I’m not asking about?
M.M.: It should be adopted. It should be adopted faster and faster. The medical community wants to bring on good solutions, but they’ve had snake oil salesmen in the past. They want to make sure it’s real. The more science we keep publishing—that the hospitals keep publishing—they get more and more comfortable. If it didn’t work, I would shut the company down. I don’t need to do this. Because it works, we should be in 100 percent of the hospitals. I’m kind of the custodian of it because the technology ended up in my hands.