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Stuart Bradley is the founder and CEO of not one, but two companies – Carolina Speech Pathology LLC and Altaravision. We caught up with him on a busy Monday afternoon in between meetings, and he was gracious enough to take some time to talk with us about his experience as founder of Altaravision and the interesting journey of their flagship product, NDŌʜᴅ.

Put simply, NDŌʜᴅ is the most portable, high-definition endoscopic imaging system on the market today and an invaluable tool for speech pathologists. It has been extremely well received by the medical community, but its path from concept to market was not without its obstacles.

Where did the idea for NDŌʜᴅ come from? Because it is a very specific product.

It came from a need. Specifically, the need to be able to do machine vision on a Macintosh. Surprisingly, there really wasn’t any software that addressed it anywhere in the marketplace.

Would you mind just briefly explaining what machine vision is?

Sure. Machine vision is the ability for a computer to view imagery or an object, take that information and then display it. Essentially, it is a computer’s ability to see.

And the capacity to do that wasn’t on a Mac? That’s interesting.

Well, no. There was plenty of software out there, but it was all secondary purpose. The bigger issue was that nothing had the capabilities you would need in a medical setting.

It all comes down to video capture. All of the off-the-shelf software could capture images, but they suffered from significant lag. What you saw on the screen might be a full second behind what was happening in real time. That might not seem like much, but when you are dealing with medical procedures that kind of lag isn’t going to cut it.

I played around with off-the-shelf software for a number of years and finally found something I thought might work, but there were a ton of features that I didn’t want or need. I reached out to the developer to make me a one-off, but he was ultimately unable to deliver a final product. That’s what led me to Oak City Labs.

Once you had your software developer in Oak City Labs, what was the hardest part about going from this idea you had to an actual finished product?

By far, the biggest hurdle was doing it in a way that maintains compliance with FDA regulations. Jay Lyerly, the one who was doing the coding, knew that from the start and was able to work with my FDA consultant in a way that we could survive an FDA audit.

The thing is, FDA audits are worse than IRS audits and you’re guaranteed to get one, whereas IRS audits are random. As a medical device company, we are audited every two years by the FDA. Thanks to Jay and Carol at OCL, we’ve been able to pass every single audit with zero deficiencies, which is nearly unheard of.

Was there a moment when you got NDŌʜᴅ out into the world and thought “ok, we did it.”

Yea, there was. With FDA-regulated software you actually do have to draw that line in the sand. Unlike other software development cycles, where updates are always being pushed out, you can’t do that with medical devices. It has to be the finished product from the day it comes out. If you add features, it has to go back through the FDA approval process, which, as you can imagine, is pretty lengthy.

If you could do it all over again, is there anything that you’d do differently?

We bootstrapped the entire thing, with CNP essentially acting like an angel investor for the product. That was really tough, especially when there are people out there actively looking for good products to invest in. If I had to do it again, I would have taken the time to seek out some outside investment instead of just jumping in and doing it all myself.

When you think about where you are today as a business owner, is there anything that sticks out to you as the thing you are most proud of?

Honestly, being able to take on, create, sell and make an actual viable business out of a medical device when I had no prior experience in that industry. I had owned Carolina Speech Pathology for years, but the journey with Altaravision and NDŌʜᴅ was an entirely new one.

What’s your favorite part about doing what you do?

It has to be the satisfaction I get from solving hard problems, and the fact that it’s never boring.

Finally, whenever you have clients or colleagues that are talking about Altaravision or the NDŌʜᴅ product, what do you want them to say or know about it?

I want them to know two things. First, I want them to know it works, and always works. Second, that it is designed to be incredibly easy to use. If you can use Facebook, you can use NDŌʜᴅ.

For more on Oak City Lab’s work with Stuart Bradley and Altavision, check out this article Jay wrote on Computer Vision for Medical Devices via Core Image. If you have an idea and need a software development partner, or if you just have some questions about the development process, we’d love to talk to you. Follow the link below to contact us!

One of the most common questions to pop up when we talk with potential clients (besides “How much?!”) is “What technology can we use that is already out there?”. Regardless of budget, it’s always a good idea to evaluate what technology components you can buy or borrow versus building custom. It could be as simple as using an open source component for a date picker in an iOS mobile application or something a little more complex like a search engine.

Often, our clients do not have in-house software developers, a CTO and/or the time to dig into the technical details. Others may not know it’s even an option in software development to use something already out there. Today, I’m going to walk through three steps for evaluating the build versus buy decision for the non-technical folks out there.

First, make sure you’ve prioritized your product features. If you’re having trouble narrowing them down, and we all do, I highly suggest following one of the three buckets models described by Slava Akamechet or Adam Nash. Slava’s three buckets are best for early-stage products and Adam’s model will fit those that have paying customers. Both will give you the mental framework to break down a giant backlog of features.

Once you have freshly prioritized feature stories in your backlog, try these three simple steps:

  1. Ask – Do we really need to custom build this feature? Possible answer: This feature is our super secret sauce and it’s critical to our business. In that case, seriously consider building from scratch. And even if you build from scratch there’s a good chance you can use open source projects to help speed up the process. Make sure to check the project is using an appropriate license for your business model. If you’re OK buying versus building, move to step 2.
  2. Research – For example, one product’ you might like to include is a built-in analytics dashboard. That would be a large undertaking to code from scratch. Let’s start with a Google search. Searching the term “analytics” will give you more results than needed and won’t necessarily be helpful. If you add “for developers” on the end, then we start to get results with different software and API options. When one result looks like a possibility, choose it and search for alternatives or competitors to get a list of options. Either learn about them yourself or just understand that, yes, there are options and building from scratch may not be necessary. The developers can take it from there.Analytics for Developers Oak City Labs Raleigh Durham Mobile App Development
  3. Analyze – At this point in the process, it would be a good idea to have a developer evaluate the list of possible options with you, but it’s not completely necessary. Next, make a list of features needed. This could include things like price, features, support, scale, popularity, community support, etc. It’s also important to consider what features are missing that you would need to acquire from another product or build from scratch. Dropping all of this info into a spreadsheet will keep you organized.

This might sound really simple, but I promise you – the mental exercise of prioritizing and then doing #1-3 could save time and money in the long run. And when working with a software development team, you’ll have a foundation of knowledge when it comes to making decisions. If you need help, we’re always happy to set up a coaching session and be your CTO for a few hours. Give us a ring.

As an app developer, we get to speak with a lot of businesses and entrepreneurs about new apps and ways of using software to solve problems. Most conversations have one thing in common: people immediately think they need custom software development to bring their concept to life. This can lead to an overwhelming experience as the person struggles to simultaneously interview multiple developers and learn about software. All the while, they are also working toward validating that the idea or app will solve a legitimate problem, that it’s a “pain killer” not a “vitamin”.

The good news? Testing your idea can be done in a number of ways that don’t involve significant amounts of coding. Previously we talked about using market research as a first tool to determining market need. Today we’re going to walk through one example of using an off the shelf products to deliver a product to customers.

It’s important to know and consider that using an off the shelf product will also depend on your business. There are some cases where it may not be possible, but I challenge you to think through it. The mental exercise will help clarify the features you need to build before you begin development.

We’ll use a recommendation or content delivery service as our example for this post. A large majority of apps are aggregating data and refining that for a particular type of customer. Menu planning services like eMeals comes to mind. It’s one of the most established meal plan services out there. There are also newer, lesser known services like PrepDish that serve a need in the Gluten Free and Paleo space. It happens to make an excellent example of using pre-built software to create a business. (I’m about to make a lot of assumptions about how these are built based on publicly available information.) But onward because this is an example.

eMeals is a PHP built site and likely has a developer or team working to build out its entire functionality. However, newer services like PrepDish utilize marketing automation software to deliver weekly meal plans. PrepDish is currently using Infusionsoft with a WordPress website. Infusionsoft is a business automation suite where you can pre-define rules or actions that should occur based on input from the user. Ontraport and Salesforce are two other examples of automation suites. Typically a user will go to the PrepDish website, which is hosted with WordPress, and sign up for emails or more information. The flow tends to look like this:

When the user signs up, Infusionsoft takes over. This allows PrepDish’s founder to focus on growing her business while the software handles the rest. The two big pieces of technology used here are WordPress, which handles the marketing site and user accounts, and Infusionsoft, which handles the email automation. Again, I’m making some big assumptions, but if I had to guess she likely hired a developer to make a custom theme for WordPress, set the website up and any necessary plug-ins. And guess what? That can also be done without a developer for those of you willing to push up your sleeves. I don’t know much about Infusionsoft, but the founder may very well have set it up on her own or she might have had someone assist. These services typically provide support (along with a hefty price) and help you get onboarded, so it’s important to use that onboarding time wisely!

There are some cons to using these tools: they don’t scale well and the more you build, the more you rely on the automation suite. As it grows you will need to hire a consultant that specializes in the suite or pay the company for additional help beyond your onboarding training. It can also be very cumbersome to migrate away from a marketing automation suite because they’re proprietary solutions. More than likely as your business grows, you’ll want to build a custom solution to offer a better experience and new features, which will allow you to retain and engage a user base, something essential for long-term growth.

As you can see, custom software development isn’t essential to bring your app idea to life in the early stages of business. With a tremendous amount of free or low cost “off the shelf” options available, there’s no reason you can’t begin and test the idea without the costly investment and complexity that comes with custom software development. And when the time comes for that, you’ll have a much better idea of what actually needs to be built. And when that time comes, we’d love to hear from you!