Meet John Klepper, CEO & co-founder PIPRA AG

Please tell us about PIPRA AG

PIPRA AG is a Zurich-based, visionary digital health startup at the forefront of developing revolutionary products that harness the power of AI and high-grade patient data for the prevention, prediction and diagnosis of delirium. In addition, we offer comprehensive services to hospitals for implementing delirium management programs. Our flagship product, PIPRA (Pre-Interventional Preventive Risk Assessment), is an advanced pre-operative risk assessment tool that accurately evaluates a patient’s risk of developing postoperative delirium (POD).

PIPRA was founded in 2019 to provide a comprehensive delirium management program in hospitals, focusing on awareness, prevention, and intervention. Our team of 9, with a majority of women, combines expertise in medicine, neuroscience, AI, and business. We’re proud to champion gender diversity and innovation in healthcare.

Tell us more about your plans for 2024 and what is your long-term vision.

PIPRA AG’s growth and internationalization strategy begins with Switzerland as its beachhead market. By collaborating with well-established hospitals like the Hirslanden Group and Basel University Hospital, PIPRA refines its software and gains valuable insights into the needs of healthcare professionals. With a solid foundation in Switzerland, our focus is now to expand into more European markets, particularly Germany, Austria, Scandinavia and the Benelux regions. Leveraging our presence at industry events and accelerator programs, PIPRA aims to forge strategic partnerships with hospitals, healthcare organizations, and insurance companies, thereby expanding its customer base and influence.

What has been the biggest success that you have achieved in your startup?

1. For the Hirslanden use case 335 bed hospital. Here I personally would use the numbers that we use in the graphical abstract of the paper. Please mention somewhere that these numbers are based on the outcomes of medium-risk patients because it is this group of patients where our program shows the most benefits. Medium-risk patients were 21.6% of the patients considered for this study

• Cost savings: This value is just an approximation based on the LOS reduction observed. The LOS across all patients is -0.55 so you can use the initial simple calculation that you like to have: 1400CHFx.55 daysx420patientsx12months. As you understand, these 3.9million that you get is not considered many factors, and at the same time doing several assumptions (like the patient number is stable across the year, nursing time reduction is not considered, extra revenue due to extra free beds is also not considered etc). Also, some people might argue and argue already that to free a bed for only half a day, does not really save any costs, so again, this is a too simplified calculation if you ask me.

• Incidence reduction: Once more, the incidence reduction is very relative. It could be either 18% or 1.3%. 18% is the reduction in the incidence if one assumes that phase II expected cases are an absolute truth, meaning that we observed 18% less because prevention avoided Delirium for 18% of the patients. However, both this and the health economics paper also talk about 1.3% reduction, since in phase 1 the observed incidence was 12.4% and on phase II it was reduced by 1.3%. This assumption is also very brave, since depending on the particular group of patients, the incidence does change. I would go for the 18%, but it must be very clear wording in order not to make a false statement
• Reduction of LOS: discussed above, -1.36 in the medium-risk patients.
• Reduction of required nursing hours on the average susceptible patient: -19.3 hours in the medium-risk patients.

2. From the Health Economy paper.

• Cost savings: 25 million to a hospital for the next 10k eligible patients, based on the data achieved in the Hirslanden study, and 30 million for the healthcare system. This calculation is based on a model taking into account different factors: price per day taken from different studies, the reduction of nursing time, the beds that are made free due to shorter stays, the cost to the system if a patient then needs to go to a nursing home as a consequence of Delirium etc. I would just write the numbers and refer to the preprint
• Incidence reduction: Same numbers than for the other paper, since this paper is only analysing the potential financial impact based on the numbers obtained in the Hirslanden paper
• Reduction of LOS: same as for the previous question, this publication is not calculating future LOS, only the economic potential impact based on the data at Hirslanden
• Reduction of required nursing hours on the average susceptible patient: Same as the last two questions

What I do find also worth mentioning (again, all depends on the audience): ” There was a 100% probability that adoption would have cost saving and a 91% probability that adoption would be cost-effective” as an outcome of the Healtheconomic analysis.

If you could do it all over again, what would you do differently? What are your biggest learnings?

Our biggest success has been demonstrated at Hirslanden Hospital (335 beds), where our program reduced delirium incidence by 18% in medium-risk patients, who made up 21.6% of the study. It also shortened the length of stay by 1.36 days and saved 19.3 nursing hours per patient, resulting in estimated annual savings of CHF 3.9 million.

What motivates you to continue your business every day?

What motivates me every day is my passion for brain health and creating a meaningful impact. After working on Alzheimer’s Disease Prediction, I realized that postoperative delirium, which often leads to dementia, is a huge unmet need in healthcare. Together with my co-founders, we strive to improve patient outcomes and innovate in this field.

One piece of advice for someone who is just starting out with their startup?

One key piece of advice for anyone starting out is to stay focused on solving a real, unmet need in the market. Ensure that you fully understand the problem you’re addressing and remain adaptable. Surround yourself with a strong, multidisciplinary team, and don’t be afraid to fail – it’s part of the innovation process​.