Ralph Finger, M.D., knew there had to be a more effective way to deliver medication to patients with asthma and COPD. So here’s how he created a new type of nebulizer.

The Nursing Beat (TNB): What inspired you to create the Flyp nebulizer?

Dr. Ralph Finger (RF): I started the whole company on a napkin in a diner. I was sitting in an airport watching someone smoke an e-cigarette in 2012 when that was allowed, and I thought we should have technology that would deliver medication for asthma and COPD that way. So I drew the design for a handheld device on a napkin.

I have a daughter who has asthma and a mother who has COPD. My inspiration was all about the fact that it was so difficult to deliver their medication. People with these diseases often have to use big, noisy machines and sit in front of them for 20 minutes.

For kids, the machines are scary. My daughter was terrified of the machine and the face mask when she was a baby. For adults, they’re tied to the machine—it’s almost a ball and chain type of thing. My mother didn’t go out of her house because she thought she would have an attack and die. So I thought there had to be a better way.

TNB: How did your work as a physician factor in?

RF: As an ER doctor, I prescribe nebulizers all the time. People come in all day long with asthma attacks, and when they leave, I will hand them a prescription for a nebulizer. Then, I’d see them in the ER again and ask, “Did you get the machine?” They’d say no. That’s one of the most significant issues in the ER: noncompliance with medication. And the people who did use their nebulizers felt inhibited and couldn’t live their lives normally.

TNB: What happened after you drew the nebulizer on a napkin?

RF: I continued with the idea of designing a handheld device to deliver medication. I worked on it out of my home office and found a gentleman who agreed to help me make it. After we built the prototype, I realized I’d made something that worked. If I wanted to bring it to market, I’d have to go through the FDA, which required an enormous amount of testing to make sure the mist was the right particle size, that it was delivering the medication properly, and that the container was nontoxic. We got it through.

TNB: How is Flyp different from other nebulizers?

RF: There are three kinds of nebulizers: jet, ultrasonic, and vibrating mesh. Jet models, which force air through the liquid medication and turn it into a fine mist that you breathe, are the most commonly used. It takes up to 20 minutes to deliver the medication, and 30 to 50% of the medication in the liquid gets delivered. So that’s okay, but it’s not the best-case scenario.

Ultrasonic nebulizers are newer and use ultrasonic vibrations to generate a fine mist. Unfortunately, they’re unreliable and aren’t compatible with all medications, such as suspensions.

Flyp is a vibrating mesh nebulizer. The medication is pulled through a stainless steel disk with thousands of microscopic holes. This creates a very precise aerosol, which includes particles in the 2 to 5 micron range. Flyp has been tested to deliver as much as 90% of the drug into the lungs, which is extremely high. You get the whole dose at the correct particle size, and when you inhale the particles, they get to where they’re supposed to go. It’s faster also: It delivers the medication in 7 minutes. And it’s genuinely pocket-portable.

The downside is that the holes in the disk are very small and can get clogged if not properly cared for. They have to be cleaned, and you have to follow directions carefully. We make this simple for our users by providing educational materials online, in our product manual, and through our customer care team. 

TNB: What are the benefits to patients and healthcare providers?

RF: From a patient standpoint, the device is easy to use. That means improved compliance and therefore improved clinical outcomes. It also reduces the stigma. It doesn’t look like a medical treatment; it looks like a cool iPhone thing in your hand.

From a medical provider standpoint, you can hand out the device when patients leave your office. You don’t have to give them a prescription for a nebulizer. As a result, they’re more likely to follow your advice. In my practice, people who previously didn’t know what to do with a prescription for a nebulizer use Flyp, and they feel better.

The same goes for payers. Patients who are more compliant and use their meds as prescribed have better clinical outcomes and fewer ER visits. That’s the triple aim of medicine now: to improve the patient experience, improve clinical outcomes, and lower the cost of care. Small, portable devices that patients like and use address all three of those needs.   

TNB: What’s the best thing anyone has told you about Flyp?

RF: We hear from patients all day long. “This is quiet.” “I can take it with me wherever I go.” One guy told us he takes it with him when he is hiking. For me, the best thing is that my mother can feel like she’s not dying. She always has the device in her pocket, and she feels safe with it. It liberated her and made her life so much better. Just knowing thousands of people like her are using my device and have a better quality of life because of it is very satisfying.