• Small, behavior-level changes in care can drive outsized health and cost outcomes — but only if patients actually follow through. Josh Freedman’s Airalux Medical tackles a stubborn gap in post-surgical recovery by redesigning a familiar device to make adherence automatic, measurable, and effective.
• In healthcare innovation, great ideas aren’t enough. New technologies must prove clinical impact and financial ROI in systems with razor-thin margins; investors are wary of adoption risk and require strong data.
• The Science Center provides more than mentorship: startups like Airalux receive the real-world validation, networks, and strategic grounding they need to survive the “near-death moments” of medtech entrepreneurship.
Rather than focusing on improving surgical experiences or optimizing medications, some companies are now looking to address areas of care where small changes can lead to notable health improvements – and big savings for hospital systems.
Josh Freedman’s startup Airalux Medical is one example – and it’s transforming how patients with lung complications breathe deeply.
Breathing, Relearned
For most of us, breathing correctly and deeply comes naturally. For patients who have had a surgery, though, anesthesia and laying in bed all day can cause them to breathe shallowly and retain mucus in their airways. This in turn can lead to lung complications like atelectasis (small airways collapsing), as well as hospital-acquired pneumonia – among other risks.
A common device called the therapeutic spirometer (picture: a mouthpiece attached to a clear plastic cylinder with a ball rising and falling within an air chamber) measures breathing and helps patients minimize these risks – if they use it, and use it correctly. But therein lies the problem.
A Classroom Idea Meets a Clinical Reality
According to a study published by the Rhode Island Medical Journal, 26% of postoperative patients surveyed failed to use their incentive spirometers correctly, while a further 38% admitted to never using the device at all.
That’s where Airalux comes in. Josh explains that the company started as a senior design project when he was a student at the University of Pennsylvania.
“We spoke to a few nurses and asked them to tell us about obstacles they encounter in their daily practice. A few of them mentioned that the patients have these devices after surgery,” he explains. They were talking about the therapeutic spirometer. For nurses, it presented a sizable challenge: they were supposed to keep track of patient progress, but rarely had time to supervise - and they could tell the patients weren’t doing it as often as they were supposed to.
Airalux Medical redesigned the classic therapeutic spirometer into a device that leads patients through the required breathing exercises and provides immediate, trackable data on their progress. Patients don’t need to self-report, and busy nurses don’t need to monitor: the device offers real-time inhalation feedback and reminders, making it easy for patients to use and track their performance.
Digital spirometers currently on the market focus on exhaled lung measurements that can help clinicians flag and diagnose lung conditions, but do not offer exercises that focus on inpatient post-surgery deep breathing.
What started as a school project morphed into something more after Josh took an entrepreneurship class. “As we started to look through the business aspects, we developed a business case that aligned with the clinical need,” he explains. He and co-founder Yi-An Hsieh stayed at Penn to complete a Masters, continuing to work on Airalux on the side.
Joshua Freedman alongside Founders Fellowship 2025-2026 cohort
Once they graduated, they continued to move the company forward, running a clinical trial with Penn Medicine. Then Josh attended a workshop on non-dilutive funding hosted by the Science Center; through subsequent conversations with the team, he was encouraged to look into the Founders Fellowship and was accepted into the 2025/2026 Cohort.
Founders Fellowship: Essential Help for Navigating the Journey
The Founders Fellowship is an immersive program that offers founders the chance to transform their ideas into a business reality. The current cohort is working on ventures related to aging and/or Alzheimer’s disease, thanks to a grant from the National Institute on Aging (NIA) Research and Entrepreneurial Development Immersion (REDI) program, with additional funding and resources are provided by the Pennsylvania Department of Health and CIC Labs + Innovation Campus.
Josh applied to the Fellowship because it dovetailed with what he needed to learn as an entrepreneur. “The nature of the patients who get this device after surgery is that a lot of them are older,” he explains. “So I thought the program would be great to get the entrepreneurial training, understand some of the considerations for aging and older adults, and allow the flexibility to continue work on my venture with some level of hand-holding and guidance because it's a very difficult and complex journey to navigate, especially when you're doing it for your first time.”
He notes that a big component has been stakeholder discovery with the Science Center, emphasizing the reality that startups can’t just solve for a problem they believe exists – they must talk to the people who would actually use or implement their technology to make sure they’re addressing the true pain points.
Josh says the focus on stakeholder discovery, engaging subject matter experts, and regular touchpoints with Dr. Baumlin, Chief Medical Affairs Officer, helped him refine a lot of the startup’s business fundamentals.
“Josh is intelligent, collaborative, and engaged with learning and supporting the other fellows in the program,” notes Dr. Baumlin. “The technology he is developing could have a significant impact on decreasing length of stay for surgical patients and decreasing pneumonia in older adult patients who are hospitalized. I've encouraged him to get good clinical data as part of his roadmap to success.”
That emphasis on real-world validation is exactly where the Science Center’s network becomes indispensable.
“I’m grateful for the deep relationships that the Science Center has within the Philly ecosystem and across the country, because it’s such a web navigating the healthcare systems: who's doing clinical work, who's doing regulatory work, and who's doing manufacturing,” says Josh. “And the Science Center obviously has very close relationships with firms and institutions in all of those different areas. We have been very grateful for the support that the Science Center has provided in terms of connecting us with all of those people.”
Devices Must Prove Their Worth
Many entrepreneurs find out the hard way that simply having a great idea isn’t enough. Health systems are often operating on a lean budget with only a tiny fraction of the pie going to new technology and innovation. A device might improve patient experience, but if it costs the hospital more money, it can be tough to move the needle on implementation.
Airalux’s challenge is that it is more expensive upfront than the standard device currently on the market. However, if they get patients to actually do their breathing exercises, the patients will be able to go off oxygen faster. Patients will be less likely to get fevers and pneumonias, and ultimately less likely come back to the hospital.
That’s where the true cost savings come in. When hospitals are reimbursed by insurance for surgery, they are typically paid the same rate for the procedure regardless of what happens. So if a patient who should be able to leave in two days needs to stay a full week because of lung complications, that’s an additional five-day period where the hospital is not getting someone new in the bed - and not collecting the next surgical payment. In other words, they are financially incentivized to adopt devices like Airalux, which help them save money by increasing turnover - without detracting from patient care.
Josh says that their biggest hurdle right now is overcoming the mix of clinical and adoption risk for the device. “A lot of investors are concerned that even with super high-quality evidence, the hospitals just might not be willing to eat the additional cost,” he explains. “We've done a good amount of research and spoken to enough people that we feel that if we get the right evidence, the hospitals will see the ROI. But it's been a huge challenge to really validate that early on.”
A classic case of the chicken or the egg often emerges at this stage of funding and implementation – you need money to get the evidence investors want, but you need investors to get the money to run the trials, and capture the data. Josh notes that being in life science entrepreneurship is particularly difficult because unlike players in the AI, B2B, SAAS etc. spaces, they can’t just build something quickly and start testing it with customers: it’s illegal to market a medical device without FDA clearance.
“It's definitely been a challenge, but that's also part of what makes this industry rewarding and interesting: navigating all those hurdles to find out the way that you can make the best impact on patients,” he says.
Built to Survive: The Near-Death Moments of Entrepreneurship
Entrepreneurship is not a journey for the fainthearted, of course. Founders are constantly reminded that many ideas never make it to deployment, despite their promise.
“I've been told many times that every successful venture has multiple near-death experiences, so I definitely want to be honest that it's a challenge,” notes Josh. “At the end of the day, it’s your company, and you are responsible for your impact. It is challenging at times, but the setbacks make the wins even more gratifying.”
Although the pathway to medical device entrepreneurship can feel Sisyphean at times, Airalux has made important strides forward in the past year. In October, thanks in part to SBIR proposal development support from the Science Center, they announced they had won a prestigious $306,000 SBIR grant. The non-dilutive funding will help them further reduce the cost of materials and continue to test the device in different environments. Receiving this grant is no small feat, as the award rate hovers at around 17%, submitting the application can take up to a full year, and the process involves prep programs and peer reviews.
Josh and his co-founder Yi-An were also nominated as Emerging Entrepreneurs of the Year by Technical.ly and Airalux placed as a finalist in Philadelphia’s Startup World Cup Competition – both serving as signals that the medtech world is paying attention to and seeing promise in this young startup.
For Josh, patient feedback is a powerful motivator to moving forward – and continues to be his guiding light.
“When I do my elevator pitch, I show people a normal device. A lot of the time they'll say ‘Oh yeah, I had that or my grandma had that.’ And they talk about how challenging it was to either do the exercises or get their loved one to do the exercises,” he recalls. “And oftentimes when I show what we're developing, the feedback is, ‘How does this not exist already? This seems like a no-brainer.’ So it's definitely rewarding to hear that from people who would be using the device, that they see this as something that could really benefit them.”
