We are happy to host Marc Ebinger, Co-Founder&CEO of RIMASYS, a Cologne-based Surgical Education startup for this mm.Blog episode.  Together with thoughts of one of medical magnesium’s founders, Kilian, we hope you find a good read on the topic of founding and running a medTech startup in Germany and the German healthcare ecosystem.

You are both based in NRW, RIMASYS in Cologne and medical magnesium in Aachen: Establishing a healthcare startup in NRW, what is your experience? What were your success factors?

Marc: “After living in Cologne for over 10 years I would recommend all young talent to try out the spirit of the open-minded and dynamic Rhineland. In addition to the high quality-of-life, more than 10 million people are living and working in the Rhine-Ruhr area. There is a high density of universities and business opportunities. NRW is very Start-Up friendly. The success factors of our region are the clinical networks here and the vibrant city of Cologne attracting brilliant talents from all over the world. As the Rhine-Ruhr is located in the heart of Europe, we have three international airports which are reachable in less than one hour. We attract healthcare professionals from all around the world developing with us new educational tools and MedTech innovations in our training center CADLAB Cologne.”

Kilian: “Our background spinning out of the RWTH Aachen university combined with the Rheinland mentality, one helps one has been a key element of becoming, what we are right now. We received support by many of the RWTH research institutes, the RWTH innovation and finally the university clinic of Aachen has become a reliable partner. The high level of education and availability of applicants for open positions, from a skilled manufacturing engineer to PHD in neurobiology at our Aachen location, was and is a crisp success factor. This enables us to build up our smart and pragmatic team at medical magnesium around the translation of latest research into surgical theatres.
Biomaterials take long breath as bio absorption needs to be validated in long term efforts. You only have one shot, as any other development cycle takes too long. Aside from collaboration with the University, I would name the collaboration among the endless list of strong MedTech companies in NRW a success factor. Even If competitive, we established partnerships with a mindset of: Big ocean – lots of fish, there is room for many trawler,  which I believe in personally.”

What is your take on German healthcare in worldwide competition? If you could forward one message to Mr Jens Spahn what would it be?

Marc: “German healthcare is more and more under cost pressure. Due to the DRGs hospitals need to shorten operation time. Additionally, keeping with the work time law surgeons in training have reduced hours used to train procedures in the OR. Thus, less number of cases and routine. This has the impact of lowering quality of skills and therefore increasing costs for post-treatment of unsuccessful operations. Every patient should have the right to get treated by experienced surgeon. With all the simulation possibilities, hands on training should be outsourced from the operation room like in other disciplines. Such as the aviation industry where pilots learn all relevant skills in a flight simulator. Training and simulation must be reflected in the DRGs and surgeons need support for outsourced training simulation without risking the patient’s outcome.”

Kilian: “The German healthcare market is characterized by a very low-price level, but high volumes compared to other countries in the EU. Compared to the US or Japanese market, it catches few economical industry attraction. But there is an astonishing number of medical experts, so industry focuses on education and convincing opinion leaders of their respective technology, with a possible fast rollout in the language cluster Switzerland, Austria, and Germany. Therefore, the German market is still of significant importance for most companies.
There is another very important characteristic of German healthcare. My message to Minister Spahn would be: Establish new and speed up existing reimbursement routes for more cost-effective patient treatment with evident clinical data. The German reimbursement system leads to a low price level, but at the same time prevents fast spreading of innovative patient treatment as very long procedural time schedules and a lack of clear responsibilities have become routine. For example, a resorbable trauma implant for children surgery with a possible total cost benefit (through eliminating removal surgery) takes several years for a general reimbursement route after it has stated its clinical effectiveness.”

Kilian, medical magnesium is producing medical implants with a very “hardware” based business model. How do you compare the German Medical technology Center Tuttlingen and your location in Aachen NRW for a medical device start-up?

Kilian: “Tuttlingen has an incredibly experienced workforce and know-how at the companies there. Sometimes it is hard to identify the right partners because most of the knowledge is not marketed and intangible. As medical device company, we have reliable partnerships with a network of companies around Tuttlingen. They offer support in many of our “daily“ requirements as an implant manufacturer.
Still, I would not consider relocating or opening a branch in Tuttlingen. Our approach at mm, sometimes naive, helps to pursue and further develop ideas with a very open minded and young team. Tuttlingen and the impressively successful companies there already lack skilled young professionals, probably mostly reasoned in its remote location and beautiful nature. Accessing and collaborating with companies in Tuttlingen from our base in Aachen, with all the benefits I mentioned above, seems to be the best pick for medical magnesium.”

Marc, the RIMASYS group is further looking into digital business models around surgical education, such as your Surgical Island platform. If you think through internationalization, is opening a US entity in the Silicon Valley an option for you or would you prefer more traditional clinical hotspots such as Boston or Houston with the impressive TMC infrastructure?

Marc: “We will always keep our roots in the vibrant city of Cologne as all our team enjoys the Kölsch lifestyle and the openness of the culture here. As the US market is in our focus over the next couple of years, we are already building up all the basic infrastructure and partnerships to address the special needs of the North American market. We would prefer more the clinical hotspots as the intense and dynamic work and the close collaboration with all the Healthcare professionals is in our DNA. To become the Go-To platform for surgeons and healthcare professionals we need the digital talents. Surely it is not just the Silicon Valley where we can offer them a harmonious working and living culture.”


Rimasys GmbH is a technology-driven health-tech start-up, founded as a university spin-off in 2016. Core of the Cologne based company are proprietary biomechanical algorithms describing injury mechanisms, utilized to generate lifelike fractured anatomical specimen with closed soft tissue mantle. Rimasys is focusing on enhancing surgical education and improving patient outcomes by advancing practical skill training and medical device development. Further innovation is focused on digital health, artificial intelligence, and virtual reality. The growing team of 35 young and ambitious professionals is aiming to build a disruptive eco-system of solutions at high pace enhancing surgeon education and interaction. For more information, visit www.rimasys.com