Using VR and AI to Upskill Health Workers and Reduce Medical Error with Alex Young, CEO and founder of Virti: Audio automatically transcribed by Sonix

Using VR and AI to Upskill Health Workers and Reduce Medical Error with Alex Young, CEO and founder of Virti: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Saul Marquez:
Hey everybody! Welcome back to the Outcomes Rocket here. Saul Marquez here today. I have the privilege of hosting the amazing Dr. Alex Young. He is an NHS trauma and orthopedic surgeon by training and is also the CEO and founder of a mixed reality training program platform called VIRTI. Virti develops immersive training tools to improve human performance in organizations and institutions around the globe. They’re powered by cutting-edge XR technology and AI. Virti helps train NHS staff at the peak of the pandemic. And they’ve also worked with hospitals, universities, med-tech companies, and corporates across the EMEA. He’s passionate about improving human performance. Alex built and sold an events company during medical school at Bristol before bootstrapping and scaling an award-winning medical education company while training in the NHS. Virti, Alex’s most ambitious venture today, has won a wealth of awards and grants, including being voted one of Time’s best innovations and inventions of 2020. Alex, such a pleasure to have you here today and excited to dive into the work you guys are up to.

Dr. Alex Young:
Thanks so much, Saul. So it’s great to be here and thanks for that introduction. I’m amazed you managed to get it all out.

Saul Marquez:
Well, hey, you’re up to some really neat things. And so I definitely want the listeners. I want to learn about it, too, what you’re up to that, Virti. Before we do, though, talk to us a little bit about your inspiration. What is it that makes you interested and inspired to do your work in health care?

Dr. Alex Young:
Yeah, definitely, Saul. For me, I mean, for me personally, I grew up being a gamer, but also being someone who was very much into sports and wanting to help people. I am from quite a very early stage, I knew I wanted to go into the health care industry. And as you mentioned in your introduction, I trained as a Truman orthopedic surgeon, partly because of my sort of interest in sports and the ability of Truman orthopedic surgery to immediately be able to diagnose a problem on an x-ray like a fracture or osteoarthritis, and then perform an operation which can transform into someone’s life, getting them back to mobility where previously they might have been disabled. And I was always very, very interested in learning education and technology and the way that all these three things meet. My mother was a headmistress at a school in the UK. I have got a degree in education alongside my medical degree as well and I was always very passionate about how we could help the workforce in any sector, but especially the health care workforce, learn, train and perform better in what they do. And I think certainly when I was training in the UK’s National Health Service, which was one of the biggest employers on the planet, there are about one point five million doctors and nurses and then another one point five million auxiliary health care staff around that. It’s something that I think any industry really needs to support, and that’s that people’s culture and how they provide people with the best learning and training tools to help them perform when it matters under pressure. And I think we’ve seen that certainly over the last 12 to 18 months during the coronavirus pandemic, where lots of frontline health care workers have had to quickly adapt and do things possibly outside of their comfort zones or outside the day-to-day jobs. And they need to really jump in and learn how to do that as quickly as possible to keep patients safe. So that was very much my reason for Virti, which was how can we use disruptive technology like XR, virtual augmented reality and artificial intelligence to really revolutionize how people understand learning and performance and then deliver that, especially in the healthcare sector, to make real change in how patient care is delivered.

Dr. Alex Young:
Alex, that’s fantastic. You know, so much discussion goes into why do we not have the types of simulations like pilots do to help surgeons in surgery. And these are the types of platforms that are making a difference. Now, help educate me so I know there’s augmented reality. So AR and then there’s VR virtual reality. What is XR?

Dr. Alex Young:
XR is sort of an industry term that kind of combines the two, the kind of virtual reality. If you think of it as if you put a headset on and you’re transported into a new environment so that when 360 video with computer-generated graphics where you completely immersed in a new environment. Augmented reality, on the other hand, that’s often seen through mobile phones or things like Pokemon Go or things that you might have played on your mobile or through augmented reality headsets like the Microsoft Holyland, where you’re still in your original environment, i.e. you can see the room or space you were in, but you’ve got something that’s projected into that space which is new or foreign to that environment that you can interact with. So if you think to Pokémon go, which is probably one of the most widely used augmented reality apps on mobile and on other platforms, you’re presented with a Pokemon in your environment, whether it’s outside or inside, that you can then interact with and exercise is really sort of encompassing both of these terminologies. And I think what we’re seeing now and certainly in the foreseeable future will be headsets and devices that combine both of those i.e. three one headset where you can have a virtual reality mode where you can be immersed in, an artificial environment, or you can have what’s called kind of augmented reality pass-through remote, where you sort of look through the lens of the headset and you’re in your environment, but you can see new things in that.

Saul Marquez:
Yeah, you know, it makes a lot of sense. Right. I never understood why they were separated to begin with. But, you know, technology has been advancing and things don’t happen all at once. Now, when you use your Oculus, when you kind of figure out your working zone, that is kind of a version of augmented reality, right? You’re figuring out where your space is, then you kind of get lost into the actual virtual world.

Dr. Alex Young:
Yeah, exactly right. And I think going back to your point, just on one kind of health care training, I mean, I think you rightly mentioned that like the aviation industry have flight simulators and things like that were a lot of the employees and pilots kind of gave three days to train repeatedly in safe environments before they fly an aircraft. And in health care, we kind of have that. Most hospital systems have what’s called a simulation center within their organization, where you might practice either with roleplay, with actors, or what’s called standardized patients, where you have someone who is either a patient suffering from a chronic disease, or a trainee doctor or nurse, or anyone can come in and practice and really learn with or you have sort of high fidelity simulators like sort of mannequins that people can interact with. And you can collect data on how people perform in those environments. And then it’s really interesting because around that, you’ve then got things that are very scalable like, say, video or people going to YouTube or doing E-learning, but it’s perhaps not that engaging. And then you’ve got what is probably the most beneficial way of learning, which is the sort of age-old apprenticeship model of things like surgery or health care, where you’re in work, you’re learning from someone who is an expert, who’s been practicing for many, many years, and you’re getting direct feedback while speaking to patients or doing an operation. Now, the problem with that is it’s very serendipitous what you’re exposed to and particularly things like surgery, where there’s a lot of variabilities, there are lots of potential, different ways to perform an operation.

Dr. Alex Young:
And I also used the example of soft skills and communication skills training, where it’s as much about body language and building rapport with the patient in a clinic as it is to sort of following a set structure. And so if you think about these two things outside of that sort of impersonal role play or learning on the job, there’s not a hugely scalable way that people can access on-demand training scenarios in the healthcare space or in fact, in most other industries. And certainly, if they do in any of those ways, access training, often it’s not very data-driven. So if you think about communication, skills training is a great example. If I was learning how to break bad news to a patient when I was in medical school or when I was in my postgraduate training, I might sit down with an actor or actress or standardized patient, deliver bad news to them in a safe environment, and then receive critique back from the actor or actress, as well as anyone observing that. But often it’s very subjective and it’s feedback based on their own experiences. And so really, one of the things we set out to do at Virti is making a lot of this training on-demand and standardized and reducing variability, we also wanted to use some of this technology like machine learning to make a lot of this training content much more data-driven and much more actionable. So one of the things that we sort of optimize for in both surgical procedures and in soft skills training is how do you turn subjective feedback into objective data that can be sort of presented back to the learner and the organization as a whole that’s training them up so we can kind of set new standards what good communication looks like, or explain to people what is the sort of standardized speed or pace or way of doing a particular operation by analyzing some of the content that gets to your platform. So those are kind of, you know, just to give listeners a bit more of an idea around, you know, how sci-fi we’re going with what we’re doing, that’s kind of our obsession on a daily basis, really.

Saul Marquez:
So, Alex, data is one of those things that you feel is a differentiator. Talk to us about that some more. What would you say makes what Virti does better or different than what’s currently available out there today?

Dr. Alex Young:
Yeah, 100 percent. I think in terms of what’s being done at the moment, a lot of training is either done kind of serendipitously in work based on patient or clinical encounters that you see. And the standard way that people kind of learn from that is either just sort of remembering things or doing a set number of operations and assuming you learn from them or you immediately go back to your electronic portfolio or whatever it is you’re using to kind of learn and train as an individual and reflect that down. Now, that’s fine. But again, it’s not data-driven and it’s not really comparing one person in one hospital somewhere in the world to another person of similar demographics at a similar stage of that training somewhere else. And if you then think about the scalable end of that, which for things like surgery, might be a trainee surgeon or a medical student going to YouTube and looking at an operation, if they’ve never seen it before, just to kind of understand the steps or how people do things. Again, YouTube doesn’t really collect any data other than views and say one of the things that we can do with our system is when users interact with the video based on computer-generated aspects of the environments that are available through our platform is we can track things like where the eyes are looking through retinal tracking or gaze movement, which gives us a really interesting behavioral insight into which elements of the scenarios they find most interesting or most challenging. And then if you think about how people respond to sort of difficulties or surprises and make decisions, we can also track that.

Dr. Alex Young:
So, for example, if something were to happen in one of these scenarios where there’s perhaps a deliberate mistake made in an operation or in a communications scenario, the patient either becomes aggressive or emotional. We can actually track how quickly people respond to that, as well as the decision-making process behind that, almost a bit like a choose your own adventure type work if you remember those. And then all of that data combined allows us to really sort of map together a personalized profile of particular users and segment them across an organization by kind of stage background and do lots of other really, really smart things of the data.

Saul Marquez:
That’s fantastic. Having that granularity really helps with training and ultimately with the coaching that a lot of physicians might need to perfect their technique or to learn something new. Overall, you’d think of this as something that could drastically decrease variability. So give us your thoughts. What’s the best way that this technology can improve outcomes?

Dr. Alex Young:
Yeah, I mean, not just as a couple of quick examples of things we’ve done over the past 12 months. I mean, a really, really interesting use case, which I’ve got to say, I never thought when I had the idea for the platform we would be using it for was actually during the pandemic. Lots and lots of possible systems having to train staff, how to apply protective equipment. You may not have routinely done that in the daily clinical practice, as well as some specialized staff on ICU’s utilizing ventilators were being Redeployed to different areas of the hospital. One really quick example that we did with a number of our customers, but I’ll use Cedar Sinai in Los Angeles as a really great example. We actually were able to put a lot of the application training of how to sort of put on your protective equipment into our mobile apps and our virtual reality apps. And then were in normal circumstances, the simulation and training teams would have had to bring individual, clinicians, and hospital staff down into the simulation center in small groups, or in some cases, one at a time, give them a demonstration, sign them off on how to apply the protective equipment, and then really kind of hope that they’re retaining that information for when they go into patient-facing environments, we’re able to digitize a lot of that, analyze who might need a little bit more help and who did need to be brought back in and who absolutely had it down and could go straight into a clinical environment. And we then we were also able to provide that as an on-demand reference tool, so if people weren’t quite sure about a few steps in how to apply your paper face masks, headsets or anything like that, they had it accessible on a wrap or through the platform so they could do some just in time training as well. And a lot of the data we then collected from that study we did both across the United States and in the UK, showed that actually, our system was able to help the learners in the clinical staff retain knowledge and understanding of how to apply protective equipment for longer, quite significantly longer.

Dr. Alex Young:
We had almost a two hundred and thirty percent increase in knowledge retention compared to the traditional methods of training that we did a study against. And the other really interesting thing was on the qualitative data side with a lot of the health care professionals who went through all training, were significantly less anxious about going into these potentially hazardous environments because they felt better prepared to put on protective equipment. And when you kind of think about the stress the frontline health care workers were under, where they could potentially become infected themselves were in fact, other patients who were, in fact, the family members when they went home. That was something we were very humbled and grateful we could help with. And we ended up doing a study in the NHS back in the UK where we won an award for it and then ended up getting featured on the Times Square Nasdaq tower, albeit in the height of the coronavirus pandemic, when there was no one actually in Times to see it. But we do have a very nice. These are just a couple of things. But I think across the platform, the ability to reduce the time needed to train employees, the ability to retain information for longer and most importantly, the ability to make people feel more prepared and therefore kind of less anxious about getting into potentially hazardous or difficult to manage environments is definitely the most rewarding thing that we see regularly.

Saul Marquez:
Yeah. Now, some great, great examples there, Alex, and examples like the pandemic or even handling rare fractures. I mean, you’re in orthopedics, right? How often will an orthopedic surgeon in training see, for instance, a distal radius fracture if they’re in the middle of a low populated area, having something like this could be a big benefit. And then also thinking about the travel piece and as companies look to train people so kind of shifting to more the industry side, Alex, getting on a plane to go to training to corporate offices is kind of going out. It’s not as viable. And with the pandemic, companies are seeing that they actually can save money by doing things virtually. You guys doing anything along the lines of corporate training with these things?

Dr. Alex Young:
100 percent. It’s a really great point. And I think whether it’s corporate training in terms of your exact level, leadership skills, and soft skills, your middle manager, difficult conversations, hiring and firing, all your kind of support staff training, again, a lot of it follows the same adage of it’s often delivered by kind of roleplay or in unengaging video-based methods where there’s not a huge amount of data backing it up or behind it. And certainly, I mean, even before actually the pandemic really took hold of everyone and businesses, especially through 2020, we were real advocates digitizing any type of in-person training. And I think if you look especially at the kind of medical device and pharmaceutical industry where a lot of training, exactly as you say, required health care professionals to either fly or be flown, in some cases to centralize training facilities, to learn how to use the new techniques or apply new medical devices in their own practice. It was hugely, hugely expensive. And then you’ve also, on top of that, got the cost of actually flying wraps out of the kind of support when devices are actually used in the field. And so, again, we’re absolutely advocates that by utilizing technology like OLS or anything really, that that kind of collects data and allows you to sort of scale your in-person training. There’s a huge amount of cost saving to be had for organizations, and it really allows them to kind of scale that training. And you can also form part of a wider sort of sales, marketing, productivity and support KEC, because if you’re your sales team are better at explaining things, or your support team can deal with any kind of issues that come up around your medical device or whatever it is you’re selling, you’re going to be better prepared and you’re going to have better outcomes in those respects as well.

Saul Marquez:
Yeah, makes a lot of sense. Appreciate you sharing that, Alex. And something for us to think about as we build our businesses to serve and scale, there are opportunities to curb costs, but also to keep your employees and also customers safe, especially when things like the pandemic come up. What would you say is one of the biggest setbacks you’ve had, Alex? And what was the key learning that came out of that?

Dr. Alex Young:
It’s a good question. So I think for me personally, I think we’ve been very fortunate in Virti, since I sort of took a big risk and left my job. I love doing Truman orthopedic surgery and took the rest to kind of found start-up and go full time on. We’ve been on quite a sort of a quick scale-up journey. However, with everything, there’s always kind of setbacks and things like that. So I think for me, one of the big things that we’ve sort of struggled and this was not just in the coronavirus pandemic, but before was actually having a very sort of quick-growing international team.

Dr. Alex Young:
Fom day one, we’ve had team members and customers in the United States, in the UK, in mainland Europe, and now increasingly kind of through a pack and in lots of different languages. And I think just the way that companies and institutions in general scale-up to deliver kind of culture and keep everyone involved, whether they’re remote or in different time zones, is absolutely critical. And I think when everyone was able to travel, it was great because I could hop on a plane, I could get hang out with our teams in Texas or the West Coast or New York or something like that. But now that’s all going to be done by Zoom. And it is really, really interesting because we’ve had to sort of adapt as an organization, we were already set up to be very remote and we were using our own products. We’ve really sort of had to adapt to how we sort of engage with people, how we do want to ones, how we do our coaching in a much more kind of personal and sort of mindful way, actually, and thoughtful way. We’re sort of really looking after people’s individual circumstances as they go through this transition from in-person work to remote training. And I think for us, just sort of scaling up really, really quickly, we’ve had to sort of adapt and map that out really proactively. And we’ve not had any sort of massive problems with that per say, however, because we’ve been hiring people at quite a pace, it’s been really interesting to distress our systems and collecting feedback from everybody who comes into the business. So it’s certainly been challenging for us kind of meeting demand through 2020 and 2021. And I think we’re sort of just about, just about staying on top of things at the moment.

Saul Marquez:
Well, I think that’s fantastic. And these obstacles that at one point seem like obstacles, sometimes if you work through them, they become strengths. That’s definitely been the case for you, Alex, and I think it’s exciting to hear about what’s next. So what would you say you’re most excited about?

Dr. Alex Young:
Yes, I mean, there’s lots and lots to be excited about I think at the moment. I think as the world starts opening back up, I think we’re going to see certainly for us in the sort of education sector, in the Healthcare sector, there’s going to be a lot of kind of hybridization of everything, really in terms of services. So I think there are lots of elements of remote learning and training that’s going to stay. But we do also need to cater for getting back to that in-person training as well, because things like health care, I’m a big advocate, that no technology should ever completely replace the face to face human element because that is obviously so important. Technology when used at its best, should get out of the way of physicians or any employee, allow them to optimize their time and do things more quickly, not take longer. So I think just getting back to normal is going to be very exciting. And I think in terms of the technology we mentioned, it’s kind of at the top of the podcast that the technology in terms of machine learning or different types of hardware and headsets and the augmented and virtual reality world is moving extremely quickly. And there are lots of new headsets and new ways that data can be pulled off those that are going to be coming out over the next two years. So whether it’s things like integrating actual physiological data that can be pulled off some of the headsets into our system, whether it’s attacking new industry problems that we see arise in the way that we sort of onboard content to the system, or whether it’s just getting more examples of amazing use cases that some of our customers have used the platform for demonstrating, I think there’s lots and lots to be excited about.

Saul Marquez:
Yeah, I totally agree. There are tons to be excited about. I think it’s fantastic that you and your team are doing what you’re doing to add the additional layers of data to help really everyone that’s using this technology improve. I think there’s a really bright future for it. For those of you that are listening and are thinking, man, I wonder if virtual reality, augmented reality or as we learn in today’s podcast, are a mixture of both. How can it benefit my patients? How can it benefit my customers? This is a great, great opportunity to connect, to learn and to take action and things that you’re learning. Ultimately, that’s how things happen. Don’t just have the idea. Do something about it. I want to take the opportunity here, Alex, to say, hey, thank you for being with us. Why don’t you leave us with a closing thought and then the best place for the listeners could get in touch with you or anybody on your team to further explore the opportunity?

Dr. Alex Young:
Yeah, I think I’m just reflecting back on some of your comments, that’s all. I mean, I would say to anyone listening, one of the things that we sort of built out with our platform is our creation tools, because we feel that health care professionals and anyone involved in any sector in learning development are the most creative people on the planet and ones that have helped their employees or their patients. And there’s a number of different ways that these types of technologies can be utilized to improve outcomes across multiple different industries.

Dr. Alex Young:
In health care, there are lots of interesting uses for mindfulness, for patient education, through to the type of training we’ve been talking about. And again, just going full circle on things that excite me the most. It’s always the ideas and concepts and content that our customers come up with. So if you do have any really, really exciting news cases, whether it’s in the research phase, whether it’s actually on the deployment side now, do you feel free to get in touch? We’re available at Virti.com. Our socials are across everything @VirtiLabs on Instagram, Twitter, Facebook, you name it. And you’re very welcome to reach out to myself or any of the team through any of these mediums.

Saul Marquez:
Love it, Alex. Well, hey, we appreciate the invitation to connect and definitely want to say thanks for jumping on with us and teaching us a little bit about the platform and how you guys are making a difference with this technology. Really appreciate it.

Dr. Alex Young:
Absolute pleasure. Any time. Thank you.

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