John Black, CEO at MediView XR, Inc

MediView: Augmented Reality Teleprocedure with John Black, CEO at MediView XR, Inc transcript powered by Sonix—easily convert your audio to text with Sonix.

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Saul Marquez:
Welcome back to the Outcomes Rocket. So glad you tuned in again today. I have the privilege of hosting John Black. He is the chief executive officer at MediView. John is a physiologist with educational background from Bowling Green State University. As an allied health professional John has experience in developing new medical devices, including design, regulatory approval and market launch. John has extensive industry sales management experience and diagnostic imaging, orthopedics, neurosurgery and capital equipment segments. He finds professional fulfillment as a partner in cancer therapy innovations, which is what we’re gonna be talking about today. The area of focus for MediView. So, John, I’m so privileged to have you here on the podcast today. Thanks for joining.

John Black:
Thanks Saul. I appreciate it.

Saul Marquez:
Absolutely. So before we dive into MediView and the great work you guys do in surgical navigation and oncology, I’d love to learn more about what inspires your work and health care.

John Black:
Thank you. Eh, flat out its dignity. I’ve looked at my career in medical device and I’ve had the opportunity to sell biologics, implants, durable medical equipment, bone growth stimulators. And I really lacked that sense that I was really being purposely engaged in the patient outcomes to the extent that I was capable of doing. And so that’s really what led to MediView just trying to have dignity in my career and invent something that truly brings significant into that cancer care continuum. And that truly is what inspires me to be here today.

Saul Marquez:
That’s great, you know. And so you’ve had a chance to feel and experience a lot of different verticals within the healthcare space and the med device side that you’re like there’s something missing. And the way I’m going to do it is by approaching it myself. Now cancer is one of those things, those areas that does require a lot of people to be involved, to really get outcomes that we need. We’re not doing a good enough job. There’s a lot of great work being done, but we’re not doing a good enough job. So tell us a little bit about how MediView is adding value to health care and the health care ecosystem?

John Black:
That’s a great question. So we are adding value to the health care system three ways. So I break it down by the clinician himself, the hospital and most importantly, the patient. So the clinician. And I’ll go so far as to say the clinician’s spouse or partner is actually a benefactor as well. Our technology was built after Carl West had lost his mentor, Dr. Roy Greenberg, to cancer associated with excessive radiation exposure. So at the very core of what we’re doing. The technology was developed as a way to mitigate radiation and minimally invasive procedures. And the passion behind the adventures is palpable every time we work it in every single day. The health care ecosystem, when it came down to the hospital system or the value analysis that would come through it. We did some initial assessments and this surgical navigation system dramatically reduces the time it takes to actually localize the tumor. Find your trajectory to that lesion, to percutaneously, come to just kill it. So and then the biggest value proposition, the one that was the most compelling to me was the fact that you can have better outcomes. I’ve had the opportunity to work with surgeons and it is terribly demanding to see what they do every single day. I mean, you’re forced as a clinician to use radiology to take a two dimensional picture displayed on a 2D screen and then reconstruct that in your mind. And so you’re applying this 2D technology to solve a 3-D problem and it becomes a terribly taxing on the physician. We saw a better way for this that helps patients to wear these guys to the plate Larger tumors and better accuracy. And at the end of the day, if we add one single day to a patient’s life or maybe save a life through this technology and increase outcomes, men so at the end of the day, I got to say that that’s really what keeps me going.

Saul Marquez:
I love it. That would certainly get me up early and keep me up late as well. Tell us about the technology, John, you know, what about it is different than what’s available today and just how does it work?

John Black:
I’m going to go with literally everything. So right now, every navigation system you’ve seen requires you to look back at a 2D monitor. What MediView has licensed and then subsequently built is 3D visualization, where you don a headset and essentially you have Superman’s vision, you see in real time, perfectly overlaid and registered to the patient. The internal anatomy, the critical structures that you need to miss on your pathway to the tumor and the tumor itself so that you can preplan in full 3D. I’m not talking 3D like you see in videogames. I’m talking volumetrically reproduce that patient’s anatomy and registered to the patient.

John Black:
So it’s as real as looking at somebody who’s actually in the room, you know, when we get demos, this technology. One of the things that I absolutely just get a kick out of is we create this hologram and this hologram is real. It’s light that’s hitting that person’s eyes and it shows it as being, you know, just full 3D. And every single time we do this, the person doing the demonstration actually walks around the hologram as if it’s there in real life. That’s the impact that it has.Yeah. So it’s more intuitive and it just helps these guys rocket through these surgeries. And the clinician confidence is tremendous at the end of these procedures.

Saul Marquez:
Super fascinating, John. Thank you. And you know, the application of augmented reality and 3-D, you know, virtual reality. Fascinating to me. So you’re saying that now they can do all of their planning in a very real way. How is it that you guys produce the images that simulate reality? What kind of technology are using for that?

John Black:
The technology we’re using is a mixture of several different things in a lot of that, we’ve grown organically within our company. So we are right now with Microsoft founder Augmented Reality. We’re actually deployed on Howland’s two. We have our last case with Howland’s one this coming Friday for a kidney tumor ablation which will be first in human. And then we use the Microsoft platform. So their ecosystem allows us to have a completely interconnected health device. So one of the things that that we leveraged is our medical device actually has dynamic’s 365 or this Microsoft teams. If you’ve seen that recently with the telehealth merger, that’s what we use. So in the middle of a procedure or in any surgical planning you can actually phone a friend and display the holograms and interact with them to try to collaborate on getting the best plan that they possibly can. So we are utilizing that technology and then we use electromagnetic tracking and some pretty heavy software from a brilliant scientist at the Cleveland Clinic named Jeff Yang.

Saul Marquez:
Wow. Very cool.So it just kind of piecing together the different tech stacks and imaging technologies to get those views. So this is primarily being used for preparation, Right. and like putting together a surgical plan.

John Black:
Now, this is intraoperative navigation.

Saul Marquez:
Ok. OK. So you’re actually seeing it. Just tell me more about that though.

John Black:
So a lot of what you’ve seen this realm is exactly as you described this pre surgical planning, not pre surgical planning. We are attempting to disrupt in every single way we can by using holography as the primary means of surgical navigation. So right now, we are on patient 11:00 this Friday for an IRP approved inhuman evaluation. And this has given us just incredible feedback on the user experience. So we talked about user centered design. We truly do that here. But this is our intended use is for the ablation. And biopsy of soft tissue and bone will be our FDA indication that we hope to have submitted later next year.

Saul Marquez:
Man, so cool. I love this. And I mean, this is truly a huge leap forward in the approach. How would you say the technology has improved outcomes or you plan that I would improve outcomes once it gets, you know, starts to be used normally.

John Black:
Definitely hope and are hoping to quantify via some qualitative and quantitative match and have lower reoccurrence of those lesions leading to more accuracy. So and then the efficiency is Saul when you see the clinician. What usually is a several hour procedure to really localize the tumor, get the right angle for it, assess what’s in the way, takes a fraction of time. When you use holography, it’s basically just peering into it to where we’ve done some ad hoc experience. But my eight year old son can successfully perform an ablation of a tumor on the Dome of the Liver which is a pretty challenging procedure with about 80 percent accuracy in alternate reality. So it really makes the procedure just that much more straightforward through visualizing the anatomy and its real orientation in real time.

Saul Marquez:
I love it. So, you know, I’m just wondering, where did the inspiration for this came from?

It really was around finding a better way to visualize and the code better. Karl West is so passionate about this. He’d spent his early part of his career as a biomedical engineer trying to find ways to allow the medical devices to show more under fluoroscopy using radiation. And he had this epiphany that instead of just allowing for things to be done with radiation, what if we tried to eliminate the radiation completely and really focus on the visualization? And we have tremendous amount of data. When you have a C.T. scan, you can recreate that segment, that anatomy out, really focus on what you need to get to. And also what you need to avoid on the pathway there. And that was really the genesis of it.

Saul Marquez:
I think it’s great. And just thinking through oncology being one thing, but how many procedures that are radiation heavy and the risk that a lot of clinicians experience? I think the quadruple aim and innovation. What a great way to help out our clinicians with this, you know.

John Black:
So we hope that this is truly a platform technology. We today we’re heavily focused and trying to maintain a clear course and trajectory to get through our first FDA five 10K, which we hope to have submitted as kind of an intermediate product that doesn’t have the full navigation spectrum, but that will be submitted to the FDA by the end of this year. And then the full-blown navigation system shortly thereafter. But we want to move into other areas. I see pediatric deformity correction. Therapeutic and orthopedic spine procedures as tremendously underserved. You look at interventional pain management, the opioid crisis, if you can give clinicians an easier pathway to the anatomy of interest and do it faster. We really are going to be in a disruptive state where this technology will be forced into adoption because it has that big of a value proposition for every stakeholder in the health care continuum.

Saul Marquez:
Yeah, for sure. And so do you need an initial CT. or do you need an initial, you know, kind of full 360 fluoroscopy image? What’s the base there of imaging that you need?

John Black:
So for our minimal viable product, yes, we still need that base MRI or C.T. However, we know that for true scalability, you’re not always going to be able to get that C.T So we’re working on some confidential ways to get a 3-D volumetric reconstruction done using no ionizing radiation. Now, I have to leave that a little bit of a trade secret for right now.

Saul Marquez:
Fair enough, man. But certainly promising Right.. I mean, you’re going to have to go in for that MRI or that C.T. anyway for diagnosis so you could pull from that anyway.

John Black:
Correct.

Saul Marquez:
So if I look at it.

John Black:
We are using a little bit of AI right now to take different imaging modalities and actually use the C.T. as a training set to build a 3D volumetric reconstruction using non-invasive or non ionizing radiation such as ultrasound. So we’ve demonstrated our first A.I. segmentation algorithm with about point nine one reproducibility and our prototype. So we’re pretty enthusiastic about that right now.

Saul Marquez:
That’s awesome. That’s awesome. And, you know, we think about getting more for our health care dollar, you know, and the CTs and the MRIs that are taken and they serve their purpose once the diagnosis is made. Talk about taking it to the extra mile there and getting even more with that image. To me, that’s just like it makes sense in it. And you talk about ROI for some of these systems to do MRI and C.T., you guys are helping them out.

John Black:
Yeah. And honestly Saul, I think that maybe I see this in this course in my career, but I hope that we’re laying the framework by using the segmentation in this holography. We have an X, Y, Z coordinate system of every point in the human body. So these procedures. That’s a tremendous amount of data. Now you’re linking that preoperative data in with real operative outcomes. You know, we talk about dignity and significance in my medical device career. That’s really where I hope that long term effect is. I think back to cervical plates. You know, working in orthopedic industry. There was a paper that came out by Dr. Park. Oh, gosh. Almost a decade ago, they showed that if a plate was lower profile, you had less adjacent level disc disease. And that changed a market that was commodifies with different cervical plates and forced everybody to change their entire design rationale on a technology that had been around for two decades. That’s really what I hope we learn from this data we’re collecting is that you’re taking that C.T. and you’re making it go farther by taking it and making it interact with the real operative environment and then tying it to outcomes.

Saul Marquez:
This is so great and the promise is big for patients, physicians. Talk to us about setbacks. What have you guys experienced thus far that became a big learning that’s made you guys better.

John Black:
The interconnected health device was a huge setback in the software encoding that went with that. We decided that in 2017 this we could not abandon having something that was truly interconnected. And to be honest, all we had a lot of criticism. The world was not ready for a telo procedure system that, you know, you’d have to overcome challenges with latency, how you networked and stream that data. Those were huge challenges. And so we had a lot of constructive criticism that we welcome because it allowed us to build the framework to reduce latency to acceptable to the clinician. And then, as you know, COVID happened. Right. And all of a sudden the idea turned into something that was not years ahead of its time. But just at the right time. And that was a huge setback. But at the beginning, because we had such criticism over the things that come with interconnected health device, we had to solve for those tactically. And it was a huge challenge for our chief technology officer, Meta Thahene, who has been a rock star to this development process.

Saul Marquez:
But you guys held strong, so you must believe this. Interconnected health device portion of it is important. Why is that?

John Black:
Well, there is always the need for that confidence from the clinician chip to bounce his ideas or his strategy. And there are other people in our first device that will be released at the end of this year. What we’re finding is there is a huge value proposition for having the ability to phone a friend in vertically and horizontally integrated health systems. Take, for example, common procedure. Bedside procedure called athoracentesis. Clinician asked to put a needle in the back of the patient in the pleural space and drain fluid off the lung. Right now, that procedure is typically done by a pulmonary critical care specialist or a interventional radiologist who is really at that high-end specialty pay cost to the hospital system. It can be done by the advanced nurse practitioner, a physician assistant or an unspecialized doctor. Now, imagine if you’ve got somebody at a rural satellite clinic that can now don a Howland’s fire up his ultrasound and phone the interventional radiologist 200 miles away. Get real time interactive feedback on if he’s in the right location and giving him the confidence to go ahead with that procedure. The efficiency’s recognize that were amazing when we did our initial economic model. So we’re looking forward to getting in that national proving that.

Saul Marquez:
Wow, that’s cool. And just I mean, access Right.. We’re talking about access. Yeah, you could do it there. Why wouldn’t you be able to do it in Africa or you name it. Right.

John Black:
Yeah. Our chief medical officer, if I had Dr. Chuck Martin talking me through a procedure, I’m confident I’d give you a thorough procedure. I would not recommend that.

Saul Marquez:
Yeah, that’s right. And that’s so good. That’s so great, you know. And just having that vision, folks. You know, you hear the it was a setback for John and his team, but yet they held strong with their CTO and everybody else involved to make this interconnected health device work. So the encouragement to you as you listen to this is if you have a technology or a process and you know that it’s the way it goes and that they were open to feedback. So, John, you know, you mentioned, hey, we’ve got a ton of feedback and we’re glad we got it. But you guys held your course, and that actually is beginning to work out. So, you know, great inspiration for everybody listening that may be in that valley of death, as they call it, to to develop those devices to fruition. What would you say makes you most excited today, John?

John Black:
I’m going to go back to patients. We spent this Friday night in the interventional radiology suite doing a walkthrough and prepping for a tumor ablation, global first in human kidney that we’re going to evaluate this Friday. And the idea that the work we’re doing right now could possibly send somebody home without having to worry about that tumor anymore. They can spent time with their family and do what they love. You know, sometimes time is the only thing nobody can buy. And that really keeps us going. I’m most excited about that. If I can look back and just say, wow, I actually did something that was meaningful in my career, did it well and helped other people. And that’s I got to tell you, that’s what I’m shooting for.

Saul Marquez:
I love it. Great, great inspiration. And definitely something to be excited about. Man Great stuff, John. Folks, if you have any any questions, if you’re curious. It’s medi view dot com M E D I V I E W dot com. Check them out there. But also, John, I’ll give you a a way to contact him or somebody on his team here shortly. But before that, give us a closing thought, John. And what should we be thinking about as we turn the corner from our conversation with you and then leave us with that best place to get in touch?

John Black:
Absolutely. Well, I thought, you know, I thought about this and I really would just like to encourage the other medical device professionals, engineers to consider the phase in in which we’re in right now. The value proposition for what a medical device should do is rapidly changing. And I think a lot of people get stuck in those big companies and those big organizations where innovation is hard. Right. There’s a lot of stakeholders, a lot of things that need to be protected within a company and a bum product launch can really pull them down and damage some reputation. In the startup world. It’s different. You get to apply your skill set, all your world experiences every single day. And so I would just encourage people out there that if you’ve ever had that that passion for innovation or want to build something or just realize that something is not right in the medical world, in the OR just the caregivers through, doesn’t matter what it is, I would encourage everybody to really consider taking that shot on goal and diving into the startup road. It’s been tremendously rewarding, tremendously stressful. But at the end of the day, you’re betting on yourself.

Saul Marquez:
Love it, John. What a great, great message for all you med device folks out there. Definitely listen and act on it because it’s true. Right. OAnce companies get huge, it’s so hard and the risk aversion is so palpable that, you know, a lot of things don’t happen because of it. There’s so much talent out there listening to this. You have that talent. Take that advice from John and take that leap. If you see or hear feel something could be so much better. John did it. He’s in the process of doing it, John. For anybody interested in partnering, learning more, getting involved. What would you say is the best place for them to reach out?

John Black:
Visit our website. Our human resources manager, Terry Helms, keeps us pretty well in line. And anybody who reaches out will get a response. And so I appreciate you saying that. Really with MediView collaboration, Right.. So for holography to really achieve its full potential is going to take a lot of cross pollination between different companies, different startups, big and small. So we encourage everybody to reach out. You will never hear nothing on the other end of the line. We will always get back in touch with you.

Saul Marquez:
Love it. Well, there you have it, folks. Just go to mediview.com and you’ll find a way to get in touch through the Web site. And John, thank you so much, man. This has been exciting to hear about the work you guys are doing there. And I’m certainly looking forward to as I’m sure the listeners are to see how you guys do here in the next coming months when you go live with this thing.

John Black:
I appreciate it solved.

Thanks, man.

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