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Solving a $50 Billion Dollar Problem with Machine Learning with Benjamin Fels, Founder and CEO at macro-eyes

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there's one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That's why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's outcomesrocket.health/podcast.

Welcome back once again to the outcomes rocket podcast where we reach out with today's most successful and inspiring health leaders. Today I have Benjamin Fels as a guest. He's the founder and CEO at Macro-eyes. He leads teams that innovate and build systems that recognize predictive patterns and macro-eyes, they use machine learning to increase access to care. Their live clinical product and a two leading academic medical center institutions they develop supply chain analytics product for one of the largest value based healthcare systems in the U.S.. Today it's super important that we find ways to apply artificial intelligence and machine learning to healthcare. Because let's face it we're not able to scale the number of patients that need care with a number of providers that can give it. And so that's why that'd be so timely to have Benjamín on the podcast today to talk to us a little bit about what they do it macro-eyes as well as the concept of machine learning and how we can apply it in healthcare so Benjamin. It's a pleasure to have you on the podcast sir.

Thank you. The pleasure's mine.

So Benjamin did I leave anything out in your intro that maybe you wanted to have the listeners know more about.

No no just kidding. That's not I. I don't love talking about myself. So maybe some other pieces of the backstory of Macro-eyes as a company or from my own history of working with my friends will sort of come out through this conversation. So I'd love to just dive into it.

Beautiful Love that you open that loop there. And so you know before we do dive into that I'd love to hear what got you intrigued or interested in the medical sector to begin with.

Well that's a good question because I didn't train as a doctor as a company we've been working in healthcare now since since 2014. But it's I bet it's a pretty unconventional route. So sort of go backwards in time here to answer that. So..

All right.

I've worked on what you could broadly call pattern recognition for many years and I believe in and I pretty sure that most of the people who are listening would agree with me that health care poses the most complex and at the same time most important problems in pattern recognition. This is where pattern recognition matters. So OK now let's go to sort of how I got to this point. So I graduated with a degree in the history of art and the way that I see the history of art as a series of exercises and pattern recognition how one artist perceives, reflects on, interacts with art that came before art from other places. And there's a way to see that transformation refraction of pattern. When I graduated college I then went to go work for a quantitative hedge fund first in Chicago then in London. My job was to predict patterns and data faster more accurately than our competitors. That was it. It was very clearly defined. I mean there's that great beauty in that in that clarity. I led teams that traded global markets 24 hours a day. I led teams also built autonomous agents so what I now know is called machine learning. So basically machines that looked at patterns and data in markets and looked for signals that we might have missed and acted upon. And financial markets as a whole are decades ahead of healthcare in terms of designing and implementing infrastructure for I guess what we could broadly call data driven decision making. So designing systems that learn as reality on the ground changes. So it's everything in financial markets is always responding reacting learning. There's a very powerful very heavily incentivized feedback loop there. Nothing is ever static. So essentially I left this hedge fund to found a company so that I could take this approach this mindset and a bit of new ideas for technology to where it is needed most. And we believe that's healthcare. And again this concept that. Pattern recognition the ability to detect patterns that are meaningful and large amounts of data where that is the most important is in both the delivery of care and the practice of care and I'll just speak a little bit about some of my colleagues in this company because it's certainly certainly not me doing this all on my own. So I found it with two other people a chief design officer and a chief AI officer. Maybe we'll get a little bit later in this conversation to why I think that mix is important. So Sebastian Cowper's and Sebastian is our chief design officer and he has had a really a career long commitment to thinking through how healthcare organizations can best use data. And this is from huge global pharmaceutical companies to one of the first personal health data dashboards which he designed for a company now more than 10 years ago and surprise our lead AI officers since read is a world renowned expert in large scale machine learning and optimization and a professor at MIT. So I hope I answered that question about sort of how how I got to healthcare.

Absolutely. And you've now focused on this area. You've got a phenomenal executive leadership team there at your company. You're tackling Data in Healthcare and making insights so as it relates to that Benjamin, what would you say a hot topic that needs to be on every medical leaders agenda today and how are you guys approaching it?

So I gave away this answer a bit already and I hope this is the answer that many other leaders in healthcare would come to but absolutely machine learning or AI and me and maybe to talk a little bit later about the distinction between those two. But again this is medicine is pattern recognition and the delivery of care should be pattern recognition at scale, at speed. And the thing that is so unique about healthcare as an industry is that it is unparalleled in the richness of the data that it holds that describes almost every one of us in incredible detail, meaningful clarity and no other domain has such an impact on human life and has this incredible picture of each one of us. And I mean all of us have experienced this for better or for worse every time we go to see a doctor or nurse. They spend a lot of time mentoring in data and speaking very, very, very broadly and I'm going to ruffle some feathers here. Very little of that data is effectively put to use to build what we could again say very broadly our learning systems for help very little of that data is learned from in a systematic structural way to personalize care to make care more efficient. And I see absolutely no reason why that should continue to be the case.

Love your passion for this. Benjamin and I agree. You know a lot of the data that we shovel into EMR is stays shoveled into silos. That is not accessible by anybody outside of the system. Definitely a problem right. And so you guys work to offer this solution to health care. You've decided on the macro-eyes. So can you give us a little bit more detail about what macro-eyes is focused on and what's the problem what's the solution you guys are providing?

Sure. So I'll tell you a little bit of the evolution of the company and also the problem that we're most focused on today. So we founded this company in 2014 and we spent a number of years refining and deploying core machine learning at a leading academic medical center in York City at Stanford at one of the largest health systems in the United States and at a number of federally qualified health centers across the country.

And what came out of this experience was a couple of a very robust technology for understanding patient behavior and understanding patient behavior multi-dimensional and what I mean by that is at many points in healthcare, the understanding of the patient is very or at least the classification of the patients is very limited. Fifteen year old male diabetic but there are hundreds if not thousands of other data points in dimensions which are going to inform both the care that is most appropriate for that patients and how we should think about risk and also opportunities and our expertise is that ability to build these very rich pictures of patients in time and the other important thing that came out of this experience largely focused on clinical decision support during these years were working with physicians, physicians scientists to answer clinical questions and from a business perspective probably the most important piece of this is that we we've got an understanding of healthcare as a business and as everybody listening here knows it's a very complicated business it's very difficult to to understand. And I think we got an understanding of the problems that are solvable and the problems that are less solvable particularly for a small company like ours and one of those problems that came to us again and again and again and from many different perspective this is really twofold. One schedules that don't work schedules that aren't predictable a day that a provider has which is chaotic. So it's a balance between having 10 patients in the waiting room all waiting for the same slot and other periods of the day where four of the five patients who were scheduled don't show up. So it's it's sort of feast or famine and there's a significant financial impact to that. There is a clinical impact that this is important to patients, it's important to administrators, it's important to physicians. Scheduling is really the front door to care. And our own response to that was to spend the last. Now more than a year developing and implementing and refining a product called Sybel and Sybel is software for intelligent patient schedule and what that means is that Sybel identifies when each patient is most likely to show for an appointment and uses that insight to build a better schedule, a schedule that is more predictable, a schedule that increases access to care and a schedule that reduces the number of times in the day when there are expensive gaps in the schedule and reduces those periods in the day when there are many patients waiting and waiting and waiting in the waiting room because they've all been booked for the same timeslot.

That's fascinating and through the work that you've done you found that this is one of the biggest problems. And you're right it's definitely a huge issue. And so you've deployed a solution to help fight this problem. Intelligent scheduling.

Yes. Yeah. And I want to emphasize and this is sort of one of the things that drives us as a company and so when all of us think about what machine learning, artificial intelligence, innovation in healthcare probably what comes to mind, Robots, self driving cars, things happening on Mars. And one of the strong beliefs in our company and that I really want to emphasize is that where innovation is both needed the most and has the greatest likelihood of actually making an impact are these issues at the very foundations. Of care issues that touch operations supply chain scheduling. Think of that as this is the roads and the airport of healthcare right. This is the core building blocks that when they don't work the whole system suffers. And when they work effectively now you have a base that you can build on and you can build something which is much more efficient. And we would argue also were personalized and enables both better access to care and more personalized care.

And I love that you've focused your efforts in this very niche area that frankly a lot of health systems health executives I mean if you're listening to this you're probably like yeah I'm definitely struggling with this. It's a billion dollar problem. There's a big loss of revenue due to people not showing up to their appointments. And so I think it's interesting that you guys decided to just niche down to this particular pain point.

Yeah and part of it has to do with again this from our perspective and this is what really, really exciting this is a problem that we believe is solvable. And again I'm gonna say maybe some some controversial things here but there are a number of issues in healthcare that particularly when you're new to healthcare as an entrepreneur and you look around and you see things that just don't make any sense. And if you're looking at that from an entrepreneurial mindset. These are why should start a company to address this and this and this and each one of these is maybe 50 billion dollar problem. But I think if you are humble and you observe carefully you start to notice that many of those issues you cannot solve them as an entrepreneur even if you are enormously successful because perhaps at some level they are the result of policy or they are the result of a certain structure that's in place. And you know we could argue whether that's a good structure or a bad structure but it's very often something that you cannot move even if you are immensely successful as a company. And what our job as a startup and as a startup that wants to make an immediate impact and I would argue that that's the job of every startup. Our job is to find those points in health care where we can affect change we can push the system towards operating better operating more efficiently giving greater access to care to patients because that's that's what we get excited about. Right we want to do something where we can have an impact.

Absolutely. And listeners by the way if you're curious if Benjamin has has hooked you at this point which definitely probably has hit pause and go to gosibyl.com. You'll see a little quick video on what the software does for your scheduling. So it's G O S I B Y L.com. Check them out. They're definitely doing some very intriguing things to use A.I. to help you keep those patients in those slots that are scheduled for whether they show up or not. So this is fantastic work that you guys are up to here. Benjamin looks like you guys even received Grand Challenges exploration grant to deploy a version of it in East Africa by the Bill and Melinda Gates Foundation.

Yeah that's really really exciting. So I'll talk a little bit about that. So we described here that this evolution. You know we we spent years in where we're up close to clinical questions. Our core technology has analyzed several million medical records and has learned from all of this and then out of this came this manifestation of that this product which uses insight into patient behavior to build a better schedule to better predict demand and to build better schedule so you can make best use of existing resources and offer the basis of that. We were awarded this very prestigious funding from the Bill and Melinda Gates Foundation and USA which is development and its government to design the first predictive supply chain for vaccines and at a certain level. And bear with me here as I as I explain this I see these really remarkable similarities. So our aim with this work is to increase the coverage so increase the number of children who can access vaccines and significantly cut the amount of vaccine wastage. And this is also a many many many many billion dollar a year problem. And it is also a problem which you can measure in terms of human lives just like in the United States where if you have to wait weeks and months to access care because the scheduling doesn't work and if you are particularly ill your illness will become far more grave with that period of time. So if a child is brought to a facility and they've run out of that vaccine that's an opportunity that you might lose forever. So our job is to analyze data which describes these different facilities and use that to predict exactly the right amount of each type of vaccine to be delivered to each clinic. No more and no less. Because if you deliver too many vaccines what happens is you're significantly increasing the likelihood that there will be wasted vaccines are very very fragile. They live in these delicate glass files they have to live uninterrupted in a very very narrow temperature range there just really easily breakable. You deliver too few vaccines to a facility and then you have this issue of people are coming traveling to this facility to be vaccinated and you have to turn them away. So this is really a case of get where you want to exactly nail demand, you want to get a perfect sense of how many people are going to show up if you can get that right. You can make best use of existing resources.

Yeah you know it's super interesting project and talk about hypersensitive matter with the vaccines. I mean you guys are definitely doing some cool work Benjamin. Scheduling Vaccines is the Bill Melinda Gates Foundation. This is super cool stuff that is making an impact. So I feel like as health leaders, we often learn more from our setbacks than the things that we've done right. And if you could just share one of the setbacks that you guys had and much you learned from it to make you guys stronger?

Sure. So I'll go again back in time to the beginning of this company. And our first customer was Stanford. And at the same time we were working with a leading academic medical center in New York City and in both at both institutions and in both cases these are these are world famous organizations. These are these are places that are at the very cutting edge of care and in both cases we're working with with brilliant physicians and physicians scientists and and I'm going to describe a bit sort of our again our our founding thesis and how we changed that idea but our basic concept again is that medicine is pattern recognition. So let's pretend here that I'm a patient and I walk into your office and you're a brilliant physician and you look at me and you look at my chart and clicking away your brain is this a version of what we call patient similarity. So where have I seen a patient like Benjamin before have I read in the literature about a case like this. As a colleague in the hallway mentioned you know I saw a patient three weeks ago with this this this and this and then that happened. And that is going to guide almost every point on the journey a pair prognosis diagnosis a notion of risk a notion of which medication to prescribe when. And our founding idea was let's bring scale and depth and muscle to this. This pattern recognition that the good doctors do and let's take it across every record that sits in that organization so they can get the best sense of when have we seen a patient like this before and what happens and what we underestimated. To a great degree is the extent to which physicians have been forced to deal with technology that asks an enormous amount of them and delivers almost nothing and because of that. Rightfully so. And I will support them the whole way here. Physicians are overwhelmingly wary of working with yet another piece of technology that will guide them during this complex process of clinical decision making and I think the other thing that we learned is that if we want to support that process of decision making we need to earn trust and that trust has to be built up incrementally slowly. It might take years to build that trust. Being inside that institution and we believe innovating and improving on the very foundations of care because the other thing that we like about the points where we have focused is that very often there are very clear metrics that you can present and you can point to the impact again and have a very clear way and that helps to build trust. So just to reiterate here I think that the big mistake we made is we thought well this is transformative technology. Of course physicians will want to use that and we just didn't understand enough about the day to day reality of what physicians have to do with technology and how how much they dislike that interaction. And again speaking very very broadly for all of us on the side of the table who are building technology for health care. This is something that we have to think very carefully about how do we gain that trust and how do we deal with a community of users who are skeptical and again rightfully so from the very beginning.

And you've brought up some great points. And I've done over 400 interviews now and the topic of adoption you know and getting clinicians to adopt a technology you it just continues to resurface. And it sounds like after the journey of figuring that out you've really gotten a clear idea of how to you know number one address it and number two just meeting them where they are. And so what would you say the best way to do that is today. Have you guys done it. It's a problem for a lot of people.

That's a good point. So I would say I mean part of our answer to that is we are trying to make that day of every physician better, easier and largely by working in the background. So our product Sibyl is not something that a physician necessarily will interact with. Now I've worked with many physicians who are extremely involved in scheduling because it impacts every second of their day and they have very strong opinions about how that schedule should be structured. But our job I think first and foremost from a physician perspective is to make their day predictable and I cannot overemphasize how important that is. So let's put aside for a second the financial actual impact. And again this is a hundred and fifty billion dollars a year are lost in the U.S. alone just scheduling that doesn't work. That's a big number that just so happens to be what I believe to be the global cost.

I knows it was in the billions that it knows 150 billion it's High.

This is more than what the world spends to care for patients with cancer. So we're we're talking big, big, big numbers here. And let's put that aside for a second and let's put aside the access to care piece and let's just think about how a physician goes through their day and imagine trying to be efficient. And imagine trying to do your best which is what every provider of care wants to do when if you have for instance five appointments scheduled for every day, you have no idea which patients are actually going to show up which means how do you prepare for that. Secondly that means if we back out from that how do you allocate additional resources when we should. What types of support when should which types of nurses be available. Which of the supply chain kick-in in winter certain goods necessary and just that feeling of going to work every day and not knowing how many people are going to walk through that door is very difficult to work with. And that's something that we learned an enormous amount about during this experience of deploying and working with different organizations and that one of the things that came up over and over and over and over again is that this is literally driving our providers crazy. In one of the things that they talk about all the time is just how destabilizing and difficult it is to do your job when you have no sense of what is going to happen in the next day, hour, two days. And the more predictable you make that schedule, the more in control of their day providers are the better they can prepare and the more efficient the whole system becomes.

Love it. You definitely honed in in a big way. Benjamin so kudos for you and your team for being so hyper focused. It's definitely what's needed to move the needle in this space for sure. So within all of the things that you're doing today what would you say an exciting project or focus is for you.

I'm very excited about these early deployments of civil just because every time we work with an organization we learn new things and this sounds cliche to say but it's absolutely true. I mean one of we recently sat with some schedulers in Alaska and they shared their scheduling care that is very complex in many levels. They're scheduling sequential care they're scheduling care oftentimes for a family because the distance traveled to the clinic is so great that maybe everybody is going to get in the car or try to see this physical therapist this occupational therapist on the same day. And so they have to find maybe four or five different types of appointments which are just certain order and balance that with the availability of providers. And they shared with us that this can take some 45 minutes to put together a schedule and we didn't build our software for that used case we didn't think about oh well this is going to save schedulers time. Our goal is to increase access to care for patients and build a schedule which maximizes utilization. But we realized well if we can cut that down to a minute for a scheduler that means the schedule will have more time and that means the scheduler could then spend his time her time in what we believe is the best use which is engaging directly with patients. So imagine that the scheduler could then pick up a phone and personally call the patients who they're the most concerned about not showing up and a personal phone call is so much more meaningful than getting a text message before moving an automated reminder or an e-mail. There's just as human beings we respond very strongly to human beings. And that's something that you can't do if you're spending 45 minutes to schedule an appointment.

It's a great call out and the journey is exciting and Benjamin if people want to engage with your software if they're curious about it they're listening right now and you're like OK just tell me how I could get involved. Where do they go?

They should definitely go to the website you just mentioned, gosibyl.com and send me a note. So my first name benjamin@micro-eyes.com, and I'd love to have a conversation.

Love that. So folks the website. Benjamin's email. All those things. I'll have them for you here on the show notes. Just go to outcomesrocket.health/sibyl and sibyl is S I B Y L. So outcomesrocket.health/sibyl and you'll find a way to get a hold of Benjamin and get started with this phenomenal scheduling platform. Benjamin this has been a blast. Time flies when you're having fun. Would love if you could just share a closing thought and then the best place where the listeners could follow the work that you're doing.

Well I think that if I could share a closing thought all a little bit more broadly to just sort of what we've observed with working with a number of health care organizations. Big, small and the lesson that I'd love to get across to health care leaders is embrace risk. So understand risk. Think about it carefully. But embrace the right type of risk. And there are very often opportunities to work with innovative companies like ours and we're certainly not the only one out there where the downside is very limited. But the upside is almost immeasurable and maybe I'm sort of putting back on my hat from when I used to trade derivatives but that's exactly the type of risk you want. Right. You know the worst that can happen here is nothing and that's it right. Yeah nothing collapses. No one gets fired. But the best that could happen here is transformative. Right it's a transformation of how we deliver care. And I would love to see more of that intelligent risk taking.

I love that call out and folks I know we've we've talked a lot about Sibyl at gosibyl.com but also check out Benjamin's company macro-eyes macro-eyes.com. You'll see some of this thought process that he has shared. He's a thought leader in this space applying what he did with derivatives into health care. We're always trying to manage risk and I think it's a good opportunity for you learn the philosophy that him and his leadership team are leading with here. So check them out macro-eyes.com. But again you could get that link and all the rest just keep it simple. Go to outcomesrocket.health/sibyl, S I B Y L and you'll find everything there. Benjamin, truly appreciate the time you've carved out for us and we're excited for you and we're excited to stay in touch.

Thank you. Thank you for a wonderful conversation.

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there's one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That's why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's outcomesrocket.health/podcast.

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Best Way to Contact Benjamin:

Email: benjamin@micro-eyes.com

Mentioned Links:

gosibyl.com

MACRO-EYES HEALTH

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How to Innovate Systems, Service Models and Products with Less with Geoffrey Gurtner, Professor & Vice Chair of Surgery at Stanford University

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there's one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That's why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's outcomesrocket.health/podcast.

Welcome back once again to the outcomes racket podcast where we chat with today's most successful and inspiring health leaders. Today I have Dr. Jeffrey Gertner with us today to chat with a little bit about health care that maybe you're not used to. Different angle on surgery as well as reconstructive surgery and startups. Dr. Gertner has a wide array of experience. He is a professor and vice chairman of surgery at Stanford University, a plastic surgeon by trade and also research scientists. He has a lab that focuses on translational projects that are developed in the lab and are commercialized to improve patient care. He's also general partner at Tautona Group where they lead and the development of new technologies for aesthetics reconstruction, room care, surgical and biomaterial devices. And finally he's founder and director at Neodyne Biosciences where they're they're basically an evidence based company developing and commercializing innovative tissue repair devices to minimize scar formation. Restoring both function anesthetic appearance lab topics that are of interest to you. So super excited to have Jeffrey on the podcast. Thanks for joining us.

Thank you for inviting me I'm delighted to be here.

So Jeffrey anything that I left out in the intro that maybe you wanted to share with the listeners?

I think you covered most of the things that I do and it kind of them little bit guilty of a short attention span I found I'm a clinical medicine and have a lab and then also have tried to work in the private sector to bring you know new technologies and innovations to patients around the world.

And it's super important work that you do. So I'm excited to dive into some of that in the podcast today. Why don't we kick it off with you letting us know why health care like what got you in the health care to begin with?

Yeah it's a good question. I think I I again was looking at lots of different options growing up and certainly in college and medicine really stood out as I thought about it just because it had a piece of it that was business, piece of it that was more art than science. That piece that was science and that really seemed like for someone again who might be guilty of a short attention span. There were lots of different paths that you could travel as a physician and it seemed more like an adventure than a job. And so you know through process of elimination I kind of just decided that it was the exciting thing to go into and kind of have never looked back since.

That's awesome. And you've definitely done quite a bit in the time that you've been in the field. Jeffrey if you had to zoom in to hot topic that needs to be on leaders agendas listening today what would you say the hot topic is and how are you and your different organizations you're involved with approaching it?

Yeah I think you know just the the thing that struck me being an academic medicine in the private sector is just the real inertia of the medical system and the real challenges we have and not just in innovations in terms of therapeutics or devices but even in innovating changes in the systems and service models so that we can become more and more efficient and do more with less and just the natural frictional points that are kind of legacy parts of our medical system in the United States that are just really those kind of nimble innovation synthetically out here in Silicon Valley you see people disrupting gigantic industries left and right. And I don't think that's really possible in medicine because there are so many different stakeholders including the federal government that are involved in it. But you know it doesn't mean it's impossible and so I think just constantly thinking about how can we make the system better how we think about how to make the care of an individual patient better and trying to knock down those those barriers our least work within the system. I think it's kind of a job one for all of us what we're clinicians or scientists or entrepreneurs or executives or innovators. It's not a simple thing. So it has to be front of mind for us to be successful.

Yeah Jeffrey I think that's a great call-out and I feel like the leaders in healthcare that have been successful at moving the needle are the ones like you that decide on a vertical and they just stay hyper focus. Now I know you like the kid around about hey you know I got a short attention span. But the thing that you've done so well Jeffrey is honed in to your area of specialty. And I just love that you've done that and that's why you've gotten the results you've gotten. I love if you could just share with the listeners how you've created results and maybe some examples through one of your companies or your lab.

Yeah sure. You know it all really starts when I started with patients and just as you go through your surgical training in my case you kind of have this illusion if you become very well trained you're going to be able to solve most of the problems for the patients that come into your office. And as you go through your training you realize there's just a lot of things that we really can't even address. There's a lot of things that aren't evidence base that we do to patients. And there's all these unintended consequences downstream and so my whole point of evolution has been relatively organic starting with "How can I do a better job for patients?" and then at a certain point you realize what we have to come up with new approaches for some of these things and that we do to the laboratory and you get to a certain point in your in the laboratory and actually that's where I was in 2005 when I was a professor at NYU and I had Art in Manhattan and had all these things that I thought were good ideas. I couldn't figure out how to get them into the real world. It just wasn't. It's not what Manhattan New York City is known for. It's not yet that time there was certainly not a med tech startup culture critical mass. I moved to Stanford figuring you know one place on the planet really knows how to innovate it's probably this area and realized pretty quickly that know all my great ideas were actually not very good ideas and they were certainly they were not good businesses in any case I learn that that final piece of what makes the idea, a good business and how it can have all the stars align and so it's just been you know unfortunately kind of just dogged persistence trying to figure out how to make a difference and how to advance the field of medicine that really has as kind of always motivated me. And you know I think again if you have that as your primary focus then I think it makes it easy to do things that maybe don't make a lot of sense like going out and you know as a surgeon and pitching ideas on Sand Hill Road to venture capitalists. That's actually how you learn. You learn by realizing that what you thought were ideas weren't good ideas. More importantly like what is a good idea and not in a vat. And then you can move forward. So you know it's a very simple motivation for me at least and that has kind of ended up you know there was never a strategic plan that I wanted to be an entrepreneur and became an entrepreneur out of necessity because that was the only way that I could see things that might impact patient care getting into the real world.

Now it's a winding road you know and it's pretty cool that you've taken it. You've been persistent with that and resilient for that matter and if you had to boil it down to the essence of what does make a good idea good business. What would you say the 1 or 2 things are?

I think you know for sure it has to me. For me at least it has to mean an unmet clinical need. I think there are arguably good businesses that are need two sorts of things. You know again you know we see it now we're kind of the immunotherapy for cancer. I mean obviously a great idea but if you don't really have the lens of a physician that's a great business. So now everybody is flowing into that sector but there's all these other areas of you know unmet clinical need that don't have investment and so trying to keep your eye on what you know and so as you alluded to I kind of focused on surgery reconstructive surgery plastic surgery as I know that area. You just have to find different ways to innovate. So I think remaining focused on the unmet clinical need believing you know I think the second piece is really really really being sure that your data is rock solid. So it's always easy to fall in love with your ideas and kid yourself and that's just a waste of everyone's time and money because you don't want to spend six or seven years worth of technology that you were aren't pretty sure it's going to work in the real world. And then I think being persistent and creative there's many paths to the top of the mountain and figuring out which way to go when you're not in the hottest sector, you're not in immunotherapy for answer. How do you foster innovation in those areas. I think sometimes requires just dogged persistence.

I think it's true and that's something that's hugely valuable and you as a leader Geoffrey and for the listeners that are in the middle of this process meaning to innovate to get their companies ahead to help patients to improve outcomes that dogged persistence is so key in what you're doing and take some inspiration from Geoffrey and his winding road and what you're doing it doesn't happen overnight. You've got to stay with it for the entire course. Geoffrey, you know just speaking of winding roads I feel like we learn a lot more from our setbacks than our successes. Can you share a setback that you had and what you learned from that particular setback?

Sure yes. But ten years ago started a company that was based on. Again you know really exciting technology that we've developed in our laboratory and it is really focused on novel ways to connect blood vessels. So that's mnemonic technologies and those kind of a classic example of that you know saying is, "It's not what you don't know that tricks up it's what you know for sure that just ain't so". As Mark Twain said and that we went into it with the knowledge that there were lots of it was a way to glue things to get real hallow tubes together. We went into it with the knowledge that there were lots of FDA approved adhesives on the market that were being used clinically and yet indications that we want to go into they were commercially available and so we assumed that the thing we didn't need to innovate on was the adhesive piece. And as we went in our core technology that enabled the using of adhesive to connect 2 hollow tubes worked extremely well. I mean it works great. What we found was that for certain applications these adhesives were really not good are not great they weren't perfect. They certainly weren't adequate for anastomosis. So you know that was kind of a real eye opener that you really need to question all assumptions. And again these were things that again had gone through FDA approval had multiple publications. And as you kind of get into the weeds of how does this actually work in patients realize that these were imperfect things and if we had known that ahead of time we would have certainly saved ourselves you know a lot of time and it would have changed kind of our assessment of the value proposition and also the risks of that thing. And so you know now as I look at projects I obviously look at every assumption not just the ones that incur risks.

No, that's such a great call-out. You know and there are a lot of things that we could get into and we assume and I think it's a great call-out. And I love the quote that you shared. It's what you know for sure. That is so that it really isn't us. I love that. And that was Mark Twain right?

Yup.

What a great quote. I'm gonna definitely have to look that one up after this and keep it in my in my quote arsenal. Because it's so true and a lot of and a lot of us in healthcare well and we mean well and we work hard and we're focused. Don't let these assumptions ruin your work. And the benefit that you could be providing the patients. Thanks for sharing that that's really insightful Geoffrey.

I'm sure. Yeah. And I think it's corollary is kind of why arrogance I think is a real, real negative for people that want to innovate because again assume that you know you know things are your confident you know things that I think you really have to have that can a learner's beginner's mind at all times to avoid essentially you know stepping into a pothole.

Love it. That's so true. So you walked us through sort of the some of the shadows with that company. Talk to us about one of the proudest leadership moments you've had to date.

Yes. So one of our one of my companies is Neodyne Biosciences and it's started actually when I was an intern at Mass General while working at the Boston Shriners Hospital in the 90s. Take care and burn patients and just realize again that was a situation where all the care is free. All technology was available and you just realized that these kids who had these terrible burns that literally were skin deep we could keep them alive. But you know their lives were immeasurably changed irreversibly changed just from that one moment. And there was nothing I could do as a surgeon. There is no technology that was out there that could change that. And so that kind of we embarked on a lifelong kind of project understand fibrosis and scar formation and really has been the focus of our laboratory. And you know one of the companies spun out of based on our understanding of one of the key determinants as a surgeon we know that mechanical forces are critically important in how a scar heals. We learn about these lines of minimal tension we're taught to orient our incisions so that they don't cross or that they are parallel to those lines with the clinical kind of anecdote that your scars will be better if you do that. And so there's you know again that that kind of thing that again was outside of surgical disciplines was not well embraced certainly when we started working on the mechanical environment how it changed fibrosis and scar formation. And to test that you know we actually did a human clinical trial with a little device that actually changed the mechanical environment and used incisions in humans and found that you could decrease the scar formation about you know 90 percent. Based on that. And originally we were just going to go and start screening drugs. But someone said Hey why don't we. We could use this device and people can make their c section scars or their knee replacement scars better and so we started a company that is Neodyne Biosciences is now and has treated basically using the experimental device it's now much slicker and has branding and all the rest of the stuff you need for commercial device. But it's true that 50000 patients are Serena Williams as kind of our our celebrity endorser. And you know it has made this reading those kind of testimonials on real self or different kind of social platforms seen how many different patients you know women who've had c sections and things like that is very gratifying and that's something that you kind of developed in your laboratory know has an impact on so many patients. But the journey is not over because obviously we feel that those sorts of devices don't help to earn patients and so we're now actually doing the thing with you know small molecules to block fibrosis for burns and so it's kind of again very gratifying that something where you saw an unmet need can impact and chip away out of it. And hopefully you know that pursue your career really change the game for fibrosis and scarring in a variety of different disease states.

What a great story Geoffrey. And it kind of all goes back to that beginning where you sort of you called it an illusion that you get the best training and you're going to be able to solve everything, you get out and you realize that that really isn't so. And sort of that that's the genesis of all the wonderful things that you've done and now you've uncovered a lot of Pathways to help this reconstructive scarring area. And you as you work to identify a solution for those kids with the Burn Burn kids. You're finding other things and you're sticking with your pursuit to find that need. What keeps you going man. Like what is it that that keeps you in the game. Because you could have given up a long time ago?

I just I think it's I mean I think that's why for me at least it's important for me to keep doing clinical medicine at some level and by far not the busiest surgeon but I still do surgery I still see patients and I think it just kind of rubs your nose in kind of how little we know every day. And for me it's those patients and just how do you move the ball down the field. How do we make things better. How you know in a hundred years how will medicine be different and hopefully better. I mean I expect it will be better through people just you know making incremental improvements all over the place. And I think now a lot of times especially as healthcare has become its own industry we can't put our blinders on and just go about our viewed generation or about this robot that are gaming the Preski any sister or whatever it is. And I think what you lose are what sometimes is lost is that holistic approach of hey we're trying to help one patient at a time by doing that we're going to advance medicine and by doing that, the world's going to be a better place. And so I think it's very I don't know exciting to be a part of. And you know just really for me it's I can't imagine not doing that I don't know when I would be that would have anywhere near the interest or urgency or meaning for lack of a better word than doing that and being part of that struggle and part of that that effort.

Now for sure. I appreciate you sharing that. Yeah it's definitely true, right? Listeners, we're in this together and there's no one person is going to be able to solve all of healthcare's problems. So think of it as as a collective work and keep yourself in the game. You're not the only one struggling to get these solutions out there. You have other Brethren and sisters out there doing the work like Dr. Geoffrey Gurtner. So tell us about an exciting project our focus that you're working on today Jeffrey?

Sure. You know again we're not only working on the process of fibrosis and scar formation but we're working on the the flip side of that coin which is you know core healing like in diabetes and aging and so we have lots of really interesting projects in the laboratory at Stanford we're fortunate enough that started a large clinical trials unit and our wound care center where we're actually able you know very rapidly. Look at what works and try to you know bring in an ethical responsible way bring new treatments to the market. So we're very excited about you know one of our projects that potentially can prevent wounds from occurring not just heal them faster and so we're we're gearing up for kind of initial clinical experience but that's you know I think an exciting and exciting effort and you know is kind of the flip side of the fibrosis and scar formation issue.

Fascinating love that you're super focused on that and you know what. I know that your work will continue to yield benefits to patients that need it so keep up the awesome work. Getting close to the end here. Geoffrey, let's pretend you and I are building a healthcare leadership course on what it takes to be successful in medicine today. The 101 of Dr. Geoffrey Gurtner we're in our right at a syllabus. I've got four questions for you. Lightning round style and then will conclude the syllabus with a book that you recommend for the listeners, you ready?

Yup.

What's the best way to improve healthcare outcomes?

I think to always keep your eye on the big picture of we're in this to advance the care of an individual patient and to progress medicine?

What's the biggest mistake or pitfall to avoid?

I think expecting the future to be like the past to expect good things that worked in the 80s and 90s are going to be the way the health care system broadly writ is going to be for the next 50 years.

How do you stay relevant as an organization despite constant change?

I think it started off by talking about the inertia and the friction that exists in virtually every vertical and horizontally across the whole system and I think although it's difficult to be nimble to always try to be nimble and have one of your aspirational goals to be nimble and you know rapidly changing organization that is not a hold into the past. And you know legacy sorts of systems.

Love that. What's one area of focus that should drive everything in a health care organization?

I think the patient you know just always whether you're a scientist, whether you're a practitioner, whether you're an executive thinking about improving the care of patients either by developing new technologies by providing the existing evidence base standard of care in the most efficient way possible. I think making a patient. I think sometimes we get tripped up with the you know the different billing in compliance and everything else. I think that patients should always be front of mind for every one.

Love that. What book would you recommend to the listeners?

So it's kind of an old one and I actually just had my 15 year old son read it and he responded well to and I thought he might just say boy this is really really outdated. So Zen and the art motorcycle maintenance is I think a great book because it kind of on the one hand is very very pragmatic it's the story of a father and son. And he expands from that sort of story into the big philosophical questions that have that humanity is pondered since antiquity of what is the meaningful life. What's the good life and you know at a really high level. So for me it's if you kind of are looking for meaning and that has practical implications I think it's a great book.

Love that recommendation. Folks if you want to get all of the transcripts, shownotes, links to the book, Zen and the Art of Motorcycle Maintenance and all the other things that we discussed today just go to outcomesrocket.health/gurtner, G U R T N E R, and you'll find all that there. Geoffrey, this has been a blast I've really enjoyed the conversation. I'd love if you could just share a closing thought. And then the best place for the listeners could follow you or get in touch with you.

So I think you just always keep the patient in mind whenever you do and be persistent and avoid arrogance not because arrogance is a bad thing. Arrogance is impedes your ability to be successful. And I'm on LinkedIn and Twitter and Facebook. So just as Geoffrey, G E O F F R E Y, Gurtner, G U R T N E R, and happy to continue in the conversation.

Love it Geoffrey. Hey this has been a pleasure. Appreciate you carving out some time with us and looking forward to staying in touch.

Thanks again for interviewing me. Appreciate it.

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there's one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That's why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's outcomesrocket.health/podcast.

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Recommended Book:

Zen and the Art of Motorcycle Maintenance: An Inquiry into Values

Best Way to Contact Geoffrey:

LinkedIn: Geoffrey Gurtner

Twitter: @GeoffreyGurtner

Facebook: Geoffrey C. Gurtner

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Choosing Turn-Key Biomarkers and Data to Treat Patients Better with Sathya Elumalai, CEO & Co-founder at Multisensor Diagnostics

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there's one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That's why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's outcomesrocket.health/podcast.

Welcome back once again to the outcomes rocket podcast where we chat with today's most successful and inspiring health leaders. Today I have a very special guest for you. His name is Sathya Elumalai. He's the CEO and co-founder at Multicenter diagnostics. Mr. Elamalai is an MBA and M.S. co-founder at the CEO for multisensory diagnostics. As I told you he's got over 14 years of experience leading product development, program management, performance improvement and new business development at MDX which is a company that he's currently leading. He's responsible for the overall product and technology development initiatives, investor relationships and has established a successful business partnership with key telehealth providers and health plans. Before joining MDX, Mr. Elumalai served as head of business development at the healthcare data analytics firm responsible for managing a one hundred forty eight million dollar predictive analytics product and implementing improvements for health insurance plans. As you could see he's very dialed into the data aspect of healthcare which is an area that we need to start paying more attention to as we turn the corner on value based care and start making decisions to impact organizations and even our employees. So it's with that that I extend a very warm welcome to Sathya. welcome to the podcast my friend.

Good afternoon. How are you.

Hey doing really well. Glad we could finally connect.

Thank you. And first of all I really thank you for this great opportunity and I think that's a great overview and I'm really looking forward to tell you more about what other things that I've done.

Yeah. Looking forward to learning so. Is there anything that I miss Satya in that introduction that maybe you want to share with the listeners.

Yeah definitely my background has been doing a lot of different things. I started off being a biomedical engineer. Like building solutions to help human lives and then I have three Masters. Everything in health care. But more importantly I spent over ten years at Johns Hopkins which is really the foundation of my health care journey. And I work closely with the providers patients and caregivers to really help them with the patients safety, satisfaction, quality improve. And I also work with several startup companies commercializing new technologies. But overall we have been or been primarily focused on bringing in cutting edge next generation technologies into healthcare and simplifying health care for patient that need.

Sathya, at the bottom line I mean that's a very noble focus that a lot of the listeners are also focused on you know improving outcomes making the entire process better. What do you think should be at the center of our listeners minds on their agenda today and what's that hot topic. What do you think there needs to be?

I think oftentimes everybody's talking about today least talking about AI and machine learning predictive analytics and all those different things but most importantly I think patient-centered care and personalized care is much more that is needed at this point of time and that's something which have been integral to my success or my journey in healthcare. And I think that's where we need to focus on having patients in the design and development of their own healthcare.

So walk us through that. What does that look like and maybe an example of how you guys are doing that at your current firm?

Exactly. So multisensory diagnostics we are chronic disease management company or you can call a digital health company with a device at the center where a lot of people are delivering care today using a more patient monitoring either like an home visit or through technologies mostly like individual devices or a group of devices that are specific to patients and their health care or help needs and everybody is taking them more individual disease specific efforts or using individual parameters to really identify what's happening with the patients. For example heart failure the standard of care is still a scale that people are using to measure the patients outcome or identifying deterioration patient's condition. But there are more to the disease. It's a complex disease which involves both cardiovascular and pulmonary issues. So that's where what we're doing is Multisensor is we have developed a non-invasive rapid medical assessment device called Multilab that can measure more than ten vital health parameters in 30 seconds non invasively so that all patients have to do is simply pick up our handheld device put it in their mouth and breathe through normally for 30 seconds and they put it back and they are done for the day. So this is a technology that is integrated into the life flow of the user without them having to deal with complex devices or apps or even a tablet because for example I always use my mom as a center because the reason for me to start Multisensor or to be into doing what I'm doing today is because of my mom and her multiple chronic conditions. So can I do something to help communicate what's happening with her health with her physician. So that's what brought us to build this device of love to tell you more about it.

That's fascinating. And listeners if you go to multisensordiagnostics.com. Right there on the landing page you'll see that device. It's a very elegant very small device used to capture all this data that Sathya just walked us through. It's super interesting Saadia you know. You're right. We're dealing with the main standard I guess the gold standard is weight using the scale. But there's a lot more. So tell us a little bit more about this device and how exactly you're gathering this data?

So basically what we wanted to do is to find one area or one region in the body where we can collect a lot of health information. So that's when my co-founder Dr. Gene Friedman. He's a professor at Johns Hopkins and me we working on finding a location and then he really is a mouth is a rich source of a lot of biomolecules or biomarkers or associated with health because it has access to breath and saliva which in turn gives access to many biological indicators of health. So we started there and we didn't want to just use or directly go into the bichemical analysis piece but what else can we do with we have the lips you're holding the device with your hands. So you are you have access to a lot of information from your hand. So we are collecting all these different physiological parameters from your breath, saliva, mucous membranes, blood vessels and the mucous membrane and also from your hand. So today we are measuring temperature, blood pressure, ECG, oxygen saturation, pulse rate, respiratory rate, respiratory pattern or breathing pattern Hatari variability hydration and parametric lung functions. These are all integral to managing a chronic condition like anything from COPD, heart failure to even certain forms of cancers where these are key parameters that a lot of people would love to have it but because they need to go to five or six different devices to get all these things. So no they are not doing it today we are presenting one device that is as simple to use as a electric toothbrush. Somebody told me or your devices idiot proof. I think that's kind of true because we want everyone from 9 to 90 plus to use it without any training or assistance or having accessories or a tablet to kind of play a Bluetooth. And most of the every data that we collecting from the device is sent via 4G using our universal IoT technology. So you don't even have to have a tablet if you don't have one. It's much easier you can use this device in any part of the world at any time. So we're actually it's like a check engine light for humans.

Love it. Great analogies here Sathya. So you guys have this fascinating pathway for health care organizations, providers, payers you name it decisions even you know local physicians to gather data from patients. Tell us a little bit about some of the results that you've had.

So at this point basically we rebuilt the first version of our device and we are ready to start a large scale pilot study at Hopkins. Our studies that we did before was with our first version of our device. In fact this device has been under development for almost 10 years because it has got so many information from that. I mean even just the other form factor was went through a lot of changes because it needs to be specific and it needs to be catered towards entire demographic. So today the data that we collected from our first version was really helpful in terms of understanding what the design and also what other things can be added to our device. And we also published a paper from that study at Hopkins. It's a randomized human study with more than 50 patients. It's called Mahd lab a tricorder concept optimized for rapid medical assessment so that tells you more about what we wanted to do and then the data is really accurate to the gold standard devices. Now we are moving in two words finalizing our technology device and taking it to the FDA.

Fascinating and Sathya appreciate you walking us through that as the listeners take this in and part of the thing that we do here on the outcomes rocket is you know we connect. We bring people together so as as folks are listening who out there can help you? How can you help them? What kind of collaboration going happen right now?

So one thing with our device it's it's a blessing as well as a challenge is it can apply to a wide variety of settings and a lot of different stakeholders are very interested in using this device because we are talking to these eight top health systems right now and you're working with seven of the top 10 pharma companies. The challenges not going to the peers yet they are the ones who are going to get most value out of our device and technology. So we'd love to connect with peers and also more importantly looking for working with advocacy groups. Right now we have great support from the COPD Foundation, as well as the American Heart Association. But what we're looking for is it's a device and technology not just for the patients but for the caregivers. So we would love to hear from caregivers and also from our perspective as I said it has a wide application and it's also a challenge. So we would love to connect with like minded people who wanted to really use our device to make an impact in whatever efforts they're doing in healthcare because we don't see anyone as a competitor. But we would love to work with even our competitors if it's going to help them to reach our customers or consumers early.

That's outstanding. So listeners they have it. If you fall into the category of those folks that Saati is looking for: a caregiver, payer, folks interested in the spot check devices - please reach out. At the end of the podcast Sathya will give you the best way to get in touch with him as well as check out his episode through the outcomes rocket website. There's always a way for you to get in touch with guests and in particular on this round, Shathya. So Sathya you guys are making some big progress here. Can you share a moment when you guys had a major setback and what did you learn from that setback?

Yeah certainly I think as being an entrepreneur there's more setbacks than successes. So basically I think the one incident where or in terms of even our device we developed it because we wanted a device that fits into my system or into my cofounder and how likely it is and how we enjoy using it or what is the impact that is creating. But we kind of forgot that the end user the consumer and the patients whether they can use it and can it be applied to a range of population who can use it and not just one set of people. So when we design we basically put in our mouth piece in such a way that we liked it and then the mobile interface was connected via Bluetooth where we felt like the bluetooth as a standard like everybody is using it. And let's put that in and then we expected that like somebody was a 70 plus I don't like my grandma still uses an iPhone so she could be able to use it. So.

Yeah.

That's what we thought about that. And then we put we started with all these basic things but what we learned from that process and with all 100 patient user feedback study and human factor engineering study that we did. We realized that we're going to lose patients after a few days or weeks if it's going to be complicated and if it's going to be uncomfortable. So we should of had patients before we actually designed it. But oftentimes that's not always possible. So that's where what we decided to have is let's have patients and caregivers throughout the care and then the product development journey. So today in addition to business and clinical advisory board we also have a patient and caregiver Advisory Board which is unheard of. So we have people who are patients caregivers and also like providers sitting there and telling us what we really need to do and how we need to design a solution that can improve adherence. Today as I told you it's simpler than brushing your teeth. And that's where what we have done is to pair one habit that another habit by providing this device right next to your brush. You get a you brush your teeth and then then you go pick up this device read into it for 30 seconds put it back and you're done. So you don't have to do anything more than that. And this change of putting in an IoT technology for 4G communication significantly improved the patient adherence because now patients don't have to bring in their smartphone or tablet to connect via Bluetooth.

There's no setup.

No there's no set up. All you have to do is they plug in a charger and then put it in an even a single charge can take up to 20 days of you can just use it for almost 20 days without a charge. So you can travel with it so it's easier. So anything that one additional step that is needed to use your product, people are going to use it. So that's what is a key lesson that we learned is to design something and have the users all as part of your decision making process.

Such a great lesson, Sathya. I feel like a lot of entrepreneurs fall into this trap of designing their dream product without having that feedback loop of their end user. I love that you institutionalize this lesson to your firm and now you have a Caregiver Advisory Board which is awesome man. Congrats on making that an institutional priority for you guys.

No certainly I would love to have every other company you have at least one or two person with a caregiver or a patient to be continuously part of even a weekly call. Just listen to it. There are people there who wanted to make a difference. And I was still part of the Corie patient centered outcomes research institute that has hundreds of thousands of patients and users and caregivers interested in helping in all these different initiatives bring them in have them part of your product development. It will make wonders for your company.

That's awesome. Now tell us about a great moment something that you're so proud of in your in your medical career to date.

There were a lot of moments especially the one where at Hopkins I was able to do like a large scale study where I was able to convince more than 150 top performing hospitals in the country to come together to disseminate their best practices. So I started off thinking about why one hospital is doing great. And then the hospital just 10 feet away from that house. I mean there are hospitals like a Texas medical center. Like you have like hospitals right next to each other. So why there is huge discrepancies when it comes to providing care and forget about the cost but even though the quality of care there's a huge difference I mean based on the headsets reading. So for me I really wanted to know will these people share the information. And oftentimes everyone disappointed like or discouraged me really to say nobody is going to share because it's proprietary. People wanted to stay up and then always on the top. Yes I was able to prove them wrong because I individually reached out to every single top performing hospitals based on three or four years of head scores under each domain of headscarves and pretty much 80 to 90 hospitals actually came for national conference at orphanages and almost 130 hospitals participated in the study. And we also published data or paper from that effort. So today I learned that people are willing to share. But we need the platform. We need a tool or technology to ensure that all the data that is presented are just translated to patient care and not just used for a consulting project.

Now well congratulations on that. It's definitely not easy to do. You picked up the phone and you got to it. And folks this is something that we all need to take a note of when everybody else is telling you now and you believe that there is a way to do it. What Sathya did pick up the phone. Get back to the basics and you'll find that it's amazing what you find on the other end of that line like Sathya did. Now is that paper available for anybody to read, Sathya?

Yeah absolutely. I mean I can put it in my linkin, I'm happy to share with anyone who can reach out to me my e-mail address is selumalai@multisensorydiagnostics.com. You can also find me on our Web page at multisensorydiagnostics.com.

Awesome. So folks they have it. We're going to be able to share that paper with you. Why not. Take a look at this amazing work that Sathya did to gather to these best minds, best outcomes together under one roof and produce a paper get access to that reach out to him. Sathya, getting close to the end of the podcast here. You're obviously working on some very outstanding projects here with multicenter diagnostics. Let's pretend you and I are building a medical leadership course on what it takes to be successful in medicine today. It's the 101 Sathya and so we're going to build a syllabus here. Four questio

ns lightning round style followed by a book that you recommend to the listeners. You ready?

Yes.

Awesome. What's the best way to improve health care outcomes?

Definitely engaging patients throughout the design and development of healthcare. It's not similar. Even here at multisensory not building a consumer gadget that is going to really use to help you to show your steps or something but more importantly it's going to engage the patients and the users so that they can be empowered. So I would say patient engagement is key.

Love it. What's the biggest mistake or pitfall to avoid?

As I told you earlier like thinking that you know everything about what you're building and what you're providing to the consumers. I don't believe that swiping left or right on a phone app or just using a device and then sending that one data is going to improve adherence. But I think it's important that you need to say what is the real need of users and also bringing in the right technologies to support them.

How do you stay relevant despite constant change?

Talking to patients talking to users on again a lot of conferences and being part of the Koreas been a huge advantage to really seat there on huge stakeholders from patients providers and policymakers. So have been really integral to our part of it as well.

Fascinating. And what's one area that should drive everything in a health care organization?

I would say more importantly what the. Not just the what the end user ones. But as a customer you have the payers, providers the pharma. We also need to take into consideration that what is their needs are and always why, whe,n how. Those are key things that somebody needs to understand and put into practice.

What book would you recommend to the listeners, Sathya?

So since we had our candidates and more on patient centered care and patient focus care I would say there's one book by Susan Framton on putting patients first best practices and patient centered care which is a great book for somebody who is into health care into their entrepreneurship life. It is a great book to start with. There are other great ones on other topics but I love this one.

Outstanding Sathya, thank you for that. And folks if you want to get access to this syllabus that we just created for you the transcripts, show notes and links that we've discussed discuss the outcomesrocket.health/Sathya. You find that his LinkedIn profile will be there as well as a way to get that paper that that he discussed here on the podcast. So Sathya, this has been a blast. Before we conclude I love if you could just share a closing thought with the listeners and then the best place where they can get in touch with you.

Absolutely. Well thank you again. I mean the one thing that I really wanted to say is I want every entrepreneur or even healthcare organizations to create something that is not complicated for this vulnerable population. Create a solution that is very simple to use something that can integrate into the life flow of the users and try to see what other things that they can do to close the gap in healthcare look specifically patient gap and I really urge everyone to join us. So let's change the culture of care monitoring. Let's change the standard of care. It's not going to be tough. All we need is the right people to be at the right time to do the right thing. So our mission of the company is to change the culture of care monitoring. And I want each and every one of you who is listening to this podcast who believe in our technology who believe in bringing patient centered care to join us even if you're our competitor as I said and talked to us let us find a way to work together to help make a difference in health care. You can reach me at my email address selumalai@multisensorydiagnostics.com. Our website is a great resource. You can also follow us on Twitter at mouthlab and also reach me on LinkedIn. I would love to connect with you guys. Thank you again for the invitation. This has been a great conversation and you made everything what I said looks so awesome.

Hey Sathya. Thank you for making the time for us. You my friend are the awesome man and we're super super glad that you're able to join us so looking forward to staying in touch with you.

Great. Absolutely. Thank you.

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there's one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That's why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's outcomesrocket.health/podcast.

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Recommended Book:

Putting Patients First: Best Practices in Patient-Centered Care

Best Way to Contact Sathya:

LinkedIn: Sathya Elumalai

Mentioned Link:

https://www.multisensordiagnostics.com/

Sponsor Episode:

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Why 3D Human Imaging Will Save Lives and Dollars in the New Healthcare Economy with Aaron Oliker, Cofounder, BioDigital Inc.

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there's one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That's why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's outcomesrocket.health/podcast.

Welcome back once again to the outcomes rocket podcast we chat with today's most successful and inspiring health leaders. As the time change we have to consider many different options to tackle the problems that we're faced with in health care and resources dwindle. We've got to look at other options that's why today I'm so excited to introduce our guest. His name is Aaron Oliker. He's a co-founder at Biodigital Inc.. Aaron is an entrepreneur, 3D animator, programmer and academic working in the field of medical visualization and 3D simulation. Aaron founded his first medical visualization company called Cyber fiber incorporated in 2000. He's got over a decade of experience close to two decades of experience in this area. And so I'm privileged to really highlight some of Aaron's work here with him. He's been a pioneer in a new paradigm in the field of medical and surgical education. His current focus is the advancement of new features and applications using the bio digital human platform. And it's a thrill to be able to welcome you to the podcast Aaron. Glad you could join us.

Thank you. It's a real pleasure and honor to be here. I can't believe it's been two decades in the field but things are evolving and I'm very happy to have this opportunity to speak with you.

It's a pleasure. And Aaron you know you are a pioneer. You've been in this before it was even a popular thing to do. And now companies are starting to look at 3-D visualization as a true option for doing more with less. What is it that's kept you in the game for so long?

I think the game is always evolving as you say things are getting cheaper. Technology keeps improving and I'm I'm such a techno nerd and an anatomy nerd and these are the things I really love. And I wake up I can do it whenever it's like a videogame game to me but it helps people so I just love the tech and I love the fact that we're doing something positive that improves a person's health. So that's just my motivating factor I guess for us to keep doing it it's just selfish enjoyment at the most basic level.

That's awesome. And listeners if there's a partner they want to work with somebody that is willing to do what they do for fun for their own reasons that just tend to dovetail into what you're doing. Biodigitals their team over there Aaron and his team have had the privilege of working with some of the largest organizations in health care including Boston Scientific, Novartis, GlaxoSmithKline just to name a few and so I always loved to understand the genesis of it all. Aaron I know you love this stuff but what is it that got you into health care to begin with?

I think the most basic level for me again is you know my sister was a physician and she actually got she had. And that's when she was about 27 years old. She is a resident. And I was a 3D animator at the time just starting out learning myself. I'm a little younger than her. And just to see her get sick and all these things and all these questions that came up in our minds. I said I wanted to do something in healthcare with my ability in 3D. And that's kind of what led me on this path. I got very lucky and I met a surgeon who wanted to do animations and it turned out that I was the first surgical animation that was ever done. We started our work at NYU in 1999 for a charity called Smile Train.

Amazing.

And that was the very beginning of my work in this industry.

Super cool man. And Aaron, you know I'm a firm believer that coincidence. I don't know if there's such a thing. You know when you're when you're properly aligned and focused. These things do tend to happen. Now you've been in this business for 20 years. What do you think a hot topic that needs to be on every medical leaders agenda today is and how are you guys approaching it at Biodigital?

So I think the real hot topic right now that's on people's agenda is what's going on with augmented reality and virtual reality and how that's affecting on medicine and for a special device companies, pharmaceutical companies, hospitals. I just came from a conference in Berlin a medical executive leadership conference for pharma and device and I did a presentation on what the direction of augmented reality is in medicine and it seems to be something that's very interesting to a lot of the big companies out there everybody including the institutions as well. A lot of people really want to understand where this is going. I feel like it's it's like the mobile technology of the early 2000s. And I think that's where it's going so I think that's the big hot topic right now. I think it's going to change a lot of things.

Now that's pretty interesting Aaron. And you know we've had several guests on the show come talk to us about augmented reality and virtual reality the applications being you know hey you know there's fellowship and resident training, there's company sales rep and clinical training, there's a lot of applications that that technology could be useful for can you take us down maybe what you think the top 2 or 3 areas that our listeners could apply this tool to?

Yeah definitely the education is number one. Education and communication. And that's basically what our product does. Just to take you back a couple that surprised the Biodigital human has is probably the biggest library of 3D interactive assets on the planet. We literally were building. We built out every nerve every vessel, every vein, every bone and what have you and we're building out every disease state and disease condition and you can interact with it in 3-D like we Guler to the human body. And what we're doing now with augmented reality is we're taking it into the real space like you use like a house like. Some people use it with like Pokemon and you're just overlaying something onto your field of view of a smartphone and you're just looking at something and there's like a filter there. But what we do is we use more advanced headset and you're able actually able to walk around and inspect and interact with the body at which is lifesize. So I think it's a game changer meaning where you can look at the body and go through a procedure and have a surgical view would have been impossible before unless you're in an OR or in a certain scenario. So I think it's great for education, for sales, I think it's it's also very powerful because it's something people haven't really seen done well before. And now you're able to see the body and look at it from any angle and look into it and it's like right in front of you like it would be if you were in an operating room or an exam table. So I think it is going to have a very powerful effect once it's in wide distribution with good equipment.

That's pretty awesome Erin. So as a customer whether it be institutional or even maybe an individual. Do you guys offer it to both just one or the other and how did they how do they access your platform.

Our platform is a cloud based platform. You can literally on any device you can go online. Just log in and have access to the entire human body and we've got pretty much any disease state or condition known to man and see it in 3D. And the same goes for mobile. So our platform is really device as an operating system agnostic. You should be able to access it from any device or any type of system you're using.

That's awesome and so as far as as users as institutional users only. And then in that you access it through your institution or can you get it as an individual too.

So my digital acumen is like I said before it's a cloud based platform so anyone can access it you can be a third grader and get on and explore the body.

Nice.

The really exciting thing about what we do is we integrate into other people's systems so we have an application programming interface and a software development kit. So if you're running a school or a student or something you can go on to Biodigital human and explore. Like you would like Google Maps.

Amazing.

And just like if you're like me and you're like an anatomy geek geek and you want to just just mess around and look you can look and look up everything you can see the beating heart and dissect the heart. I look up a bit. This is where you can hear in the way we work with device companies and clients is a lot of times they'll integrate our system into their website or they'll add their CAD files to our system and you can visualize how devices work inside the body. You can create a procedure for you so you can see a procedure step by step. You can see how the device affects the body. You can create air your pathways if you're a pharmaceutical client or a pharmaceutical, we go mechanism of action but it's interactive it's not just an animation and rotated. You can interact with it. You can test it you can test people on it and that's essentially how it's used where we use different types of configurations whether you're configuring for you know an MOD or you have a new device or you're doing training or something along those lines. We customize the system to whatever the client need is and they can disperse it internationally on all devices and in multiple languages for all the different users that target audience might be.

That's super powerful and super powerful. And to know that the base of the technology exists kind of like that like you said right the Google Earth for the human body. And then when companies or providers or anybody wants to make use of it they just go, reach out to you guys and then you guys find a way through API and SDKs or whatever get access to what you guys are doing to make it a playable to their particular needs?

Right. Very much so. And a lot of times what we want to do is make it cheaper and easier for people to get access. Like you said people have less resources and less time and things are always getting more demanding. So think of it like almost like a Lego set and you have all these different building blocks and so if you wanted to do something yourself you know you wanted the storyboard something or or just add a condition to a Web site. It's very easy just to come in and you know like a YouTube movie and you get embedded into a Web site or into a mobile application or you need something more complicated. We definitely do a lot of different complex projects for enterprise projects for the large institutions and organizations.

That is outstanding. Now you guys are doing a lot to improve outcomes in this way. Is there one particular thing that sticks out Aaron as something that has been just amazing that you guys have accomplished?

Yeah you know there were several great projects that we've worked on in a couple come to mind. One is the outcome health project. You know it's wallboards that people use that point of care for patient education and essentially what happens with these Walboards that in doctors offices and doctors to the patients. And right now that technology was embedded into 50000, 50000 doctors offices around the country. It's not just that one client but several different clients that yes you add to that in that capacity and you hear the testimonials and it's amazing. So better to think of it as a point of care application. A 3-D technology is very powerful because the better you can communicate with your patient population and they really truly understand what you're saying the more likely it is for them to take that advice and regimen to heart. So you're going to get better patients because they really understand why the why they should. They're not just talking at the patient they're talking to the patient in a way that the patient understands and that it's extremely powerful. So for a point of care we find this is one of the most powerful usages of our technology to really connect with the patient alleviate their anxiety, to really communicate them about what's happening inside their body in a way that's very quick and easy to understand really efficient and something that can affect their behavior which is probably the most important part.

Now at super critical and for those of you listening that are providers looking for ideas to take your practice and outcomes to the next level. Think this is a really great education and communication tool as as Aaron described it to help patients really understand and level set with providers at the point of care. Aaron how about on the other side of this. Have you had a setback in your journey. And what did you learn from that setback that you could share with the listeners?

Oh there's there's always a setback. Many setbacks. I think one of the biggest things that I can say is it's just before we had a platform we really did a lot of one off projects that were very expensive to create very expensive to maintain. And that's what led us to this. And I say it's a failure because it drove us to some difficult times because we we really needed was just so hard to maintain many different applications that were so. And we spread ourselves kind of thin as a result of that and what we did the positive thing as a result of this kind of failure to create a more consistent to have a system in at these one off projects is to create the digital platform was born out of that that failure to have a consistency where you're trying to reduce cut costs really and create something that that's very high quality for our clients and like easy to maintain. So the failure I guess was just not having that consistency in technology which is very difficult to do. It's a learning process I guess.

Yeah, so you guys went through the pain of having to figure this out going from individual projects that were expensive tough to maintain. And then you sort of hit this point in the road where you're like we've got to fix this and that's when the Biodigital platform was born. What is it that makes the Biodigital platform so I guess able to serve so many customers. Because you guys serve a ton of customers.

It's the technological evolution that made it possible. In about 2000 when we wanted this to happen. We knew kind of struggling with the way the system was and in 2011 when she came out web G.L. like the graphics card because the games the graphics started improving in the computers and mobile technology really started improving in about 2011 web G.L. came out where he didn't need a plug in because before you have that the reason you have to maintain all these different graphics cards and all these different things and the big companies like Apple like Google and Firefox got behind putting 3D in a browser. And so what that allows us to do was just focus focus on delivering 3D. Like you didn't have to download anything you didn't have to have certain dry resolves whatever crazy stuff that happened a decade before and now because of that it was just say OK let's just focus on making awesome content. Let's just focus on making one really great engine and that's what we did. The more focused the more you can kind of narrow how much how many technical things you have to do the better the outcome is.

That's so cool. And I appreciate you walking us through that air and you know it's been an evolution and folks like I was telling you before you know if you're looking to partner with somebody in 3-D Aaron and his team literally have been around the block and back several times and they've seen an entire shift in our ability to access technology as it sits today even in the actual browser. So take a look at what they have to offer. Their Web site is biodigital.com. They've got some pretty cool demos available there. Aaron this has been a blast to walk through. If you had to say right now and one of the most exciting focus areas in your company is today what is that?

Yeah I think like I mentioned before the augmented reality in our expanding library what we're doing right now is very exciting. It's something that I'm leading and I'm really enjoying every minute of it just because you're taking something from a flat screen just like put things in the browser. Now you're taking it out of the computer and putting it into like a real space. And I think that it's super exciting and it's a real experience so I'm very excited where everything is headed on that front.

Yeah and let's just take it a little glimpse at the med device piece of this. You know folks if you're looking to use augmented reality, you buy yourself a pair of those glasses. Let's just say on the high end they cost you five six hundred bucks and you are able to provide your sales force, your clinical people with training from home. And they don't have to fly. You don't have to get them hotels. All of this is going to save a bundle with technologies like the one Aaron is talking to us about. So if you're not excited about this I think it's time to learn a little bit more because it is truly an exciting time and we're turning around the corner of some excellent efficiencies. And would you add anything else to that?

Yeah you know and not just at home but just like conferences people eat it up. It's really great just to run the sales and one of our med device clients that uses it was telling me that you know they really once you have that one of these headsets on their people they're not going to you're not going to run away that easily. You really get a good conversation going. So it really does lead to some good great conversations with prospects and whatnot if you're doing the sales on that conferences. So that's another great way to use for sales.

So awesome yes. So so many great applications so if you haven't started thinking about this I would add this question to your arsenal of potential problem solving questions. How can I use 3D how can I use augmented reality as part of a solution to my problem. So Aaron Timeflies and you're having fun getting close to the end here. Let's pretend you and I are building a medical leadership course on what it takes to be successful business and medicine. The 101 of Aaron Oliker and so we're going to we're going to build a syllabus here for questions lightning round style followed by a better that you recommend to the listeners are you ready.

Yeah.

Awesome. What's the best way to improve healthcare outcomes.?

It's a safe focus. I think to have the best communication possible with your patients. And that means that really great communication if you can communicate well with your patients, if you can communicate well with the surgeons that you're training with your clinical staff, you're going to have great outcomes.

What's the biggest mistake or pitfall to avoid?

Spreading yourself too thin trying to do too much in too many areas. If you end up doing nothing well jack of all trades and a master of none. So I say it's really important to stay focused and to really master one thing at a time at the very least.

Love that. How do you stay relevant as an organization despite all the constant change?

You work really hard. You really have to stay on top of technology. You really have to stay on top of what's going on and have a great team. I think the other thing is just love what you do. It's sounds that kind of a corny cheesy thing to say but to really stay on top but to really work hard you got it. You got to enjoy it. So that would be my answer.

Love that. What's one area of focus Sessa drive everything in a health care company?

Outstanding experience for the end-user. I think the more you focus on creating a really fantastic experience. Easy to understand just intuitive and natural. I think you're going to be successful.

Love that. And finally Aaron what book would you recommend to our listeners?

A great book that I like. It's more of a business book right. It's Dog by Phil Knight the Nike story.

Love that. Oh yeah, oh man, it's so good.

Yeah. And you just listen to the struggles he goes so it's an incredible book and fun to read. I got a lot out of the in a couple of times.

Folks.

I recommend that book.

Great recommendation my Aaron there shoe dog by Phil Knight the founder of Nike. Incredible story inspiring. Much like Aaron's story and the path that he has taken and now where where his technology and him and his team are taking this so if you have any questions about today's interview, you can go to outcomesrocket.health/biodigital, B I O digital and you're going to be able to find all of the show notes the transcript as well as links to the resources discussed here today. Aaron if you can just leave us with a closing thought and then the best place where the listeners can get in touch with you.

Yeah my closing thought would be that it's a really exciting time in medicine and technology. All these different technologies are converging to create better experiences for education, for physicians. And it's just it's really a lot of fun. And if anybody wants to check out what's going out the body is like our system is constantly evolving, please check out the site. It's free to just get on in and look at it. So I highly recommend just going on and taking a look at some of the stuff we have to offer. I really appreciate that.

Outstanding Aaron. Absolutely. So take that call to action folks go to a biodigital.com and check out the platform that they're offering here. And again Aaron just want to thank you for carving out some time for us to discuss this innovation and we're excited to stay in touch with you.

It's a real pleasure thank you. The honor and a pleasure. Thank you so much.

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there's one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That's why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's outcomesrocket.health/podcast.

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Recommended Book:

Shoe Dog

Best Way to Contact Aaron:

LinkedIn: Aaron Oliker

Mentioned Link:

BioDigital Inc.

Episode Sponsor:

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Eliminating 100K Yearly Deaths Caused by Healthcare Acquired Infections with Mert Iseri, CEO at SwipeSense

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there's one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That's why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's outcomesrocket.health/podcast.

Welcome back once again to the Outcomes Rocket podcast where we chat with today's most successful and inspiring health leaders. I've a wonderful treat for you today. From the great city of Chicago, our guest's name is Mert Iseri. He's the CEO at Swipesense. Mert is the young turk of design. His journey started off in Istanbul, Turkey and change courses completely once he arrived at Northwestern McCormick School of Engineering. After graduating with his own degree in the spring of 2011 he's excited to embrace design and entrepreneurship to galvanize a generation into positive change. He pick health care of course to do that. During his time in Northwestern, he cofounded design for America, a national network of students that lead design studios working to create social impact and currently as I mentioned he's the co-founder and CEO of Swipesense, a company that aims to save the 100000 deaths that occur every year in the U.S. due to a HAIs hospital acquired infections. So it's with the tremendous pleasure that I welcome this fellow Chicago in, Mert to the podcast. Welcome my friend.

It's my pleasure to be here. Thank you so much for having me.

Hey it's a pleasure, Mert. And so tell me what is it that catapulted you into the medical sector.

Ever since I was a kid I knew I wanted to be an entrepreneur. I was one of those kids with the candy racket in elementary school. I was selling thing in school, I was organizing events. To me it was just what I wanted to become when I grew up. I was just sort of waiting to grow up I guess. And I believe it's a part of me that feels really really passionately about the craft of entrepreneurship is that the endgame is to truly create impact. It was back then. It is now. I hope that it will be in the future that it's about the improvement that you create in society in people's lives that are tangible and measurable. I don't get as excited about potentially selling ads online. I mean nothing against businesses that do that. I think it's wonderful it's amazing. I'm glad to have Instagram in my life. But at the same time in terms of finding the good fight I want to save lives. I want to do something that matters. And one thing that I've found over and over and over again you can walk through a house and start chewing gum or you'll probably save someone's life. It's an amazing privilege to be in health care because ultimately you know that all the sleepless nights all the hard work all the effort that goes into it. It truly makes someone's life better. It's the kind of future that I want to live in because of the change that we're creating in hospitals. So I find it infinitely rewarding to know that your work has a social impact component to it. And I'm the biggest capitals in the world. I don't think that takes away anything from the business liability if anything it adds because it's it's a tremendous joy to be a part of it for myself and all of our team members.

Mert there's no doubt that you are passionate about what you do. I love the energy that you bring. We had a chance to connect here before on some of the local happenings and you know what. It's true with healthcare being so complex it doesn't have to be that way and I'm excited to dive into some of the things that you have done and things that you've unlocked to make health care better. On that note what would you say a hot topic that you feel needs to be and every medical leaders agenda and how are you guys approaching.

Consumerism in healthcare. I think health care is on the verge of an earthquake of realizing how much of the quality of care that exists in the hospital is actually directly tied to the value of hospitals brands hospital spend a tremendous amount of time and energy to market their services by taking up the billboards and running ads and of course this is a fight. And everybody wants to capture as much market share as possible but realizing that the single biggest thing you can do is actually improve someone's experience during their care. So they become ultimately repeat customers. Thus what an amazing new idea that has to be on the forefront. The first question that every hospital CEO has asked when they started there and the last question that they asked when they really in the building is, how have we created a brand positive experience for our patients that come through these doors because we know that more people have access to information that ever before more people are talking about the time they spent in the hospital more people are recommending things online anonymously or tied to their identity. And the fact that that doesn't sort of take up the decision making process in the hospital is extremely bewildering to me. And it's you know somewhat disturbing as well. It almost shows that this monopoly mindset that has existed in health care for a long time continues to exist and hospitals that have made the leap in understand that they're running a service business that just happens to serve folks who who want to gain their health is a big shift in mindset that has to be every medical leader's mindset right now.

I think that's a really great callout and we're approaching this so you know big thing it happened listeners as you are now is this big increase in in the deductible that we have to pay that is making it more real for us.

Absolutely. Basically it's money leaving your pocket. I mean we always talk about healthcare costs versus health care prices. I think once you have a deductible they have to pay three four grand for that cost because the price and you are much more conscientious about who you see that service from. And it's again it's basic things that I don't want to wait no line in an amusement park or in a hospital. So it's not necessarily new things that hospitals need to start realizing they just need to recognize that their customers their patients have a different worldview now and they have to adapt accordingly.

Now it's a great callout Murt. So talk to us about Swipesense what are you guys doing to help these systems be more consumer centric. Tell us a little bit about what Swipesense does and how you guys are doing things differently to create results.

We have a very simple value add to the healthcare operations. We basically improve healthcare performance metrics and I like to think of these as boring things like are my doctors and nurses washing their hands appropriately and in exchange what we get by improving these metrics like hand hygiene is we improve patient outcomes. I mean everybody sort of knows that if you wash your hands more you get less infections inside the hospital but it's extremely difficult to measure and extremely difficult to change. It's a cultural issue. People don't like to be told what to do. All sorts of things that come into. But ultimately what I want hospitals to realize is we basically shift the conversation around performance indicators like hand hygiene into things that are predictable improvements. Again these are things you should worry about measuring and improving and having a dash worker. These are things that should just improve over time. So this is exactly what swipes does for hospitals. And to our point on health care as a consumer and health care as a choice or health care as something that people will now have optionality in. I think it's increasingly important that hospitals get the basics right. People go to the hospital not to spend time there but to get better. And if I'm going to have a hip surgery I want to be discharged in exactly the same time that my doctor told me to do. I don't want that to be any complications in my care and I want to enjoy my lunch while I'm there. But really number one and to first. So our organization's value is almost this whole grade of predictability in health care by basically allowing hospitals to do exactly what they tell their patients to do. And we've started from hand hygiene. We've seen some tremendous results accordingly and now we're expanding into additional bottlenecks inside the hospital.

Very cool. Very cool. Now if we dive deeper into your hand hygiene application for instance what sets you apart like what is it that you guys do to make it easier?

Very very straightforward. Hospitals today use pen and paper to solve this problem. They basically have what they call secret observers that are not so secret because their colleagues with pen and paper in the corner of Allaway but they basically just wash their beers and every unit as we do a certain number of observations per week, per month and they analyze it and nothing happens. This is our largest competition. This is our status quo. Now about five years ago, companies like Swipesense started attacking this space and now it's a very very good opportunity with cutthroat competition amongst companies. And the reason why Swipesense is different is we've sort of separated this into two problems. One of them is a technology problem. How can we install something in an affordable manner? How can we not disrupt workflow? How can we give you a sense that you have to recharge? All the good things that make the Apple phone better than some Android phone. These are things that are intuitive and well designed. But I always viewed as half the problem Swipesense basically easily implement much more affordable than your competition. But ultimately what it does differently than anyone else is that we are obsessed with what you do with this data. I fundamentally do not believe that it's good enough for me to simply give a graphic or a number to a hospital and hope that they will get better and by the way the starting point for these hospitals is much worse than people anticipated. The average hospital starts from 30 to 40 percent compliance in their hand hygiene from a journey which is a very disturbing and scary number. What it's even scarier when your task to improve this number. It's easy to get 80 percent to 90 percent. Much much harder when you're signing up from 30 and your perception is that you're at 90 percent. So we spend an awful lot of time trying to understand the behavioural economics behind why people act a certain way inside the hospital and it is fascinating. So we have the most number of customers in this space because we really took an obsessive approach into figuring out what ticks people, what motivates them, what rewards them, and ultimately will do a fantastic job in getting that predictable improvement over time versus just the dashboard and sort of a good luck wish in terms of improvement down the road.

Love that. I love that, Mert. Thanks for walking us through that listeners if you have any curiosity about this go to swipesense.com you'll find the hand hygiene module there and they also give you a nice downloadable case study where you could take a look at some of the things that they've done validated backed by hospitals that have actually gone through this process. Very cool work that you guys are up to there, Mert. Tell me something give me an example of a time when you guys had a setback. And what did you learn from that setback? What helped you guys keep going?

Absolutely you know early on our product looked nothing like it is today. Now believe it or not the reason why we're called swipesense because we had a portable dispenser and the original idea was it's as easy to swipe your hands on your pants. It's the intuitive gesture of hand hygiene. We thought all we have to do is take the dispenser on the wall and put it into a little dispenser and attached your hips and it's going from the wall-mounted phones to the cell phone. That's what we want to do and the company swipesense because it just makes sense. Turns out this was not such a good idea because health care workers have so much on them that they really don't want one more thing either of them which ID card that we're giving them right now. It's one more thing for them to carry around. And it's a big no no in our early dispensers. I mean I thought it was the most beautiful thing in the world that is egg the top health came of it this unique design and we patented the cartridge we were so excited about this moment to realize that nobody wanted it. And that's a hard thing to realize because you love your baby as ugly as she is, you love your baby. That really sort of was a humbling moment because it made us realize a very very important lesson early on. Just because the problem is there doesn't mean that it's worth solving. It was incredibly difficult to find this wearable dispenser that way to a certain amount that a cartridge that was cheap to manufacture that easily attires did not leak. We spent a tremendous amount of energy. What we didn't realize is actually pretty stupid idea. It turns out that all you had to do was build a handful of these prototypes give it to people on watch for a week for you to realize that this would never work. Sure there's these little bottles that people carry around but it's really for maybe five percent of healthcare workers and really for the 95 percent you've got to do something with the Walmart in dispenser. This is like I've said a humbling moment. But they taught us this lesson early on. So now we're incredibly skeptical doesn't mean that we doubt our success or don't have conviction that the end game is meaningful. It just means that we have very very very questioning approaches whenever we come up with a new application or a news service or a new feature. We go out there and ask some pretty tough questions for our potential buyers or users. The same with actually moved the needle for them and if it doesn't we're brave enough to say that we were wrong earlier in the process rather than you know living it out and spending tons of time and energy into making them a reality. That was a large setback it took us about a year and a half to realize this but I think I've gained about 20 years for the rest of my life in terms of the future mistakes I'm going to avoid because of this.

That's a great way to look at it. You had a setback that cost you some time but now you're looking at it as an investment that's gonna help you avoid losing more time in the future.

Absolutely every mistake is an experience as long as you learn from it. There's no such thing as failure only experiences in life.

Love that my friend love that listeners take that and implement it into your current product or focus. If you're company or even a provider for that matter working on it on a current project or a focus area before you go all the way in and bake everything pressure test it against your market pressure test it against the users before you move any further because it will save you a lot of time and give you the insights that you need to make an impact for product. What would you say Mert is one of your proudest leadership moments that you've experienced to date.

I was reviewing this and thinking through it. One of our customers held a fireside chat and we were at the Atick meeting. I think it was two weeks ago. This is the Super Bowl of infection control. This is our one time of the year where we get to meet our most number of customers and we'll be going there for five years and we're sort of is a reminder a five year anniversary or anything sort of a full of checkpoints for you to realize oh we've been doing this for a little bit you know we're. So there was my fifth time there. Obviously I grew as an entrepreneur, as a leader, as a CEO, as a student of healthcare - as I like to call it but we held a fireside chat. Where we really wanted to sort of put our thoughts to the test and we took one of our customers. We took 20 of our prospects. We got everyone in a room and we said look we're going to do something quite orthodox we're not going to moderate or lead a conversation. It's really raw and ask anything. Ask our customer whatever they would like you would like to know because we ultimately believe that they tell the story the best.

Yes.

And this is one of our healthcare network partners are based in Tennessee and she shared the story of how the first couple that they implemented Swipesense had 23 infections in the previous year 23 almost two infections per month. Yeah they implemented Swipesense in December of last year. So December 2017 and they sort of have been looking very closely for the first six months. And really this was the first time that they were publicly talking about their outcomes. And again just going into a little bit of a surprise as well because again we wanted to take a chance and truly become vulnerable in front of our prospects and say look this is because we're getting a real partner. She says since the beginning of the year we've had one hospital acquired infections in the States. And she shared with us how in this hospital now they don't talk about decreasing their HAI. They talk about infections as something that should never happen. They have this big sign you know I don't know if you have ever been to a factory but usually they'll have they since last night. Yes. Yes. That makes them more in a sort of a thing that should never happen like that number should be a big number. Every time you look in this hospital they have a big sign that says they since last infection. And again it's a change in mindset.

Huge huge change.

To hearing that from our customers say look we think differently about these things now.

Big shift.

With an organization that simply does not do this and this hospital the centers that you do not get an infection and it might happen. But it's really strange and we're going to really understand what went to the bottom of this. I thought long and hard about why I was really proud of that moment. On one hand it really is the product does what it says. Of course it's exciting and you work very hard for things like this and I think it correlating with the five year anniversary was a big milestone for us.

That's awesome, Mert.

Healthcare as a whole. I think the structures are something much larger and it sort of represents the shift of how Hustle's can't think of quality instead of using them as sort of an improvement process. Why don't we view it as sort of a never event process. Why do we tolerate these in the first place and I was so proud of that. I mean I you know I was I would always say I cried in the background but I was going to be thankful and grateful to be in the world that I'm in right now that I wouldn't trade it for anything else.

That's so awesome. What a great story. And I love the shift in paradigm you know rather than say hey you know let's reduce these to why are we having them in the first place. That's such a great shift and a great transformation by that health care facility. Big kudos to them and kudos to you and your team for teaming up with them to achieve that. Now tell us a little bit about an exciting project or focus that you're working on at Swipesense.

We recently decided to expand or capabilities as a company. Now this is again very early stage. We basically took a couple of our sensors about a year ago and started asking ourselves some critical questions around what additional problems we can solve in healthcare and we have now a number of partnerships with our customers were utilizing our technology for things other than hand hygiene. One of those solutions that we came up with is basically a novel asset tracking system. Asset tracking has existed in healthcare for a long time. These are large infrastructure projects and we're sort of trying to come up with sort of the portable version of asset tracking how can we use something that's quick and easy to deploy. That almost becomes an afterthought, a department or a one small unit and just obtained the systems for themselves. Now we've done a number of rollouts and we're sort of learning a great deal about people's behavior or sort of viewing the products the mobile devices that exist in healthcare almost as healthcare workers themselves. I mean they have jobs to do you know an EKG monitor has a job in terms of serving a patient on the pump or a wheelchair. These are all things that have jobs as limited and singular as they are and of course they need the support of assistance of an actual healthcare worker. But it's really interesting to see some of these devices have shifts just like healthcare workers. Some of them are busier than others some of them are lazier than others and it's really interesting to look at that as products inside healthcare as things that almost like workers themselves with their own needs and maintenance, certain age and retention and longevity and so on and so forth. And we're seeing very interesting parallels between devices that are overutilized and as a result have all sorts of issues versus devices that are simply over purchased and it's almost like you hired 20 extra nurses where you didn't really need them. Seeing this shift inside the hospital terms of how they operate and their capital resources. And by the way I don't need to tell you this. These are not cheap things. I mean iTunes is like a 10000 unit or it's elementary module is ours to view these things not as. That's how we've always purchased things versus really thoughtful analysis of what we do and what we don't do and plan intelligently for our next capital cycle is to me a tremendously interesting Simendinger of The state has never existed before. There was never a sensor on a particular device that told you this device gets used ten times more than the other. This was a similar insight that we found out in our handwriting hygiene when we found out that certain distances are used literally ten times more than the other announcers. Some of them barely get used up here and yet they're still there. I mean that's sort of a similar analysis on the products that you have inside the hospital has to be really really exciting.

Just a quick question are you guys taking some data output from the devices as well or is it mainly just kind of like in use or out of use type data?

It's in use not to use data so actually turns out something's location and their power of movement tells you all about whether they're used or not because it's again very predictable an EKG monitor does certain things when they're in use versus when they're not in use. So you could have a reading that tells us about what their behaviour and sort of their shifts "are looking like". And like I said treat them as almost employees of your hospital as well and make good decisions for their hiring.

Love it that's very exciting and with thousands of dollars being spent millions and billions of dollars being spent every year asset tracking is key. Why not do it a little bit differently folks and it's a pretty interesting idea that Mert is offering up here again. Mert is the CEO of Swipesense. It is all the information that we're talking about is that swipesense.com as it sounds Mert let's pretend you and I are building a medical leadership course and what it takes to be successful in health care today. The 101 of Mert Iseri. And so we're going to write out a syllabus with four questions lightning round style followed by a book that you recommend to the listeners. You ready?

I'm ready. I'm so excited for this.

Awesome. Let's go. So what is the best way to improve health care outcomes?

Peel the onion until you understand the core incentives of what you're trying to do.

What's the biggest mistake or a pitfall to avoid?

Assuming that it works in another industry that it translates into health care.

Love that one my friend. How do you stay relevant as an organization despite constant change?

Obsessively compulsively listen to health care executives and frontline staff they know more than you will ever learn in your entire career as an entrepreneur in healthcare.

Well that and that's what we do here and the outcomes rocket so keep listening.

Absolutely.

What's one area of focus that drives all else in a health care company?

How many lives have we saved today. No matter what we decide it has to serve our patients.

Beautiful. What book would you recommend to the listeners as part of this syllabus?

The Hard Thing About Hard Things from Ben Horowitz.

Love that we've had that recommendation once or twice before and.

We can do another one then if you already have.

No, that's perfect. I mean so what's the big takeaway for the listeners. Why should they read it?

Keep going. It's dark it's ugly. It's the same for everyone. And what separates the good ones from the great ones is your ability to survive.

I love that I love that listeners. You can get this book link as well as the syllabus that we just put together for you. Show notes, transcript. All of that's available at outcomesrocket.health/mert and Mert, this has just been a blast. I really appreciate your enthusiasm. Your very fine tuned detailed to what it takes to make healthcare better. Before I conclude I'd love if you could just share a closing thought and then the best place where the listeners could get in touch with you.

Easy to get in touch with me is just simply me mert@swipesense.com. My first name and the email address of the company is you're out. I'm more than open to connecting with folks who are in healthcare who are thinking about getting in health care very approachable and have office hours that are open to anyone on Sundays and 2 to 5 to pick an hour with me no more than happy to sit down with you. In terms of takeaway, you know one of the things you realize after doing this for a number of years is the importance of the trust you have in the team and really how you should find yourself trusting and leaning on everyone else who makes magic happen. It's very easy to think that you're smart brilliant. What have you. It really humbling to realize that you really are a small piece of this puzzle and it's your relationship and the accomplishments of the team that's around you that matters the most. So I really have found to be tremendously helpful to build a dynamic inside the office that aligns people around the strong why which is in our case, saving lives. But that ultimately give people the freedom to basically follow their own interests and pursuits inside the organization. Yes we have a common direction we have a common North Star on how they should be defined by the people around the table rather than simply mean dictating. We need to do this and do that next. That humbling realization like I've said is something I've come to realize. After a few years I was very much the overconfidence. Let me get everything done type of entrepreneur early on. I've certainly loaned more to let go over the years and trust the folks that are around me. It's been the thing that has been the most rewarding for me and I really encourage all of us to take a similar approach where surround yourself with extremely smart people and just get the hell out of their way. That is the best thing you can do as a CEO your organization.

I love it, Mert. What a great message listeners take note of that and be the leader that you are. Trust your team to deliver. Mert, there's no doubt you guys are doing outstanding things. Thank you so much for sharing them with us and we're excited to keep in touch.

Very, very excited. Thank you so much for the opportunity. And I'm looking forward to the next episode.

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there's one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That's why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's outcomesrocket.health/podcast.

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Recommended Book:

The Hard Thing About Hard Things: Building a Business When There Are No Easy Answers

Best Way To Contact Mert:

mert@swipesense.com

Mentioned Link:

https://www.swipesense.com/

Episode Sponsor:

Medical Device Design and Development Insights with Dr. Andrew DiMeo, Innovation & Design Coach at Trig

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there's one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That's why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's outcomesrocket.health/podcast.

Welcome back once again to the outcomes rocket podcast where we chat with today's most successful and inspiring healthcare leaders. I really thank you for tuning in. Today we have an outstanding guest. His name is Andrew DiMeo. Andrew is an innovation and design coach at Trig industrial design firm specializing in consumer insights design and branding for medical, durable and consumer products with a background in NYC Motion Pictures. Andrew's last 20 years are in medical innovation including 12 on faculty at UNC and N.C. State North Carolina. His students coursework led to multiple startups including 410 medical and M E D I C and winning national competitions from NCEES and the NIH. He founded the North Carolina Medical Device organization and co-founded EG Gelero. Worked for Alaris Medical Systems as a design engineer, served as a business adviser and speaker for the Wallace H. Coulter Foundation and adviser to the NIHC3 eye program, director of Duke neuro innovations an on the planning team for BME idea. He holds a B.S. in physics English Literature and Secondary Education from UNC Charlotte and an M.S. in B.M.E biomedical engineering from UNC Chapel Hill and also a Ph.D. from UNC Biomedical Engineering Department. You've got a glimpse into this outstanding man and his contributions as well as his very interesting background but what I want to do now is open up the mind to Andrew himself to round out that intro anything that I missed Andrew so excited to have you on the podcast.

Well no, that was awful and very, very, very kind. So thank you so much stuff, nothing to add. I really appreciate you having me on here today.

Hey it's a pleasure Andrew. And you know you've you've been so focused and you've done so many interesting things in the space. What is it that got you into the medical sector to begin with?

Well you know I think I've always been service oriented. So you know my earliest memories of being in college was a tutor, tutor at risk kids in high schools. And I just love teaching, mentoring, tutoring. I don't know. Always been really interested in impacting people's lives to be healthy and happy. And I think I just found that being involved upstream at the Innovation stage of medical device design and development is where I found I could have the biggest impact.

That's pretty awesome. It's at your core and you've just found this this area where you could deliver on that core in a big way. You've obviously made a big splash in the industry work with very influential organizations and companies. Out of all the things that you've seen Andrew just kind of thinking of today. What would you say is a hot topic that needs to be on every medical leaders agenda and how are you guys tackling that at Trig?

Mann So what I'm looking at is a question that's being asked during due diligence over the past decade and whether that's a big company and looking at there as the team due diligence or you know investors to make an investment in a startup. And over the past decade what I've observed is the question primarily going from, hey you you know what's your regulatory pathway to approval. That's what you used to hear. And then it haven't changed too. Is there an existing reimbursement tool for this. But to day to day I feel like I hear over and over again how will this change clinical practice and when I hear that question I feel like the bottom line is that the change from a fee for service to a value based healthcare system shifts the focus to improving outcomes reducing costs and really improving the overall clinical experience. So how do you impact that. How has that addressed. Our approach is to be part of the product development process early enough to truly understand all the stakeholders and to design a form and function into products to maximize the human experience. That's the thing I would be paying attention to today is really thinking about improving the experience for everyone involved and who's using and being impacted by the products that we're making.

I think that's a really interesting call out because when we are not at the initiation phase of that design process, I think we could lose a lot. So what you and your colleagues at Trig are doing is really sort of enabling this value based care through the design itself. Can you share with the listeners an example of how you guys are creating results by doing things differently?

It's about sort of a non dualistic approach or a holistic approach. I'm going to take a step back and say hey you know the last 12 years I've actually been on faculty at NC State teaching design and innovation and what it really came down to is multiple mindsets and collaboration and what I mean by that is you know we need to be innovative outside the box thinkers while at the same time being comfortable in a highly regulated environment. And that's not so easy to do to do both of those things simultaneously. We need to embrace all of the different mindsets that we ourselves can deploy or those that are on our team might have. So so things like exploring with a scientific mindset, solving problems with an engineering mindset, understanding users needs and generating solutions with a designer's mind. And considering the business case, the economics, the legal aspects are found that when this is done will this type of multiple mindset approach and collaborative approach. We have a real shot at developing iconic solutions.

It's that window wing approach right having different hats on. To be able to get the result that you're looking for.

Yeah, it's not compromising too. It's kind of interesting that oftentimes you'll hear sort of a non dualistic approach be a compromise you know like you've got to be confident but humble and you might say that in sports or something like No you don't need to be confident but humble, I'm going to be confident and humble, it's about getting all the way. Like all in all in outside the box and all in following the regulations right, you know it's really interesting when you can bring it together in a holistic sense.

It really is. It really is. And so you've taken this career and sort of you've been in and out of industry as well as academia which I think provides for a really cool mix of those two spaces. What would you say something that has happened already that you learned a setback in one of those areas that you learn from that's made you a better designer or a better contributor.

Yeah you know if I told you all the failures you probably have to start a whole new like failure podcast, failure rocket.

Failure rocket. Nobody wants to be on that one, right but we got to embrace it.

No but all kidding aside of course failed many times. And learning from those failures is really really important. And the one that jumps out to me when I ask this question is going back to my earliest days as a design engineer at Alaris Medical Systems, I was young, I was fresh. I didn't have any experience at all. And I was put on a project to lead and develop a new vacutainer and you know vacuntainer is like the vacuum filled container to draw blood.

Yes.

And the whole idea was, hey you know make this more user friendly for the phlebotomists make it more comfortable for the patient. You know you make it you know it could be done on one hand you know et cetera et cetera. And I went back and forth between patients phlebotomists patients, phlebotomists you know trying to understand how this product was going to be used. And got it, got it really far along into the product development process. And we were, we were making soft tools you know building you know production like products to get into the hands of the users and get some some really good feedback. And when you're that far and it's pretty expensive to the company. And as we get deep into the product validation and verification testing there was a hiccup and it was it did not fit in the centrifuge at the lab, headed it totally kill the project and it was just horribly embarrassing as a young design engineer.

That's tough.

It was and it opened my eyes early to this whole idea of really understanding all of the people that were going to be impacted by the product that you were developing and all the way down to this idea that that there's like real humans inside clean rooms assembling product all day long and you know what impact are you having on their lives. You know like are you causing these folks to have arthritis because you're designed something that is just a pain to put together. Who are the people working in the labs that are processing samples as they're coming through. You know it just really opened my eyes to have to have a full appreciation from you know initial sourcing and materials to disposal, you know what impact is this product going to have on people's lives. So yeah the lesson like the journey map following the patients, the payers the providers and all the impact of stakeholders. And considering every piece of that was a big big guy there for me.

That's such an interesting lesson. Andrew appreciate you sharing that. Wow. And I'm sure you've been able to pull from that experience to help all the designers that you've trained in your in your years as a professor there and now back in industry. I think the same problem applies listeners you can apply this not only to design but also a patient going through the care continuum you know whether it be an episode of care or just taking a look at them if you're payer or an insurance provider really and like Hey where are they going. Long term care where were they before. And it's the same process that we've got to keep in mind. Like Andrews is reminding us it's that big picture and understanding how to impact whether it be a design or a patient really great share. Andrew Thank you for that.

Thank you.

So you hit that big bump. The product did it and I'm not launching because of that?

Yeah it was a complete failure. You know we canceled the product.

You couldn't you couldn't have changed the size a little bit and saved it?

Now that just. Yeah wasn't that easy. And you had as far as like a new product development team was considered before you knew it I was pulled onto a sustaining project and you only get to cut your teeth so many times. Cradle to Grave product development project. I got to work on different projects there at Alaris, got a designed patent on a vial adapter you know worked on some really cool projects. But that particular one was just it just didn't happen.

Yeah. Hey I totally get it. And now you're better for it. You know we learn more from our setbacks than our successes. But let's talk about success. You've had a lot of those successes in your life in this medical field. Can you share with the listeners one that you're most proud of?

I guess coming into this especially over the past 12 years. My proudest moments have been when when the students have achieved some success you know won some national design competition. But the one that stands out to me is for ten medical and this is there's a story that exemplifies what happens when students and faculty make it real. Not an academic exercise. What happens when hospitals and caregivers open up their doors to collaboration. What happens when an entire ecosystem of academic and professional resources come together to move ideas from the bedside to the bench and back to the beds. So 410 Medical has a rapid infusion device for circulatory shock rapidly and fuse sailing through a hand pump. So this project started out in the classroom in my classroom many years ago with students doing observations at a local hospital and it turned into an international design excellence award for Trig, the company I'm working with now and how that made it from students observing a doctor to start up company to raising money, even just all the pieces coming together for this story including the local universities down here have angel networks so there's Duke Angel Network, Carolina Angel Network, Wolfpack investor network, Israel Lams and associated folks of the local university system who have no network to finance startups that are associated with the various academic institutions around here and in this particular case and 410 Medical. All three angel networks came together and invested in the product.

Nice.

Trig industrial design came in and took it to the finish line. We've got you know local manufacturing here in North Carolina Raveling medical one of the best contract manufacturers in the country right here in North Carolina and they're manufacturing it. So from from final manufacturing, packaging, distribution, all the way back to the day that it was conceived to the financing they got it there. It just took an entire village the villagers the RTP region to get this thing to market and it's saving little kids lives. And to think that what started up as a school project is saving, saving little children's lives now is just awesome.

That's awesome. Pretty story and 410 medical is that still the company's name Andrew?

Yeah yeah. 410 medical you look it up you can probably find it right like and I think it's for medical or medical care.

Love that folks if you're curious about 410 medical. one of Andrew's proudest accomplishments I've got a pretty cool website ,410medical.com ,saving children. Pretty amazing feat that you've done there with the collaboration of your students and local industry. And now you're at Trig which is kind of cool. Tell us about an exciting project that you're focused on at Trig?

Yeah you know so something that I'm really excited about working with some of the most amazing industrial designers in the world here. These guys are just unbelievable. But you know I've been tossed around this idea I called the diligence dashboard. I don't know if you're familiar with the business model canvas. To those that might have might have heard of business model canvas. It's like a visual aid to go through a business modeling exercise and really really useful tools. These visual tools, I've been dreaming up this dashboard that takes design thinking and put together diligence factors that you would for medical device product development like regulatory reimbursement intellectual property market and technical risk. And what I say about this dashboard is that industrial design plus the dashboard allow you to present a flight simulation mode before you ever take-off. So if you think about this if you can really define a really well unmet medical need and start to conceive of solutions for that need industrial designers are just brilliant. First of all understanding or defining that need and then coming up with realistic renderings of what the solution might look like. But before you ever spend a minute investing real hard design development resources into it you can start to map out these areas of risk and get a good visual understanding of what the journey is going to look like and see can you do the flight simulation mode on multiple options. See if you've got an opportunity to take off on one and then keep your eye on that dashboard while you're in flight too coz you're going to usually typically have to make some course corrections along the way. So that tool is something that I've been conceiving of for a long time but it's really taking the expertise of what's under the hood at Trig and putting it together with the deep medical device to and an experience to develop new new tools to help help get products to market.

That's pretty cool Andrew. Now if you're a an individual, a leader at a device company or some sort of medical device firm this may be something of interest to you. Go to trig.com. You'll see what the folks over there up to and end this project that Andrew has taken up is fascinating and you guys know Andrew with his background and experience great things are going to happen. Andrew This is exciting. And what's your roadmap like when are you looking to have this done by?

We're implementing it immediately. You know it's it's minimum viable product time. So we've got a version of the dashboard..

That's awesome.

That took us weeks soon as I joined..

Amazing.

Since I joined Trig you know we started packing it right away and it's been continuous, continuous improvement mode. So we're going to be adding to that. Sure.

I think that's so awesome man. And folks when you when you have a product like this that can help you derisk any of your investment. This is a worthwhile pursuit. Andrew this interviews just been a ton of fun man and the time flies. Let's pretend you and I are building a leadership course on design, what it takes to be successful in the med device design. The 101 of Dr. DiMeo.

You're speaking my language.

We're going to write out a syllabus my man and we've got a lightning round with four questions followed by a book or two that you recommend to the listeners. You ready?

Sure.

Awesome. What's the best way to improve the design in med device?

Specialization and collaboration it's that end. Right so it can be deeply specialized and collaborate. The best way to go about it.

What's the biggest mistake or pitfall to avoid?

Kind of the opposite of that. All in one all in on specialization or compromising to meet in the middle. I think compromise is the wrong way to go or giving too deep into anyone's specialty areas. There's also a big mistake.

Love it. How do you stay relevant despite all the change?

I'm going to go back to the diligence dashboard. Keep your eye on it. The importance of the indicators change over time. You know we talked about how we went from pathway to approval to the reimbursement. You know now we're really focused on the clinical experience. That's going to keep on changing and what's important on the dashboard is going to change. And so we've got to keep our eye on it, keep adjusting it never get comfortable with it.

I've been that's such a great Kholoud and as healthcare leaders we've got to understand the dynamic of these changes. And I really love what you've highlighted here for us in this dashboard right, whether it be a dashboard that you're working on as an organization you always got to keep it relevant. What scenario focus should drive everything in med device design?

Values. I think core values is the most important thing. At the end of the day where we're trying to improve and improve life extend life, it's about happiness, it's about health. So if we can stick to those core values and do good, then everyone will benefit.

I love that. What book or books would you recommend on the syllabus?

Definitely Zen and the Art of Motorcycle Maintenance.

You like riding?

You know I do and I have been in a long time. I love to ride motorcycles but really you know the book is this is really about. It's about classical thought processes and romantic thought processes as one thing, that they are not they cannot be separated and form and function. This is sort of this whole design thinking mindset form can exist without function and function doesn't exist without form. It's not some kind of compromise. It's not making something functional and then making it look good later. It's not about having something that's beautiful that doesn't function well. It's one thing it's one device that is given the have both. So this book is a really interesting exploration of what is good and what is quality and both a classical and romantic perspective. And I think it's a key read for anyone that's interested in innovation and entrepreneurship.

There you have it folks take note of that and again you don't have to memorize what we just said. Just go to outcomesrocket.health/trig. You can find all of the shownotes, a transcript of our discussion and all the insights that Dr. DiMeo here has is sharing with us. Andrew this is this has been a true pleasure. If you can, I'd love if you could just leave us with a closing thought and then the best place for the listeners could get in touch with you.

Ok great closing thought. I'm going to say this if you're an engineer don't look for a doctor to find the problem to solve. And if you're a doctor you don't look for an engineer to solve your problem for years but work together work together to solve and unmet medical need for a patient that needs it and whether you're a doctor or an engineer designer or a business person or a scientist. Whatever you do for a living work together to solve real medical needs for the people that need those needs solved.

Love that. It's a strong message very consistent with the theme of the podcast today. And Andrew what's the best place for people to reach out collaborate or connect with you?

Feel free to email me andrewdimeo@trig.com, you can go to the trig.com website, you can find me there.

Outstanding and listeners will include that email as well as a link to Trig. But just to clarify Andrew DiMeo it's D I M E O.

Yes.

This has been a ton of fun. Again thank you for spending time with us to talk about design and med device and being impactful. It's been a really insightful discussion.

It's been my pleasure. Thank you so much for having me today.

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there's one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That's why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's outcomesrocket.health/podcast.

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Recommended Book:

Zen and the Art of Motorcycle Maintenance

Best Way to Contact Andrew:

LinkedIn: Andrew DiMeo, Sr.

Email:  andrewdimeo@trig.com

Mentioned Link:

Trig

EG Gilero

410 Medical

Episode Sponsor:

A Novel Therapeutic To Cure Dry Eye Disease with Dr. Jeffrey Nau, CEO, Oyster Point Pharma, Inc.

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there's one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That's why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's outcomesrocket.health/podcast.

Welcome back once again to the outcomes rocket podcast where we chat with today's most successful and inspiring health leaders. I thank you for tuning in again because we have a wonderful guest today. His name is Dr. Jeffrey Nau. He's the CEO of Oyster Point pharmaceuticals. Doctor now has been building his career and developing novel innovative therapies for a disease of the eye. With over 15 years of experience working with biotech pharma and med device companies. Most recently he was V.P. of clinical medical affairs at Optotech. Prior to that he was mad science director at Genentech working on the development of Lucentis to transformative drug for retinal disease. And Dr now has raised more than 150 million in equity for startups such as Janiero corporation, Acuity pharmaceuticals and Neo Vista inc.. He has numerous patents in the space as well as peer reviewed publications and I'm so excited to welcome Jeff to the podcast. Welcome.

Well thanks Saul. Thanks for having me on.

It's a pleasure to have you Jeff. Now what is it that got you into health care to begin with?

Yeah it's a good question. So I started out really I think as most young college students do you know heading down the premed path and wanting to go into medicine just based on my my love for science and I loved learning about the human body was very sports growing up and I loved all the exercise physiology and just learning about the you know muscles and bones and things and so I ended up taking a little bit of an odd path from that. I had a small class that had an elective in my undergrad which was intrinsic biology and I end up working in the medical examiner's office and within a couple of weeks, I found myself doing autopsies and really being into the sort of I would say elbows deep into medicine and learning about the human body from a different aspect and that ultimately translated into some work that I did while I was in school and sort of paid my way through school working with the organ transplant team that was often in there and really was into the surgical aspect of medicine. And then when I went off to school never really thought about the pharmaceutical space or the Medtech space and all always very focused on the clinical piece of it. And for a whole host of reasons that we could probably spend a whole another podcast on, ended up deciding to veer off and head down that pharmaceutical path and first I think it was kind of a patch to figure out where it was going and it just snowballed. And I've been here ever since and you know I really love being at the forefront and cutting edge of developing either drugs or devices and found myself in ophthalmology for almost my entire career.

Amazing what a winding road but always very focused on health care. So fast forward to today, Jeff you're working on this exciting project at Oyster. What do you think today is a hot topic that needs to be on every medical leaders agenda and how are you guys addressing it over there?

Yeah I think one of the things that's going to be it's really important because we are kind of in a time right now and I think there's probably a cycle to it if you were to look back through the annals of medicine where we have these bursts of innovation where things really move forward fast. You know we have karty therapy we have CRISPR technology. On the oncology side of things, things are moving so fast it's really exciting. Usually that followed by some period you know some cooling off period where things kind of slowed down a little bit and then we have another burst of innovation. And I think one of the things that I think is really important to keep in mind is we have to continue to be innovative and we have to continue to think outside the box. You know one of the nice things about Oyster Point you know we're a venture stage startup pharmaceutical company focused on treating Dry Eye Disease and it's through a real novel pathway. So for years and years we've had therapies that treat Dry Eye Disease whether it's over-the-counter or prescription eye drops. We're very focused on the topical aspect of delivering medication. What oyster has done is really transformative in the sense that we're treating the disease and going through the intranasal route. So a very what I would say disruptive and novel approach where we're actually leveraging the body's own parasympathetic nervous system and we're still doing pharmacological stimulation of the nerves inside the nose which then ultimately result in tearfoam formation. So fascinating things like these where for years and years we've had sort of a stagnation and we've been very focused on attacking a disease in one particular way and then all of a sudden something changes through innovation. And now the whole field shifts you know and if you think back to a decade ago, harnessing the body's immune system to go after cancer was always a thought we always had these ideas. I remember learning about it when I was an undergrad but until recently the terms CRSPR and carti have not been on everybody's tongue like they are today and so I think fostering innovation always looking for new approaches to go after a disease are very important. And I think it's just evidenced by the exciting kind that we're in where now really the treatment is just really blowing up right now.

Super fascinating. Thanks for walking us through that Jeff and what keeps your innovation juices flowing?

I think the thing that really keeps me going is you know I started out going into medicine wanting to help people. You know I love the patient contact aspect of it. If I was to say the one thing that I'd miss being an industry versus being on the clinical side is I loved interacting with patients and being able to help a patient whether it be just through consultation or whether it be actually delivering a treatment. I really enjoyed that. And so I think that staying on the cutting edge of innovation, you have to keep that patient peace in mind and that patient interaction piece and you always have to remember that if you're doing the right thing for the patient, not only from the standpoint of bringing these novel treatments to the forefront but also thinking through all the form factors that go into therapy and how patients are receiving health care today, how patients may or may not like whatever therapeutic option you're bringing to the table because of the way that they're going to either attain it or ultimately utilize it. And so I think there's ways to innovate around a lot of different aspects of medicine not just if you're focusing on the actual treatment itself but how are these patients getting these treatments and how are we keeping them on these treatments and so I just think that there are so many opportunities to really keep yourself patient-centric focused and innovate around that sort of holistic idea and that that's really what keeps me going is working in companies you mentioned in my past that I had worked at Genentech and I worked on this amazing drug who sent us that literally stopped people from going blind. And so to be able to see that type of innovation come to fruition and see the impact that it has on people take you back to when you were in the clinic and you were you could do something to help someone and that just feels great. And that's really what keeps me going.

That's awesome Jeff. And no doubt it you guys are doing it yet again here with oyster not sure what detail you do go into it but maybe if you can dive into some of the things that you've seen early on with this new approach at Oyster for dried eyes.

Well so dry eye disease is becoming a little bit more I would say at the forefront of people's minds. One of the things that Oyster has benefited from with the most recent drug approval in the space is Shire's Xiidra™ and they've launched an eyelove™ campaign which is really all over the TV and radio ads and people have seen Jennifer Aniston talk about her eyes. And many of your listeners have probably seen these commercials. And so you know the concept of Dry Eye Disease and just eye health in general is really taking a big step forward by all of this marketing that's going on now and this market is really massive. So there's a few markets in the pharmaceutical space where you have 34 million patients that are out there with Dry Eye Disease. You have about 20 million of them that have a diagnosis of Dry Eye Disease. So there's a huge number of patients that just are not seeing in eye care provider. And then of those 22 million or so that have a diagnosis there is literally about less than 2 million patients on prescription medications. And there's a whole host of reasons behind that but it's just a giant unmet market where there's opportunity for a really good therapy to come to the table. So what we're trying to do is really bring the therapy to the table that gets at the root cause of the disease and really impact the disease early on in its existence. And the whole concept of Oyster Point is really by putting healthy tear film onto the eye on a regular basis. So as you and I sit here and we're just sort of breathing in and out of our nose that airflow going across our nasal cavity causes basal secretion of tear film and so when we have things like stuffed up noses we often get dry eyes. The whole host of other things that can cause it. But the one thing that is keep in mind is really the reason that you and I don't have Dry Eye Disease although I'm not a hundred percent sure you don't have dry eye disease is have healthy tear film. And so having that healthy tear film is really the key to not progressing down this slope of inflammation and sort of a chronic dry eye disease state. So what we're doing here is pharmacological stimulation of the trigeminal nerve that causes tear film formation and we think that by keeping these patients moist with regards to their cornea over time will alleviate many of the problems that we see with patients with Dry Eye Disease. And so it's a disruptive approach. No one else has ever gone through the nose to try and treat with a pharmaceutical and it just makes sense from a biological perspective because we're really we're sort of harnessing the person pathetic nervous system to do our work.

That's fascinating. And how are the results coming out. Are you seeing that it's working?

Yeah. So we had some early studies that gave us a glimpse at how well it worked and it was eye opening. No pun intended but it was it really was exciting for us to see that we actually have completed a 160 patient Phase 2 trial that will be presenting in July. And although I won't give away the results I will tell you that the results are pretty amazing and we're super excited to present it. We think it's going to be a game changer. Really excited about the opportunity to bring another therapy to this patient population because it's just growing. You and I are both sitting here right now probably looking at a phone or looking at a screen. The screen time is going up you know Dry Eye Disease is not going away anytime soon. And so there is a real need in this marketplace for another therapeutic option.

That's awesome. That's so great. Thanks for walking us through that Jeff. And really neat that you've taken on this approach and as the market sits today, is this something that is also reimbursed by insurance providers?

Yeah so the two products that are out there right now which are topical drops are reimbursed. We expect that our product once it gets the market will be reimbursed as well.

In the same way?

Yeah.

Got it. Very cool. Very cool and very innovative to think about this. And folks take a note from Dr now here and the things that him and his team have done, there's another way. When you thought that the only way was topical, they found a different pathway to have the same result or even better. And so think about what you could do to approach your problems in a different way and use this episode as inspiration to do just that. What would you say a time when you maybe had a setback it could be at oyster, it could be at one of your previous roles and something that you learned from that setback?

Yeah. One of the examples that I always tell people is we started a company back in the early 2000 timeframe called Neo Visto which was a therapy that was brachytherapy so we use a very small strontium 90 pellet that was on an applicator and this applicator was placed through a surgical incision into the eye and held over a neo vascular lesion for patients with Criddle new vascularization due to age related macular degeneration. The surgeon would hold this applicator over the lesion for a number of minutes. We deliver a very focused dose of radiation and then they take the applicator out and we close the patient up when we were starting that process. First of all, this was pretty 9/11 before we had a lot of safeguards in place for how radiation traveled throughout the world. But I think we also went into this study as mostly pharmaceutical and medical device folks with no real radiation experience and so we very quickly underestimated how hard it was to a transport radiation and radioactive material throughout the world to do clinical trials. All the people that needed to be involved. I had never heard of a radiation physicist before and I quickly figured out who those guys are and what they do. And I think without really understanding what we were getting into we were pushing forward so fast that we didn't know all the players that had to be pulled together. So we got ourselves into a situation where just to start a clinical trial rather than getting one physician under contract we had a RETNA surgeon, a radiation oncologist, a medical physicist, a surgical suite, a hospital, the local authority who oversaw radioactivity in the area. You were over your head in just contracts for one cent there let alone doing a massive multicenter Phase 3 trials throughout the world. So I think where we failed there or where we made a mistake there is we just didn't get to know all of the intricacies of that particular technology fast enough or really enough to be able to be proactive in plan. So it probably caused us some some delays once the machine started moving forward we got pretty good at getting all those sites up and running and how they were going to work. But I would say if if we had a lot more institutional knowledge beforehand things would've went a lot smoother, moving forward.

That's fascinating. And now you sort of build those learnings into what you're doing at Oyster and I'm sure the level of due diligence you took it even to the next level.

Yeah.

Now that's really great Jeff. Thanks for sharing that. And how about the other side of the coin. Right. That was a setback. Tell us about one of the proudest leadership experiences you've had to date?

Yes. I think one of the one of the other things that I touched a little bit on the forward was that I feel very passionate about the patient aspect of developing new therapies and making sure that you're always doing what's in the best interest and what's right for the patient. And if you sort of lives live by those rules and when you have big questions that you have to answer, if that's always the basis for how you're going to answer those questions, you'll you'll likely make the right choice. So one of the things that when I was a Genentech when we were developing sent us there was a cry to use the drug and infants that were born with this condition called Retinopathy of Prematurity where they have a blinding condition when they're born and without receiving therapy such as Anti-VEGF therapy immediately their retina can be basically damaged for the rest of their lives and in many cases these patients, these very young patients are just going to be blind for the rest of their life. And so the physicians out in the field were using drugs off label to treat these patients with maybe not the best safety profile behind it, but they were doing the best that they could to help these babies. And we had this drug Lucentis that we knew could help and has the potential to help. But it certainly wasn't approved and it was very risky for the company to go down that pathway as you can imagine. So I'm going to tell you that one of my proudest moments from a medical leadership perspective ultimately ended in failure. But it successfully took proposals up to the very highest level within that organization to allow for these babies to get access to the medication. And unfortunately for you can imagine legal reasons and some risk tolerance reasons it didn't move forward but we were very, very close. It almost happened and that was a proud moment for me and the team there really sort of pushing through when we knew that we were going to face them adversity and trying to get that approved. But trying to do the right thing anyway.

That's pretty cool. Jeff you were sort of at that juncture of your passion for patients and also your passion for innovation and pushing the envelope and you're just kind of in-between both then even though it didn't come to fruition. You were pretty darn close and the outcome was the right outcome even though it didn't work out as giving them access to that.

Yeah. And then I think that that's it's important. I think it's important for a lot of people to understand the people who work and in this industry by and large, they're the same folks that live in your neighborhoods and they have the same level of commitment and concern about really improving people's lives. And you know I think there's there's times when the farm industry gets a bad rap for being very focused on profits and finances and things of that nature. But I would say by and large throughout my career, I just always run into people that really just want to do the right thing and really want to bring something to the table for patients and the ones that are most successful are the ones that really live and breathe that mantra and are focused on that line of thinking.

It's a great message. I agree. You know I do feel like pharma does tend to get that bad rap but it's great to hear from folks like you Jeff to level set and give people an opportunity to revisit that paradigm. I too have I've met tons of great people in pharma. I would agree with you. Now tell us obviously oyster is your exciting project. So rather than dive into that deeper maybe you could just give the listeners some ideas so that they could continue in their innovative pursuits.

Yeah so I think the one piece of advice that I would give to people is never stop thinking about what's next or how you can move forward and prove something. I don't you could put a price on momentum. I'm kind of always in awe of some of these folks that are serial entrepreneurs and how they just have that momentum and drive to move forward despite any obstacles that get in their way and they're always thinking about innovative ways of tackling a problem. So the people are the most successful of also probably had the most setbacks and the most adversity. So I think the biggest piece of advice I would give is just continue with that momentum and keep going forward. And you know I often tell my staff you know when we have certain little setbacks whether we have comments from the FDA or we have some interesting data that might make us pause for a second that look, these are the bumps along the road and the end of the day people look back at most of these projects with 20 20 hindsight and just think it just happened and it was just organic the way it happened but it really is momentum moving forward, overcoming some of these hard times really embracing the times when you're successful. Just don't stop innovating. We need a lot of really smart minds out there to continue doing what they're doing and bringing new things to the table. You know I just read an article the other day that was sort of the history of the CRISPR technology and I was around when there were some setbacks in gene therapy in Philadelphia where a young boy had passed away. I was developing a drug that was a small interfering RNA at that time. So we we felt that pain. But look where the industry is now and there was a setback there but we're about to go through sort of an amazing and transformational period in medicine.

That's amazing yeah. What a great message Dr. Nau. And I always think of momentum as well. And you either have forward moving momentum or backward momentum. There really is no plateau. I am a firm believer that plateaus are they don't exist you're either moving forward or back. And this advice you've given all of us here will definitely serve as inspiration to keep moving ahead. Let's pretend you and I are building a medical leadership course and what it takes to be successful in medicine. It's the 101 of Dr. Jeff Nau. And so we're going to write out a syllabus lightning round style with four questions followed by a book that you recommend to the listeners. You ready?

Sure.

Awesome. Let's do this. What's the best way to improve health care outcomes?

I think the best way to improve healthcare outcomes. And again this is this translates into all areas of life is to go out and build relationships and build relationships with your target audience whether those be patients or physicians. Good relationships with those that you do business with. Make sure that you're networking. Make sure that you're building relationships where others trust you. You'd be amazed at how many innovative projects come out of two people sitting down and having a coffee and talking about something completely innocuous and then all of a sudden some transformational breakthrough comes into one or the other person's mind. So build these relationships, foster them, make sure that you're talking about things that you're thinking about with others to the point that you can. But I think the way that we improve healthcare outcomes really is it is not single individuals but it is a massive team of people moving forward and I benefit from thousands of other people out that have either come before me or are moving in tandem with me. So there's holing up in your office is certainly not going to move the needle not for the patients and certainly not for your company.

It's a great message. What would you say the biggest mistake or pitfall to avoid is?

I think this is another one that translates to areas outside of medicine which is make sure that you're listening. And you know we're told often from a very young age like our mothers that you need to listen but that's not the type of listening that I'm referring to. I'm referring to the step back. Allow the people in your organization, allow the patients, allow people to have a voice where they can contribute. They feel like their message is heard before you interject and give your opinion and allow that team approach to happen by learning how better to just sit back and listen and then to contribute after you've allowed the rest of the group to come to the table. And so I think one of the biggest mistakes or pitfalls to avoid is really to stifle that process and to as a leader to be able to step in and say here's what I think we should do. What do you guys think. That's one of the biggest mistakes I think anyone can make because they're not listening and taking the other inputs and then disseminating those back to the team in a way that you know is going to drive things to move forward. So I would say you know not listening is one of the biggest mistakes or pitfalls to avoid.

Beautiful. How do you stay relevant as an organization despite constant change?

Yeah I think that one of the ways to stay relevant we touched on earlier is really to continue to innovate. And one of the nice things that I really love about Oyster Point and other companies that I've been involved in is you know we're really at the forefront with oyster. One of the beautiful things is it's just disruptive and very innovative approach that no one else is going down that path. So we're really at the sort of tip of the spear with regards to leveraging this pathway to treat this disease. And so for us maybe fortuitous that we're in a really great place to stay relevant and not from that perspective but I think continuing to innovate, continuing to do the right thing for the patient. Continuing to always ask "Is there anything else we need to be thinking about" is how you stay relevant.

What's one area of focus that should drive every thing in a health organization?

I think I already touched on it which was as a leader I think it's really important we often get tied up in the sort of nuts and bolts of day to day operations but I often think that it's really a good thing to do which is to take a step back with your team and make them do something that helps them understand the patients that they're trying to treat, whether that be taking a day off and for us we're in the ophthalmic industry and so you know we take them to some of these organizations that help people with low vision. Having them understand that there is a person on the other end. So you know I often tell my team look we have a great drug. But now you have a responsibility and your responsibility is to bring this thing to the market and it's not a responsibility necessarily like in the shareholder responsibility it's a responsibility because there's literally millions of people out there that need another therapy.

That's a great great piece of advice there so listeners in whatever company you're in. Or even as providers you're at the front line of this so the reminders constantly there for you. Take away some time to be able to remind your people and refocus them on the reason why you're doing this which is the patients. What would you recommend to the listeners.

I may be slightly boring in that I am not a fiction reader and I think that's where the science piece comes into play. I'm actually right in the middle of a book called 1491 right now which is about the Americas Before Columbus came to the shores. I would recommend that by an author by the name of Charles Mann and had just finished up reading. I think it's an older book but I hadn't seen it when it first came out a book called Guns Germs and Steel by Jared Diamond which is a great read as well.

Awesome. Some great recommendations listeners you could get all of the shownotes, transcripts, links to the resources discussed. Just go to outcomesrocket.health/oyster and you'll be able to find all that there. Jeff this has been a blast. Love if you could just share a closing thought with the listeners and then the best place where they could collaborate with you.

Yes so I think we talked about a lot of different topics here but my thoughts that I would share with everyone or just continue to do innovative things, continue to collaborate even if you have a product where you think or therapy that you think. Okay we just got to get to the finish line. Always keep thinking about you know is there something we're missing. Is there a different way that we need to do this. Pressure test it, poke out. Because you'd be amazed how many things change through the process and don't come out at the end the way that they came into the system and so continue to innovate. We need innovation. Continue to work and collaborate with others. And you know last but not least continue to keep that patient-driven focus in mind. Not only when you make decisions but with your company keep them focused on the fact that they have a responsibility to bring these therapies to the patient population that's out there. And there is a responsibility that you're not pouring lattes. This is a very important task that you're working on. I think just within about a week or so we'll actually have a Twitter feed. We'll have a LinkedIn page, OysterPointRX. We also have a website, www.oysterpointrx.com. And you can send us a note through our info section on that page there as well.

Outstanding Jeff. This has been a true privilege to connect with you on this, not only the novel therapy but also your thoughts on leadership and improving outcomes for patients. We wish you guys the biggest success and looking forward to check in again here in the next year or two to see how things are progressing.

Yeah we were happy to check back in and let you know how things are going Saul and I appreciate you having me on.

Hey Outcomes Rocket friends, thanks for tuning in to the podcast. Once again as a leader in health care you have big ideas great products a story to tell and are looking for ways to improve your reach and scale your business. However there is one tiny problem. Health care is tough to navigate and the typical sale cycle is slow. That's why you should consider starting your own podcast as part of your sales and marketing strategy at the outcomes rocket, I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's outcomesrocket.health/podcast.

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Recommended Book:

1491: New Revelations of the Americas Before Columbus

Guns, Germs, and Steel: The Fates of Human Societies

Best Way to Contact Jeffrey:

LinkedIn:  Jeffrey Nau

LInkedIn:  Oyster Point Pharma, Inc.

Twitter: @OysterPointRx

Mentioned Link:

www.oysterpointrx.com

Jennifer Aniston’s chronic dry eye story | it’s time for eyelove™

Episode Sponsor:

Solving Complex Issues in Healthcare with Data with Simon Fitall, Co-Founder & CEO at Galileo Analytics

Thanks for tuning in to the Outcomes Rocket podcast where we chat with today's most successful and inspiring health leaders. I want to personally invite you to our first inaugural Healthcare Thinkathon. It's a conference that the Outcomes Rocket and the IU Center for Health Innovation and Implementation Sciences has teamed up on. We're going to put together silo crushing practices just like we do here on the podcast except it's going to be live with inspiring keynotes and panelists. To set the tone, we're conducting a meeting where you can be part of drafting the blueprint for the future of healthcare. That's right. You could be a founding member of this group of talented industry and practitioner leaders. Join me and 200 other inspiring health leaders for the first Inaugural Healthcare Thinkathon. It's an event that you're not going to want to miss. And since there's only 200 tickets available you're going to want to act soon. So how do you learn more? Just go to outcomesrocket.health/conference. For more details on how to attend that's outcomesrocket.health/conference and you'll be able to get all the info that you need on this amazing healthcare thinkathon. That's outcomesrocket.health/conference.

Today I have Simon Fitall. He's a co-founder and CEO at Galileo Analytics. He's a specialist in knowledge management with specific interest in a longitudinal patient data, data capture and analysis techniques as well as the assessment and evaluation of IP and pharma and biotech, including all stages of drug development from discovery to death of the product. His expertises is in data integration, modeling and forecasting. Definitely a guy that you would want to have by your side. He is also fantastic at designing and building complex data systems aimed at helping to solve complex issues such as the longitudinal Bayesian analysis of patient data. Simon is a member of the Global Advisory Council to the Interprofessional Healthcare Workers Institute also known as I H W I at Rosalind Franklin University as well as being a member of the education committee of Intelius. He is a leader and a fantastic contributor to Health Care and it's such a pleasure to have him on the podcast. Welcome to the show Simon.

Thank you very much indeed.

So Simon, what is it that got you interested in healthcare to begin?

I kind of fell into it. It found me rather than me finding it.

Is that right? Yeah that happened.

My first job, I mean this is long long time ago, my first proper job was working for AC Nielsen in market research. Besides doing the television audience measurement stuff that they've been most famous for they also used to run a retail business unit basically looked to product sales across all different sectors and in those days this was before scanning before barcodes if you can think about that and they had hundreds of people who would go around the country to samples of stools and they would collect the data. So it will be manually calculated all kind of say thinks some of you will be going way way way back. But anyway, they have a client service operation. And I got a job in that kind of set of operation and one of my clients was an over the counter medicines company and they were looking to expand. And I developed a really good relationship with them and they ended up offering me a job as a product manager. So I took it went into that. Then from there I went into market research in a different field looking for a company called Tyler Nelson. Now part of Cantle and from there I set up a consultancy and from there my first major client was a big international pharmaceutical company and was working on one project with them got friendly with another guy in the department who was really interested in modelling, modelling and forecasting. And quite literally over pizza and beer with. We went where we were in Switzerland. This was an organization that used to be called Sandoz now called Novartis and we're sitting in a pizzeria which is no longer with one of those paper tablecloths and we were talking about trying to solve some problem, we ended up drawing the design of a modeling system on this tablecloth.

Awesome.

And at the end of the meal to the tablecloth and then that was what really goes with.

Was it a proper tablecloth?

Made of paper.

OK. Oh wow that was courageous you took the tablecloth.

And that was where I got sucked into it and wow I started to realize..

That's a great story.

About how important some of this stuff is because we were talking about that particular time I'm talking about a new drug for early stage Alzheimer's. Now the drug didn't actually go anywhere but in the process of learning about that product and then working on other projects with the same company and then developing small business with other big pharma companies which basically go completely and utterly hooked on healthcare.

Wow. Talk about a you did fell into it in a very interesting way.

Yeah yeah it was one of those things where you know I've been a product manager and I was really cocky because in those days over the counter was a really hot thing and I'd been on over the counter product manager for a few years so I figured I could set up consultancy and do over the counter consulting and I never got a single account a consulting job. The first that first project with sandals which was a description drug development turned into more and more and more prescription drug development projects and didn't do a single over the counter project my entire time.

And so well fast forward to today. You're doing some fascinating mark had Galileo, if you had to simplify it for the listeners who don't know as much as we do about the company. Would you say the problem that you guys solve and who do you solve for?

The problem that we solve is sort of two sides of the same coin segmenting and sequencing segmented is understanding all of the different types of patients that there are and sequencing is looking at all of the different things that happened to those patients had done for those patients in order to either fix them improve they just broadly speaking improving their health status whether that's aiming towards a specific outcome or preventing a specific outcome. The segmenting as you said in your introduction most of the work that we do now is with longitudinal patient data. It's very granular. It's I hate describing it as anything like big day because that there is no such thing but let's not go there. There are large datasets to cover whether it be medical records clinical trials, claims data or combinations of all of those three. And what we know and everyone in healthcare knows that patients are really complicated things and what we're able to do with this much more granular data than we previously had available is we're actually able to characterize and quantify the differences between those patients and we can then use those differences to look at the way in which those patients come into become patients and what treatment patterns and pathways they go through that aren't just related to the specific disease that you might be interested in but it's related to the patient's complete condition.

Yeah, for sure and offering some very deep insights on what may at first not be apparent.

Very much so. One of the things we found very early on I say we most of our clientele up in pharma bio companies will not work elsewhere but that's the majority of our business and the pharma bio industry tended to have a disease specific focus. You're developing a drug for Parkinson's disease, you're really interested in Parkinson's disease. Your focus is on Parkinson's disease COPD or breast cancer. Breast cancer has a slightly different but you're focused on the disease and what tends to happen is you frequently forget the fact that the vast majority of your patients that have got COPD for example, half of them have got anxiety or depression. A third of them have got cancer. Another third of them have got rheumatoid arthritis. So those sorts of coma abilities and they overlap so much that you end up with four or five or six or eight different conditions all of which are trying to be managed. And what we're able to do is to look at the way in which that combination of coma abilities creates a creates difficulties for the treating physicians but also creates in many cases conflict conflict of outcomes conflict of treatment because you might be physicians trying to treat one condition might be wanting to use drugs or procedures that are actually going to be if not beneficial possibly harmful to other conditions that the same patient has got.

For sure. So this in-depth look. And the sad part Simon is that as much as we try it seems like we have such a difficult time in doing what you're saying. What would you say the biggest thing that's holding would there be providers or medtech companies. What's the biggest thing that's standing in the way of being able to see all of the insights versus just kind of being that siloed one track mind?

At the macro level quarterly reporting because you have to report quarterly. Have shareholders that you're worried about therefore your quarterly results are important. Therefore all of your decisions end up being made on a short term basis. It sort of cascades through the entire system and so you end up with managers who are more than capable of seeing the bigger picture because of the short term focus they end up focusing on the things that are right in front of them every day. At the same time they are trying to make strategic decisions obviously drug development processes is a hugely strategic issue which means you then trying to forecast out 5 10 15 sometimes 20 years which is extremely difficult to do at the best of times. And when you then overlay on that the fact that you've got a market that you think of as having three or four patient segments and you then realize that it's got so 10 or 14 patient segments. The complexity of that becomes overwhelming and it's actually easier to say you know what we're not going to worry about that today. We're going to stick with our 3 or 4 segments. We're going to concern ourselves with that group for the time being and we'll deal with everything else later. And part of the problem is all too often later never actually comes.

Yeah, that's so interesting you know and it does happen and that is a big challenge Simon, I mean even at hospitals right, publicly traded hospitals which is not a majority of them but you know a good segment of them were faced with definitely at the company level. You know the fact that we are held to quarterly results and taking that big picture approach is not always incentivized so how do we get the incentives in place to encourage people to take this thoughtful and insightful approach?

It's very difficult again at the macro level you have to think about the way in which we we fund healthcare as is fairly obvious from my accent on British originally. And so I have a very positive experience of single payer healthcare and where we see single payer health care working within the U.S. system which it does and we've got a couple of very, very good examples of single payer systems Kaiser Permanente is probably the biggest commercial single payer system that exists only in single payer in the context that they may not only manage the money like all of the insurance companies but they also employ the physicians they and the hospitals and so on and so forth. I mean they're even setting up their own medical school so they are a single payer system. They get really good results and they do that by having the beneficial feedback loop of looking at the data good not only looking at it from a financial perspective looking at it from a patient outcomes perspective and that feeds back into procedures and processes across the board whether it be using checklists or training processes or team protocols at the individual hospital unit level. They identify ways in which they can beneficially manage patients and then quantify that that turns into incentives that turns into measurement protocols and the whole thing becomes this large snowball because the continuously looking for ways of improving the process because they've got the incentives to do it because they are a single payer system where you've got individual physicians who are coming under increasing pressure from reimbursement that forces them to think in terms of spending less and less time with their patients more and more time thinking about how do I maximize my my reimbursable time. We end up in the process where we're doing too many tests because there's an incentive to do tests. We are probably treating too often because there's an incentive to treat were not following enough because there isn't an incentive to follow up on it being very broad and there are lots of examples of ways in which there are all sorts of really good things going on in the system. Broadly speaking we've got an incentive system that is built around physicians and hospitals doing stuff because they get reimbursed for the stuff that they do.

Right.

When we all know that there will be huge benefit from actually doing nothing. The problem is how do you get people to pay other people for doing nothing.

That's the nature of the beast.

It is it's the nature of the beast. So you end up with these misaligned incentives. That's something that I'm always looking for whenever we work with hospital groups or with patient advocacy groups. We're always looking for areas where we can properly align the incentives as opposed to the current broadly misaligned incentive.

Now you bring up some great points Simon and here's a thought. What about approaching payers. Right. Because I think employers are also their own insurance providers. They're interested in aligning and ensuring that their patient populations are being treated well and it's in their best interest to keep them healthy. Have you guys approached employers in this space?

We have and where we get the positive outcome generated motivation. And if I can use that phrase There's a very high level of acceptance of the ideas. You're absolutely right. The large employers who are interested about genuinely interested in both the health benefits for their employees and their families as well as of course the financial benefits for the corporation. Very interested in this whole approach. And there are some super examples of companies that run really effective systems that do have an impact. The problem that we have from a system one perspective of course is that although employer based insurance is still a huge part of the market the vast majority of the employers are too small to be able to have their own healthcare unit working centrally doing the research doing the assessments and so on and so forth and then not in a position to be able to to fund additional research outside that. So again there's a there's a complex limitation there as well.

Makes a lot of sense. I was just curious about what that look like sounds like you guys have gone down that path and seems like maybe not not the right amount of traction because of the capabilities that the employer has.

I don't think there's an area in healthcare at the moment where isn't some interest in a process of improving the way in which we manage healthcare the way in which we manage patience the way in which we we strike out with the objective of achieving better outcomes. Everyone's looking for that. But all the different places that you look they've all got their own constraints that in many many cases prevent them getting to where they really need to get.

For sure. So what would you say. Simon is a time when you had a setback. I feel like we learned more from our setbacks than our victories. What did you learn from that setback that you had?

Oh basically there's no such thing as an irrelevant variable. There are variables that do and don't affect the outcome that you're looking at. Just about everything is at some point in the in the equation going to turn out to be relevant and this specific example I thought of was that there was a situation where I was running a business development project for a client and we'd gone through thorough analysis of the market products all the players. We got a strong recommendation and they rejected it because there was some critical internal issues that had been considered but they had been determined by the team as not relevant to the project. The problem was that there were other people higher up who consider them to be important and relevant to the project and so the proposal got rejected. There was nothing wrong with the proposal it was the way in which we managed the process that was wrong and essentially the thing that that taught me more than anything else was make sure that you've asked all the questions at your briefing and don't make any assumptions about what you've been briefed. If there's a gap there's any sort of perception of a gap in what you think you've been briefed. Go back and confirm because there's a good chance that there's a bear trap there and if you miss a bear trap you could be in trouble.

That's a great call. Simon ask your questions. Make sure you definitely don't leave any bear traps uncovered. The expertise here being shared by Simon from Galileo Analytics. It's crucial folks so definitely keep yourself tuned into this episode. Now tell me about Galileo thermometer?

Oh that's a product. The idea is very simple. We created an analytical approach that we call Galileo Cosmos and when we apply that to data sets, we're able to do some analyses really very quickly very much more quickly than traditional methods. So what we did was we said in the business development world we very frequently running up against extremely short deadlines, it's possible to do a much more detailed appraisal of the data prior to making your Bidi decision. If you use a system that combines good quality data with fast and detailed analytics and that's the idea behind thermometer.

Very cool. So listeners if you're on the provider side or the business side, we're looking at some pretty advanced ways to analyze your number one be it variability if you're in the clinical space or if you're simply a company looking to vet out what you're doing to provide value to the market rather than sinking millions of dollars in, maybe worth a Galileo thermometer on your idea where they take a look at demographic's psychographics. diagnoses, treatments et cetera. And it's a fascinating way to get short term results on your idea and decide whether or not it's something worthwhile to pursue or not. Super fascinating things that you guys are doing there. SIMON What would you say an exciting project or focus that you you're working on today?

A couple of really interesting things going on at the moment but I'm not allowed to talk about them publicly so I'll talk generally. The red space is one that's a lot of interest around the industry at the moment particularly with all from drug sites as being something that people are seeking out because it has significant benefits. But in the process by definition you've got a disease that has relatively few patients. And so one of the major questions that comes up is how do we find those patients in order to analyze them and what we found, again using Cosmos very efficiently is that if you have a large claims or medical record dataset probability is that you'll find some of these patients as well because if you go to a disease that might be a subset of depression for example if you've got a dataset that covers patients with depression then you've almost certainly got patients with your subset. And what we're able to do is to find those patients very specifically and then analyze them in the context of not just the subset of patients themselves but also in the context of other patients who are quite like them but don't actually have the rare disease that you're particularly interested in. So you can get a good picture of the way in which those patients are managed if they're being managed at all what the opportunity looks like. But also what the opportunity just immediately around looks like which can make a big difference when it comes to the way in which you communicate to physicians because frequently with these diseases they are conditions that physicians are very very unaware of. And if you can describe the patient these patients look very much like one of these other patients but they're not quite. And the reason of the different is because of this this this these particular characteristics. You can help the communication which helps the physicians to understand what it is that they're looking for because the rare condition that you're dealing with is something that is rare some by definition. Most physicians haven't seen very many of.

That's fascinating Simon. And listeners one of the key insights that Mr. Fitall is offering us here is that oftentimes we don't look at the missing pieces of information. You have certain data sets and you assume that maybe this isn't it. The reality is that maybe it is what you're looking for and the capabilities that Simon and his team over at Galileo Analytics have put together. They really offer you the ability to look beyond the what would be apparent. And so Simon this is really great. I think you guys are doing some fantastic work to help improve outcomes and I'm excited to see where your new projects take you. It's definitely exciting work.

Yeah we were enjoying it. In another area that we're getting involved in as you mentioned in my bio The Interprofessional Healthcare Workforce Institute. What we're looking at there is ways in which we can improve the quality of the workforce in healthcare beyond the traditional training lab technicians for example. They are very well trained to be lab technicians but they also need an understanding of data analysis. Now they don't need to be data scientists but they do need to have a good understanding of the data that they're dealing with on a day to day basis. So one of the things that the I H W I is looking at is internationally recognized certification programs that expand the professional training of individuals in healthcare. So that's another area that we'll be getting involved in which is fascinating.

It really is. It really is folks if you have any curiosity about the things that we're discussing just go to galileoanalytics.com you know fine. Now the things that Simon and his team are working on to provide that insight that is certainly required in healthcare to take the next steps to get the results that we have gotten before and improve outcomes. David getting close to the end here. We've got some lightning round questions and a book that you recommend to the listeners. This is what I'd call the 101 of Simon and so how do you make analytics work for you and healthcare. So here are the four questions for you. Lightning round style. What's the best way to improve healthcare outcomes?

True sharing of data are across all disciplines and locations.

What's the biggest mistake or pitfall to avoid?

Falling for the latest fad-old buzzword at the moment. It's artificial intelligence and machine learning.

I love it. I love it, straight to the points.

Three years ago it was big data.

Yeah yeah I love it. How do you stay relevant as an organization despite constant change?

Well I think you just have to treat change as the only constant. It's the only thing that never changes is the fact that we always have changed. If you accept that and build that into your thinking then you have a better chance of coming out the other side.

Wise words. What's one area of focus should drive everything in a health organization?

From our perspective quite simply yes. Creating analytical capabilities that genuinely affect results.

Fantastic. And what would you say your all time favorite book is?

This is a good one. You very kindly sent this through. I was thinking of things like thriving on chaos by Tom Peters and the creative gap on the Joro and books like that kiss or shake hands is a terrific book on international cultures. But I ended up coming back all the time to a book that I read many many times and it's all about how we treat each other and how we think about the world rather than a specific business thing. And funnily enough it's Winnie the Pooh.

Really. Yeah. All right now is there one particular book. Because I've seen many books on Winnie the Pooh out there.

Yeah. The best one. There's an anthology. Basically there are two books one is cool Winnie the Pooh and the other one is called The house in Pooh's Corner and they're based on this very simple philosophy of a relatively simplistic way of looking at the world but actually what you derive from it is the kind of understanding of the way in which personal relationships should be managed in order to essentially foster the kind relationships that can lead to success and in health care the one thing that's true of healthcare more than anything else is that it is both local and personal. The only person who truly cares about my health is me and the same applies to everybody. But when I'm dealing with I'm dealing with a CEO of a big pharma company we're talking about drugs to treat tens of thousands hundreds millions of people and each one of those individuals is an individual. And if we can keep that philosophy in the back of our minds I believe we end up making better decisions.

Outstanding. What a great point and an off the beaten path recommendation on the book. I really appreciate that Simon.

It's just one of the things that I'd love to do is reading stuff that isn't business related because everything I read you end up with thinking about when I like reading books some physics for example and it just helps you broaden the way in which you're thinking about stuff and it allows your subconscious to be working on the things that you have to work on.

What a great message listeners for the show notes the transcript link to the things that we've discussed just go to outcomerocket.health/galileo and you'll be able to find all the things that we've talked about today. Simon, I wish we had more time to chat but I'd love if you could just share a closing thought with the listeners and then the best place where they could get in touch with you.

Well take the the last one first. The easiest way to get hold of me is simon.fitall@galileoanalytics.com. And I'm pretty good at picking up most of those e-mails. I'm also on LinkedIn as you'd imagine so please connect. No, I think my closing thought, I appreciate the invitation to come on I've enjoyed it very much indeed. And it's actually made me think about some things I don't normally think about. Point I was making just now about the subconscious is the ability of the brain to work on an issue without consciously thinking about it is something I think that's very important. It allows me to take a break when things aren't working properly. I'll take a break. Go for a walk, go get a coffee. Don't even think about the work because the work will catch up with you and if you force it you end up forcing the thinking which frequently are more frequently and in my experience ends up with a bad decision.

What a great call out there and as leaders that want to affect change we tend to take the opposite end of that and focus even more. And I think Simon's words of wisdom here will definitely do us well. So do as Simon says. Simon, this has been a pleasure my friend. I really enjoyed our time together and I just want to say thank you so much for spending time with us.

It's my great pleasure. Thank you.

Thanks tuning in to the outcomes rocket podcast. If you want the show notes, inspiration, transcripts, and everything that we talked about on this episode just go to outcomesrocket.health. And again don't forget to check out the amazing healthcare thinkathon where we could get together to form the blueprint for the future of healthcare. You can find more information on that and how to get involved in our theme which is implementation is innovation. Just go to outcomesrocket.health/conference that's outcomesrocket.health/conference and be one of the 200 that will participate. Looking forward to seeing you there.

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Recommended Book:

Winnie-the-Pooh

The House at Pooh Corner (Winnie-the-Pooh)

Best Way to Contact Simon:

LinkedIn: Simon Fitall

E-mail:  simon.fitall@galileoanalytics.com

Mentioned Link:

Galileo Analytics

Episode Sponsor:

Improving Operating Room Outcomes and Efficiency with Jennifer Fried, CEO & Co-Founder of ExplORer Surgical

Thanks for tuning in to the Outcomes Rocket podcast where we chat with today's most successful and inspiring health leaders. I want to personally invite you to our first inaugural Healthcare Thinkathon. It's a conference that the Outcomes Rocket and the IU Center for Health Innovation and Implementation Sciences has teamed up on. We're going to put together silo crushing practices just like we do here on the podcast except it's going to be live with inspiring keynotes and panelists. To set the tone, we're conducting a meeting where you can be part of drafting the blueprint for the future of healthcare. That's right. You could be a founding member of this group of talented industry and practitioner leaders. Join me and 200 other inspiring health leaders for the first Inaugural Healthcare Thinkathon. It's an event that you're not going to want to miss. And since there's only 200 tickets available you're going to want to act soon. So how do you learn more? Just go to outcomesrocket.health/conference. For more details on how to attend that's outcomesrocket.health/conference and you'll be able to get all the info that you need on this amazing healthcare thinkathon. That's outcomesrocket.health/conference.

Hey I really thank you for tuning in today. I've got an outstanding guest for you. Her name is Jennifer Fried and she's the CEO and co-founder at ExplORer Surgical. She's a med tech innovator. She's a founder there and what it is it's a workflow management software for the operating room and interventional suite. Now, healthcare leaders listening to this you may want to stick around because she's offering some major value as well as for device companies in this space so she's really passionate about building innovative businesses in the health care industry especially those that use technology to solve inefficiencies and improve healthcare and that's why we have her on the podcast today. She's got a fabulous history in both venture capital as well as consulting and strategy. So I want to open up the microphone to Jennifer to round out that introduction maybe fill in any of the gaps that I missed. Jennifer welcome to the podcast.

Thank you for having me. A quick note it's Jennifer Fried. So don't worry ,lots of people say that all the time.

Jennifer thank you so much. I appreciate that. Jennifer Fried ladies and gentlemen, get ready. Don't be like me.

It's OK. I also let my friends call me Jen but I'm jackpot two Ns which gets very confusing but I never get people mixed it up.

Well Jennifer really appreciate you being on the podcast today. And so let's dive into some of the cool things that you're up to. But before we do, oh folks the other thing Jennifer's base here in Chicago so she's a neighbor here in the in the great Windy City doing some awesome things to represent the med tech industry here which for those of you that don't know is growing. Jennifer, what got you into health care to begin wit?

I became really interested in healthcare when I was getting my undergraduate degree at Northwestern. I was studying math and economics and I think one of the things that really struck me about healthcare is when you look at it from an economic lens, consumers can't make rational decisions about healthcare. So you take something that I believe in essence as a public good. Yet there are so many economic distortions that you can't really look at buying behavior the way that you would. Other types of public goods or private market goods. And so I just became really fascinated with it from an academic perspective. When you say there is this industry that impacts every single one of us, every person in the U.S. is going to consume health care and have either yourself or a loved ones that go through significant health challenges. Yet when you look at the industries surrounding it, there are so many opportunities for improvement. So I just became really fascinated looking at, what are the new models that are coming into health care? What's changing? How can we continually make it better? And while you're looking at technology and innovation and new business models, let's apply it to an industry where it can really make a difference.

That's super interesting. So you really found this this opportunity to to make things better and now you're doing an amazing job. And what you do today. I love if you could just level set with the listeners. Tell us a little bit more about what your company does and if you were to answer it and I have this problem. What can you do to solve it. What's that problem and how does your company fit it all.

Yeah so we started the company to solve a fundamental problem that we saw happening in operating rooms which as a surgeon reaching out their hands and that over procedure and realizing that the tool or instrument that they needed wasn't there and this was something that we started other her research lab at University of Chicago Medical Center where he was studying this problem. And when I first learned about this, this was little over five years ago I was pretty shocked. So my co-founder Alex Lenger men as a head and neck surgeon and what he said to me as John Half-Time I come in the room I have my favorite scrub nurse. I have my favorite wrap. I have an anesthesiologist I worked with all the time. Everything runs so smoothly it's clockwork it's perfect. But the other half of the time they come in. I have a task that's rotated in from another specialty. I have a new anaesthesiologists that I'm working with by wrap isn't there yet and my entire room is chaotic so I literally have my patient open on the table and reaching out my hands and because what I need isn't there we're stopping the procedure and sending somebody literally out of the room down the hall in the supply cabinet to go get and I got them. So I saw I know that you spent time so correct So we're used to being laughed before. But for me,.

I know.

Shocking. It's just it's not what you'd wanting would nudge in if you think about it being you or your kid or your mom that lie on that table you say why is it ever happening? And when we started looking at it academically we said, let's study that and see what's going on and what we saw were surgeons all procedures differently. You have tons and tons of new products and devices that are phenomenal that are coming to market that have the complexities. How do you use them. You are very high turnover and oversack so you constantly have new nurses and new techs that are rotating in and an obsession academic sorry that were rotating around. And so what this means is that in a hospital setting you don't have that high volume. I'm doing the same procedures with the same people day in and day out. You have all this variability,yet there's nothing to actually support. What can be a 5 6 7 hour case. So nurses and techs were literally taking note cards and notepads and writing down OK here as you know the size of instrument that this particular Doc wants. Or take a picture on my phone of how to set up the Naos stand and the best sales reps were doing that themselves too and texting us around insuring our coverage drops. And so we saw all of this and said, this is not at all what we should have if we're trying to think about how we deliver the best care for patients. So how do we take these complex new game changing devices knowing that we have a variable staff and may not always have all the team members that we work with all the time. And how do we put all those pieces together to create the right environment for delivering these interventions. So what we decided to do was to build a software tool that could actually be used in the intra operative part of surgery. So we'll take procedures and break things down step by step. But then also roll by roll. So knowing that what your sales rep needs to know is different than what your scrub techniques know, that's different Noyer anesthesia team needs to know have all of that laid out in a digital playbook that have enough pictures and videos, information to reference and also having a large screen on the wall where everybody can see what step of the teaser we are and where are we going next. So it's a relatively traditional software workflow tool but we're applying it to a very different type of stabbing that has generally been pretty old school when it comes to technology.

That's pretty fascinating Jen and so you've put together a really great workflow solution and tell us a little bit about some of the results you're having and some of the outcomes that you've been able to improve?

Yeah it's interesting. So we we work with field hospitals and also medical device companies on the hospital side. The main points that we look at our time and then also suppliers. So we'll look and say, Can we get cases set up faster on the terms of the preoffset out of time. The answer is yes we've generally seen around a 10 percent reduction preoffset of time and then in the intra operative part of procedures some of the data we've been collecting even just having the data has been a game changer. So what we see is that between 5 and 10 percent of intra operative time is being spent on preventable delays like the one that I described at the beginning of the case at the beginning of the interview so we should have day nobody else has been measuring or capturing that data. So in some of the controlled studies we've done, we've been able to reduce that time and delay by about half. And we'd like to see it get even bigger and start to compose to eliminating it. But we're happy to start to see some results there and even just having the data as a baseline. And the therapies that we look at is the supply spent and we know that hospitals are running on very thin margins. So we see a lot of waste in the OR. We generally see between two and three hundred dollars of disposable supplies that are getting opened and then not used in a particular case and that whole range across specialty and it can be much higher and more expensive procedures and usually that waste is driven by team members trying to be as prepared as they can for procedures. So what that means is they're opening up everything. I'm not sure exactly what the stock wants to use so I'm going to open this version and this other version. So by having the right tool that is easy to use that's available in the sterile field they can prevent those items from being opened in the first place. That's a really going on the hospital side on the device side. We've been working directly with companies to support new products launches so working and position education sales education and market development. So when you take a product that is very new. So for example moving a procedure to a minimally invasive technique that it usually been open we can start to map out that procedure and think about the right way to modify that procedure. Train new physicians that the clinical patents on how to use it and then start capturing that data in the field.

Yeah, and so approaching it from a provider as well as a medical device perspective, you're capturing some pretty important groups here in this space and just thinking through some of the time savings. I mean if you're reducing time by half I mean if you're an elderly patient with a lot of comorbidities and you really could benefit from less anesthesia than less time is better Jen. So I think you guys are doing some pretty awesome stuff and in the conversations that we've had on the Outcomes Rocket, just a resurfacing theme that in health care it's not new products that are innovative it's actually being able to implement them and to you and your partners success. you've been able to do that. So congratulations for putting this and being able to implement it because that's the challenge.

Yeah I agree with you and it's something that we are always still striving to improve. I think there are so many great ideas in healthcare and it's some, it's gotten harder and harder to get innovative technologies in the hospitals. There's a split proliferation of new health curate key company which is so fantastic but I think it's been overwhelming for hospitals to know how do we process, how we manage us and say speak, A permanent governance put around this. So lots of decisions made by committee that can make it very difficult. And then I think also at the end of the day, you're putting in new products and in patient care setting and patients come first. So you have to work really hard early on to capture the data that proves that your product is going to make patient care better or at minimum not interfere with that. And that takes a long time.

It really does. So just congratulations right because half the battle is implementing and for those listening you've heard the episodes right. I mean we as we talk to leaders that have had success in medicine like Jan it's so important that we start thinking about how we operationalize these technologies. So you guys have had success early on. Jen can you share a time when you guys had a setback and what you learned from that if you like we learn a lot more from those setbacks?

Yeah I think one of our biggest setbacks was in our initial go to market. So we launched the company out of the hospital out of their academic hospital and we're very focused on how do we grow our presence in more hospitals. And you know one of the things that we pride ourselves on was thinking about all the different stakeholders. So knowing that you have these big committees that you need to get a approval through and that it really only takes one naysayer to shoot down a new product. We've spent a lot of time designing our product saying how is the surgeon going to interact with it. How is the scrub nurse going to interact with that. How with the OR manager is going to interface with this. How with anesthesia team interface with that. And I think the critical portion that we left out early on was industry and all of the different vendors and I think a part of that was spending more of our time in specialties that had a lighter rep presence but a lot of people early on said you should talk to some of the device companies, you should talk to some of the capital equipment manufacturers. And I initially said no you know I think we really want to be just focused on providers and we don't want to tie ourselves to any one type of company. And now we spend most of our time in the cardiac orthopedic and spine space, that was our all specialties where..

The rep headed.

Yes. And the vendor in the room has a very important role and to be honest,we didn't think about that stakeholder enough early on that was a huge oversight on our organization side and over the last year when we started to work with a number of these companies directly, I think that has really accelerated our path to market and these organizations have been phenomenal customers and partners to us.

What a great story and a great learning that you guys pivoted from an in the business model has has been reshaped and impacting both the vice and and health care so I congratulate you guys for that.

Well, thank you.

What would you say is one of your proudest medical leadership moments to date?

There have been so many amazing moments and they have all come from working directly with our customers. So having surgeons call us and talk about how the app prevented an issue from happening in surgery has been huge. And then you I think touching upon what we're doing now with device companies. One of our hesitations initially, I worked on the best price so how exactly is this going to work. Right if you look at the economics medallion proposition it's totally different with our first big medical device customer. The CMO ended up writing us after we started working with our medical education team and sent us this note saying this is going to completely change the game of how we think about medical education and training for a novel products.

Nice, it's pretty awesome.

It is really exciting and I think it was very validating very sad.

Totally.

Oh, Got it. That is the right way to enter these organizations and start working with them. And that was a big inflection point for the company.

So awesome that's on that one. And as you guys continue to make iterations work with different providers and device companies, what would you say today is one of your most exciting projects?

I can't talk about all of them publicly. One that is public is that we are working with Siemens health and ears as part of their digital ecosystem. We are one of their 5 inaugural partners.

Nice.

And so we have an API where we have a single sign on now with their digital ecosystem. So for the new C-arms that have the screens embedded you can log right in and you can access this large surgical through that. And so we have been working with them. Our primary experience was personally Allar and then also in the cap lab and the key lab where doing work with Siemens interventional radiology on some of the more complex procedures like Titos. So that has been pretty interesting and we've also seen working with their large customers that they're moving some complex orthopedic procedures into the IRS sleeve which as you can imagine is a huge change in the workflow when it comes out. Yeah mean our procedures generally can package most of what you need in a pretty small set and you have everything you need from there from the room right next door. And now you're talking operating and big ortho trades and doing this very novel new procedures. That's been really exciting to see that's really kind of an emerging surgical specialty. And then also, now having our technology be so well integrated into a large player where you can just take down some of those barriers and getting started where it's ok we can log on on that we have our C-arm and its right there.

That's pretty cool. So you power up the C-arm, it's right there on one of the screens and you got yourself oriented, you'd do a time out. And now everybody's on the same page.

Yeah that's the vision for it. So you have a digital ecosystem. It would seem as it is going is very cool.

I think that's exciting John and so there's definitely a lot that could be done to continue improving efficiencies in the OR and I'm thrilled that you and your team are just taking the bull by the horns to make this happen.

Yeah it's been a wild ride. So one that's been really exciting and also really meaningful.

So Jen let's pretend you and I are building a medical leadership course on what it takes to be successful in operating room efficiency. Today, it's the 101 of Jennifer Fried. I've got four questions for you. We're going to put together a syllabus in the form of a lightning round. So four questions followed by what you think the best book for our listeners to read. You ready?

Yeah.

All right. Here we go. What's the best way to improve health care outcomes?

Start by capturing the rate data.

What's the biggest mistake or pitfall to avoid?

Ignoring stakeholders.

How do you stay relevant as an organization despite constant change?

Short sprint times so always having customer feedback they can incorporate it and then having an agile technology organization that can make those changes in short order.

Powerful and what's one area of focus that should drive everything in the company?

Patient first. That's the name of the game in healthcare and we talk about it all the time as a company is as it is about designing our product. We say if this was your kid that was on that table having surgery, what is the tool that you would want guiding that? What areas that you want for the team around it.

Beautiful and what book would you recommend to the listeners Jen?

So a book that I read a year or two ago that I really like reckonings my health care friends is a thousand naked strangers. Has anybody brought this up yet on your podcast?

No. So what does it, a A Thousand Naked Strangers?

Yes.

Okay, first time.

I know people always talk about Gawande and his books are awesome and obviously very relevant to our organization. I thought I'd bring a new one. This is like I named named Kevin Hazzard. He was a reporter and after 9/11 decided he wanted to make a career change and he became a paramedic and then about a decade as a paramedic. So this is a story that talks about his experience on the frontlines of that job and I found it so fascinating. You know I spent a lot of my time in the hospital but I personally didn't know as much about what happens for those first responders. What is that experience like. And I just it was a really interesting read and I would encourage everybody in health care to go check it out.

What a great recommendation. Listeners One Thousand Naked Strangers and listen all the things that we talked about today don't worry about writing them down, if your out for a run, if you're driving. Definitely don't write them down if you're driving.

Unless you have a Tesla, oh accident it's still into it.

Yeah yeah. Even still. Just go to outcomesrocket.health/explorer like ExplORer Surgical and you're going to be able to find all of the show notes, a transcript and links to the recommendations that Jen just gave to us today. Jen it's been a ton of fun. Super exciting for what you and your team are doing if you can, just leave us with a best place where the listeners could get a hold of you or follow you.

You can follow me on Twitter. I am @jenn_fried. Also find our website which is explorersurgical.com.

Awesome. There you have it listeners. Best place to get in touch. Best place to follow what the folks at explorer surgical are doing and Jen and her leadership team over there, just doing some amazing things so Jen just want to say thank you for spending time with us today and looking forward to staying in touch.

Sounds great. I will see you around the town for about a mile away.

That's right. Looking forward to it.

Alright, take care.

Thanks for tuning in to the outcomes rocket podcast if you want the show notes, inspiration, transcripts and everything that we talked about on this episode. Just go to outcomesrocket.health. And again don't forget to check out the amazing healthcare Thinkathon where we can get together took form the blueprint for the future of healthcare. You can find more information on that and how to get involved in our theme which is "implementation is innovation". Just go to outcomesrocket.health/conference that's outcomesrocket.health/conference. Be one of the 200 that will participate. Looking forward to seeing you there.

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Recommended Book:

A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back

Best Way to Contact Jennifer:

LinkedIn:  Jennifer Fried

Twitter:  @jenn_fried

Mentioned Link/s:

explorersurgical.com

Episode Sponsor:

Human Excellence, Neuroscience and The Platypus Institute with David Bach, Founder and President: Platypus Institute

Thanks for tuning in to the Outcomes Rocket podcast where we chat with today's most successful and inspiring health leaders. I want to personally invite you to our first inaugural Healthcare Thinkathon. It's a conference that the Outcomes Rocket and the IU Center for Health Innovation and Implementation Sciences has teamed up on. We're going to put together silo crushing practices just like we do here on the podcast except it's going to be live with inspiring keynotes and panelists. To set the tone, we're conducting a meeting where you can be part of drafting the blueprint for the future of healthcare. That's right. You could be a founding member of this group of talented industry and practitioner leaders. Join me and 200 other inspiring health leaders for the first Inaugural Healthcare Thinkathon. It's an event that you're not going to want to miss. And since there's only 200 tickets available you're going to want to act soon. So how do you learn more? Just go to outcomesrocket.health/conference. For more details on how to attend that's outcomesrocket.health/conference and you'll be able to get all the info that you need on this amazing healthcare thinkathon. That's outcomesrocket.health/conference.

I really thank you for tuning in and I welcome you to go to outcomesrocket.health/reviews you rate and review. Today's podcast because we had a magnificent guest. He has done so much in health care by starting many different companies. He's a physician. He was a physician, frontline for some time. His particular expertise is in Applied Neuroscience and he's doing some pretty interesting work currently at the Platypus Institute. But let me tell you a little bit about the special guest. His name is Dr. David Bach. He's a Harvard trained neuroscientist and he's the founder of the Platypus Institute,a New York City based research and training institution focused on the question of how neuroscience can be practically applied to radically enhance cognitive functioning and the human experience. He's got much success to discuss. But right now his core focus is this and what I love about David is that he's a physician that's very focused on wellness. He's got a wonderful story that we're going to dive into as well as his work at the Platypus Institute. Lots to cover here. But what I want to do is open up the microphone to David to fill in any of the gaps in that introduction that I missed. Welcome to the podcast.

Thank you so much. It's a pleasure to be here.

And the other thing that I want to mention is that David also has a podcast which by the way if you wanna excel what you do in your life, it's called Neuronfire podcast. He interviews world's leading neuroscientists and elite performers that I think you'll find very intriguing. We'll leave you a link to that below. But David tell us about your story. Tell us about you?

Well first of all thank you very much for the kind introduction. I kind of have. Two stories that ran in parallel that got me to the point where I wanted to start the Platypus Pnstitute so I guess you'd call it the external story is a pretty traditional I guess physician executive route so I went to Harvard College. I went to Harvard Medical School. I practiced medicine. I did science a lot of work in cancer research left and then went into business was a venture capitalist and then started a bunch of companies. And so that's the kind of resume story the parallel track though is an internal journey. I've been on in the last 15 years and this is probably what's most relevant that guided me to start the path of this institute. So around 15 years ago I hit a low point in my life. So that's the point when I had just started my first company I had left academia. And the bottom line is it was really not going well you know as I told you I had a history of you know at least from other people's perspective success but at this point I just couldn't make the company go anywhere we were doing okay on a revenue perspective but the problem was our expenses were a lot higher than the revenues and break it out. And I was working like 15 or 16 hours a day and just chronically exhausted I and I was just drinking coffee like by the gallon. And not only that I hit a point in my life where for the first time in my life my body started to give out on me. And I just didn't know what to do and there was one morning it's 6:00 AM I'm looking at myself in a bathroom mirror and I said to myself I said, OK David, enough, you know something needs to change.

Yes.

And it was just this bizarre thing and I had this thought as I was looking at myself and I said wait a second David you're a trained scientist. What if you approach this problem this moment from a scientific perspective saw that that was the moment that basically changed my life and began my journey into what I now do. Because from that point you see I started to look at myself differently I looked at myself objectively the way a scientist would look at a lab rat. And so I mean this is a bit of a strange story but the first thing I did as I started to do what any scientist would do so I started to collect data about myself. So I collected my brainwave data and I looked at my heart rate and I looked at my thoughts and my posture and my breathing you know what was I looking for it was I was looking for patterns you know something that I could scientifically measure that correlate with you know how much my life sucked right and you know and ask those patterns started to emerge. The next thing I did is I started to do experiments on myself to say OK can you change these things.

Yes.

And you know as I'm sure you can imagine through that process I learned a whole lot about myself and you know I obviously went down a bunch of rabbit hole. But what I can report to you is this the guy talking to you today is an unrecognizably different man than you would have met 15 years ago. So for example I turned around my health and I'm sure you know you can measure your body's biological age or just to measure of how old your body is based on your blood chemistry and not your chronology. Right. And what I could tell you is my biological age today is four years younger than it was 10 years ago when I stop. I know it's crazy. I you know if you do that math correctly 15 years from now I'm going to be eight. I'm kidding.

I was going to say.

But it's really beautiful and you know I turned around my cognitive function. I became happy. And in fact I turned around my business as a result of that you know by stretching myself mentally by stretching myself physically. I became a different guy who was then able to find his way toward taking this company. We grew it up to a hundred and thirty five million dollars in sales and significant profitability and then I did that with a couple other companies. So I I'm kind of like the hair club for men guys I'm the first customer of a scientific approach to rewiring and it had a very powerful impact.

That's such an interesting story.

I know it's bizarre but.

And The one thing that I do is I know you want to continue David but I do want to highlight listeners in the light of all the things that we do like David. We all have an internal and external story right. In a lot of times we're so focused on that external story. As healthcare leaders how could we improve this. How could we reshape that. How can we help patients feel better. How can we improve the finances at the expense of our internal story. And so I love that David shared this very personal story about himself and the transition. I think every one of us can identify with him and the things that he went to David continue please.

Actually I am just building on what you just said. I guess what I will tell you is the discovery I made through this process and probably a dozen years ago and this was really the discovery that changed my life is you know speaking about this internal story is that you and I, we've got unconscious patterns right that is. Yes hatters that we have no conscious awareness about and those patterns have a huge impact on how we show up in life. You know that's things like how we hold our body how we breathe our automatic reaction to stimuli and the like. And what I discovered is because those unconscious patterns have such a profound impact on how we show up in life, we characterize measure and change those patterns. Our life can get better quite profoundly without any additional effort. And that's really that's really the insight that drove me personally and I think the insight that is is driving our work at Platypus.

Super insightful and definitely want to dive into this and folks just want to highlight that David the three companies that he founded they all grew to be more than 100 million dollar enterprises venture capital. Now there's no doubt what he's doing produces not only internal but external results and impacts society in a very positive way. I'd love to dive into what you do at the Platypus Institute David. But first why platypus?

So I don't know if you know anything about the platypus it's indigenous to Australia but what I love about that animal is it's made up of multiple component parts that don't normally go together and so it's got a duck feel about an Otter Tail and that's a mammal but it lays eggs and that's waterborne and that's got a poisonous Spore and the list goes on and so

Australian animal right?

Amalgam of multiple things that don't fit together and so when we named platypus we liked it as a metaphor because we see ourselves as doing something similar where we're kind of neither fish or fowl were glomming together a bunch of unconnected pieces to create what we think is a new and exciting opportunity. But the other thing about it is you know we're a scientific organisation and people like us we have this tendency sometimes to take ourselves a bit too seriously and so we kind of like it because it's whimsical and it's it's just really hard to look someone in the eye and say I worked at the Platypus Institute, seriously?

Yeah right.

It's like you know now that I've been through this whole entrepreneurial journey a bunch of times it's really important to me that we have fun. So you know I was telling you earlier we have a little stuffed platypus and every time we have company retreats we put the platypus up there in a leadership role so that we know kind of who we work for, you know.

Amazing.

It's fun, it's really fun. You know I have to tell you. I know you listen to the podcast with Andy Walsh. Yes. To prepare for this fascinating. And he's a really cool guy and when I started this I didn't think I would be able to get him because he didn't know me and I just cold called the guy and they said I'm starting this thing called the Platypus Institute. And he told and he's from Australia and he.

Wow cool.

And he took the call is because anyone who names themselves after an Australian animal is going to be.

I love it. And folks, Andy, he's in charge of all the amazing things that happen with Red Bull athletes and as David astutely put it in that episode. He teaches them how to fly and I'll provide a link to that episode something that you should definitely take a listen to. That's super interesting and congrats on getting him on the podcast.

It was phenomenal. I was so proud of him because I think I think he went a whole three minutes without swearing which for him was an accounting record.

That's awesome. So let's dive a little bit deeper David into the platypus Institute. What is it that you guys do. Why should the listeners be intrigued?

It'll take me a few minutes to answer that question. So let me start with what we do at a high level give you an example and then talk about what I think the implications are which is pretty big. So what we do for a living as you said in the introduction is we try to translate neuroscience research into practical applications to upgrade human performance and to upgrade the human experience. You know it's funny. Back when I started my first company I was at a conference in Silicon Valley and it was talking about the future of technology and I'll never forget there was this Silicon Valley investor a very famous accomplished guy who got up there and he said I predict that ten years from now mobile technology is going to be pervasive. It's going to effectively replace the computer. People are not only going to look at e-mails but they're going to be searching on the Internet they're going to use that to connect with each other not only through telephone calls and it's going to become a new mode of communicating. And I remember sitting in the audience just rolling my eyes and saying this will never happen. And even if it does one thing I'll tell you for sure is I'm not going to be one of those guys carrying a device like that around. You know. Of course now. Everything I do is through my iPhone. Right.

That's some foresight.

So I. It was amazing. Why is it that he and everybody you worked with knew that was going to happen while I I mean I ran a kind of a health care tech company that I had no idea. And the answer is he was in the middle of the science and he saw what was happening about it. He saw the implications, he saw the impact on consumers. And so for him it was blindingly obvious that this would soon become pervasive. Now the reason I tell you that story is that's where I am today with Applied Neuroscience. The fact of the matter is 10 years from now what I do is going to wind up being pervasive worldwide. That is people will be using neuro technology in a way that they are fundamentally rewiring and upgrading their brains and it's going to be pervasive like the internet and mobile phones simply because it is so incredibly powerful and it's a really kind of exciting place to be. So let me go back and tell you practically speaking what I'm talking about and I'll just tell you a case study about this. So I would imagine you might have you've heard of the notion of neuroplasticity?

Yes.

Right. So the history is when I went to medical school we were taught the adult brain is fixed right? That essentially after your kid your brain takes on a certain shape and then it just doesn't change. Now since that time neuroscience researchers have demonstrated that that conclusion is just completely wrong. Our brain is continually rewiring itself in response to stimuli. And so what it looks like today is very different than what it may look like a year from now or even a month from now and that rewiring happens throughout the lifetime so you can see that even in very elderly people. About 10 years ago neuroscientist started to ask the question well OK if the brain can be rewired can we do stuff to it to induce that rewiring that is to kind of make it go from point A to Point B? And so they said what can we do things like accelerating learning speeds where you're trying to learn a new language or you're trying to learn a new skill? Can you speed up the process and speed? Can you reduce cognitive decline that comes with aging and they started building a series of technologies in order to do that. So I'll give you the classic experiment which was done. And this is probably a dozen years ago. It was done out of DARPA which is the defense agency research program that does all the sort of secret stuff, they're the ones who did the original work for the Internet and so on. This was done by the chief science officer at Platypus Amy Cruz. And what she did and it was a pretty revolutionary study back then and she asked the question is there a difference in the brains of experts and novices and she studied a bunch of tasks and the one that was the most important to the military was shooting, and a shooting a gun. So she took a bunch of elite snipers. She put sensors on their head and on her chest and so on. And she looked up what happened when they took a perfect shot. And then she took a control group of people who didn't really know how to hold a gun. These were people who were just come into the military who were being taught and what she discovered and it was a big discovery is that there is a signature brain pattern associated with the lead shooting. That is you take the perfect shot your brain always looks the same. And that way your brain looks is radically different from the brain of somebody who's never shot. So it's a trained state. Yes. That comes through practice. She asked the second question which was even more exciting and she said, "OK now that I know what an expert brain looks like could I do something with technology to accelerate the process for people learning how to become expert snipers?" So she built what's called a neuro feedback paradigm and what she did is she just put a headset on somebody measured whether they were in the zone or not and then gave them feedback saying you're in the zone, you're not in the zone, you're in the zone you're not in the zone. And she did it in a whole bunch of ways she did it with haptic feedback where it would buzz on their body. She gave them visual feedback and what she found is she could radically accelerate the process for people to become experts snipers basically with an hour of training. She could get them 85 percent of the way there. And not only that she.

Impressive.

Experts and she could make them better snipers just by teaching them what they're like when they get a perfect shot so that they got much more consistent at it. This was a big deal. And so then you know that was the beginning. And since that point in laboratory settings. So people have done things like doubling the brain's processing speed, tripling learning speed for a many many things like language learning quadrupling memory dramatically reducing cognitive decline. And we're just beginning. And it's not all neurofeedback. There's a lot of techniques. But the bottom line is what we're doing is we're measuring what an optimal brain looks like and then using technology to induce rewiring to get the brain to that state. And the end result is we are now building I guess you'd call it the capability to rewire the human brain, to bring it up to levels of performance and experience that no one has ever conceived of. And that's actually just the beginning. We're also doing things where we're learning to connect brains to other brains connect brains to computers connect brains to the Internet of Things. So it's a very exciting world where in essence 20 years from now probably 10-20 years from now the experience of being human is going to be fundamentally altered because of neuroscience and neurotechnology what we're calling neuro performance technology.

Super fascinating David and there's no doubt that through the process you're definitely improving outcomes for the people that are there doing these things. You mentioned I read on your site that you're working in some examples include like peak performance athletes, elite Wall Street traders. You're helping them take their games to the next level. How is it that you're doing it right. I'm sure that audiences still left with the question of how what mechanisms are used?

So let's just talk about those two examples. So in athletics let's take basketball for example. I would give you two examples in basketball where neuroscience directly impacts people and by the way this is true in every athletic endeavor but it's different by sport. And so I'll give you the most obvious one. Think about free throw shooting.

Yes.

In NBA, you see some people who have free throw percentages in the low 90s, 91, 92, 93%. But you've got other really good basketball players who shoot 65 70 75 percent The same exact technology that was used to train snipers can be used to train free throws. It's exactly the same thing you get into a zone. You can teach yourself to get there. And through neuroscience, you can rewire people's brains so that you can you know I think pretty consistently take someone who's shooting 70 percent and get them into the low 80s. And if you think about the economic impact for a player or a team that's huge. That's actually a small example. Here's another one remember I told you you can accelerate the processing speed of a brain. Yes. It's the same thing as this processing speed of a computer. And there's different processing speeds. You process visual stuff and you process auditory stuff. But let's talk about visual stuff. If I take the worst NBA player out there, there are visual processing speed is about eight times as fast as mine. So when we test them they can see stuff. I can't even begin to see it's crazy

Really?

But I'll also tell you is the processing speed for the best people in the NBA is 32 times as fast as mine. Right. So there's a threefold difference. And then if you build a correlation analysis and you say what does that processing speed correlate in anything it turns out it correlates immensely with a number of points they score per minute is specifically assists and steals. So your ability to play in the NBA and generate assistance steals, number of assistance steals per minute is directly tied to the visual process and speed because you're just trying to anticipate where the ball is faster than someone else. Amazing. And so it's a right. I mean it sounds silly but athletes all know that mental capacity has a huge impact on performance. We can measure that. And so the fact is we know now here is a metric you know the same as body fat or heart rate that you can measure which is tied to performance and we can somewhere between 50 and 100 percent improvement in visual processing speed for any athlete and that translates directly into points. And so you can imagine if you're a professional athlete, you can't afford to not do this and what you're seeing is it's just starting to work its way in. But the best football players in the basket basketball players are now spending a bunch of their time during neurocognitive training because just like weightlifting are just like running. It's training their brain to allow them to be happy.

Yeah and you know one of the things to David thanks for walking us through that and if we take a look at the you know this is the athletic side of things and we take a look at for example in your in your analysis here you got the physical part but then you also have the neuro scientific part. The same is true when going to your primary care doctor on a yearly basis you go, you get a checkup. Why not go and get a mental health checkup. I think it's just as important and this should become more routine.

Yeah I think our belief is that ten years from now there are going to be probably five years from now, there'll be a set of brain vital signs which are standard in most medical offices. Right now, this stuff is still kind of laboratory based but there is I can't even tell you how much venture capital money is getting poured into this. And I think it's essentially inevitable that there is going to be very affordable rapid testing where most people are going to just have seven or eight key metrics about their brain measured.

That's exciting. I always had a sense.

I was actually just on the phone yesterday. I don't want to give his name because I don't know if he wants it but with you know let's say one of the most famous scientists in in neuroscience and he was talking about exactly that and we're very confident that that's going to be affordable. And when you look at research, what you will see is there's actually tremendous consumer appetite to have these brain Vital Signs measured. And so yeah, I think it's pretty much an inevitability that that that's evolving and that's why I'm saying this neuroscience is going to wind up being pervasive because once you can measure how your brain does, you're going to want to do it the same as if you're wearing a Fitbit and you're tracking your steps or you're tracking your heart rate.

Absolutely. Well I didn't mean to disrupt your train of thought here you were going to dive into the. The other example of Wall Street.

You want to go into that? Ok.

Yeah.

Now let me say you're asking me for specific examples but we could go through a bunch of them and I actually want to tell you about one more.

Sure.

Because it's just because it's so fun, I'm about to record a podcast about it. I'll tell you about the finance one quickly and then I'll then I'll save it for last. Well first of all when I talk about finance, I'm talking about Wall Street traders these are the people who work at the large hedge funds what are called portfolio managers and they are the ones sitting in front of a series of computer monitors making buy and sell decisions where every one of these decisions is worth you know a million dollars, 5 million dollars, 20 million dollars or so. Right.

Right.

So neuroscientists have done research where they've put sensors on these traders and asked the question, "Is there something I can measure about the brain that correlates with the profitability of an individual trade?" Right. Remember the sniper saying, "OK your brain looks like this, when you hit a shot it looks like that when you when you miss it". So it turns out that same thing appears to be true with portfolio managers that you can use neuroscience we believe to predict whether a trade is going to be profitable or not before the trade estimate. And it's really cool and appears to be really reproducible. And I'll walk you through the science it's actually very simple. It turns out that the key predictor of profitability for an individual trade is the amount of stress that's in the person's system. Now you may know when your nervous system is in a fight or flight mode right when you're really kind of stressed out. What happens is you have a lot of blood flow going to your muscles, you're pulling blood away from your brain and the part of your brain that is primarily deprived of blood and fuel is the frontal part what's called the prefrontal cortex where you do your executive thinking. So if a wall street trader gets into that fight or flight mode and they are lizard brain takes over that lizard brain which is really useful if you're in the woods getting attacked by an animal turns out to be very counterproductive.

Right.

And so in that scenario, you can actually use neuroscience to monitor your neurocognitive state and make sure you're in the zone when you're making trading decisions and it can also be used by the people who run the hedge funds to track how their individual traders are doing. And you know in Wall Street where it's all about trying to find an edge in where it's all about using cutting edge technology. This is a very hot area right there so.

Fascinating.

That's my second example but I want to tell you the third one that's here. So it turns out that another application area for what we do is in the world of sex. Have you ever heard of these people who have these like eight hour long tantric orgasms. You know like stag.

And you know what I actually haven't heard of the eight hours long huh.

Well it's apocryphal. Anyway I'm interviewing I think in a week some tantric practitioners. But it turns out, there's people who've spent decades learning how to experience ecstasy better than kind of your average person and appears. There's a measurable brain state associated with. So we believe we should be able to use neuroscience to train people to get there more quickly. Now, unlike Wall Street or sports I actually haven't done any market research confirming that there is a market appetite for it but we have this hypothesis that there may be a market opportunity in that arena as well.

Fascinating.

Yeah, it's very cool.

Your covering all areas David. And listeners, it's fascinating to think about this right. We've got to start thinking outside of the box and I really am intrigued and I'm sure that you are too with what David and his team are doing to make our experience here as humans that much better. David what would you say right now is one of the most exciting focused areas that you're working on?

I think the thing which is the most exciting is the fact that today we are at a point in history where this is science which is no longer going to be only in the laboratory, it's going to be able to make an impact on individuals. And the most gratifying thing for me is when I see it having an impact on people, when I see them reducing their stress. Becoming more happy, becoming more of who they are capable of being. It's just wonderful and I feel, I feel really fortunate to I think probably the only time in my life to be part of a new industry emerging. It's just a really cool thing so I think that's how I'll answer your question.

Now that's really great David and you know from the perspective of frontline physicians right we're sort of in a kind of a crisis let's call it what it is. Where you know physicians are committing suicide. There's burnout and I'm sure there's people listening to this thinking what is it that we could do with the Platypus Institute to help our frontline physicians. How would you answer that?

First of all let me say you could answer that question on two levels. There's a question about how applied neuroscience will effect healthcare itself. But I think you're really asking personally if I'm a doctor. How will neuroscience have an impact on the internet. I think the answer is burnout is a neurocognitive state right the same as being in the zone or having an orgasm it's it's just a thing that your brain does automatically. And right now it's a very challenging time to be a doctor. But you can rewire your brain so that you don't go to burnout so that in the face of a stress sore, you know something triggering you your body moves into a place of relaxation and ease rather than this fight or flight reaction that I was telling you about Wall Street. And so the alternative to that fight or flight reaction is this thing that we call the flow state where you actually relax where your your brain actually calms itself down you get more of what are called alpha and theta waves which are kind of associated with meditation. And in that case, your body is healthier but your productivity is actually higher than it is when you're operating from stress. And so I think what Applied Neuroscience or neuro performance technology will offer specific to that burnout issue is a way of rewiring the brain so you just don't go there. It just has an automatic behavior pattern. Your unconscious reaction to stress will be to relax rather than to tense up and it's going to make a huge difference on you know of health of people who learn that and productivity.

That's super fascinating.

It's very cool.

Yeah, if you've got questions about this, if you're curious I definitely recommend that you check out David's website. It's platypus.org, that's P L A T Y P U S dot org. Super fascinating work that's happening there and so David this has been a really fun discussion. I think what you've done is created curiosity in this realm of neuroscience and applied neuroscience and what it could do for us as health leaders and individuals. I'd love if you could just give us a closing thought and the best place for the listeners to get in touch?

You know I hate to say this because it sounds egocentric but I do think my story is relevant. The insight that our brains can be rewired I think is a really profound one. And so I think if I'm going to leave someone with a closing thought it would be this, "if you start paying attention to your automatic and unconscious behaviors with the understanding that those are neural patterns that can be changed. The process of becoming aware and trying to change them can have a very profound impact on your life" and that's what I would say and in terms of getting in touch with us as you said the website url is platypus.org. My email address is david@platypys.org. And I get a lot of e-mails but if you're right I will absolutely right back and you know the podcast we do. It's great. Not just you know not because of me but I get really cool guests and I have the opportunity to do interview. You know the world's best neuroscientists and Tantric Sex experts. So you know I feel like podcasts would be a privilege to have to listen to ours.

And now definitely a testament to that folks. The neuro fire podcast is fascinating. They're talking about big data. They're talking about hacking consciousness. Some really fascinating episodes and the guests that David brings on are just wonderful so.

And they're so cool.

They're so cool right?

I know. I think you feel how lucky I am.

Hey, and I feel the same way here you know at the outcomes rocket. We're just having folks like you David. It's just a privilege. And so folks check that out. All the things that we discussed. You're going to be able to find links to David's podcast neuro fire. You're going to be able to find the Platypus Institute website as well as a transcript of what we just discussed. Just go to outcomesrocket.health/platypus. That's P L A T Y P U S. Really excited to have you check that out. And David, I just want to give you a big thanks my friend. I'm looking forward to staying in touch.

Thank you so much.

Thanks for tuning in to the outcomes rocket podcast if you want the show notes, inspiration, transcripts and everything that we talked about on this episode. Just go to outcomesrocket.health. And again don't forget to check out the amazing healthcare Thinkathon where we can get together took form the blueprint for the future of healthcare. You can find more information on that and how to get involved in our theme which is "implementation is innovation". Just go to outcomesrocket.health/conference that's outcomesrocket.health/conference. Be one of the 200 that will participate. Looking forward to seeing you there.

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