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

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: 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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