Outcomes Rocket Podcast_Sam Ajizian: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Saul Marquez:
Hey everybody. Welcome back to the podcast. Saul Marquez here and I want to welcome you to the Outcomes Rocket here at ViVE in Nashville, Tennessee. We’re having some incredible discussions around the transformation of health care. And today I have a treat for you all. I’ve got the outstanding Dr. Sam Ajizian with us today. He’s the chief medical officer of Medtronic Patient Monitoring, Doctor Ajizian joined Medtronic in 2015. His first role was vice president of Medical Affairs for the Patient Monitoring and Recovery Business Unit. In this capacity, he oversaw safety issues for devices in the field and provided medical direction cross-functionally for product development, research, education and engagement of key opinion leaders globally. In 2018, he assumed direction of the MITG Medical Safety Office. In this role, he oversaw patient safety investigations, issue impact assessments and management of high-level safety and regulatory issues, supporting the medical device side. He’s just an extraordinary leader, understands patient needs, clinician needs and what consumers are looking for in health care. So, Sam, really a pleasure to have you here on the podcast.
Sam Ajizian:
Thanks, Saul. It’s great to be here. Thanks for the opportunity to share today.
Saul Marquez:
Absolutely. Now, yesterday you had participation in one of the panels where you guys discussed some of the relevant things around med devices. Do you care to share some of the insights that came out of that?
Sam Ajizian:
Yeah, absolutely. It was great to be able to hit this global audience here at ViVE in Nashville and proud to be part of the conference. And yesterday’s session was titled Taming Wild Device Data. And I thought about it and think of my career as an intensivist. We’ve got so much data coming at us continuously, which in one way makes our job easier, but it can also make it tougher as we have less providers around, we have sicker patients, and even outside of the ICU now the data has to be customized and has to be presented in a different way than we’re used to. So while there’s lots of data coming out, it’s not usable unless we package it in a way that large amounts of patients can be looked at quickly. And we use a little artificial intelligence there to kind of direct us where our eyes and efforts need to go first in sort of a triage way.
Saul Marquez:
That’s great. And there is a lot of information how we use it when we use it, what insights are derived out of them, and ultimately what actions can clinicians take is the question, right?
Sam Ajizian:
Right. And if you think historically, like my career over now almost 30 years, medicine is a reactive process inside the hospital, right? We tend to do really, really well at responding to alarms, and rushing in, and doing dramatic things with rapid response teams, Code Blue’s, and those are incredible skill sets that we’ll never not need in the hospital. I look forward to the next decade being the start of a renaissance in patient monitoring where we become a preventive type of specialty. And I think of patient monitoring really is a medical specialty, a medical discipline that with the right guidance and the input from medical leaders, from medical societies, from industry leaders and companies, we can come together and take this radar and put it out forward looking rather than reactive, make it preventive. Earlier interventions, the trend, moving care into the home where patients really want to be and shoring up the care inside the hospital. The first and foremost keep patients safe. But when they are having deterioration or even improvement, we respond earlier in that ramp and make differences accordingly.
Saul Marquez:
Yeah, I love your vision, Sam. And so how can we enable health care providers to make sense of all the data coming from different devices, wearables, because the vision is clear, but the pathway to there is not as clear?
Sam Ajizian:
That’s right. And it really is an old cliche business phrase, it’s a paradigm shift. It honestly is. And again, it’s going to involve multiple sources of input to generate educational content on the way high-level monitoring can occur and trend monitoring of vital signs in which the patient has their own control can be implemented on med surg wards, in hospital at home, and hospital to home spaces. And ultimately, as that data becomes more and more robust, departures within the patient’s own trend become the most meaningful thing not adherence to a specific number or range. So that concept really at the core is personalizing medicine, it’s personalizing care to where you normally live physiologically or pathophysiologically, depending on the case.
Saul Marquez:
So rather than following a number, you’re looking for trends. It’s exception based management.
Sam Ajizian:
It’s exception based management and the algorithm engineers will be a cornerstone in building these tools to help us evaluate trend departures and what they mean. You know, we’re looking at also developing clinical evidence around this strategy that supports its use, particularly inside the hospital and the general care floor or med surge ward environment, that actionable trends are there and can be picked up with simple, vital sign trending with wearable monitors rather than looking at vital signs the way we do now, which is intermittent snapshots four hours, if you’re lucky, most likely every six hours apart. Very difficult to ascertain the directionality of care.
Saul Marquez:
Yeah. Thanks, Doctor Ajizian. And so there’s the perspective that you mentioned, a shift in perspective, and we have to take those steps on the technology side as we’ve been talking about. But we also have to take those steps on the workflow side and care teams and care models. Do you care to speak to that?
Sam Ajizian:
Oh, yeah. Saul, this is a huge part of where we’re going in Medtronic. We want to be bringing solutions to the market that are based on three main principles. One is workflow improvement, and that includes workflow for the staff as well as the patients. We want to be putting out data that’s useful and it’s all got to be connected. It’s got to be connected to the IT ecosystem of that hospital or hospital system. So how do you do that? Well, first of all, you have to have a good form factor that patients are comfortable wearing, that’s easy to put on by nurses or patients themselves. It can stay on for an indefinite time, ideally weeks. They can shower with it on, they can move with it on things like that. So the human factors have to be right. The device has to sense the right parameters. And then of course, because it sits on the patient, the computing and the algorithm analysis occurs in the cloud. So you have a unique device-cloud relationship. And from the cloud, the connectivity part has to be moving that data into the EMR, not necessarily because clinicians will look at the EMR for trends. We think that there’s probably software solutions in between that are much more vital and active and can action AI. But because the EMR is the repository in the medical system for all of that data, it’s also used for billing, it’s used for quality purposes, et cetera. So data, workflow improvement, and connectivity are the foundational, the three legs of the stool you’ll need to do this kind of monitoring in the future.
Saul Marquez:
That’s great. Really appreciate that. And as everybody’s listening to ways that you too can operationalize these types of remote patient management solutions, it’s important to keep these three things top of mind. So thank you for sharing those, Sam.
Sam Ajizian:
Sure.
Saul Marquez:
From your perspective, as a former practicing physician and somebody in the device industry, what types of data are most important?
Sam Ajizian:
I think it’s really important to listen to our customers now. And those customers are not just physicians, they’re nurses, they’re respiratory therapists, and they’re patients. And I think what we’re hearing, the types of data they need are things that allow intervention earlier. Intervention can mean saving someone from an unplanned return visit to the ICU, it can mean no rapid response calls, it can mean getting them home earlier or it can mean bringing them into the hospital earlier. So the important thing is to be able to have tech that can be used across the medical spectrum, not just in one cohort of patients in one stage of their hospitalization journey. It’s really important to have tech that can be applied across preoperative phase, post operative phase, hospital at home, hospital to home. If you have that capability, then the data the customer needs can be customized very easily. So for example, if you’re a bone and joint surgeon doing lots of knee and hip replacement, it’s you’re probably worried about two things, mainly, post-operatively, a wound infection and is my patient ambulating and doing the physical therapy that they need. With the right technology that data can be given to the practitioners and they can get early alerts about key signals that may portend problems with those two areas. If you’re a heart failure doc and you run a heart failure clinic, then you’re going to be more worried about heart rate changes, respiratory rate changes, activity changes and things like that. And so we want to focus on having a platform that drives care for everyone in every phase of the hospitalization. That is really ambitious. But we have the plan, the strategy and the resources and most importantly, the people to get it done.
Saul Marquez:
That’s great, Sam. You know, just thinking through making the experience and that data that everybody receives curated to the specific metrics that they’re after, to get the outcome, which is health, right? And so as a cardiac surgeon, you’re looking for heart health that has an algorithm of things that you want. As a pulmonologist, there’s an algorithm of things that you want. And so what the company is doing is packaging it in such a way that is custom to the outcomes they’re looking.
Sam Ajizian:
That’s right. And when we look at partnerships like we have with companies like Bio IntelliSense and the ability for them to present the data that the sensors are picking up in a way that’s easily used by not only any specialists or any nurse, but anyone in that health care vertical is now brought into that care because it’s such an easy interface to understand and quickly assimilate. Now we have more people looking at data that can actually help make a decision that’s basic crew resource management principles. And that’s what we’re trying to do, is increase the participation capability of everyone in the health care vertical to be able to contribute to patient well-being.
Saul Marquez:
That’s fantastic. Well, Doctor Ajizian and I want to thank you for spending time with us today. What closing thoughts would you give to the listeners on this journey to make healthcare better?
Sam Ajizian:
Yeah, I think it’s a really exciting time to be in the patient monitoring field. We’re going to see our patients untethered, so less wires. We’re going to see data actioning interventions earlier in the deterioration and improvement process that will ultimately drive care quicker and actually move patients home and even keep them home, which is where every patient wants to be. Of course, we’re going to have patients in the hospital. We will have that covered for sure. But as we move care outside of the walls of the hospital to be able to provide an umbrella of safety and meaningful observation is an exciting part of everything we’re doing.
Saul Marquez:
That’s fantastic. Well, thank you for the closing thoughts. Folks, take action. And if you’re wondering how you could engage with Doctor Ajizian or any of the team at Medtronic, we’ll make sure to leave links to the website as well as ways, Sam, your LinkedIn profile.
Sam Ajizian:
Absolutely.
Saul Marquez:
Fantastic. We’ll link that up. We encourage collaboration and most importantly to take action.
Sam Ajizian:
Awesome.
Saul Marquez:
Thank you.
Sam Ajizian:
Thanks for the opportunity. Saul.
Saul Marquez:
It’s a pleasure to have you.
Sam Ajizian:
You too.
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