Rafael Grossmann, Surgeon & Healthcare Futurist

How this Surgeon is Leading the Charge in Digital Medicine and Augmented Intelligence with Rafael Grossmann, Surgeon and Healthcare Futurist

: [00:00:01] Welcome to the Outcomes Rocket podcast where we inspire collaborative thinking, improved outcomes and business success with today’s most successful and inspiring healthcare leaders and influencers. And now your host, Saul Marquez

Saul Marquez: [00:00:18] Outcomes Rocket listeners welcome back once again to the outcomes rocket podcast where we chat with today’s most inspiring and successful healthcare leaders. Really want to thank you for tuning in today. I invite you to go to our comes rocket dot com slash reviews where you could rate and review the show and let us know what you thought about today’s episode. Without further ado I want to introduce our outstanding guest. His name is Rafael J. Grossman. Dr. Grossman he is a surgeon. Speaker Ted x attendant and speaker exponential Medicine faculty. First Google Glass surgeon the guy has an amazing presence in the digital medicine field and he loves what he does as a practicing physician in general acute care trauma and advanced laparoscopic and robotic surgery. I want to introduce him and I want to open up the microphone so he could fill in any of the gaps of the introduction. Rafael welcome to the podcast.

Rafael Grossmann: [00:01:15] Thank you. So it’s a pleasure to be here and thank you for your kind introduction. It’s great to be here.

Saul Marquez: [00:01:22] You know it’s awesome to be here the first time that I saw your work. I was at Exponential medicine a couple of years ago. You were up on the stage and I could see the passion in your eyes and just in the way that you spoke about just using Google Glass but also digital medicine. So I want to ask you what got you in the medicine to begin with.

Rafael Grossmann: [00:01:42] My father is a surgeon but I don’t have too much to do about it I guess shaping my mind down to the level of high school of thought that medicine would be a profession for me the right profession for me I guess I don’t want to be too general but I guess helping people you know working with your hands and making a change that you can see those were things that are was attractive.

Saul Marquez: [00:02:09] Yeah no that’s that’s really interesting and you know it’s that heartstring element that gets a lot of us into it. I know that’s what sort of got me into it. Rafael but tell me you’re deep into the digital realm. What do you think a hot topic that should be on every medical leaders agenda today and how are you seeing it implemented.

Rafael Grossmann: [00:02:29] Well it’s a very interesting question and there’s so many things you know that we should be using and that we are not using. I mean we we all use computer we all use digital records. Most of us in the U.S. I think that certainly recommend a physician out there every aspiring physicians out there to really research the topic of health being you know from healthcare social media to be engaged culture social media to then things like. Apps things like the advent of virtual reality the advent of augmented reality things are going to change the way we do medicine nowadays you know more and more we use smart glasses more and more we don’t want a augmented or artificial intelligence being a helper medicine about robotics we talked about launching that AI and block chain are really going to revolutionize the way medicine is practiced in the next five years or less.

Saul Marquez: [00:03:35] Absolutely. I definitely love your perspective here and one of the things Dr. Grossman is the assumption that people make sometimes you know and I’m guilty of it too. The assumption of hey you know everybody knows what digital medicine is but I think you make a good point. If you’re a practicing physician or an aspiring practicing physician the research this area of digital medicine and I think it’ll blow your mind away and the other thing that you’ll see is that Dr. Grossman Raffael here is pretty deep into it and influencer in the space. And the other point that you made. As you said augmented intelligence which is awesome this concept that AI is taking over us but in reality it’s only helping us and you expand on that a little bit more.

Rafael Grossmann: [00:04:17] Yeah it’s sort of a terminology that has been catching up is not really artificial. It is but it’s really augmented in the actual. And this technology is not to create a parallel system or intelligence that will compete with us. And the same is for many things in digital health. I think that these tools are here to augment us to power to exponentially make us better so that I see very clearly that we human doctors can then it be more better. You want doctors and let the devices that she’s applied for use the artificial electronic glasses do what they do best which is you know counting. Remember in selecting a memorizing we are not as good as those systems to do this but we are very good and we should be even better on empathizing and being more human communicating with patients. Maybe wanted more time with each patient but we can certainly get better time with each patient you know computing will not be able to you know hold someone’s hands or cry when someone tries not to laugh with someone. Those are things that we are going to be allowed and enabled and empowered to do by you know some of the areas that are better for the computers to handle.

Saul Marquez: [00:05:35] I think that’s a really great call out Raphael and listeners there’s so much power behind Artificial Intelligence in medicine and it’s just being able to understand that without humans that care and health care cannot be provided health can you know you could spray health on people. But it’s that empathy that helps bring better outcomes to the table. Rafael give the listeners an example of how you have improved outcomes by introducing digital technologies and medicine in your practice.

Rafael Grossmann: [00:06:04] Well it’s hard to prove in a way you know improving outcomes. I haven’t done any formal studies in my clinical practice. Again many studies out there and some of them have been involved with in regards to validating oldest technologies to improve what we do and the factual sense in the personal level. I can see how the patients react. I can see how the patients understand better when I explain to them it with the help of an app or when I put some smart glasses on a patient and they can see a hologram of their heart beating for example when I show them on it I’m being watched you recently on a platform using this company any Myra’s and we have an arcade platform that is called Insight heart. When you show that to the patient on a smartphone the patient can go around the heart floating in the room and seen the heart beating irregularly. You can see how finally you know this little old lady understood you know what a dreadful relation means that she can get close and die inside the heart and see different. Those are things that are intuitively better and things that are sometimes hard to quantify what the improvement of the outcome I think is just a matter of improving connectivity and communication. Th that’s that’s the whole goal that automatically has to improve outcomes.

Saul Marquez: [00:07:26] Yeah. Rafael that’s a good color. Right. You know being able to communicate with their patients better is as pivotal to outcomes and why you haven’t done the studies in your practice per se. You’ve actually seen the spark in the eye or the acknowledgment of understanding that leads to better outcomes.

Rafael Grossmann: [00:07:44] Absolutely absolutely.

Saul Marquez: [00:07:45] That’s great. Give us an example of a time when you guys or you know your team or you have had a setback or failed. What did you learn from that moment.

Rafael Grossmann: [00:07:54] Well you know many times technology is fun when it works and that means you know technology can just tell you and leave you ground or some knew where to begin. Yes I’ll have to think back to you know just trying to show someone how cool a an app or a platform and suddenly you don’t have internet you know you can me on the Internet. So those are simple things that really prove the point. Wow. Sometimes things don’t go as smoothly as they should. And you know there are patients that interest you know patients who you know nothing to do with that with established or with a smartphone just draw it to the to model is not for everyone. Certainly something that is a tool that they can empower us to communicate better and to get to the patients and get the message through much much better.

Saul Marquez: [00:08:43] That’s really great. You know and this technology is not for everybody. And when you spend so much time on just trying to impact your patient and make sure that they’re better you just have to be flexible. And as you’ve had many years of experience Rafael in this field if you have to fast forward to the end of your career and you’re just the final day and what you do what would be the one thing that you want the health care realm to remember you by.

Rafael Grossmann: [00:09:12] Well I would say that my general idea and my you know motto I guess is that I am all about trying to use technology in a smart way to improve the way we do healthcare and we teach help to communicating and connecting better honestly might jump to fame I guess was the fact that I was the a surgeon who use Google Glass on the training surgery. Yes there was there and there was something very intuitively Don think much about it I just did you know that this cool head mounted camera would be really great to stream a surgeon from the perspective of my the students instead of being right behind me trying to see what I was seeing. They were just next to me you know sipping coffee and answering questions asking questions and having the front seat view of what I was doing. So I thought that that was a pretty simple way to use it but obviously it caught up and it went very very much exponentially viral and that’s sort of thing that brought me to before that I don’t know you know some text that talks that if we had used an touch back in 19 2011 when the iPhone 4 came out. The iPod Touch to do a teleconference in a basically a daily console for actual trauma. So that got me to do my first direct start to madnesses. But you know in general is my passion is using technology in a smart way to not fancy technology and that’s just common technology that sometimes has created gaming. You eventually save a life. So that’s sort of the whole concept.

Saul Marquez: [00:10:45] I think that’s wonderful Raffael and I think you definitely have left already. You’re still early into that early but mente career and you still have a lot of time ahead of you. You’ve already left the legacy. What are the things that you’ve done and it’s going to be exciting to see what you do ahead here when the years kind of take forward. I’m really excited to keep up with your work and what you’re doing. You do have a pretty cool social media presence. Listeners if you’re curious you could find Dr. Grossman and Twitter. It’s @ZGJR or he also has a website at RafaelGrossman.com that’s G R O S S M A N dot com. Take a look at what he’s up to. I think you’ll find it pretty intriguing and it’ll spark some thoughts. And I know Dr. Grossman always welcomes communication and chatting right.

Rafael Grossmann: [00:11:37] Absolutely. That’s the point to communicate and connect.

Saul Marquez: [00:11:40] Absolutely. So tell us about an exciting project that you’re working on today.

Rafael Grossmann: [00:11:45] While there are so many things really the scope of things so basically that I’m more focused than anything else. I’ve been working on a mixed reality know the fusion between virtual reality and augmented reality for a couple of years. I started using the Hollow Lands Microsoft holographic lenses for almost a couple years. I learned about those early on and then had the chance to try them very very early. When I was a judge in MIT tech had fallen on virtual reality and the people of case Western Reserve showed them to me and then really got engaged. So there was a couple of companies sort of that that I’ve been involved with and one of them and their medical adviser. One is called Ani Mares. Out of Germany to my view they are really the best NJT WEP illustrator’s out there and they do a lot of healthcare and they came up with this pollinates app called Insight heart and I happened to be in the hollow lands working on something and their appertain if I saw it and I thought it was interesting so try it in. It blew up my mind it was just a heart. Very very realistic anatomically correct hologram of a heart that I could manipulate and I could go around and open up. So immediately I give my grade review and I was the first user and the first reviewer of their app that caught their attention and then we connected and then after some time and basically interacting with them we’ve been having a great relationship and then make an advisory. So we started not just a show in this heart but I really wanted heart to be incorporated into in a way that meets reality seen in the way of opening up manipulating and moving it talking to it and then we started to connect this to censorship that we all were tractors and wearables whatnot. So we started thinking about well we need to see how this art can show not just a being a rate that the artist is giving it but your own heart rate until you started doing that. Yes equinoxes so that that was really pretty cool to see your own heartbeat and then a Arcand out a you know for the iOS 11 and they’ve been working very diligently. His kids are amazing. Connecting with Apple and Microsoft and a level that any company would just be jealous of. And they came out with inside hard market a module for the iPhone. And it’s unbelievable. Everyone should try this. It’s you know we sat nav that cost I don’t know a dollar or so but it’s really unbelievable you can do you can have a floating hologram hard. And it’s interactive you compare it with your Apple Watch you have an Apple Watch and you can see your own heart beating or your old rate and with them and you know it’s just fantastic is just exponential. Now there’s another company that how many of these devices and VDI VHS. It’s a Capalaba physicians a radiologist and a neurosurgeon and I met with them that I changed and they have a platform for hollow lens that is unbelievable. It’s a platform that really has a whole spectrum. It goes from teaching platform of teaching anatomy. And they also have a platform for the smartphone put in Holo Lens. They go from teaching platform to then a diagnostic platform where you can look at images in a holographic way and interact with them and dynamic way. See in medicine we look at x rays and we look at on flat screens you have 3-D images that we can manipulate on that flask is something different to see the air floating in front of you and you interact with that image and the other aspect is not just diagnostic is therapeutic. You can bring that image and superimpose that image on let’s say a patient and then basically potentially enabling a better surgical procedure. So this is all in the early stages. That’s the goal. You’re going to have these interactive holographic images superimposed in real anatomy and then you can improve what you do therapeutically so it goes from educational diagnostics to therapeutics. I think it’s unbelievable. I think it’s something that will certainly set the pace of how things are going to be done.

Saul Marquez: [00:15:55] It’s so so interesting Rafael and you know one of the things that you mention that going into close to 100 interviews now on the outcomes rocket there’s been common themes surfacing and one of the themes that just keeps coming up and hitting us in the head is this idea that in medicine innovation is not necessarily innovation but it’s actually implementation of things that already exist that are not being used in medicine. And these examples that you’re giving us are just awesome. And to the listeners whether you be a provider or an executive at a hospital or even even somebody at a medical device or pharma company or even a payer for that matter any stakeholder what is it that you can do to implement already existing technologies. Because it’s in that implementation that we’re going to get some interesting outcomes and able to kind of change the way we’re doing things and medicine would you agree, Rafael?

Rafael Grossmann: [00:16:49] 100 percent. No I think that it’s really a matter of thinking differently not and I quote Apple’s motto Nothing different. You have to think that you have to improve things. I mean you can imagine new things and that’s always good. But I think innovate really means disrupting the traditional production and using sometimes the technologies that are right in front of you to improve what you do. In this case will benefit you know use Skype all the time I’m from Venezuela called my family on video. So why not then call our provider hundred miles away or a patient hundred miles away who was in a way that doesn’t need to happen you know physically or you know you and I are connected by audio and video and this does not substitute the physical. This is just another tool to improve on what we do communicating and connecting.

Saul Marquez: [00:17:36] I love it. Now that’s so true. That is so true. Rafael you’re a teacher as well as a provider and an innovator. Let’s pretend you and I are building a medical leadership course on what it takes to be successful in medicine. It’s the 101 or the ABC of Dr. Raphael Grossman. So we’re going to write out a syllabus here. I’ve got four questions. Lightning round style so I’ll ask you give me some shoot shooting answers short and then we’ll finish with a book for the listeners. You ready for it.

Rafael Grossmann: [00:18:04] Absolutely.

Saul Marquez: [00:18:05] All right. What is the best way to improve healthcare outcomes.

Rafael Grossmann: [00:18:08] Using technology in a smart way.

Saul Marquez: [00:18:10] What is the biggest mistake or pitfall to avoid.

Rafael Grossmann: [00:18:13] Don’t assume anything.

Saul Marquez: [00:18:15] How do you stay relevant as an organization. Despite constant change.

Rafael Grossmann: [00:18:19] You have to think different and not risk failure.

Saul Marquez: [00:18:23] What is one area of focus that should drive everything else in your organization or practice.

Rafael Grossmann: [00:18:28] Looking to the future and having a vision of what the future is going to look like and not be shy to get there.

Saul Marquez: [00:18:34] Rafael what’s your all time favorite book that you’d recommend to the listeners.

Rafael Grossmann: [00:18:38] There’s so many have there. But I think that in healthcare innovation I have to say that Dr. tarballs but it’s really guided me created disruption of medicine and the patient. We’ll see you now those are two books that really shape but in medicine in general thing book by Atul Gawande is complications. You by Atul Gawande that when I read it many years ago I called my program director and told him this and every intern for a day or into should need to get these patients and for anyone who’s anyone related to healthcare.

Saul Marquez: [00:19:12] Awesome thank you for those recommendations. You know Atul Gawande has come up various times here in this section of the podcast so I think it’s time that the listeners if you haven’t read including myself I haven’t read any of his books. Time to pick one of those up because when the themes are there there’s a reason you know these health care leaders are providing us with some guidance. Please take a look at these books that Dr. Grossman offered. And don’t worry about writing them down. Go to outcomesrocket.health/Rafael that’s R A F A E L. You’re going to find all the show notes with the discussion that we just had today as well as this syllabus that we just put together for you. So dive on and their outcomesrocket.health/Rafael before we conclude Rafael I’d like to just invite you to share a closing thought with the listeners and then share the best place where they can get in touch with you.

Rafael Grossmann: [00:20:02] Yes absolutely. I want to just mention more when I said I said Do not risk failure I meant. Do not be afraid of failure. You know when you ask me those questions I think that my closing thoughts will be related to the message that will be entertaining. I think it knowledge is here to help us. We should not be afraid of technology. We should be afraid of not using technology in a smart way to do what we do as patients and as providers. I think that the future is really bright. He’s up to us that to happen and a communicator and the speaker more than anything else a provider of my passion are my patients and love to connect with people in the social media channels that you mention to them. My website is a non-commercial site that is an educational site. It lists everything I do and everything I learned that I think is interesting or posted there. I am always looking for opportunities to engage physically visually. Conferences to go to. I’ve been around the world and it’s always good to visit places and see what they’re doing and learn from people in different parts of the world. You know it’s just my honor and my blessing to be invited to do so.

Saul Marquez: [00:21:10] Rafael this is great and listeners just to remind you the Twitter handle is at @GJR and the website is Rafael Grossman with two S’s to https://www.rafaelgrossmann.com/. Visit him. Get in touch. Rafael you contained a lead the way here for providers and digital medicine. So really excited to keep up with what you’re up to and so thankful that you decided to join us this morning. Thank you so much.

Rafael Grossmann: [00:21:37] Thank you, Saul.

: [00:21:42] Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.com for the show notes, resources, inspiration and so much more.