From Audiology to AI: Sandie Dela Cruz on Healthcare's Digital Transformation

[00:00:01] [SPEAKER_01]: Welcome to the Chalk Talk Jim podcast, where we explore insights into healthcare that help

[00:00:08] [SPEAKER_01]: uncover new opportunities for growth and success.

[00:00:11] [SPEAKER_01]: I'm your host, Jim Jordan.

[00:00:18] [SPEAKER_01]: In today's episode, we're joined by Sandie Dela Cruz.

[00:00:21] [SPEAKER_01]: She's an innovator at the intersection of healthcare technology and medical devices.

[00:00:26] [SPEAKER_01]: She has a background in spanning audiology, corporate training, and now digital solutions.

[00:00:31] [SPEAKER_01]: Sandie brings a unique perspective of the evolving landscape of healthcare.

[00:00:35] [SPEAKER_01]: In this episode, we'll explore the transformative potential of AI medicine from improving physician

[00:00:41] [SPEAKER_01]: training through virtual reality simulations to revolutionizing patient diagnosis and

[00:00:47] [SPEAKER_01]: care.

[00:00:48] [SPEAKER_01]: Sandie shares insights on how digital tools can reshape medical affairs and bridge gaps

[00:00:53] [SPEAKER_01]: in healthcare access.

[00:00:55] [SPEAKER_01]: We'll also discuss the challenges and opportunities in adapting to rapid change

[00:00:59] [SPEAKER_01]: technology in the medical device industry.

[00:01:01] [SPEAKER_01]: So whether you're a healthcare professional, a tech enthusiast, or simply curious about

[00:01:05] [SPEAKER_01]: the future of medicine, this conversation offers valuable insights into the innovations

[00:01:11] [SPEAKER_01]: shaping patient care.

[00:01:13] [SPEAKER_01]: So Sandie, tell me in the audience a little bit more about yourself.

[00:01:18] [SPEAKER_00]: Being professional then moved into the corporate world into more operational excellence.

[00:01:25] [SPEAKER_00]: And with that is the exposure to digital solutions.

[00:01:31] [SPEAKER_00]: How I got into this is started off when I was in the Philippines.

[00:01:37] [SPEAKER_00]: When I was in high school, I think that was the advent and development of the internet

[00:01:41] [SPEAKER_00]: era.

[00:01:42] [SPEAKER_00]: I still remember the modern days.

[00:01:44] [SPEAKER_00]: And so that sparked my passion for digital solutions.

[00:01:49] [SPEAKER_00]: And with the combination of my passion also for Legos, the restorative process of just

[00:01:58] [SPEAKER_00]: looking at a process, how do we break that down and how can we be more efficient?

[00:02:02] [SPEAKER_00]: I already had that mentality some sort when I was young.

[00:02:07] [SPEAKER_00]: So that's how it evolved.

[00:02:09] [SPEAKER_00]: And then I moved into college, went into more of a scientific background.

[00:02:14] [SPEAKER_00]: My family is a distributor in the Philippines for hearing instruments and that's why I

[00:02:21] [SPEAKER_00]: came here in the U.S. to finish my doctorate in audiology.

[00:02:26] [SPEAKER_00]: Then I went into practice and found that I could provide better impact in training

[00:02:33] [SPEAKER_00]: in corporate world versus seeing patients because my passion is public speaking,

[00:02:40] [SPEAKER_00]: continued development.

[00:02:41] [SPEAKER_00]: And back then, the L&D space, it was still siloed amongst other corporate functions.

[00:02:51] [SPEAKER_00]: So I had the goal and task on how our L&D operations at least would merge with the

[00:03:00] [SPEAKER_00]: corporate commercial operations.

[00:03:03] [SPEAKER_01]: Yeah, that's our audience.

[00:03:04] [SPEAKER_01]: What's L&D?

[00:03:05] [SPEAKER_01]: Learning and Development.

[00:03:06] [SPEAKER_00]: Yeah, and so then that evolved into just learning about process, how to make it more

[00:03:15] [SPEAKER_00]: efficient.

[00:03:16] [SPEAKER_00]: I got exposed to different engineers.

[00:03:18] [SPEAKER_00]: They taught me the Lean Six Sigma process and looking at even that, so we were going

[00:03:26] [SPEAKER_00]: through different kaizen's.

[00:03:27] [SPEAKER_00]: I did not have any knowledge of that.

[00:03:29] [SPEAKER_00]: So I will honor my company for providing me all of that knowledge before.

[00:03:35] [SPEAKER_00]: So they provided me with all the tools necessary to evolve and grow.

[00:03:40] [SPEAKER_00]: I took that, I ran with it, and now I work for Edwards Life Sciences specifically

[00:03:46] [SPEAKER_00]: to look at what our current state is and how can we eliminate silos among

[00:03:52] [SPEAKER_00]: different groups?

[00:03:55] [SPEAKER_01]: So kaizen for our audience is a Japanese word for continuous improvement,

[00:03:59] [SPEAKER_01]: right?

[00:03:59] [SPEAKER_01]: So it's like a cultural attitude that overlays Lean and Six Sigma.

[00:04:06] [SPEAKER_01]: But you started out, I saw on your LinkedIn that you started out in Siemens.

[00:04:11] [SPEAKER_01]: So you started out in equipment.

[00:04:12] [SPEAKER_02]: Yeah.

[00:04:13] [SPEAKER_01]: And is that what gave you exposure to how the medical industry processes

[00:04:18] [SPEAKER_01]: things?

[00:04:18] [SPEAKER_01]: Because if you go back at that time, that was the entryway because

[00:04:22] [SPEAKER_01]: healthcare IT at that point in time was really oriented towards billing,

[00:04:26] [SPEAKER_01]: right?

[00:04:26] [SPEAKER_01]: It wasn't.

[00:04:27] [SPEAKER_00]: That was back in the 2000s.

[00:04:30] [SPEAKER_00]: I remember that.

[00:04:31] [SPEAKER_00]: I will tell you Siemens when I visited their factory, it was in Singapore back

[00:04:37] [SPEAKER_00]: then.

[00:04:37] [SPEAKER_00]: We were trying to replicate how they were doing things because we were going

[00:04:42] [SPEAKER_00]: to put a manufacturing company in the Philippines because the back and forth

[00:04:48] [SPEAKER_00]: of hearing aids from Singapore shipping to the Philippines was just

[00:04:54] [SPEAKER_00]: extremely expensive.

[00:04:55] [SPEAKER_00]: So my father tasked me to go to Singapore and stay there for three

[00:05:02] [SPEAKER_00]: months, be immersed in that process.

[00:05:04] [SPEAKER_00]: And it was truly amazing.

[00:05:07] [SPEAKER_00]: It was back again in 2000.

[00:05:09] [SPEAKER_00]: They had everything optimized down from how many minutes will it take for

[00:05:15] [SPEAKER_00]: this chip to go from this point to this point?

[00:05:18] [SPEAKER_00]: And there's already this place where efficiency where, okay, in this

[00:05:23] [SPEAKER_00]: amount of time, we're able to produce this amount of chips.

[00:05:26] [SPEAKER_00]: And I was able to even experience how to back then in 2000, they were

[00:05:32] [SPEAKER_00]: still using soldering irons to solder each chip to a wire function

[00:05:38] [SPEAKER_00]: of a hearing aid.

[00:05:40] [SPEAKER_00]: There was no AI.

[00:05:41] [SPEAKER_00]: It was still, there was some sort of AI component already in hearing aids,

[00:05:45] [SPEAKER_00]: which is sound classification, memories, the basic function of AI at least.

[00:05:51] [SPEAKER_00]: So not, it has evolved over time.

[00:05:55] [SPEAKER_00]: Right.

[00:05:55] [SPEAKER_00]: But AI has been present since the 1970s.

[00:06:00] [SPEAKER_01]: I think since you've introduced some words to the audience, I'd continue

[00:06:04] [SPEAKER_01]: with that.

[00:06:04] [SPEAKER_01]: So there's a before automation, they would have these tools and jigs

[00:06:09] [SPEAKER_01]: and fixtures and the Japanese will call them Pokey Oaks, right?

[00:06:12] [SPEAKER_01]: So they're full proofing devices.

[00:06:14] [SPEAKER_01]: And I think what's important from that experience is when you take it

[00:06:20] [SPEAKER_01]: to healthcare and you realize where healthcare is at and where these

[00:06:24] [SPEAKER_01]: manufacturers are at, even today, 20 years, 25 years later, there's

[00:06:29] [SPEAKER_01]: just such a gap.

[00:06:31] [SPEAKER_00]: There is such a gap, right?

[00:06:33] [SPEAKER_00]: I think it's because of the regulations associated also to the

[00:06:39] [SPEAKER_00]: healthcare industry, at least the one that encircles it.

[00:06:42] [SPEAKER_00]: There's limitations to at least the speed of how they can

[00:06:47] [SPEAKER_00]: implement things also.

[00:06:49] [SPEAKER_01]: And I think talking to my chief financial officer friends who work in hospitals,

[00:06:54] [SPEAKER_01]: it's more of a, they have their costs and big buckets.

[00:06:56] [SPEAKER_01]: It's very hard to get down to individual procedures.

[00:06:59] [SPEAKER_01]: Now at Edwards, what is your place in the continuum of healthcare?

[00:07:02] [SPEAKER_01]: What is it that you do for Edwards?

[00:07:04] [SPEAKER_01]: Because I think of them as catheters and equipment is my vision of

[00:07:09] [SPEAKER_01]: that.

[00:07:09] [SPEAKER_01]: Am I incorrect in that?

[00:07:10] [SPEAKER_00]: Edward's Life Sciences, now if you've heard about, it's

[00:07:14] [SPEAKER_00]: been in Wall Street, right?

[00:07:16] [SPEAKER_00]: We have already spun off one of our business unit, which is critical care

[00:07:21] [SPEAKER_00]: for us to concentrate on structural heart.

[00:07:26] [SPEAKER_00]: So now we have one main goal.

[00:07:27] [SPEAKER_00]: So it's, we'll be more on structural heart diseases and how Edwards can help

[00:07:32] [SPEAKER_00]: those people that have that condition.

[00:07:34] [SPEAKER_00]: And we can have a laser focus on that one.

[00:07:38] [SPEAKER_00]: So it will be heart valves.

[00:07:39] [SPEAKER_01]: Yeah.

[00:07:40] [SPEAKER_01]: I was going to ask you, what is structural heart?

[00:07:41] [SPEAKER_01]: You said it's heart valves.

[00:07:42] [SPEAKER_01]: What else is it?

[00:07:44] [SPEAKER_00]: So heart valves, anything that's really regards to the surgical component of it.

[00:07:49] [SPEAKER_00]: So now there's just basically two functions really at Edwards.

[00:07:54] [SPEAKER_00]: We have a company that's under the business units, that's for

[00:07:59] [SPEAKER_00]: trans catheter heart valves.

[00:08:02] [SPEAKER_00]: And we have another business unit for the mitral side of the valves.

[00:08:07] [SPEAKER_00]: Right?

[00:08:07] [SPEAKER_00]: So there, that's a different parts of the heart right there.

[00:08:11] [SPEAKER_00]: And then we have the surgical portion.

[00:08:14] [SPEAKER_00]: The surgical portion also helps on the surgical portion of structural heart diseases.

[00:08:20] [SPEAKER_00]: Yeah.

[00:08:20] [SPEAKER_00]: So that's at least the three main functions.

[00:08:23] [SPEAKER_00]: And then we have what we call our advanced technologies

[00:08:27] [SPEAKER_00]: where all the research is done.

[00:08:30] [SPEAKER_01]: So you're in the digital solutions and analytics group.

[00:08:33] [SPEAKER_01]: How does that fit within the continuum?

[00:08:35] [SPEAKER_00]: Yeah.

[00:08:36] [SPEAKER_00]: So I'm in sitting in medical affairs.

[00:08:38] [SPEAKER_01]: Okay.

[00:08:39] [SPEAKER_00]: So that's how we sit in the continuum is that we are in charge of physician

[00:08:45] [SPEAKER_00]: training, scientific communications, publication, investigational studies.

[00:08:51] [SPEAKER_00]: I'm part of that group.

[00:08:52] [SPEAKER_00]: I'm part also the group for the trans catheter heart valve group.

[00:08:58] [SPEAKER_00]: So specifically for those physicians or target, our target audience

[00:09:02] [SPEAKER_00]: is interventional cardiologists.

[00:09:06] [SPEAKER_01]: That's I grew up with interventional cardiology.

[00:09:08] [SPEAKER_01]: So what are the challenges that you have as you work with these folks?

[00:09:12] [SPEAKER_01]: Cause your medical affairs is got this sort of like between regulatory

[00:09:18] [SPEAKER_01]: and sales and marketing.

[00:09:19] [SPEAKER_01]: It's an interesting place, right?

[00:09:20] [SPEAKER_00]: Yes.

[00:09:21] [SPEAKER_00]: I would say you're definitely right.

[00:09:25] [SPEAKER_00]: And especially in the medical device space, medical

[00:09:29] [SPEAKER_00]: affairs is a new function.

[00:09:31] [SPEAKER_00]: In the pharma space, it's definitely much more mature.

[00:09:36] [SPEAKER_00]: Right.

[00:09:36] [SPEAKER_00]: You know what medical affairs is doing, but on the med device phase, at least

[00:09:41] [SPEAKER_00]: it has just been implemented recently.

[00:09:44] [SPEAKER_00]: So really our main goal is to be the function does not have any

[00:09:52] [SPEAKER_00]: commercial intention or at all.

[00:09:55] [SPEAKER_00]: Our intention is to disseminate scientific knowledge among the group.

[00:10:02] [SPEAKER_00]: So, so we keep in mind the regulatory purpose of things, right.

[00:10:07] [SPEAKER_00]: And the baseline, but at the same time, keeping in mind some of

[00:10:11] [SPEAKER_00]: the commercial components, but this is where it gets real tricky that

[00:10:15] [SPEAKER_00]: you need to have that hard line.

[00:10:18] [SPEAKER_00]: You can't have that mixture between sales and medical affairs.

[00:10:26] [SPEAKER_01]: Well, the same line is there for regulatory.

[00:10:28] [SPEAKER_01]: So I once mentioned to a gentleman in the big pharma company, he was

[00:10:32] [SPEAKER_01]: touring me through his medical affairs department that was sitting next to

[00:10:36] [SPEAKER_01]: his regulatory and I said, so what's the difference between these two?

[00:10:40] [SPEAKER_01]: And he said, this group is full of my PhDs and that 10 things to be black

[00:10:45] [SPEAKER_01]: and white, which is the regulations.

[00:10:47] [SPEAKER_01]: And then I have moments where the question is how important is this?

[00:10:51] [SPEAKER_01]: And so you think when doctors are triaging in an emergency room,

[00:10:55] [SPEAKER_01]: right, something's very important.

[00:10:57] [SPEAKER_01]: Something's less important.

[00:10:58] [SPEAKER_01]: We have time to discover, you need someone to be able to give that

[00:11:01] [SPEAKER_01]: judgment.

[00:11:01] [SPEAKER_01]: So Mike was always a good analogy for me.

[00:11:03] [SPEAKER_01]: That was my sense about the differences be between the functions.

[00:11:07] [SPEAKER_00]: That's definitely correct.

[00:11:08] [SPEAKER_00]: That that's on point.

[00:11:10] [SPEAKER_00]: And then I think a lot of people get confused of what medical

[00:11:13] [SPEAKER_00]: affairs is, but we have under us is a pool of talent or VP actually tells

[00:11:20] [SPEAKER_00]: us that we are the black seal team of the company because we are highly

[00:11:27] [SPEAKER_00]: specialized.

[00:11:28] [SPEAKER_00]: So we have decisions underneath as a PhD, biostat, our biostat team.

[00:11:35] [SPEAKER_00]: So every scientific paper that you see that goes through a process

[00:11:39] [SPEAKER_00]: within medical affairs that it gets thoroughly vetted, not only on the

[00:11:43] [SPEAKER_00]: regulatory side, but also on the medical affairs side, because we

[00:11:46] [SPEAKER_00]: want to look at the scientific landscape of interventional

[00:11:51] [SPEAKER_00]: cardiology and make sure we are providing value.

[00:11:55] [SPEAKER_01]: You mentioned devices.

[00:11:56] [SPEAKER_01]: It's a relatively new function.

[00:11:57] [SPEAKER_01]: Is it like 15, 20 years old?

[00:12:00] [SPEAKER_01]: Would you say?

[00:12:00] [SPEAKER_00]: For a med device, for to have medical affairs.

[00:12:03] [SPEAKER_01]: Yes.

[00:12:04] [SPEAKER_01]: So to not get company specific, but just a broader view of that

[00:12:07] [SPEAKER_01]: 20 year history, what has changed in that role in 20 years or what

[00:12:13] [SPEAKER_01]: sort of perspective or tools that are new to you that you didn't

[00:12:15] [SPEAKER_01]: have when you started?

[00:12:17] [SPEAKER_00]: I'll talk specifically to my experience, right?

[00:12:20] [SPEAKER_00]: I think what I've seen how medical medical affairs have evolved

[00:12:25] [SPEAKER_00]: through a medical device company is first it was solely focused.

[00:12:30] [SPEAKER_00]: Initially, it was solely focused on scientific papers and then it

[00:12:35] [SPEAKER_00]: grew to investigational studies.

[00:12:38] [SPEAKER_00]: Then it grew to physician training, but specific on opinion

[00:12:44] [SPEAKER_00]: leaders, key opinion leaders.

[00:12:47] [SPEAKER_00]: Then now it moved on to my group or my group, which is

[00:12:52] [SPEAKER_00]: operations and digital solution.

[00:12:54] [SPEAKER_00]: So this is how it has really evolved because one, we're now entering

[00:12:59] [SPEAKER_00]: the era of how can we have or how can we use digital tools to proliferate

[00:13:07] [SPEAKER_00]: our knowledge within the community?

[00:13:10] [SPEAKER_00]: Right.

[00:13:10] [SPEAKER_00]: If you've also seen our audience has changed.

[00:13:15] [SPEAKER_00]: So let's just take for example, the new fellows that are coming in now.

[00:13:21] [SPEAKER_00]: Scientifically, they get some of their information via papers, but they

[00:13:25] [SPEAKER_00]: like the easy access of Twitter and the digital opinion leaders providing

[00:13:31] [SPEAKER_00]: their information there because they can easily see it versus a paper of

[00:13:36] [SPEAKER_00]: how many pages and they only have some time to read about it.

[00:13:40] [SPEAKER_00]: So what does the opinion leader say about it?

[00:13:43] [SPEAKER_00]: And let me see if I'm interested about it versus back then we didn't

[00:13:47] [SPEAKER_00]: have digital opinion leaders, right?

[00:13:49] [SPEAKER_00]: It was mostly like papers, podiums, those kinds of things and discussions.

[00:13:55] [SPEAKER_01]: And now I'm aging myself.

[00:13:56] [SPEAKER_01]: So because you didn't have a digital solution to go to, you would also

[00:14:00] [SPEAKER_01]: train your sales reps and certain people to cover regions should you

[00:14:03] [SPEAKER_01]: have an issue.

[00:14:04] [SPEAKER_01]: So I remember my father being slightly horrified early in my

[00:14:08] [SPEAKER_01]: career that I had a pager and you'd actually call into the OR if

[00:14:12] [SPEAKER_01]: you had like a vena cavers filter slip and the doctor, but you try

[00:14:16] [SPEAKER_01]: to educate and say that these companies that design these things are

[00:14:22] [SPEAKER_01]: actually the best in class, right?

[00:14:24] [SPEAKER_01]: They're educated and they've got to get that education out there.

[00:14:27] [SPEAKER_01]: So now with digital solutions, is this an opportunity for you to know

[00:14:35] [SPEAKER_01]: that there's no confusion in the communication on a situation to a

[00:14:40] [SPEAKER_01]: customer, meaning that I'm assuming you're starting to roll AI into

[00:14:44] [SPEAKER_01]: this in some form or another.

[00:14:46] [SPEAKER_00]: Yes, I would say specifically to generative AI, our company is in

[00:14:53] [SPEAKER_00]: the stages of writing policies around that.

[00:14:59] [SPEAKER_00]: As I've said, like AI has been used by many of the industries already.

[00:15:04] [SPEAKER_00]: Some there's automations already process automations.

[00:15:07] [SPEAKER_00]: So that has been, our company has been using that, but generative AI,

[00:15:11] [SPEAKER_00]: I think that's where we see a lot of value and we actually have an AI

[00:15:16] [SPEAKER_00]: and data strategy team specifically sitting in the commercial side.

[00:15:23] [SPEAKER_00]: So how can we provide tools for our physicians to better

[00:15:28] [SPEAKER_00]: evaluate certain things?

[00:15:30] [SPEAKER_00]: So we work with Echo, Echoes, right?

[00:15:33] [SPEAKER_00]: Echo cardiograms.

[00:15:34] [SPEAKER_00]: And just say, I think you've seen this and it's been posted to a

[00:15:41] [SPEAKER_00]: of the identifications of certain diseases and AI would just take a look at it.

[00:15:47] [SPEAKER_00]: And now how can we just have a physician take a look at it, review it.

[00:15:52] [SPEAKER_00]: And that, that eliminates a lot of lag time.

[00:15:55] [SPEAKER_00]: It also eliminates just the amount of time that a physician needs to

[00:15:59] [SPEAKER_00]: look at it, because you have to remember for one physician, how many

[00:16:02] [SPEAKER_00]: things one day they are already seeing patients second, then you have all

[00:16:08] [SPEAKER_00]: these readings that you want this person who has expertise in this disease to

[00:16:12] [SPEAKER_00]: read it because their peers need their expert consultation.

[00:16:18] [SPEAKER_00]: They can't just read it in 24 hours.

[00:16:21] [SPEAKER_00]: Usually it takes three, five days of turnaround time.

[00:16:24] [SPEAKER_00]: And with the use of AI, I think this is where we're trying to look at.

[00:16:28] [SPEAKER_00]: How can we let or not eliminate, but just minimize that gap.

[00:16:32] [SPEAKER_01]: Could you define generative AI for our audience?

[00:16:35] [SPEAKER_00]: Yeah.

[00:16:35] [SPEAKER_00]: You've seen, I think chat GPT, Claude, Bard, all of that's a form of generative AI.

[00:16:46] [SPEAKER_00]: Anything that generates from GPT is called pre-trained, right?

[00:16:51] [SPEAKER_00]: Generative pre-trained function already.

[00:16:54] [SPEAKER_00]: You have a set the database that you have.

[00:16:57] [SPEAKER_00]: And then if you ask a question, the AI will try to parse through all

[00:17:04] [SPEAKER_00]: knowledge that they have and create an output for you based on the questions

[00:17:09] [SPEAKER_00]: that you've, the questions or question you answered.

[00:17:12] [SPEAKER_01]: That's interesting.

[00:17:13] [SPEAKER_01]: There's a company I know about.

[00:17:14] [SPEAKER_01]: You might know about it.

[00:17:15] [SPEAKER_01]: It seems I'm a core and they are focusing on hemodynamic ultrasound

[00:17:21] [SPEAKER_01]: for understanding how you treat people with fluid issues and heart issues.

[00:17:26] [SPEAKER_01]: And when you realize there's three or four things that are, that you

[00:17:29] [SPEAKER_01]: move around that are dynamic, but we've actually haven't measured it today.

[00:17:32] [SPEAKER_01]: What we're doing is looking at the flow coming out of the heart and trying to

[00:17:35] [SPEAKER_01]: make the best decisions we can.

[00:17:36] [SPEAKER_01]: And it seems to me that these are the types of things that AI can start

[00:17:42] [SPEAKER_01]: enabling so that people can act quicker.

[00:17:44] [SPEAKER_01]: And I imagine that part of the importance of this technology and

[00:17:48] [SPEAKER_01]: this approach for your company is that you can't have your professional,

[00:17:52] [SPEAKER_01]: your clinical and your sales or people everywhere, right?

[00:17:54] [SPEAKER_01]: So we've got physician shortages coming up.

[00:17:57] [SPEAKER_01]: We have issues in rural health.

[00:17:59] [SPEAKER_01]: These technologies have a lot of value.

[00:18:01] [SPEAKER_01]: So where are you guys in the AI approach?

[00:18:06] [SPEAKER_00]: We are definitely steady.

[00:18:08] [SPEAKER_00]: We're, we have a research team for it to where it is.

[00:18:13] [SPEAKER_00]: I cannot really divulge that, but what I can say is we're working very hard

[00:18:20] [SPEAKER_00]: to make sure that see here's the gap.

[00:18:23] [SPEAKER_00]: I will tell you in the general landscape because I, this is close to my

[00:18:27] [SPEAKER_00]: heart because I actually have a neighbor that's close to me that just

[00:18:33] [SPEAKER_00]: recently passed from heart disease.

[00:18:37] [SPEAKER_00]: It could have been prevented.

[00:18:40] [SPEAKER_00]: The problem is it was already too late when he saw the physician.

[00:18:46] [SPEAKER_00]: The problem with heart disease is sometimes you think you're

[00:18:49] [SPEAKER_00]: just breathing heavily, oh, it's just old age.

[00:18:52] [SPEAKER_00]: I'm getting older.

[00:18:54] [SPEAKER_00]: And then so you don't go to the doctor.

[00:18:56] [SPEAKER_00]: And so you just like, you would climb a number of steps and you're like,

[00:19:01] [SPEAKER_00]: and you just think, oh, I'm just tired.

[00:19:04] [SPEAKER_00]: You don't get your heart check.

[00:19:06] [SPEAKER_00]: So that's where the gap is.

[00:19:09] [SPEAKER_00]: So if you look at our physical, like our yearly physicals, Kaiser, I will

[00:19:14] [SPEAKER_00]: tell you has the best closed loop system.

[00:19:18] [SPEAKER_01]: They do absolutely couldn't agree more.

[00:19:21] [SPEAKER_00]: Exactly.

[00:19:22] [SPEAKER_00]: If you go to a private professional, I think that's where the gap is.

[00:19:25] [SPEAKER_00]: That one, okay.

[00:19:26] [SPEAKER_00]: You get tested by your primary care physician.

[00:19:29] [SPEAKER_00]: I'm breathing heavily.

[00:19:30] [SPEAKER_00]: I'm having trouble and they will just take a look at it.

[00:19:33] [SPEAKER_00]: They'll give you, okay, see this physician.

[00:19:36] [SPEAKER_00]: You might or you might not see that position.

[00:19:39] [SPEAKER_00]: That's a problem.

[00:19:40] [SPEAKER_00]: And now where would that patient go afterwards?

[00:19:43] [SPEAKER_00]: That's the, it's a drop off.

[00:19:45] [SPEAKER_00]: No one follow up on them on the next visit.

[00:19:50] [SPEAKER_00]: Maybe they will be to visit their primary care physician again, or maybe

[00:19:53] [SPEAKER_00]: they'll go to another one.

[00:19:54] [SPEAKER_00]: That's another issue right there.

[00:19:57] [SPEAKER_01]: It's funny you say this, I'm involved in this company called treat space.

[00:20:00] [SPEAKER_01]: It started out literally it's a beautiful sad story also like everything

[00:20:05] [SPEAKER_01]: we do is personal, but I had a, the president of it was actually ran an ad

[00:20:09] [SPEAKER_01]: agency and he looked next door to this person who had a brain tumor and

[00:20:14] [SPEAKER_01]: his name was Adam and, and he goes on to tell the story that Adam says to

[00:20:19] [SPEAKER_01]: him, I can go on Facebook and find out who my last girlfriend's dating,

[00:20:22] [SPEAKER_01]: but I can't find a doctor with this particular brain cancer that I'm involved in.

[00:20:26] [SPEAKER_01]: And so he started this company and part of it, the company ended up

[00:20:30] [SPEAKER_01]: morphing into this referral management closed loop system.

[00:20:34] [SPEAKER_01]: And what's shocking is I go to my primary care physician.

[00:20:39] [SPEAKER_01]: They say, go see this cardiologist, this oncologist, whatever it is.

[00:20:42] [SPEAKER_01]: And there's no followup.

[00:20:43] [SPEAKER_01]: And this is where Kaiser is dogged at, right?

[00:20:46] [SPEAKER_01]: Making sure that it's a closed loop, but most systems aren't that way.

[00:20:49] [SPEAKER_01]: And not only has he solved the problem with this data, he started this process

[00:20:54] [SPEAKER_01]: before MIPS, which for the audience is a value based bonus for physicians.

[00:21:00] [SPEAKER_01]: And it's about how do you track that your patients, well, they

[00:21:04] [SPEAKER_01]: didn't have a method to track.

[00:21:05] [SPEAKER_01]: So now that they have this method, he can actually tell you that

[00:21:08] [SPEAKER_01]: the perceived great doctors in the area actually don't have great

[00:21:12] [SPEAKER_01]: followups and that some of the smaller doctors are absolutely amazing.

[00:21:17] [SPEAKER_01]: And then when they start showing the data to these physicians, they're

[00:21:21] [SPEAKER_01]: unaware that their practice is behaving this way.

[00:21:24] [SPEAKER_01]: So I think this is absolutely critical.

[00:21:27] [SPEAKER_01]: So where do you see this technology solving this problem

[00:21:32] [SPEAKER_01]: of your neighbor in the future?

[00:21:35] [SPEAKER_00]: I think one with a system that you have, I think if we can also

[00:21:41] [SPEAKER_00]: have standard practices or best practices or standard metrics for

[00:21:47] [SPEAKER_00]: you have to remember cardiology is a big space.

[00:21:50] [SPEAKER_00]: So you can go to a general cardiologist.

[00:21:52] [SPEAKER_00]: There's a difference of how they see things from mild, moderate, severe, right?

[00:21:58] [SPEAKER_00]: You might have something mild right now and then they won't refer you

[00:22:02] [SPEAKER_00]: and they'll say, oh, we'll just follow up.

[00:22:05] [SPEAKER_00]: And then the patient does not follow up.

[00:22:07] [SPEAKER_00]: And as you said, I think fixing with this technology, what I think there

[00:22:11] [SPEAKER_00]: should be a technology where there's a lack of education about one, the

[00:22:16] [SPEAKER_00]: current disease state that you have and where it could lead to if

[00:22:20] [SPEAKER_00]: you don't even do things.

[00:22:23] [SPEAKER_00]: They don't know that.

[00:22:24] [SPEAKER_00]: They don't know that my neighbor did not know that this would happen.

[00:22:27] [SPEAKER_00]: He was young.

[00:22:28] [SPEAKER_00]: He was only 60 years old, long life to live.

[00:22:34] [SPEAKER_00]: But because he first saw his physician five years ago, COVID

[00:22:40] [SPEAKER_00]: happened, did not follow up.

[00:22:44] [SPEAKER_00]: A year ago just started to have fainting spells.

[00:22:49] [SPEAKER_00]: And now when he visited the physician, it's now too late

[00:22:53] [SPEAKER_00]: to even put in a heart valve.

[00:22:55] [SPEAKER_01]: So it strikes me and both of us has been in a lot of ORs over the years

[00:23:00] [SPEAKER_01]: and a lot of cath labs and talking to patients and it strikes me that so

[00:23:04] [SPEAKER_01]: many people think that when I cross that line, whatever that line is

[00:23:07] [SPEAKER_01]: stage renal disease, diabetes, whatever it is that I can get back over the line.

[00:23:12] [SPEAKER_01]: So I won't worry about it till I cross the line.

[00:23:14] [SPEAKER_01]: And I think these educational programs and the ability to start connecting

[00:23:21] [SPEAKER_01]: they call it a real time healthcare system, which is a big vision that we

[00:23:25] [SPEAKER_01]: probably won't see for a long time, but how can we connect our phones

[00:23:28] [SPEAKER_01]: and our watches and our pulses and our oxes and see all these things

[00:23:31] [SPEAKER_01]: and find the drift early and change it.

[00:23:35] [SPEAKER_01]: And there's a lot of education to go with that, but it's also from

[00:23:39] [SPEAKER_01]: an equality equity perspective.

[00:23:42] [SPEAKER_01]: Not a lot of people can afford the Apple watch or afford with scale that

[00:23:45] [SPEAKER_01]: connects so we haven't quite yet as a healthcare system recognize

[00:23:50] [SPEAKER_01]: that there may be value today.

[00:23:53] [SPEAKER_01]: We see it as an expense, but there may be value to including these in the future.

[00:23:58] [SPEAKER_01]: So you've had a lot of change in your life and in your career.

[00:24:01] [SPEAKER_01]: So can you share with you on this?

[00:24:02] [SPEAKER_01]: Maybe a time where you had to adapt or shift quickly and strategically

[00:24:06] [SPEAKER_01]: to get to where you're at now.

[00:24:08] [SPEAKER_00]: Yeah, I, my background in the Philippines initially was actually optometry

[00:24:15] [SPEAKER_01]: because my, I'm like, how did audiology?

[00:24:18] [SPEAKER_00]: Oh, well, I'll tell you.

[00:24:20] [SPEAKER_00]: So my father, again, we, my father had this business already,

[00:24:23] [SPEAKER_00]: audiology business since in the eighties.

[00:24:26] [SPEAKER_00]: And so he had two daughters.

[00:24:29] [SPEAKER_00]: So the plan was one would be in the vision and the other one would

[00:24:34] [SPEAKER_00]: be on the ENT space.

[00:24:35] [SPEAKER_00]: My sister pursued that ENT space all the way through.

[00:24:39] [SPEAKER_00]: So he's now, she's now an ENT surgeon taking over my dad's practice.

[00:24:44] [SPEAKER_00]: I'm supposed to be an optometrist in ophthalmology

[00:24:46] [SPEAKER_00]: and we merge our practice together.

[00:24:49] [SPEAKER_00]: In Europe, they're merging vision and hearing, right?

[00:24:52] [SPEAKER_01]: I did not know that actually.

[00:24:54] [SPEAKER_00]: In Europe, they're doing that.

[00:24:55] [SPEAKER_00]: So my father had that vision to bring that in Asia and for, at

[00:25:00] [SPEAKER_00]: least in the Philippines.

[00:25:02] [SPEAKER_00]: And when I went to pre-med, I was like, this is not for me.

[00:25:07] [SPEAKER_00]: Again, as a young kid, I always knew I was designing my dad's

[00:25:12] [SPEAKER_00]: website back then when you needed to code and there was no

[00:25:16] [SPEAKER_00]: chat GPT to copy and paste code.

[00:25:18] [SPEAKER_00]: I had to learn how to code by myself, by myself, old school way.

[00:25:23] [SPEAKER_00]: And so this is what's my passion, but I guess again, with education, right?

[00:25:28] [SPEAKER_00]: In the Philippines that's not seen as if you're not a doctor, a lawyer, or some

[00:25:33] [SPEAKER_00]: of that, that medical field, you're not successful.

[00:25:36] [SPEAKER_00]: I went that route because I did not know any better.

[00:25:39] [SPEAKER_00]: Again, I was 17 years old going into college and I don't know what to do.

[00:25:44] [SPEAKER_00]: My parents decided for me and I'm like, okay, I'm happy to take it.

[00:25:47] [SPEAKER_00]: Went through it.

[00:25:48] [SPEAKER_00]: And again, college life was just all about having fun.

[00:25:51] [SPEAKER_00]: I loved it.

[00:25:52] [SPEAKER_00]: But then when it's time to become a physician, I just, I was very

[00:25:59] [SPEAKER_00]: squeamish on blood and I could not.

[00:26:03] [SPEAKER_00]: Like I was fainting every time there was a cadaver.

[00:26:06] [SPEAKER_00]: I'm like, this is not for me.

[00:26:09] [SPEAKER_00]: I have to do something else.

[00:26:10] [SPEAKER_00]: So my dad told me, why don't you take up audiology?

[00:26:13] [SPEAKER_00]: I think you would be a great add-on to our business and you can help out.

[00:26:17] [SPEAKER_00]: And you know what?

[00:26:18] [SPEAKER_00]: I started helping him out in business.

[00:26:20] [SPEAKER_00]: So we started out with three clinics and now it's into 20.

[00:26:24] [SPEAKER_00]: We have over 20 clinics back home.

[00:26:27] [SPEAKER_00]: So I helped build definitely my sister and my dad continue is

[00:26:31] [SPEAKER_00]: continuing that process now.

[00:26:34] [SPEAKER_00]: However, well this actually, I was supposed to go back to the

[00:26:37] [SPEAKER_00]: Philippines, but I met my husband here in the U S so I went into corporate world.

[00:26:44] [SPEAKER_00]: Yeah.

[00:26:44] [SPEAKER_00]: I went into training and that's where actually I saw my passion

[00:26:48] [SPEAKER_00]: because you would think training does not have a lot of technology, but I

[00:26:52] [SPEAKER_00]: had an amazing manager.

[00:26:55] [SPEAKER_00]: She allowed me to explore the bounds of training and development where

[00:27:00] [SPEAKER_00]: use every digital technology you can possible.

[00:27:05] [SPEAKER_00]: So back then when e-learning wasn't even big, we were already

[00:27:09] [SPEAKER_00]: exploring e-learning when back then we were visiting physicians.

[00:27:15] [SPEAKER_00]: I was already implementing virtual engagement with them using

[00:27:20] [SPEAKER_00]: Calendly as a tool and Calendly wasn't even a big thing back then.

[00:27:26] [SPEAKER_00]: Using avatars recently, avatars if you know some of the companies.

[00:27:31] [SPEAKER_00]: I was using that when one of the companies was still in their B series funding.

[00:27:37] [SPEAKER_00]: So very early on I'm that kind of person that I tend to look at

[00:27:41] [SPEAKER_00]: and see how can I implement this to be much more efficient for me and for my team.

[00:27:48] [SPEAKER_00]: And I think that's how you evolve as a person.

[00:27:50] [SPEAKER_00]: I think now I'm so excited actually with all of the generative AI coming out,

[00:27:57] [SPEAKER_00]: just the knowledge within our fingertips.

[00:28:00] [SPEAKER_00]: And when you're seeing all, I think this is where we can solve this because

[00:28:04] [SPEAKER_00]: one, I don't know if you've listened to Google's showing the latest

[00:28:10] [SPEAKER_00]: development of using one of the ophthalmology tool to detect heart

[00:28:17] [SPEAKER_00]: disease early on and you were talking about connectivity and all of that.

[00:28:23] [SPEAKER_00]: And I was thinking also, if you look at Apple, they have so much data on us.

[00:28:29] [SPEAKER_00]: Just if you can connect all that.

[00:28:31] [SPEAKER_00]: I'm also like, I went into genetic testing for myself as I can see the

[00:28:38] [SPEAKER_00]: customization of pharmaceutical and I just found out that my father was

[00:28:43] [SPEAKER_00]: actually taking this drug and genetically, at least for me, this drug

[00:28:48] [SPEAKER_00]: wasn't like it would not be effective for me.

[00:28:51] [SPEAKER_00]: So I think if my dad had a genetic test, this drug would not even

[00:28:56] [SPEAKER_00]: be effective for him at all.

[00:28:57] [SPEAKER_00]: It's for heart disease also.

[00:28:59] [SPEAKER_00]: And so I was like, wow.

[00:29:01] [SPEAKER_00]: See even that alone.

[00:29:03] [SPEAKER_01]: Oh, it's, it's so interesting because I break down AI into

[00:29:07] [SPEAKER_01]: this is sufficiency component of it and operational excellence, which I

[00:29:12] [SPEAKER_01]: think is the low fruit because nobody dies from that if it goes wrong.

[00:29:16] [SPEAKER_01]: And then we have the insight wisdom.

[00:29:18] [SPEAKER_01]: Right?

[00:29:18] [SPEAKER_01]: The, the insight is I'm looking at a patient that got these issues

[00:29:22] [SPEAKER_01]: and one in 100,000 could have this situation.

[00:29:26] [SPEAKER_01]: It doesn't come up on your triage list.

[00:29:27] [SPEAKER_01]: Right?

[00:29:27] [SPEAKER_01]: So it's a good, it's a really good reminder.

[00:29:30] [SPEAKER_01]: And I also think it's great in a crisis for like emergency rooms to

[00:29:33] [SPEAKER_01]: remember that you might've skipped something or something like that.

[00:29:36] [SPEAKER_01]: But those I think are going to be a ways off.

[00:29:40] [SPEAKER_01]: I think we're going to do the efficiency and then been involved

[00:29:43] [SPEAKER_01]: in robotics and stuff like that.

[00:29:44] [SPEAKER_01]: That's very, I call that closed loop in the O R it doesn't really

[00:29:48] [SPEAKER_01]: go outside of the O R so you don't worry about privacy and security.

[00:29:53] [SPEAKER_01]: Cause it's all capped there.

[00:29:54] [SPEAKER_01]: But how are you keeping current on all these technical changes?

[00:29:58] [SPEAKER_01]: Because this you were trained one way and then there's an adult education

[00:30:02] [SPEAKER_01]: piece and I'm going to forget the regulation from the FDA, but on

[00:30:06] [SPEAKER_01]: medical devices, I'm going to say 10 years ago, they basically had you

[00:30:10] [SPEAKER_01]: take your device and your equipment and you had to actually test.

[00:30:14] [SPEAKER_01]: So you'd work with people on day one and they'd come in on day two

[00:30:17] [SPEAKER_01]: and they'd have to run the equipment and test the intuitive nature

[00:30:21] [SPEAKER_01]: of the buttons and everything.

[00:30:22] [SPEAKER_01]: And that wasn't there 20 years ago.

[00:30:24] [SPEAKER_01]: So that's all evolving.

[00:30:26] [SPEAKER_01]: But now as we're learning human AI interface, that's

[00:30:31] [SPEAKER_01]: like cutting edge stuff.

[00:30:32] [SPEAKER_01]: So how are you keeping current on all that?

[00:30:34] [SPEAKER_00]: Again, I think ever since back then this was something a passion of mine.

[00:30:39] [SPEAKER_00]: I'm always been technology driven.

[00:30:41] [SPEAKER_00]: I just attend Nvidia as their health conference.

[00:30:45] [SPEAKER_00]: I attend, there's amazing individuals there and believe me the

[00:30:48] [SPEAKER_00]: presentations that see what could be possible for healthcare.

[00:30:54] [SPEAKER_00]: Diagnosis, prognosis, everything that they're presenting right now on paper.

[00:30:59] [SPEAKER_00]: I'm just fascinated with it.

[00:31:01] [SPEAKER_00]: And I can see application.

[00:31:04] [SPEAKER_00]: I've always done this where I'm like, okay, this could be applied.

[00:31:07] [SPEAKER_00]: This is my personality.

[00:31:09] [SPEAKER_00]: I'm more of a visionary.

[00:31:10] [SPEAKER_00]: So I see things.

[00:31:12] [SPEAKER_00]: So I need someone to be like on my team.

[00:31:15] [SPEAKER_00]: That's more of a, this is how you do it.

[00:31:18] [SPEAKER_00]: And I can execute also, but I'm more first a visionary.

[00:31:22] [SPEAKER_00]: And so when I see one of the Google CEO seeing that this is a possibility,

[00:31:27] [SPEAKER_00]: I can just see even the application of this in rural communities.

[00:31:32] [SPEAKER_00]: Cause you were even, let's not even talk about rural.

[00:31:35] [SPEAKER_00]: Let's just talk about California, just access to even a heart team.

[00:31:42] [SPEAKER_00]: So if you look at, let's say you look at the south fountain, that area,

[00:31:47] [SPEAKER_00]: that spot right there, South side, the closest heart team they have is Cedars.

[00:31:56] [SPEAKER_00]: And if you don't have a car, do you know how long bus take it's like a two hour

[00:32:01] [SPEAKER_00]: bus ride.

[00:32:02] [SPEAKER_00]: So can you imagine if you are having a heart problem or your, or just not even

[00:32:07] [SPEAKER_00]: a heart problem, just having you think you have issues of breathing heavy and

[00:32:11] [SPEAKER_00]: being feel lightheaded now, I'll just go to the nearest physician that might

[00:32:16] [SPEAKER_00]: not even diagnose that as a heart problem also.

[00:32:20] [SPEAKER_01]: So I had to, I did a strategic planning session with a, with a

[00:32:24] [SPEAKER_01]: nonprofit hospital group in Idaho of all places.

[00:32:28] [SPEAKER_01]: And one of the things that they did was have all these little, I don't even

[00:32:34] [SPEAKER_01]: know if you call them up like four or five bed, 10 bed places all over

[00:32:38] [SPEAKER_01]: because the main hospitals were two to four hours away.

[00:32:42] [SPEAKER_01]: And so they, they had a wonderful system that they had put together.

[00:32:45] [SPEAKER_01]: We're part of it was having the digital technology to be able to get

[00:32:48] [SPEAKER_01]: some insight.

[00:32:50] [SPEAKER_01]: So if I recall your type or traveling a lot in the field, so you see a lot of

[00:32:56] [SPEAKER_01]: competitive reps and you have a sense of beyond your culture, but just the

[00:32:59] [SPEAKER_01]: entire medical device industry.

[00:33:01] [SPEAKER_01]: What sort of changes do you see the medical device industry is going to

[00:33:06] [SPEAKER_01]: have to do in terms of recruiting people and dealing with these

[00:33:09] [SPEAKER_01]: technology changes in the future?

[00:33:10] [SPEAKER_01]: Cause we've been mostly mechanical electrical people, I guess would be the

[00:33:14] [SPEAKER_01]: best way to describe it.

[00:33:15] [SPEAKER_00]: Right.

[00:33:16] [SPEAKER_00]: Yeah.

[00:33:16] [SPEAKER_00]: Engineer.

[00:33:18] [SPEAKER_00]: I would say that the younger professionals coming in now has this vision of, or

[00:33:26] [SPEAKER_00]: even knowledge of AI, right?

[00:33:28] [SPEAKER_00]: I will tell you specifically, we are onboarding a lot of teams that

[00:33:34] [SPEAKER_00]: have knowledge in AI coding.

[00:33:37] [SPEAKER_00]: Python is really one of the foundations of generative AI.

[00:33:42] [SPEAKER_00]: So we're recruiting that type of talent and bringing that in.

[00:33:46] [SPEAKER_00]: So I think you could bring in that.

[00:33:48] [SPEAKER_00]: You should also bring in people who have visions for those hard skills and

[00:33:52] [SPEAKER_00]: those soft skills of like, where could this go?

[00:33:54] [SPEAKER_00]: How can we connect all of these things?

[00:33:57] [SPEAKER_01]: I got involved with a group between Carnegie Mellon University

[00:34:00] [SPEAKER_01]: and the university of Pittsburgh.

[00:34:01] [SPEAKER_01]: They call themselves the Pittsburgh learning Triangulum.

[00:34:04] [SPEAKER_01]: And it's a group of professors that step back and said, learning

[00:34:08] [SPEAKER_01]: is going to change and even how we do science, we are ending up

[00:34:14] [SPEAKER_01]: realizing that if we think about like cell to cell interaction, that has

[00:34:17] [SPEAKER_01]: mechanical, electrical, it has all these things going on and even our AI

[00:34:21] [SPEAKER_01]: models that we have today are not prepared for that.

[00:34:24] [SPEAKER_01]: So I think that's also going to be changing too.

[00:34:27] [SPEAKER_01]: So do you have specific resources you follow that the audience could check

[00:34:32] [SPEAKER_01]: in on in terms of how you keep your resources going?

[00:34:35] [SPEAKER_01]: Not besides going to a conference, but are there websites?

[00:34:37] [SPEAKER_01]: Are there people you follow?

[00:34:39] [SPEAKER_00]: Yeah, definitely listen to podcasts like yours.

[00:34:43] [SPEAKER_00]: Keep yourself updated on that one.

[00:34:46] [SPEAKER_00]: I am not an employee of Siemens anymore, but the Siemens

[00:34:50] [SPEAKER_00]: help in your podcast is actually really good.

[00:34:54] [SPEAKER_00]: Like they have discussions about digital twin.

[00:34:56] [SPEAKER_00]: We didn't even touch that.

[00:34:58] [SPEAKER_00]: That's amazing that hopefully we can get there someday.

[00:35:01] [SPEAKER_00]: And then even like looking into just general updates of open AI, right?

[00:35:08] [SPEAKER_00]: If you've seen the update right now of open AI, that has a great

[00:35:12] [SPEAKER_00]: implications to education where remember it can show the AI a picture of it.

[00:35:19] [SPEAKER_00]: So just imagine, again, let's just imagine, let's forget about

[00:35:22] [SPEAKER_00]: the regulatory aspect, the privacy component.

[00:35:26] [SPEAKER_00]: I know there's that those are hurdles.

[00:35:28] [SPEAKER_00]: I'm just talking about the vision of use.

[00:35:30] [SPEAKER_00]: Let's just imagine an echocardiogram and you put that image in front of AI

[00:35:37] [SPEAKER_00]: and it's able to detect, okay, this is the possibility of this

[00:35:41] [SPEAKER_00]: patient or for you as a patient.

[00:35:44] [SPEAKER_00]: See, sometimes when you come to a physician's office, they also say,

[00:35:47] [SPEAKER_00]: no, we'll send you the result after three weeks.

[00:35:49] [SPEAKER_00]: You get the result and you're like, okay, it's a one-liner,

[00:35:54] [SPEAKER_00]: but they don't send you the images.

[00:35:56] [SPEAKER_00]: What if they send you the images and open AI can actually educate

[00:35:59] [SPEAKER_00]: you about what that disease is?

[00:36:02] [SPEAKER_00]: What can it do for you?

[00:36:03] [SPEAKER_00]: Like if you don't do anything about it, this is what will happen.

[00:36:07] [SPEAKER_00]: And this is what you need to do.

[00:36:08] [SPEAKER_00]: Here's the list of physicians that are experts in this field.

[00:36:12] [SPEAKER_00]: Go see them now, or because this is your risk profile.

[00:36:16] [SPEAKER_01]: And I think we were glad we were talking about the Apple

[00:36:18] [SPEAKER_01]: watches and stuff like that.

[00:36:20] [SPEAKER_01]: I, they now have, I'm going to look at my phone, just apologize

[00:36:23] [SPEAKER_01]: to the audience and my guests, but there's apps now on HRV for

[00:36:28] [SPEAKER_01]: training for your heart and things like that.

[00:36:30] [SPEAKER_01]: And I can actually notice that if I literally had a drink the night

[00:36:34] [SPEAKER_01]: before the next day, my numbers will be different.

[00:36:37] [SPEAKER_01]: And so you start making a cause and an effect, but if you don't know

[00:36:43] [SPEAKER_01]: that you just happily go along your way.

[00:36:47] [SPEAKER_01]: So what is the biggest lesson you've learned in your journey thus far?

[00:36:52] [SPEAKER_00]: I think the biggest lesson for me is to continually to make sure

[00:36:58] [SPEAKER_00]: that we learn, but not only that we learn, we apply those

[00:37:02] [SPEAKER_00]: learnings and we adapt.

[00:37:04] [SPEAKER_00]: I think the, as the saying goes, if you don't adapt, you die.

[00:37:08] [SPEAKER_00]: I think it's very true.

[00:37:09] [SPEAKER_00]: And you've seen that before with the big companies,

[00:37:13] [SPEAKER_00]: ODAC, Blockbuster, who knew that all of those companies

[00:37:17] [SPEAKER_00]: would just be bankrupt now.

[00:37:20] [SPEAKER_01]: And I think AI can teach us to learn meaning that because

[00:37:23] [SPEAKER_01]: you train a lot of people, I'm sure you're doing this very

[00:37:26] [SPEAKER_01]: naturally as you listen to someone talk, you're determining

[00:37:28] [SPEAKER_01]: whether they're visual, auditory, kinetic, you're trying to

[00:37:32] [SPEAKER_01]: determine how they learn.

[00:37:34] [SPEAKER_01]: But when you're teaching in a classroom and you have 50, 60

[00:37:38] [SPEAKER_01]: students or you're doing something live online, what I'm

[00:37:43] [SPEAKER_01]: finding now is I can put a presentation into AI.

[00:37:48] [SPEAKER_01]: I'd like Claude to, so in addition to chat GPT, and you

[00:37:53] [SPEAKER_01]: can ask, how can you misinterpret this slide?

[00:37:56] [SPEAKER_01]: How can this word dealing with the Spanish culture,

[00:37:59] [SPEAKER_01]: I'm going to be in France, how could this word mean this thing?

[00:38:03] [SPEAKER_01]: And it is shocking some of the feedback you get.

[00:38:06] [SPEAKER_01]: And so I think the other aspect here is we're probably

[00:38:10] [SPEAKER_01]: going to have to relearn how to learn.

[00:38:12] [SPEAKER_01]: And I think that maybe we used to have to regurgitate

[00:38:15] [SPEAKER_01]: facts that might be less important than understanding

[00:38:19] [SPEAKER_01]: how things come together.

[00:38:20] [SPEAKER_01]: Now you need to know the facts to have systems come

[00:38:23] [SPEAKER_01]: together, but I think we used to be focused on teaching

[00:38:27] [SPEAKER_01]: pieces of facts as opposed to looking at how the system

[00:38:31] [SPEAKER_01]: comes together.

[00:38:32] [SPEAKER_01]: It's just amazing.

[00:38:33] [SPEAKER_01]: So what do you see as the biggest opportunity for growth

[00:38:36] [SPEAKER_01]: and the biggest threat in healthcare as you look out

[00:38:39] [SPEAKER_01]: in the next five or 10 years?

[00:38:40] [SPEAKER_00]: Wow, the greatest opportunity there is a lot.

[00:38:44] [SPEAKER_00]: There's because again, we just, we talked about

[00:38:47] [SPEAKER_00]: digital twin.

[00:38:48] [SPEAKER_00]: Let's talk about simulation learning for physicians

[00:38:51] [SPEAKER_00]: even have this capability.

[00:38:54] [SPEAKER_00]: You don't need to practice on cadavers and cadavers

[00:38:58] [SPEAKER_00]: are limited to each one of you now can be in virtual reality.

[00:39:02] [SPEAKER_00]: Practice all of the things that could go wrong,

[00:39:06] [SPEAKER_00]: that critical errors that could potentially cause death.

[00:39:09] [SPEAKER_00]: Right?

[00:39:10] [SPEAKER_00]: You can practice it and see, OK, if I twist it this way,

[00:39:13] [SPEAKER_00]: that will happen.

[00:39:14] [SPEAKER_00]: And you can't do that in a replicated way when you're

[00:39:20] [SPEAKER_00]: doing it in a cadaver because you've already

[00:39:22] [SPEAKER_00]: destroyed the structure.

[00:39:25] [SPEAKER_01]: So we're going to have fighter pilot training for

[00:39:27] [SPEAKER_01]: physicians basically, right?

[00:39:28] [SPEAKER_01]: But you handle many crises and set up situations

[00:39:32] [SPEAKER_01]: that you could never really present.

[00:39:34] [SPEAKER_00]: Yeah.

[00:39:34] [SPEAKER_00]: And that's with just the training also that's on

[00:39:37] [SPEAKER_00]: the training of the medical portions.

[00:39:39] [SPEAKER_00]: I can just see that.

[00:39:41] [SPEAKER_00]: How about having tapped into the knowledge of

[00:39:44] [SPEAKER_00]: this experts that can't travel in let's say for

[00:39:49] [SPEAKER_00]: other countries.

[00:39:50] [SPEAKER_00]: Now you have an expert here in the U.S.

[00:39:52] [SPEAKER_00]: teaching someone again via VR how to do this

[00:39:56] [SPEAKER_00]: procedure and the other person is in Singapore

[00:39:59] [SPEAKER_00]: and the Philippines.

[00:40:01] [SPEAKER_00]: This now access to health care would be in how

[00:40:04] [SPEAKER_00]: knowledge being dispersed in the industry now

[00:40:07] [SPEAKER_00]: is definitely much more better because of this

[00:40:11] [SPEAKER_00]: industry or the technology that we have in

[00:40:14] [SPEAKER_00]: this industry.

[00:40:15] [SPEAKER_00]: How about even diagnosis of it?

[00:40:17] [SPEAKER_00]: If we talk about the possibility of genetic

[00:40:23] [SPEAKER_00]: personalized medicine, because one you might

[00:40:27] [SPEAKER_00]: think why is this medication not working for

[00:40:30] [SPEAKER_00]: this patient and it worked for this patient,

[00:40:33] [SPEAKER_00]: but you're giving them the same medication.

[00:40:36] [SPEAKER_01]: Yep.

[00:40:37] [SPEAKER_00]: So now with that just I'm excited about the

[00:40:41] [SPEAKER_00]: future because we're seeing the glimpse of

[00:40:45] [SPEAKER_00]: future of AI and I see we were talking about

[00:40:49] [SPEAKER_00]: knowledge and education is extremely powerful

[00:40:54] [SPEAKER_00]: because if you know what you can do then you

[00:40:59] [SPEAKER_00]: can fight for it.

[00:41:00] [SPEAKER_00]: So if you think you're not getting the right

[00:41:02] [SPEAKER_00]: care from your physicians, you can say well

[00:41:05] [SPEAKER_00]: based on what I read here and you can even

[00:41:07] [SPEAKER_00]: have sightings and say here's the sightings

[00:41:09] [SPEAKER_00]: to different publications.

[00:41:11] [SPEAKER_00]: I want to be referred to this.

[00:41:13] [SPEAKER_00]: You can never do that back then because he

[00:41:15] [SPEAKER_00]: didn't know.

[00:41:15] [SPEAKER_00]: He just trusted your doctor to know everything.

[00:41:19] [SPEAKER_01]: I think too, now that you say this, I

[00:41:20] [SPEAKER_01]: think the younger doctors also are coming out

[00:41:24] [SPEAKER_01]: very comfortable with you bringing that data

[00:41:26] [SPEAKER_01]: to the discussion and you don't maybe see

[00:41:29] [SPEAKER_01]: that in some of the more senior folks who've

[00:41:32] [SPEAKER_01]: been around or maybe people getting ready

[00:41:34] [SPEAKER_01]: to retire.

[00:41:34] [SPEAKER_01]: That's just not the way it was.

[00:41:36] [SPEAKER_01]: But my wife had a situation where her

[00:41:38] [SPEAKER_01]: doctor retired and she got a younger

[00:41:40] [SPEAKER_01]: doctor and we showed up with all the

[00:41:42] [SPEAKER_01]: doctor Google notes and she sat there

[00:41:44] [SPEAKER_01]: patiently with her everything, which was

[00:41:46] [SPEAKER_01]: absolutely fantastic.

[00:41:47] [SPEAKER_00]: Because again, you never know what you

[00:41:49] [SPEAKER_00]: don't know, right?

[00:41:50] [SPEAKER_00]: Again, you might be taught this way and

[00:41:52] [SPEAKER_00]: I was, I had fantastic instructors, but

[00:41:56] [SPEAKER_00]: that was back when I finished my PhD

[00:41:58] [SPEAKER_00]: back in 2012 and that was knowledge at

[00:42:02] [SPEAKER_00]: that point of time.

[00:42:04] [SPEAKER_00]: There are new discoveries.

[00:42:06] [SPEAKER_00]: So we can't blame our physicians if

[00:42:09] [SPEAKER_00]: they don't know everything up to date,

[00:42:12] [SPEAKER_00]: just because sometimes you do have a

[00:42:14] [SPEAKER_00]: limit to even if you attend conferences,

[00:42:16] [SPEAKER_00]: you can only absorb so much.

[00:42:19] [SPEAKER_01]: There's a lot of dynamics going on.

[00:42:21] [SPEAKER_01]: I told you earlier, I was doing some

[00:42:23] [SPEAKER_01]: qualitative interviews last year for a

[00:42:25] [SPEAKER_01]: big pharma company and we were talking

[00:42:27] [SPEAKER_01]: to neurologists and this gentleman made

[00:42:30] [SPEAKER_01]: me literally cry.

[00:42:32] [SPEAKER_01]: I mean, he, we have a Parkinson's

[00:42:34] [SPEAKER_01]: patient, you have these patients for

[00:42:36] [SPEAKER_01]: like 40 years.

[00:42:37] [SPEAKER_01]: So we, other specialties aren't like

[00:42:39] [SPEAKER_01]: that.

[00:42:39] [SPEAKER_01]: And so when you listen to what he or

[00:42:42] [SPEAKER_01]: she was looking at, he recognizes the

[00:42:45] [SPEAKER_01]: entire family is involved in this

[00:42:47] [SPEAKER_01]: disease and that if they get too tired

[00:42:50] [SPEAKER_01]: or they get physically disabled,

[00:42:52] [SPEAKER_01]: there's a lot of problems going on

[00:42:53] [SPEAKER_01]: there.

[00:42:53] [SPEAKER_01]: And so there was so many dynamics

[00:42:56] [SPEAKER_01]: that he was managing.

[00:42:57] [SPEAKER_01]: He ended up filling the place with,

[00:42:58] [SPEAKER_01]: in his case, he could afford it.

[00:43:00] [SPEAKER_01]: Nurse practitioners or physician

[00:43:01] [SPEAKER_01]: assistants to track that and start

[00:43:04] [SPEAKER_01]: envisioning now where information like

[00:43:06] [SPEAKER_01]: that could come to you.

[00:43:07] [SPEAKER_01]: It's, it struck me my, my dad's

[00:43:09] [SPEAKER_01]: but he had a pacemaker near the end and

[00:43:14] [SPEAKER_01]: the doctor would call him and say,

[00:43:15] [SPEAKER_01]: last night this thing happened.

[00:43:17] [SPEAKER_01]: I need to see you.

[00:43:20] [SPEAKER_01]: So hopefully that's where we're going.

[00:43:22] [SPEAKER_01]: Thank you so much for joining us.

[00:43:24] [SPEAKER_01]: Would you have anything else you'd

[00:43:26] [SPEAKER_01]: want to share with the audience?

[00:43:28] [SPEAKER_00]: No, I truly appreciate being at your

[00:43:31] [SPEAKER_00]: podcast here.

[00:43:32] [SPEAKER_00]: This has been a great conversation.

[00:43:34] [SPEAKER_00]: I'm very passionate about, you can

[00:43:36] [SPEAKER_00]: see how I get excited about the

[00:43:38] [SPEAKER_00]: future, right?

[00:43:40] [SPEAKER_00]: And I think we have hurdles to

[00:43:43] [SPEAKER_00]: overcome with regulatory privacy,

[00:43:46] [SPEAKER_00]: but there's things already being done.

[00:43:48] [SPEAKER_00]: And I think with the continuous

[00:43:51] [SPEAKER_00]: growth of AI and technology,

[00:43:54] [SPEAKER_00]: we will be there are future state

[00:43:56] [SPEAKER_00]: of healthcare.

[00:43:58] [SPEAKER_00]: If we just let go of all of the,

[00:44:01] [SPEAKER_00]: there's the commercial piece of this

[00:44:03] [SPEAKER_00]: that is the biggest hurdle.

[00:44:05] [SPEAKER_00]: If we as a community unite and let

[00:44:11] [SPEAKER_00]: down some of our guards with regards

[00:44:13] [SPEAKER_00]: to that, I think we would be better

[00:44:15] [SPEAKER_00]: in helping people improve their lives.

[00:44:20] [SPEAKER_01]: Thank you so much.

[00:44:20] [SPEAKER_01]: Appreciate it.

[00:44:23] [SPEAKER_01]: Thanks for tuning into the Chalk Talk

[00:44:25] [SPEAKER_01]: Gym podcast for resources, show notes

[00:44:29] [SPEAKER_01]: and ways to get in touch.

[00:44:30] [SPEAKER_01]: Visit us at chalktalkgym.com.