Heroes of Healthcare
Heroes of Healthcare

Episode · 2 months ago

How Medical Technology Is Augmenting Healthcare Decision Making

ABOUT THIS EPISODE

Humans are capable of incredible things—we’re smart, we’re adaptive, we’re resourceful—but one area where we are limited is our capacity to incorporate new information and modify a decision once one has already been made.

Dr. Matthew Cooper, Chief Medical Officer of the Medical Solutions Division & Director, Global Safety for the Health Care Business Group at 3M Health Care, believes that’s where medical technology can be most beneficial. In this episode, he shares a vision of a world where medical technology augments healthcare decision making.

We discuss:

  • The scope of the work at 3M Health Care
  • Recent breakthroughs in medical technology
  • How 3M contributes to patient safety
  • What medical technology might look like in 5 years 

To hear this interview and more like it, subscribe to Heroes of Healthcare on Apple Podcasts, Spotify, or wherever you listen to podcasts.

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We have profound capability to do big data analysis and use that to be predictive in terms of preventable morbidity, preventable mortality, preventing the need for hospital readmissions. You're listening to heroes of healthcare, the podcast that highlights bold, selfless professionals in the healthcare industry focused on transforming lives in their communities. Let's get into the show. Welcome to the hears of healthcare podcast. I'm your host, Ted Wayne. Today I'm joined by Dr Matthew Cooper, who is chief medical officer of the Medical Solutions Division and the director of Global Safety for the Healthcare Business Group for three M Corporation headquartered in Minneapolis Minnesota. Three M is ranked number ninety six on the fortune five hundred company list and exceeds thirty two billion dollars in revenue. Probably most known for its office product posted notes, three M is a manufacturer of the n ninety five masks, which have become the mainstay during this pandemic era we are living in. However, three M is also a leader in healthcare innovation. We're excited to hear more today from Dr Cooper. Dr Cooper holds his medical degree from Nyu School of Medicine and achieved an MBA from the Watson Graduate School of Management at Oklahoma State University. For almost ten years, Dr Cooper has been leading transformative philosophy, strategy and operational chain at the world's number one wound Care Company and leading science company. I think you'll all enjoy hearing about the innovation that's coming from healthcare today, as we talked to Dr Cooper. Welcome to the here as a healthcare podcast. Dr Cooper, thanks for joining us. It's my pleasure to be with you today. Well, we're interested to get into this today because your background and experiences different than what we've had on the show and so I think it's going to be very exciting for the listeners to hear some different things and get some new information coming out of some of the things that you and your team are working on at three m but before we jump into that, I'd love for you to maybe share with the listeners a little bit about yourself. What made you passionate about what made your decision to get into healthcare and had to make that jump, and what made you make that jump from the clinical side over to the corporate the corporate side, but really where there's impact as well, and I think that's going to be important for the listeners to hear as well. So that's a potentially long story, but I'll make it brief for you. I was influenced early because when we were kids my brother had leukemia, a form of a lukemia that he passed away from. Remarkably, nowadays, that same acute leukemia as a ninety odd percent survival amazing. So very early on I saw the potential growing up, I saw what it had done to my family and my parents and how they survived and how they looked after our remaining two brothers and regard. So that influenced me very early on. I flirted with a career in music for a while and and thought ultimately that I could do medicine and still participate in music and and did that. In terms of how I got into corporate life, I was practicing adult and pediatric cardiac surgery and transplantation for many years and most topic occupations are very similar in some respects, and that is it's after so many repetitions. The socalled tenzero repetitions. It is a bit of a pattern recognition and once you recognize that pattern which may take a few milliseconds. Then the subsequent algorithm is pretty well defined. And I was getting a bit intellectually bored. I was doing consulting in the application of aviation based out safety practices to healthcare. I had picked up an MBA in design innovation and I saw an opportunity to go from influencing one v one to having a broader influence with three am in healthcare. Wow,...

...yeah, so obviously right. Instead of you mean one V one versus, instead of one patient to one patient at a time, you could do work that could impact many. Yeah, right, and certainly much of what we do at three am as global, global impact. Yeah, well, I'm sure. And and we'll give put a little connection to the people who aren't at familiar with three am. Probably most known for posted notes, is one of the more famous things. But multi billion dollar CO OPERATION BASED OUT OF MINNESOTA, if my recollection is correct, free M is Minnesota, mining and manufacturing. Well, it used to be, but officially we change one name, two three am just a couple of years ago. Okay, very good. So that shows that I'm old and I remember that the other name as well. But yeah, I know it's exciting to hear and obviously your the breath and depth of three m goes well, well beyond posted notes and and some of the consumer products that people are familiar with. But would like to dive into that. So tell me a little bit about what does your role to comprise of at three m? What do you focused on? What is your team doing? How do you move the needle, how to impact the many that you're working on? So I'm part of a medical affairs organization, in what we call our healthcare business group, and in medical affairs we have several roles as physicians and healthcare providers and we bring that perspective to complement our colleagues who are more purely scientists or researchers or experts and regulation, quality and things like that. So among the things we help to do are identify gaps and capabilities, gaps in capabilities of devices, how we might think about improving care, how we might improve care by devices, by solutions and too, end solutions of our patient's journey through healthcare, how we improve the decisionmaking of healthcare providers, all aimed at a proving outcomes, and we do that by gaining information from from providers, from patients. We learn from each other, we bring our own experience and expertise and and then we help to design, help to study, test and then proceed through the entire regulatory and commercial process to release those products to the market. And then we continue with feedback, if you will, of end user insights. Are we solving the problems that we started out to solve? If not, what do we need to tweak? What do we need to take back to the design bench to improve? What do we need to make better in terms of educating end users how best to use the product? And again, it's always reconciled with the reason we came up with those products to make sure that they're doing what they're intended to do. That's that's awesome. Try to tell you a little bit about how to how is it different for Pharma, pharmaceuticals, versus some of the device or some of the surgical equipment that you're developing? Is it the same level of regulatory that you have to go through it? Does it have require clinical trials and things of that nature? Yeah, so it's the same but different. Obviously there's a there's a pharmacaceutical side, the drug side of the FDA. If you will. And then there's the medical device side. So I would say that they're equivalently robust on the medical device side in terms of our necessity of proving both safety and efficacy. You know, it's the Prim Anonymous Aram the first do no harm, but then does it actually work? MMM. So the development of the PRODUC different device products, surgical tools, things that that you're working on, you have to go through a it's a pretty long process from concept to market. Right, it is, and and it's actually frustrating sometimes because we can't necessarily be as agile or work at a pace of which our ideation or our problem solving may take us, because we...

...still have to go through those hurdles. And, as you've seen in the recent pandemic, the whole concept of Eua, emergency use authorization, occasionally allows you to accelerate that, but very often the regulatory process is a slower process that's than our own ideation and development. Yeah, I was just but it's great because I'm going to ask that. I mean, do you think that some of this rapid emergency acceptance that we've gotten on the vaccines and the boosters and some of those other things? Do you think that when hopefully the pandemic is died down and we're hoping that that's we haven't keep waiting for the next variant, of hoping that it's one is the last one. But when that is died down, do you think will see changes there? Do you think there's learnings that came out of it that says, Hey, listen, the normal x time that used to be really long. You know, we maybe it shouldn't be that Short, but there's some compression that can be done here. Yeah, and I think you already started to see that even before the pandemic. There was a recognition among the leaders at the FDA that you could safely commercialized products and allow products to be used if you accepted an increase risk up front. HMM, that is the pre market development cycle. You could accept more risk up front if you had more robust postmarket follow up and organizations like the medical device innovation consortium, which is a not for profit. They don't lobby and, interestingly, industry is able to sit on the board with the FDA work together to look at prospectively. How do we evolve evidentially requirements? How do we change the necessary acceptance of risk so that we can accelerate the process. And there have been other other organizations and partnership with FDA, for example, to try to look at Compassionate Development and acceleration of products for at risk populations like children and such, to try to to accelerate to market what's necessary and need to and you know, these are just kind of questions are coming. So when three am goes through and says he we've got a product, we go through the development process, we do all of our the trials and the piece and we get the approval. Does that, how often does that stat that process have to be replicated for you to take the product internationally? Does every country have its same, similar process? You know, do you have to do that in the EU? Do you have to do that in Australia? Do you have to do an after cat? Yes to all of those, Oh gosh. And and now now with Brexit, we have multiple, multiple complex layers as well. So yes, so sometimes the studies that are used for FDA approval are equipped, are considered equivalent and sufficient. Sometimes we have to do reduce studies with particular slants on either safety or effectiveness. Sometimes for certain countries like China, see FDA. The Chinese FDA equivalent is very focused on using Chinese populations of patients. So very often we have to consider redoing studies with local regional populations to get approval. But we have been over the last couple of years, as other medical companies have been, in a major work cycle and preparation for the EU MDR, the medical device regulations, which has because has been very robust in terms of safety and efficacy. We've had to comply that in you in order to keep our products on the market, not just to introduce new products. Okay, so product ideation through FDA, through global delivery, is quite quiet a long time. I guess once you get I do run those in parallel. I guess your when you once you're trying to get FDA approval, you're also getting EU approval. Your all of those are running in parallel. Yeah, sometimes, and this is quintessentially a team sport. I mean we have a regulatory and quality professionals and outside consultants to help us navigate what is a truly complex process.

And again it's part of a strategic plan over the next three to five years. which country or countries are we going to do first, or we're going to commercialize something first in the US or it doesn't make sense, based on the clinical needs, based on the performance of the product, doesn't make sense to commercialize it elsewhere first, right for the speed to market? Sure, yeah, so let's get into sound of the fun stuff. And you talked about when we prior to when we talked, you talked about the use of data, the use of information to be able to make better outcomes and better decisions within medical so I'd love to hear what you guys are doing and how you're doing that and I'd love to hear some of the medical technology advancements that three M has recently delivered and put and then and the impact that those are having. Sure, maybe just a comment about the foundational human condition. So we'RE PRETTY SMART, we're pretty adaptive, we're pretty resourceful, but from a human factor standpoint, one of the ways that we're limited is once we have a plan, once we make a decision, we're not really good and incorporating new information to modify our decision to socalled, change the direction of our decision vector, and we have learned from models and actual studies of battlefield decision making that we can augment the human condition and by assessing data in different ways, by delivering it when it's needed. And it doesn't mean that technology is making the decision, but it's a way of providing that new information to us, allowing us to incorporate that new information and nuancing or flexing our decisions to make better decisions to achieve better outcomes. And so that's where where we see technology coming in, certainly not taking over, but improving the decision making process that you can do that in a couple of different ways. Obviously, we and others look at the populations. How do you manage populations? Would respect to health, with with respect to preventative issues and others, which therapy is a most effective well, that can be derived from data. So we have one of our significant medical divisions is health information systems. For example. Most people don't know that almost ninety percent of all medical records in the United States go through three msoft and this has been the pace for over thirty years. So we have profound capability to do big data analysis and use that to be predictive in terms of preventable morbidity, preventable mortality, preventing the need for hospital readmissions and such. So we can do that on a population basis. But you might say, well, what about individuals? How do we use that to modify and improve the care of individuals? And we are very much involved with that on a daily basis now. So, for example, if the next patient that walks into my office has a particular condition in the context of their age, race other other medical factors, how do I best treat that person? Well, what if I were able to match that person to six hundred people just like him or her with the same conditions, had that and had different therapeutic options and from that data, determine what is most likely to be the best option and apply that to the person standing in front of well, that would be a dramatic change. A certainly is. As we've discussed earlier, the whole concept of telehealth has taken off. It was pretty much about forty percent of all all providers provided it before the pandemic, but has certainly been rooted in the pandemic. But what do you need to be a provider sitting via telemetry or sitting on the other side of a television from your patient? You need a whole battery of biometric measurements, medical parameters, more than just the usual vital signs. So the whole concept of developing, if you...

...will, Star Trek tricorders for the modern error is very much with us now. And how do you take those things to augment the human being? So, for example, when a physician or nurse as a physical examination, we're using our five senses. We're using our five senses to interpret the language of the physiologic systems of the body. HMM. Well, technology can improve the sensitivity and the specifics, the specificity of what we're able to detect, and when you put those together, then we have a better picture of what's been going on and also what we should too to potentially improve the situation. And so we are very much involved in looking to that future and mapping at a strategy of how we get there. So it's obviously we need to leverage data to make better decisions, make it better outcomes, but it does just in my mind, in terms of seeing it and picturing it, is it, as you said, a patient coming in Ben Office or doctor on rounds in a hospital setting and he or she has their tablet and there as they're entering an information about the patient that maybe they're collecting right there. That hasn't been put in already. The data is system is starting to say this might be or have you thought of or have you done? You know, is is it that sort of example? Well, it starts at and and while physicians are often prone to talk about the generation, you know when we did things, when I was a student, we get having so many better but but I think it is true that one of the things I see is that when when a patient comes to with a series of complaints or a problem, what what is going on with them is contained within what we call the differential diagnosis, the sphere of all the potential things going on and by history, physical examination, diagnostic tests, we try to narrow that down to the actual cause, the actual diagnosis. And I think that over time the world has gotten much more complex. What we know or could know about patients as much more complex, and so I think individual providers do need help and framing that initial sphere of what the potential is. So to your point, I think all of those augmented capabilities of sensing, testing, perceiving help with that initial sphere and then allow us to focus to actually what's going on. Right so the data can say, Hey, it might be this and then we can use our skills and that, as a physician, you could use your skills and your education and your sensory as you said, to validate and say, Oh, that is what it is. Or HMM, not, I'm not I don't know. You know that, you know, maybe, but or discounted all together. Right. So, so, like with other human endeavors, in an ideal world, everyone who's making a decision has either been there before, seen it all before, something just like it, or have seen something close enough that they can apply the learning from what they saw to the current situation. But what do you do with those who were new to the field? How do you immediately improve their decision making capability up to that equivalent of the experienced operator? Right, yeah, yeah, again. Well, it gets people ramped faster and somewhat levels the playing field. To Talk to me about the does genetic data start to also become another factor in there? So if by some chance you have genetically mapped me and as the diagnostics is going on, it's saying, Hey, by the way, I notice he's genetically disposition disposed towards something, a type of cancer, a type of liver disease or something, it can it would change the algorithm where the data in that way. Sure, the so socalled field of precision medication, precision medicine, that is and I think that's very much at play. One of the challenges, though, is how do you create interoperability, if you will, to...

...steal the term from other others. How do you put all that together, that the genetic composit the genetic predisposition to what you're seeing in front of you? Well, and do that in a real time, or near real time, so that you get an impact on on decision making? We're not quite there yet. That's that's the future, perhaps. Right. So your meaning is, how do we pull that day, those two data pieces together right to do it? And we're yes, that makes sense, but right, you were not. We're not there yet, but so let's we'll crawl walk, running to this. So for so, for example, we know that something like prescribing blood thinners for patients who have plots. Well, we know that there are genetic sensitivities to the dose and those. Well, how do we, how do we make sure consistently that we know those genetic considerations when we do the dosage so as to prevent bleeding or clotting tendencies to spite our persunifers, or, I guess it's a yeah, or, as you say, or side effects or you know, you because we see something we need to change that are or temper it in tell us a little bit about some of the real kind of cutting edge innovation stuff that three am is doing, some of the results that you're getting and where you where are you feeling like, wow, we're really making a big impact here and this is kind of state of the art stuff. Yeah. So, so one of the things that we're very excited about is a partnership we have with a company called Echo and, as you and your listeners may know, we, we three am, manufacture Litman stethoscopes and have for many years. So we have, in partnership with Echo, release something called the Litman core. This is a stethoscope that has an overlay of artificial intelligence. So many physicians, in many nurses don't necessarily always detect the presence of a murmur or an abnormal heart sound. So using the artificial intelligence and this partnership, we can improve the detection of those murmurs. Soon will be able to tell that if a murmur is detected, is it of clinical significance requiring further workup or not, or is it benign and of no significance? Further in the future, will be able to tell which Valvet came from. We'll be able to assess the severity. And that's just the heart. What if we took equivalent capability and apply that to the lung and other organ systems? So the cardiac capability is there, it's on the market, it's for sale and again, like I mentioned earlier, what it does is it brings a minimum standard of sensitivity, specificity and perception much higher across the board. It has outperformed experience providers in many ways without that capability. And again, it's going to make a huge change in both screening and therapy and it's the tip of the iceberg in terms of what we can do. Wow, yeah, well, I'd stay and I would think, if I'm a cardiologist, why wouldn't I want that tool? Now you might have an answer to that, but I would think if if I've got a tool that in my tool box and somebody's come out with one that's better, why wouldn't I want to carry there's no reason why you wouldn't. I mean as human beings. We have a bad day, we have a an upper respiratory we're not hearing quite as well. There's a lot of ambient noise in a trauma situation or a helicopter, life flights. Yeah, like that. Yeah, absolutely, absolutely. It's a step above the performance of potentially even the best stethoscope provider. Sharpening's sure right. Why wouldn't I want it? Or, like I said earlier, why wouldn't I want to Taly say hey, you may want to check this right, you know, or you know I'm detecting this. You might not be, but I am still will better to know maybe than and discounted out, then to miss it all together. And that that sense of confidence is what we hear your back, particularly...

...from non specialists, so the general practition practitioners, the nurses, nurse practitioners out there. That degree of confidence and what they're hearing, yeah, is very yeah, you're right. I didn't even think of that. Right. So the cardiologist who's got the trained deer knows what to look for, but the primary care person or the nurse practitioner who doesn't, and and then I think, pops up says we're detecting a murmur. Here now I'm might be catching something earlier than I might have normal. Normally said to this patient, you sound great, go home and but look at this. There's something here that we should be looking a little deeper into. Yeah, I didn't even think of that, but yeah, and it's not just and it's not just the sound, not just an acoustics. So, for example, we know that humans respond to visual things. So we show them what the sound looks, okay, and we show them where it occurs in the cardiac cycle. So it becomes browth, a learning device and helps put it into the context of what's going on, perhaps with the page. Very cool, very cool. Yeah, the the things that are coming out in medicine with the use of technology and data is staggering. We Love we love talking about it here. We want to try to continue to get more of that on this show. Tell me what else? What are some what are the other thing? Any other thing, things that you have in development that you can share? I know some of it's obviously confidential and and that sort of thing, but but other what other things are? Are is three am excited about so. So, for example, many people don't know that three M is now the largest wound care company in the world. By acquiring CACI approximately two years ago, we are now the world experts and negative pressure wound therapy. So chronic wounds that don't heal, how can we apply a system of not just suction but but micro and macro processes that facilitate accelerated healing? How can we apply that not just to chronic nonhealing wounds, but for incisions? We know that we can positively impact the healing of even incisions that are closed at the time of surgery, in particularly in high rest individuals, but potentially across a larger and larger population. How do we prevent those incisions that break down the Hernie is that form, the rehospitalizations, the infections that go on with St Standard Incisions? Well, we can do that and we have the potential to do that, so we're very excited about that. We're also very excited in applying our capabilities across soft tissue trauma, for example. So when somebody has orthopedic Trauma, it's not just the bone that's broken but the soft tissue around it is also traumatized. How do we help that process to heal, but in terms of rehabilitating and restoring that patient back to their their home, their lives, their job, their full function. So we're very excited about those capabilities. That's it's amazing to when you talk when it. I've heard that term before, but tell me that when you say zero pressure wound, come tell me what does that mean? Because right when you see, when you when you see TV or here like Oh, got a wound, you I meily say apply pressure on to it. Right. Well, so a little different. So what you're thinking of is applying pressure, as in Tampaa. So you have a bleating site, apply pressure to stop the bleeding. What we're talking about is what's called negative pressure wound therapy. So it starts with suction, but that's that suction is not wall section, so to speak. The technology takes that suction and is delivered in a dispersed way throughout the tissue to a specific depth that causes new blood vessels to form, fluid to drain, infected and non viable tissue to be removed. All the facilitate healing. And so by various application of those forces, we can apply forces that help the wound to contract, to heal from the bottom out, to reduce the volume and ultimately to heal more rapid understand right. So it's kind of it's pulling...

...instead of the what I describe let's push down on it to stop something, right, it's pulling to create a lot of positive things, to remove, like you said, move bacteria, create better blood flow, gets to get the bad stuff out. Interesting. Interesting. Yeah, and traditionally it's been used on open work, those open wounds, either from trauma or other otherwise. But over the past few years we've learned that those same principles can be applied to close wounds because of what we do to the surrounding tissue, and so we get not only accelerated healing, we get better healing. So we we talked earlier and you've talked about that. Your team and your group is not just research, it's medical affairs, it's patient safety. Tell us a little bit about how does that break he how does that breakdown in terms of you know what you what is medical affairs and had is three m you know, play a major role in patient safety. Sure. So I think it's useful to know that historically and traditionally, healthcare has not been considered a high reliability and and things like commercial aviation nuclear power. Might surprise people to know that they are by virtue of the infrastructure of how it humans interact with each other, how they back each other up, how they communicate and such and so among the things we are applying at three am and have been for several years, and we're doing this across healthcare, but but in other parts of the company as well, and it's a partnership of many people, not just my group but the quality folks, regulatory folks. Is, we're looking at this from a systemic, systemic way, starting with populations but also to the individuals. So, for example, Alla the aviation model, we look at manufacturing trends that have the potential to harm patients may not have yet and hopefully we catch them before they do and we actively surveil for that and then we intervene if we see that. We look at situations that may come in as near misses with patients to learn from, similar again to the aviation model, and then we look at alleged adverse events that may occur or complications with use of our products, both on a low acuity side or on a high acuity side, to evaluate one whether our products are even causally related or not. And we learn from that and we feed that learning back into how we design products, how we apply products and, in particularly, how our users use those products. You know, one of the things I think we've learned is that we have to be smarter and how we design products. So we know that, for example, when users get almost any purchase they get, it's too of healthcare providers to the first thing they do is throw away the instructions and so and so. How do you design into a product a reliability, a degree of safety, when you know that a lot of people aren't going to read the instructions? But yet they expect, and we expect and patients expect, predictable safety and effectively. Yeah, even though they're their provider may not have read the instruction. Yes, and so we try to design that in up from to tolerate of variability and use, if you will, to get to that same endpoint. And and we've got to be created pretty creative sometimes to do that. Yeah, and and just make sure that I'm clear. So to me that would you know, one of the companies is probably most famous for this is apple. Right, apple is known for making products that are super intuitive. You don't need that you to open up the box, start up the product and just start touching or pushing and it's a kind of goes. You know, I run a group here and they're at Jackson and coker and I run the product and Technology Group and we put a lot of time into user experience. Right. So how does a user use it? Is a clear is it easy for them to use? And so is that when you talk about some of that? Is that what you're referring to? Well, so, for example, if we if we have clinical evidence to suggest that there is safety in using addressing for three days and and the...

...patient doesn't get into their appointment or the provider decides to leave it for five days, we want to make sure it's not going to do any harm. Or if a product has a particular effect for which is being used, more complex product, we want to make sure that it will continue to function to some degree. Beyond the parameters. We use something called instructions for use, which is very common in healthcare of medical devices, so called if use. And in an ideal world, if there are intricacies and use, someone should read those instructions. But they're not always and and it's a training proficiency issue. Like like other things. So we want to make sure that even if somebody misuses it in some fashion, it's not going to hurt anybody and it will continue to be as effective for as long as we can. We can make it so interesting. Got It? So it is that it's a term I'm not familiar with. You talked about earlier the aviation event. Is that with that? Is is is or instead of me guessing, why don't you explain that for us? What is that aviation effect? Well, it's not so much an aviation effect, but but I think what commercial aviation learned is that there are patterns and human endeavor. For example, if we look at the course of it of an airline flight, from take off to landing, that's a trajectory. Things occurred during that flight that, if that information isn't isn't heard, processed and potentially intervened accordingly, you may not get safely to your destination. You know, a Comme, a common complaint is that you don't get your luggage at the destination. Are Right, but there's some rates, e. Sigma dated to suggest that in many cases the likelihood of getting your luggage at your destination is greater than getting the right medication after a heart attack in a US House. And so there are. My point is is the the healthcare system is evolved, but we can learn from other endeavors and under enterprises and apply what works there, because the commonality is where human being right. We make mistakes and we know we're going to make mistakes because we're all fallible. So how do we prospectively design systems to catch them early that allows us to then intervene, to to write the ship to get things back on the right trajector understood? Got It? Okay, well, that's helpful. Thank you for explaining that. Yeah, yeah, and I and I. Let's see, you know, it's so funny. It's not something you would think of, but I love your explanation about like the bandage, if it's supposed to be ideally left on for three days, you know, how do we make sure that five days doesn't hurt? You right or you know, if that sort of thing, and you have to think that beyond what my goal is, has to be taken into consideration because you can't always guarantee that the proper application or use will always be executed exactly. So, as we're kind of coming around on our time tell what else, what else with medical affairs or some of the other groups? What are some of the other things that three m's got going that that's got too excited? One of the errors people don't often think about because it's not as glorious as the others is, for example, what's the process look like in sterilizing instruments used in the operating room? How do you make sure that the instruments that have been used on the previous patient are good to go for the next? It's a little bit of trust and verify. So three M is very active in evolving the processes by which not just how we sterilize, but how we verify that adequate cleaning and adequate sterilization has had occurred so that there's no transmission of potential contagious disease to the next person. And how do you do that in timely fashion? And how do you do it now that we're moving from the hospitals to ambulatory certain circum centers to dental operatoris? We're all sorts of oral surgery or done. All of the those use instruments and there's a timeliness. So how...

...do you decrease the cycle time of both sterilization and testing, but as sure safety at the same point, at the at the same juncture, and so we're very active in the development of accurate tests that take less and less time. Great, so we so when I go from you go from next surgery next, those implements are more guaranteed safe. Well, we never say guaranteedrity, but higher probability of safety. Right, we've were we've verified the effectiveness of the processes. That's great for that's Great. Well, I guess my last question before we kind of wrap up here's where do you think we'll see in the you know, if you start, if you kind of daydream, I had five years or things happen so fast. But where do you think we'll see some of the biggest advancements, not only just from three M but in medicine? You know, what is it? What is the medic what is the medical industry and healthcare industry look like in you from your view, in five years? Well, I think you alluded to it a little bit. I think we will have a precision component, that is, we will be able to perhaps it's something that you get done at various stages in your life, have a genetic map of who you are, what your predispositions might be, what your particular sensitivities might be in terms of certain drugs or certain procedures, how best to predict how you're going to respond. I think we'll have that as a foundation. I think more and more we are going to push people to prove that what they offer, books and and it has to work, not just just at one level. It's got to be effective to the patient, it's got to be cost effective and it's got to somehow have longevity of benefit so that you're not back at the same decision point soon. You know the sort of this recidivism rate, the AH hurrens rate. You know if wounds going to heal. Is that wound going to break down and show up again two years from now or is it is it hem for good? So I think we're going to look for all of those factors and I think it's true that once, once things work, once things are effective for patients, usually the economics follow. So it's not so much that the cost upfront is the target, but if it works, then we can justify the cost and and as if you look at total cost of care, then the economics are yeah, where it has to be there as well. That's awesome, that's great. You know, I always, always love to just kind of forecast out and see what's going to happen, because it's amazing how quick technology, and you and I talked about this before, how much covid has changed accelerated certain things, and we've talked about that on this podcast, about how certain things have gotten to the market faster because of it. You know, not just the obvious, that vaccine and things like that, but we talked about earlier the regulatory things getting knocked down. On telehealth, we're better and tell health faster, probably because of the pandemic. I think the other thing to look to the future is is we're working very hard to make sure that access to our healthcare calabilities are enhanced and then figure out how how if providing access, how do we hame liver and to all sorts of places? They're not all economically or socially equivalent. How do we get what's needed to the places? Yeah, most, and I think we're going to have all that as well. That's what we're excited a couple of weeks ago we had Dr Sandra Ford from the White House on the show and that's her her. She's been as hired as a special assistant President Biden, and that's our job. Health equity. How do we get it? How do we get it across the board? How do we make it sure that whether I'm in a little town in rural America or I'm in a major city, that I can get access to the same, same care and service? It's that's going to require that we leave our rank at the door and come up will the sincere prioritization of what do people who really need and delivered that order, because it's...

...not just, it's not necessarily the same thing for the same the four different groups across the board. No, that's for sure. That's for sure. Well, Dr Cooper, thank you for your time and your insight. Thank you for all the work that you do in at three am. Again, I think that a lot of people's eyes hopefully been open to hear about all the Great Park that you guys are doing to help change and healthcare. As we always wrap up the shows, we always love to ask our guests, as you look back at your your career and and currently, who is your hero? Throwing up? So that's an easy one for me and it's my father and he's no longer with us, but all of the things I saw in him and learn from him are hopefully things that I embody in my life and hopefully pass on to my daughter. But among the things that I think are most remarkable is he always has a sense of who he was and where he came from and who we learned from and who he grew from in terms of his predecessors who came to the United States and what it took for them to build a life here. He always treated people well as he would want it to be treated. He was always the first to offer a hand. He was always the first to give up for himself so he could help others, and he did it at tirelessly. I saw that with family and I saw that with strangers. But he was also a person who had the courage to stand up for his convictions and he didn't shy away from a fight if necessary. So it's that combination of the sense of history, of context, of thinking about not just yourself and your family but the others, because we're a community, but also to fight for principle, and I saw him suffer because of his willingness to take on a fight. But without people like that we won't progress. That's right, we have no, we don't have any progress. And but, and what was his name? His name was Leon, Leon on Cooper. That's awesome. Well, thank you. Thank you for sharing that, and we find that it's, you know, great leaders in our lives often our closest to home for many of us, myself speaking as well. So I appreciate you sharing that to Dr Cooper. It's been our pleasure. We thank you so much for your time and you're in your in the effort that you and the team. There are three I'm are doing and we'd like to open keep the door open. I always had to come back again every time you guys have some new and exciting thing coming to the market. We'd love to continue to hear about them. We love to hear about the innovation happening in healthcare. Absolutely I'd look forward to that, ted, and thank you very much for for today our pleasure by now, but you've been listening the heroes of healthcare for more. Subscribe to the show in your favorite podcast player or visit us at heroes of healthcare podcastcom.

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