Heroes of Healthcare
Heroes of Healthcare

Episode · 1 year ago

Pandemic Innovation: COVID Vaccine, AI, & more

ABOUT THIS EPISODE

Have you been hearing rumors about the COVID-19 vaccine? It can be hard to know what source to believe.

It’s time to dispel any misinformation about the COVID-19 vaccination. In this episode, Dr. Eric Eskioğlu, EVP & Chief Medical Officer at Novant Health, does just that.

Plus, he and Ted discuss:

  • The socioeconomic effects of the pandemic
  • The future of AI and other advanced technologies in healthcare
  • Dr. Eskioğlu’s unconventional journey into medicine and his advice for new physicians

Heroes of Healthcare is hosted by Ted Weyn.

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

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 years of healthcare podcast. I'm your host, Ted Wayne. I'm privileged to be joined today by Dr Eric Eskiaglu. Dr Eskaglu is the Executive Vice President and chief medical officer Van Health. He's a neurosurgeon, he's a former aerospace engine here and he's clearly one of the people on the forefront of revolutionizing healthcare. He's leveraging technology and he's certainly a shifting paradigms. As you'll hear today, Dr Eskiaglu joined Avon Health in two thousand and fifteen as an svp of neurosciences, unifying processes and protocols to ensure a world class experience for patients across the Novant health system. Before joining Navan Health, Dr Eskiaglu held several leadership roles in advancing neuroscience and medicine in various healthcare systems. Before his career, and as you'll hear later on today, he worked as an aerospace engineer at Allied Signal Aerospace Division and Boeing. He continues to apply his engineering background and efforts to streamline healthcare. Dr Eskiaglo earned his medical degree from the University of Kansas, was a fiser clinical research scholar fellow at the endovascular vascular neurosurgery fellow for the Univer Vercity of Florida and completed his residency at Vanderbilt University Medical Center. It is certainly our privilege to be joined today by Dr Eric Skiaglo. Welcome, drank so much to thank you for having me. Yeah, we're excited. I'm really excited to get into some of the topics that we talked about today. But before we jump in, if you don't mind, do you mind sharing with our listeners a little bit about your background? I think you have a fascinating background, great heritage, great education. If you could share some of that, I know they would love to hear a little bit more about you. Absolutely thanks for allowing me to do that. I'm Eric Stag Nur surgeon. I am the chief medical officer and Siguli Vice President at no long tel. We are six billion dollar multi state integrating healthcare system across the Carolinas and Virginia. We spend sixteen hospitals as well as over six hundred and fifty care sites and with your chair sites. I am a first generation immigrants from my family is from Turkey. My parents came here as immigrants from Turkey. I am also a former airspace engineer. I worked as an airspace INGAS here for three years before getting to healthcare. I've been in healthcare for over twenty two years now and I can tell you that what we're facing right now is history. But also, I'm presidented in the Times I've ever been in healthcare. So glad to be here. Yeah, well, and again we appreciate it, as you and I said before we kick this off, we appreciate your time in the midst of everything. So not only are we dealing with this major resurgence of covid but you're also dealing with a vaccination effort as well. So I'm sure the pressures on the system are great. Yeah, so is. You know, we all...

...had the first experience in April when we had to go into hurry up offense mode with covid nineteen surge. But I can tell you our surge is about four times higher than what we ever had in April. Wow, this is the biggest one we've had and it is stressing our healthcare system. It is stressing our healthcare providers. Positions are nurses, are team members. You know, we're resilient bunch at Novantel and we're trying our best, but at the same time we're trying to get shots into people's arms with the covid nineteen vaccine as quickly as possible, because we know the only way we can end this pandemic is not only by continue to do social distancing, continue to wear a mask, wash your hands obsessively, but also getting as many people as we can vaccinate. It emonizes with the COVID nineteen Vaccinat so we're doing dual things right now, dealing with the surge and taking care of our other patients. Don't forget the search is part of what we're dealing with, but we still have ninety five percent of our patients are patients that have other healthcare needs. They're just as urgent or emerging. So we're taking care of that, but the same time we are ruling out our vaccination. I'm proud to say that Novante over the last two weeks we've vaccinated over Elevenzero of our frontline team members. Creation of partners and yesterday was a historic day because we start vascing our first patients in North Carolina's Nov on tell so I'm proud of that. And again, our goal is, as soon as the vaccines arriving to our shelves, to get him off the shelves and be able to give it to people. Great a man. There's so many questions coming to me. So one of the things before we jump into little more at the vaccine and some of that and one of the questions. I know that really hit the healthcare systems hard the first surge, as you said back April May, of two thousand and twenty. It's hard to say that we're in two thousand and twenty one now, right, it goes fast. But in two thousand and twenty was that all of the surgical areas, all of the non critical things got shut down, which obviously hampered the organization's cash flow, their income pieces. In this second flow, how is that changed? Are you guys still doing a lot of that work? Are you now doing that? Where in the past you shut it down, now you're doing in parallel. Yeah, so couple of things. First of all, it was less about cash will, but it was all about taking care of our other patients. When we shut down everything, just like the rest of the nation, for about six eight weeks to prepareing to deal with the first surgeon April, we realize that a lot of our patients stayed away from the hospitals, even emergency patients, righttral patients weren't calling in the MS part of the act. Patients weren't coming to the yards. They were all afraid and we noticed that we start falling behind other routine maintainance such as Restmemography, call and cancer screen these are all important things that we need to continue doing. With the first surge in April, we also learned how to take care of these fishes that are much better way. We learned from the experiences of New York City, we learned from the experience...

...of other areas like Seattle, and we learned how to better take care of them. This time around, we are in a balancing act where we're not only taking care of our covid patients, they're in desperate need, but we're still continuing to give as much as we can. We have not cure killed any services. Yet we're continue to take care of our other cases, other patients that need different medical needs beyond covid. We have a whole bunch of them. So we don't want to, you know, neglect those patients, ignore those patients. Sure, we're trying our best. We're having to use all the resources we have, everything we got as team members, but also having to shift things around in different hospitals. So, for example, you know we have in co hoording most of our critical patients in covid. Nineteen at our large tertiary hospital. Were continued to do that. That way it allows us to continue to do regular surgeries, regular maintenance, the other urgent cases at our outline fasophies that don't have as much covid burden. Unfortunately, we're seeing that burden start rising because our tertiary hospitals are getting called Yes, and I guess, and I my senses that, while not fully back some of those people who in the first wave and had there's a lot of unknown around covid and all are now a little bit more willing to come back. So those patients that you said earlier, the stroke Pasin, so the cardiac patients are you seeing them? Even at the midst of this new surge? There there's a little more willingness to come in and get treatment. There is, and I think it took a while for us to convince our patients that are hostels are safe. You have the safest in our sytement Novo on health. WE HAVE THE SAFEST CLEANING PROTOCOL STERILIZING PROTOCOLS. So your chance of getting a covid and a hostel is almost nil. And we had to convince the patients because at the beginning it was all unknown. So we are seeing the patients coming back, we are seeing the demand from the patients. My biggest concernings. We see our huge bump after Thanksgiving when the families got together, and we're starting to see a huge bump after Christmas when the families got together as well. Yeah, and I don't think we're going to you know, hopefully. To me the first one seemed like a hill. Now, looking back at the time it didn't seem like that. Scaling a Small Hill. We've had literally three ways. The first one was in April May, the second one was in June and July and this one is the last one, hopefully, the final one but each that sess the way, I felt like the mountain was getting steeper, and right now I feel like we're scaling the Himalayas, but we are going to be on the other side. I'm an optimist. We are going to scale the Himalayas, we're going to go to the other side, and I just need everybody to understand that. We need to continue maintaining social distancing, wearing our masks and obsessively washing your hands during the day, and that's how we're going to end up beating this. In addition for getting our inoculations, we need to be injecting anybody they want, anybody that can we can get our hands on with the covid nineteen vaccine. Well, they thanks for sharing that message again, because it can't be said enough. We have to be vigilant in those things. You know, there's...

...so many. Of course we've made everything political and then there's a political side that says, I don't need to this isn't real. And you know no doubt this is real. So people like yourself who are in the front lines fighting this out, who are saying please wear your mask, you know we have to continue to echo that message. So thank you for continuing to support that. So let's talk about a little bit, if you don't mind. The vaccine right. So that's, you know, probably a lot on people's minds. You guys have been receiving it both from I'm I'm assuming the fies are and the Maderna have been coming in. Logistically, with these cold temperatures, that this thing has to be maintained at how does navant handling that? Yeah, so we actually were, you know, we kind of saw what's coming down to their back in August. So we actually secured, we got reannew for deep freezers that are very large industrial freezers, seventy and we have the capacity store up to seven hundred fifty thousand vaccines at any given time. Wow, we have a capacity. We planned for this. I can tell you. This vaccine roll out is logistically probably the most complicated and most difficult I've ever seen in my lifetime. But our teams have done a great job at Noven to help. Yes, we are getting both fisor bio and t vaccine, as well as the with their in a vaccine, because their messenger are in a. They are fragile vaccines. So we need to keep my mind is seventy and we need to deliver in pretty quickly as soon as we saw them. You can't put them back into a refrigerator freezer. That doesn't work. But our teams have done a phenomenal job, both from the nursing side with our chief nursing officer, as well as from the pharmacy side with our chief pharmacy executive. We've really operationalizes it's in an incredible way and we've gotten to a place where we have vaccination fights in our hospitals for our team members. Now we just rolled out vaccination site and our cities, large cities, to be able to vaccinate people, and also we have put on a Health Equity Lens because we want to make sure that we get to the population that's this proportionally affected with covid nineteen. We want to make sure that they get the vaccination. The one part that gives me pauses even in the healthcare workers across the nation, there's about a forty percent hesitancy to get the vaccine and that really gives me pause. You know, I've heard people saying this vaccine process was rushed. How can you get a vaccine done in four to six months? When it used to take two to three years. There's a lot of misinformation. Unfortunately, social media is not helping us at all. Lots of misinformation out there. What I want to tell you is, when my turn came up, I took the vaccine. I trust the science and, you know, I want to tell everybody when you get a shot, don't pass it up. Take your shop and you know, I would encourage every to think about is very carefully. The size and side behind the vaccine has been in the making for ten years. Yeah, I want to talk about yeah, let's go. Let's talk about that, because I think that's the critical piece for me that you know, as you said, people are concerned that at this was a rush to medicine, when it's really not. The foundation of this has been under development for many, many years. Yeah, it's been going on to it for ten years and luckily it came through...

...a cruisition just about the same time covid nineteen was hitting our communities around the world, in the USA, and so this messenger, any technology, was though, initially for our bodies to be able to fry cancer, and I think that offers a lot of promise. But we were able to quickly pivot for Vaccine Devil, and so I want people to understand that even though the vaccine process they have seemed faster, going forward this is probably going to be the norm. Any kind of different viruses, move viruses, anything we get that may be new, the way we got vaccines is probably going to be much shorter than what we had seen in the past ten, fifteen, twenty years ago. So I just want people to understand that. Yeah, no, I think that's I think that's key and I think the other thing that was interesting too, I'd love you to share with the listeners is how you feel that this could have a big impact in the future on HIV and cancer, because the to lead doctors on this were actually oncologists, which I didn't know, because they were developing this technology, as you said, for over the last ten years to really affect cancer. Yeah, their wife and husband team that they'll ope is the scientist. They're actually on colleges, Dr Shahi and Dr Kur AG, their Germans, their Turkish Germans, Turkish like me, and you know, they they'll off this for cancer. What they wanted to do is they'll off a way you can replicate a cancer cells. Portion of the cancer. So I'm not the entire cancer self. You don't want to make it active. A portion of it that your body recognizes foreign using the antigens and your body will attack me self. Now, when we talk about Imnology, when we talk about you know, our body's own depends. We always think about defensive out words, but our body, during any given time also does internal surveillance. It takes out bad self, it destroys them before they become a problem. Cancer cells are the ones that escape that surveillance. And what this husband and wife scient this team, was trying to do, as they're trying to develop a system where your body recognizes anything that's not right inside your body. I believe this is going to open up a lot of doors for cancer treatment. I can tell you that the way we deal with cancer in the next five years is going to be very different. We're already doing a lot of that with cartee therapy, but it's going to accelerate. I'm also very hopeful that, you know, there's another virus we haven't been able to conquered for the last thirty five years. It's called HIV, and I'm also very hopeful that this is going to open the doors and once we get ahold of this pandemic, it stop and it's tracks for Covid nineteen, we will find a vaccination for HIV as well. So, as hopeless as things look right now, and they there is a, you know, civil lining. There is a lot of hope on the horizon. There's a light at the end of the tunnel and I think we're going to come out of it much stronger as the healthcare system. That's great. No, it is definitely very exciting. Looking forward to seeing how that, how that plays out. So let's also talk about the long term effects of Covid I know you've mentioned to me about some of the mental health aspects and some of the things we've seen that came out of the two thousand and eight economic issue,...

...but now we're dealing with a whole new, different issue. Talk to me a little bit about what some of you think some of the long term effects might be on the mental health side. Yeah, absolutely so. If we look at the two thousand and six to two thousand and eight financial crisis and when we look at the you know, the amount of mental health issues that caused. Our population are a period abuse and our mental health issues went up by about thirty five to forty percent, and that was a huge bump. Big Unfortunately, covid nineteen is going to be proved to be even worse, in my estimation. You know, we have a lot of our fellow countrymen losing their jobs, losing their booms, not being able to provide for their families, and that is starting to increase a lot of opioid addiction and that's also going to start to increase a lot of the you know substance a use besides opioids, but also mental health issues, depression, suicide risk. That's all going to be on the rise. And even if we were able to get a hold of ovid nineteen, say in the next six months, the tail effect of that will probably last at least two to three years. So the social effects is going to linger for a while, unfortunately, and so we are really focused on how do we take care of those after effects of covid nineteen. You know, we're working on the artificial intelligence side. We have a huge artificial intelligence push in our healthcare organization. We believe that is the next you know wave and healthcare. That's going to make us more efficient, more effective less costly. So we're looking at ways of not only helping patients with their virtual you know, be a real health hospital concept, but also identifying team members or identifying employees that might be susceptible to getting too depression or substance abuse before they get into that and helping them out proactively if they want to be helped proactively. We don't have enough. Before our covid nineteen, our favorite health in this country was on crutches to begin with. So, you know, we have to come up with innovative ways because we don't have more psychiatrists. We have to call anybody of ways how we can solve this problem once it's shows up on our doorstep. So covid nineteen is obviously horrible, but there's going to be a lot of other things that come along with this that we have to deal with. One of the other things we're seeing is a lot of mental health effects on people who have that covid nineteen. About thirty to forty percent of the people. You know, they lose smell, they lose pace, but besides that they're having mental issues afterwards. We're seeing renal issues, kidney issues afterwards, we're seeing long issue their lungs don't return back to normal where their lung function should be. So we'll be dealing with a lot of the different effects of covid nineteen many years after we've conquered this scot off of pandemic, and so we're pivoting towards that. Are also looking to the future. What do we need to do to keep our patients healthy and how can we help them in that aspect? Now? I think that's great and you know, you answered one of the things which was you know, obviously in the behavioral health is not rich with providers right it's...

...already resource strapped and there's just not enough psychiatrists and psychologists to go around. So can you give us a little bit of a idea of how ai how what are you guys seeing, or an example of one of the ways that you might be able to leverage ai or some of the things that the system is doing that will help you be able to bring more services with honestly, less people? Yeah, so we have started a journey way before covid nineteen. Fortunately for us, we have a very good data analytics team, we have an incredible technology team. Are Chief Transformation and technology officers, phenomenal. So we work with them very closely. We had started our journey initially with our stroke patients. We started using a system called is ai with our stroke patients where the artificial intelligence detects the stroke of the patient while they're in the cats cannon without them being able to leave the cat standard. So we cut that step and we're able to not only detect the stroke even before the patient leaves the cat scanner using machine learning artificial intelligence, but that alert goes on your smart being. You know, most of my providers, most of the positions, are a million AL generation. They have smartphones, whether it be apple or Samson Galaxy, and what they have been able to do is they get that alert on their smartphones and they can look it up anywhere anytime and they can activate the whole team from the smart being, whether it be the are physician, whether it be the or staff, whether it be the nerologist, whether it be the pharmacist. Just think about the old ways we did stroke in this country. Has Been and they still wet. They're still places. How they do this this way? Patient comes into the air with a stroke alert, gets taken back to the CAT Scaner, cats gang gets done, you get a stat meeting from radiology, which in the best of times takes fifteen minutes. Sometimes it can take even more. Right and the Radia sends up calling the eear physician saying there's a stroke. The are physician hangs up the phone, has the secretary call the nerolgist on call say he needs to come down and look at it. The neur ages looks at it, then he will have to call the nurse. Urge in the Vassion Nerdy Agis to activate the team. Just think about the steps you lost. Yeah, and every second of a stroke you lose about thirty TWOZERO BRATS UP. So we've been able to shave we were one of the best in the country as far as help with we could give the clock busting drugs to our patients. You're about thirty nine minutes and the national standards about sixty minutes. Within sixty minutes of stroke, we've been able to shave it down to twenty nine minutes. That's ten more minutes. That's about nineteen million more brave self on average for patient. Yeah, well, so have because you cut it more than half. Yeah, you so. You. This is one of those things that you really not only improve the outcomes, but you also maximize the efficiency or what you're doing, and I guess this is my Air Smith engineering background coming here to play. I like process is very efficient and process. They...

...are finally tuned and you keep getting it better. I mean motch instead of process. It doesn't stay that way and we're making this even better, you know, collaborating with the company, trying to make this process even more smooth and much more fast on. But this is the one of the examples of ai that would be using. Another example of AI that would be using is, you know, helping our patients stay out of the hospital with heart failure. We can predict who can come into the heart failure and who we end up in the hospital. You know, we want to make sure that they're taking care of in their own home environment. They don't need to come to the hospital out of this stuff, and so we're predicting which patients and we're paying attention to those patients. The one thing I need like you to mention, you know, Ai to me seems like it's going to be the great equalizer for all populations, for healthcare equity and we you look at stroke care. It doesn't matter if the patient is an uptown Charlotte or there in rural Elka, North Carolina. They get the same care with neurology and with artificial and cold same on amount of attention, same details, same protocol, and we're trying to do this for all our disease processes because, you know, I want to be able to provide all our patients the same utmost care regardless of their entry point into our system. Yeah, that's great, right, because the AI doesn't see the biases, and not that a I can't get bias. It can learn to bias. He and you have to always be tweaking that. But the AI doesn't see the same emotional, socio economic a typical human biases. Yeah, H thank you, human biases that all of us just tend to do. So yeah, well, that's that's amazing. That's great. Talk a little bit more about you. You have an interesting you know your background it, you know your engineering background and you started off, obviously, with school and Engineering and ended up in medicine. But talk a little bit more about how you see that play out, obviously in terms of process and efficiency, but how does it helped you when you're in you're not only your practicing of medicine. But now in you're you're administrating, you know, your role as as an administration arm and executive arm of the hospital. Yeah, you know, I look at health care very differently because of my engineering background and you know, I actually practice as an engineer for three years. I didn't just go to school, I graduate from uners. There's on. I've worked as an aerospace engineer, work with different plane manufacturers and had a great time. But during that time what I realized is this was in the late s early S. I'm kind of dating myself here, but what I realized is they had gotten their stuff together. They knew how to maximize the processes and make him efficient and really zero tolerance, almost zero tolerance, or any kind of error. And I tried to bring the same mental the healthcare. And when I first started healthcare, a vanderbuilt by trained a vanderbilts as a nurser, who resident. You know, it started and vanderbolts a fantastic infusion problem, one of the best in the country. But health care in general start on me how far behind it was technology wise compared to...

...any other industry. We still are. And then, in my estimation, we're about ten to fifteen years behind other industries in in getting technologies and advanced, you know from modules and to help here, the one thing that I have seen that really helped us out is covid nineteen. I can know everything unfortunately comes back to covid nineteen, but the silver lining has been it's really exceed our technological advances. I'll give you the example of our position before covid nineteen. We're doing about hundred and fifty televisits a day, you know, and you talk about six hundred fifty care sites with over, you know, one thousand, nineteen hundred physicians. kind of q seems like a low number. Once we hit the pandemic, we had no choice right everything had to cut down. The only way to interact with your patients were us through tell the medicine and, to the credit of it partners, we're able to rise that up pretty quickly. At the height of the pandemic we're doing about sevenzero visits a day. Just think about one hundred fi two, one hundred and fifty two, seven thousands outsola. Those numbers have and I told people those numbers are going to go down, but they're going to plateau and it has it's about two five hundred televisits a day. And there's that certain segment of the population that includes my wife, who makes all the healthcare decisions for us in the in the household, including my kids. You know, they have gotten used to tell the medicine. They feel like this is a good venue for me to access health care. Yes, that's never coming back. And so in, and in a good way, covid nineteen has been the great accelerator for us to be able to move into these technologies that may have taken years for us to get into. The other thing I have seen, as you know, with competitors, we become almost overnights collaborators for covid nineteen because again, we're in friendly competition with couple of systems in our areas that we serve. But what happened is we got together as systems and we really want to do what's best for our communities. We realize that this is our community, not their commuting, not my community, our community, and we started really it's amazing to see how competitors can come together and, you know, work for the best of the community in the worst of times. So that gave me a lot of hope as well. That's great. So tell me, when you were working Arrow space and you were being an engineer, what made you pivot and change your mind or decide that you wanted to get into medicine? There's a fair amount of difference there. There is. So I actually used to be responsible for the I used to work on a team where we looked at the interface of the blowing seven seven seven aircraft's wing with the jet engine. So it was a fantastic project. Really loved it. I started actually volunteering at a children's songs group over the weekends and I started rounding with the pediatric attendees. They were really kind to take me in and volunteering there, just trying to help families. At that point I realize that, you know, everything they did was a different problem. Every problem was unique like your fingerpin, and none to patient was alike, and that fascinated me.

Now you have to understand, my dad was a pediatrician, he was in the innithologist. He was the okay, helping save kids lives. I never want to be a doctor. I'm a very analytical person. I'm a very math based person. So all I want to do is work on plays because I was fascinating with space and planes ever since I was a young age, beyond the usual child's fascination. I still am. I know we've talked about that. Yep. So when I started seeing the positions and they tacklely each problem and each problem was a unique problem where you could have an effect on somebody's life, that's what change me. Now it wasn't an overnight switch. It wasn't like I went there twice and I felt like, Oh my God, I got to change my life right. It took about a year of me volunteering and at one point I realized I really love what they do. I want to make a difference in people's lives. I felt like I was making a difference as an engineer in people's lives, making it better and more technologically advanced, but I felt like I want to get in a deeper way to be able to make a difference in people's lives. So I quit my job. I remember my supervisor at the time thought I was joking because I had a pre you know, bright career and I went back, at the tender age of twenty five, back to biology on one because I've never taken biologies and under and dissecting frogs with eighteen year olds. They one your premed and of course gone to medical school and the rest is history. The best part in my medical school I did get selected to a very prestigious program that was on the startup phase called and I Schoqua Research Start Scholars Program. Interestingly, it was sponsored by FISOR. Okay, so I have that fiser connection in Charlie Sanders, who was there. EMERTA CEO was one of my mentors there. So it was interesting just dealing with that and you know, I had a fantastic time and I age. I spent two years there doing coloqual research, translational research, and that's where my love for research came in and all this advancement technologies came in, and so fell in love with that. So it's it's clear to me, you know, Navant, and as I've been following some of the things that you the post on Linkedin and stuff, I always find a fascinating in terms of they're really trying to continue to be part of the leading edge. What are some of the other things, covid or non Covid, that you see coming out of the system that gets you excited, that you really think you guys are really on the forefront and cutting edge and creating some really good new opportunities and healthcare. Yeah, I think the biggest thing for us is really trying to provide equity to healthcare to everybody that comes in and we're using any kind of agnostic knowledge is including machine learning artificial intelligence. The next the other thing that we're really excited is the ZIP line drone, where we hope to be able to start delivering medications to patients with a drone so they don't have to go out of their house pick up medications, especially people are the most vulnerable. During the pandemic, we did get an FA waiver to be able to do on demand delivery of our PPEES who are hosspools with ZIP line. That was a good experiment for us.

That was a good dry run. I should it wasn't driving. We actually did provide a lot of PPE. But my next hope is that, you know, the next big push for our organization, and this is led by our CEO, Carl and Monto, and our board, is really to be not on the not just on the leading edge, but being in the front of everybody else as far as offering the artificial intelligence in the ADNANSTIC knowledge is anything that's going to make healthcare more efficient, effective and more precise, precision medicine. But also by doing that, at the same time you reduce the oncle variations that you make it less expensive. It's just because you pay too much to it doesn't mean that's a good product, and we've seen that with other products besides healthcare. Sure. So our goal is to make it so precise and so finally tuned for each individual patient, because every one of us is like our fingerprint. We have unique problems and none to diseases the same kind of fine tuned make it precise for every patient but the same time lower the cost using all these fantastic advancements in technology. That's awesome. That's great, you know. And what as we're starting to wrap up here, one of the other things I had from my notes that we talked about in our in our first discussion, was a virtual hospital model and you talked about being very excited about that. Can you you share a little bit more about that? Yeah, absolutely. So I've been fascinated. Of course, this came about my thought process about space. I'm fascinating about space and of course during this covid pandemic, a lot of the space launches we've had kind of went a limit unnoticed. If we didn't have code, I think would be front page news every day. You know, with SPACEX shuttle launch is almost one every week now, right routine, and you know in the next three to five years I'd ventured to guess that we'd be colonizing the moon and we are at a race with Chinese and the Russians to be able to collonize and mean there's been a lot of discoveries there. But from all that thought I start thinking, well, when we colonize the Moon, how are these hundred, two hundred people going to get their healthcare? You know, well, how we going to do that? So it came from an idea where whatever we can do on Moon we could directly apply it to good old earth here. And one of the areas I think we've seen, unfortunately, a dramatic closure of our rural hospital system. So we have a lot of hospital deserts in this country right now because rural hospitals are not able to sustain themselves. I feel like the rural hospitals can be supported not only by these advanced technologies. So we're doing like MIS AI. We're trying to keep the patients in their own hospitals rather than bring him all to the big mothership in the tertiary hospitals. That will help them both financially also a comically. But where there is no rural hospital, we should be able to offer this virtual hospital model where a patient literally will walk in, whether we are or are and be able to feel that there in a setting and be able to interact with people at virtually and by doing that I think we can help a huge amount of...

...population. That you can't do virtual heart surgery, you can't do virtual brain surgery. Show those are those are very futuristic. But if you think about the things we're doing today, and you know, I want your listens to to leave this podcast understanding that today is probably going to be the slowest change of pace you're going to see in your entire life. From this day on, every day, the change of pace you're going to see, especially in medicine, is going to be excited and getting larger and larger and larger. So you know, a lot of these things that we thought ten years ago could not be done, we're doing it now. I mean, when I was training, we couldn't, you know, for brain and yours and is the only way we could do that was by opening up the skull and going to the brain and clipping the a yours. And now we can be eighty percent of them with what I call band aid. Certain we go through the growing go through the femoral arty, go up to the brain while the patients sleeping, take care of that a yours have come out. The patient leaves home the next day, and these were things that were unthinkable fifteen, twenty years ago, and now we're doing all of this stuff. So the future of medicine very exciting and I urge people to think how they can contribute. In closing, one of the things I also urge medical students to think about is the future position is not going to be only a physician who's excellent and colinical diagnosis been colinical skills, but also who is has some data signs component to their training, and what I mean by that is understand some of the python training understands on the data science, because they are going to be able to want be the ones that utilize this fantastic, you know, technology to be able to be better doctors. Ai's not going to replace positions, but AI will replace position to resist them. M position through use. Ai are going to replace position from resist Ai. So I can tell you that for sure. Right got embrace the change because it's coming, whether you like it or not. It's here. It's already here. Well, and what I love and I love about your positivity and your you know, in the face of the disasters we've all been in, the hard ship that we're dealing with, you continue to see the positive part of it. So I appreciate that and thank you for that. I also love the fact that you're you're basically validating that because of the positive coming out of the pandemic, is going to be an acceleration in medicine and technology. There's going to be advancements. I think the tele of medicine thing is just even a perfect example how the regulatory things were standing in the way of a growing tell of medicine. Due to the pandemic, we had to get them, throw those things away and they're not going to come back because we're seeing all the benefit in the value of the thing. So there are right things that come out of the out of the disaster as well. So I love that. Love that about you. I Love Your Spirit. Thank you for being a frontline hero, as we like to talk about it here as a healthcare you guys are, you know, doing superhuman things. We typically, as I mentioned, you, close these segments with our heroes of healthcare, and I love to ask you the question, when you think about it, who is your hero? My hero is not a healthcare hero. It is actually professor Edward Demi, and the reason I fell in love with him as an engineer was professor Demi was the...

...gentleman that went to he as a professor, he was a systems engineer and he went to Japan after World War II and really made them what they were as an industrial powerhouse. He inspired people to believe that every one of you can improve your organization, regardless of the level you are, and some people called total quality management, some organization called continuous quality improvement. But he gave the notion and concept of you have your destiny in your own hands. As any the the vidual person at the organization, you can contribute that your level of regardless to where you are. So he is my hero, Professor Edward Demi, help and I think, I think if I remember the Japanese call that Kaysen Kais in Yep, it is kays in, and a lot of our technology and long of our companies in the late s adopted those methodologies. I was actually on the receiving and and well, that's I'm dating myself too. That's how I that's how I know Kaysen, because I'm old too, and that's when I started getting into it. I love it. I mean that's I think. And again, the possibility of empowering your own employees to improve things without waiting for somebody from higher up to tell them that. Take control of it amazing. Well, Dr Thank you so much for joining us. It's our pleasure to have you on the heroes of healthcare podcast. Continued success, keep trailblazing, keep finding new ways to do this. I love the hope that you bring to us, the confidence in the vaccine. Keep wearing masks, keep being vigilant. Let's keep that message going and we just continue to thank you for your service and wish you all the best and you continued success as you move forward. Thank you so much. And again I want to leave by saying when you get a shot, to take it, don't pass it up amazing. Thank you. Thank you so much. Good 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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