This Week Health

Don't forget to subscribe!

Clinical Automation is the topic with Andrew Gostine, MD and CEO of Artisight. An ingenious solution that has so many practical applications in healthcare. I caught up with him at the Healthcare to Healthcare event and I wasn't the only one impressed with the solution. Have a listen, hope you enjoy.

Transcript
Bill Russell:

Today in health, it,

Bill Russell:

Another one of our interviews and action.

Bill Russell:

This comes from the healthcare to healthcare event, which I was a guest

Bill Russell:

at from the serious health care team.

Bill Russell:

It was in Montana.

Bill Russell:

And I was able to sit down with a handful of CEOs.

Bill Russell:

And I'm going to share those with you here shortly.

Bill Russell:

My name is bill Russell.

Bill Russell:

I'm a former CIO for a 16 hospital system and creator of this week in health.

Bill Russell:

It.

Bill Russell:

A channel dedicated to keeping health it staff current and engaged.

Bill Russell:

I hope you're enjoying these interviews and action.

Bill Russell:

We were able to do these interviews at the health conference, the

Bill Russell:

chime conference, and now the healthcare to healthcare event.

Bill Russell:

I've really enjoyed doing them.

Bill Russell:

, just a reminder.

Bill Russell:

We're going to get back to our normal programming where I take

Bill Russell:

a new story, break it down.

Bill Russell:

And talk about why it matters to health.

Bill Russell:

It.

Bill Russell:

We're going to be doing that as soon as the interviews are done we have

Bill Russell:

done 10 from the chime conference eight from the health conference and

Bill Russell:

we have five from the healthcare to health care conference so i hope you

Bill Russell:

enjoy another one of these interviews

Bill Russell:

All right.

Bill Russell:

We're doing an interview from the healthcare to healthcare event.

Bill Russell:

It's a serious invite only event.

Bill Russell:

And I'm joined today by Dr.

Bill Russell:

Andrew Gustine, our CEO, CEO,

Andrew Gostine, MD:

founder

Bill Russell:

CEO, founder of artist site.

Bill Russell:

And we're going to talk a clinical automation essentially

Bill Russell:

is what we're gonna do.

Bill Russell:

So tell us a little bit about artist's site

Andrew Gostine, MD:

before we get going.

Andrew Gostine, MD:

Doug artist's site is it's really an IOT sensor-based automation.

Andrew Gostine, MD:

To bring automation into the clinical space.

Andrew Gostine, MD:

You know, as a practicing physician, I was looking out at the different automation

Andrew Gostine, MD:

tools that were available and I realized most of them were focused on back office

Andrew Gostine, MD:

types of automation, but the biggest problems we have in healthcare often,

Andrew Gostine, MD:

not in the back office or at the bedside.

Andrew Gostine, MD:

And I saw a huge gap in the marketplace.

Andrew Gostine, MD:

And so developed this platform as a solution to a lot of the problems

Andrew Gostine, MD:

I was seeing at the bedside.

Andrew Gostine, MD:

Th

Bill Russell:

the reason we do it on the administrative side and not the

Bill Russell:

clinical side is the quality of data.

Bill Russell:

And so I think it's fascinating that you're getting the data raw

Bill Russell:

data directly from a camera that's embedded in that clinical setting.

Bill Russell:

And then that obviously for our listeners is going to create a whole

Bill Russell:

bunch of questions, but talk about

Andrew Gostine, MD:

the solution.

Andrew Gostine, MD:

So you talk about the first part of your statement, you know,

Andrew Gostine, MD:

the back office automation.

Andrew Gostine, MD:

Just the first evolution of automation because of all the discreet data

Andrew Gostine, MD:

that was available, uh, you know, the amount of charges we generated,

Andrew Gostine, MD:

the, um, different insurance broker that was handling the payments.

Andrew Gostine, MD:

All of that information was quantifiable and available.

Bill Russell:

Just brief data easily to work off of.

Andrew Gostine, MD:

Okay.

Andrew Gostine, MD:

All of the information I have available at the bedside to

Andrew Gostine, MD:

me is coming from a clinician.

Andrew Gostine, MD:

It's a clinician that is seeing.

Andrew Gostine, MD:

Is talking to the patient is feeling the patients and then putting

Andrew Gostine, MD:

that information into the EMR.

Andrew Gostine, MD:

If you don't have the clinician that is there to capture the data,

Andrew Gostine, MD:

you don't have any discrete data.

Andrew Gostine, MD:

And so what we saw in the marketplace, uh, really at the

Andrew Gostine, MD:

bedside was that there was a gap.

Andrew Gostine, MD:

We didn't have access to the discrete data.

Andrew Gostine, MD:

So we developed these IOT sensors to structured data for us, putting

Andrew Gostine, MD:

a camera in the room and developing.

Andrew Gostine, MD:

To look for events or pieces of information that we can capture

Andrew Gostine, MD:

in real time and build automation around so that we could remove

Andrew Gostine, MD:

the human component of data entry.

Andrew Gostine, MD:

No,

Bill Russell:

we only remove the component, but actually assist them

Bill Russell:

because now you take that error away there, you know, they forgot

Bill Russell:

to put in information about whatever whatever's going on in that room.

Bill Russell:

That's missing information.

Bill Russell:

You can't really act on it, but the camera is there.

Andrew Gostine, MD:

The camera's always there.

Andrew Gostine, MD:

It's a lot cheaper than a clinician.

Andrew Gostine, MD:

It doesn't need a bathroom break.

Andrew Gostine, MD:

It can always be watching, looking for things that we tell it to, to see,

Andrew Gostine, MD:

and kind of to the other side of that, won't look for things that I don't

Andrew Gostine, MD:

want it to see, because I don't want to put a system in a hospital that

Andrew Gostine, MD:

clinicians feel like his big brother.

Bill Russell:

And that was interesting.

Bill Russell:

So looking at some of the video clips that you were showing

Bill Russell:

yesterday, everything's blacked out.

Bill Russell:

The patient's face is blacked out.

Bill Russell:

Blacked out, but you're still picking up that data.

Bill Russell:

You're still processing that data.

Bill Russell:

So what are you doing around privacy?

Bill Russell:

Obviously that's one step, but you're doing some other

Bill Russell:

things around privacy as well.

Andrew Gostine, MD:

So I think people have to change how they think about a camera.

Andrew Gostine, MD:

When people think about an IP or security camera, they think of it

Andrew Gostine, MD:

as the closed circuit TV system.

Andrew Gostine, MD:

That's recording video.

Andrew Gostine, MD:

That was a lot of the initial use cases.

Andrew Gostine, MD:

When we talk about an IP camera, we really think of it as just a light switch.

Andrew Gostine, MD:

That if you look at those pixels makes a picture, but we don't have to record it.

Andrew Gostine, MD:

We have elder rhythms that just watch the video feeds in real time.

Andrew Gostine, MD:

And we'll look for different combinations of pixels that represent

Andrew Gostine, MD:

objects or events of interest.

Andrew Gostine, MD:

They will structure some type of data from the event that it's witnessing, but

Andrew Gostine, MD:

we can then just save the discrete data.

Andrew Gostine, MD:

We don't have to save the video.

Andrew Gostine, MD:

So we can just retain the parts of that video feed that are interested

Andrew Gostine, MD:

to the hospital, but not any of the risks or any of the concern

Andrew Gostine, MD:

that a clinician might have.

Andrew Gostine, MD:

If we don't train the camera to see something, it is totally blind to it.

Bill Russell:

Yeah.

Bill Russell:

And it was interesting.

Bill Russell:

One of your users was here and they said their legal team came back and said,

Bill Russell:

Hey, can we get access to the video?

Bill Russell:

And the answer was, it doesn't exist.

Bill Russell:

It goes into the AI engine.

Bill Russell:

It gets.

Bill Russell:

It generates those insights, if you will.

Bill Russell:

And then it's,

Andrew Gostine, MD:

it's, it's somewhat like time where we live

Andrew Gostine, MD:

in the present and I don't really have a recording of the past.

Andrew Gostine, MD:

It's the same thing with our video feeds.

Andrew Gostine, MD:

We run inferencing on them in real time, but we don't save videos.

Andrew Gostine, MD:

There are some exceptions for other use cases where surgeons want records of their

Andrew Gostine, MD:

surgical videos for education purposes.

Andrew Gostine, MD:

But for the vast majority of our use cases, we don't say that.

Bill Russell:

So let's talk about some of the use cases.

Bill Russell:

So people are probably thinking right now, if I had a camera in there,

Bill Russell:

obviously we're doing tele-health, uh, fall detection, hand-washing clean rooms.

Bill Russell:

I mean, it really is limitless.

Bill Russell:

Really?

Bill Russell:

What if it's really limited by people's creativity of what they can imagine?

Andrew Gostine, MD:

Computer vision is very powerful, uh, in many

Andrew Gostine, MD:

ways, a lot better than humans in some ways it's not as powerful.

Andrew Gostine, MD:

That's the best way to think about computer vision is it's

Andrew Gostine, MD:

a much more cost efficient way that can capture the same data.

Andrew Gostine, MD:

As if I put an educated person in every part of the hospital, just

Andrew Gostine, MD:

collecting data with their eyes.

Andrew Gostine, MD:

Computer vision can see the same way that humans can see.

Andrew Gostine, MD:

And if a human can witness something with their eyes and tell me about it,

Andrew Gostine, MD:

I can most likely train a camera to do the same thing for a much cheaper.

Bill Russell:

It's really interesting.

Bill Russell:

So you showed up fall detection.

Bill Russell:

So I assumed, is there training that needs to go on at each

Bill Russell:

institution or do you have, are the algorithms already trained to detect?

Bill Russell:

So

Andrew Gostine, MD:

it's again, similar to humans.

Andrew Gostine, MD:

You know, if I teach you at one hospital, how to monitor what it looks like when

Andrew Gostine, MD:

the janitors are cleaning a room and then I take you to another hospital and

Andrew Gostine, MD:

you witnessed janitors cleaning a room, you're going to be pretty accurate.

Andrew Gostine, MD:

They might use.

Andrew Gostine, MD:

They might have different scrub colors on, but you're going to be able to

Andrew Gostine, MD:

tell me with reasonable certainty that you're pretty sure a janitors cleaning

Andrew Gostine, MD:

an operating room or a room or whatever, same thing with computer vision.

Andrew Gostine, MD:

If I train it at one institution and take it to a second out of the box,

Andrew Gostine, MD:

it's going to be pretty advanced, but we will do some retraining over a week

Andrew Gostine, MD:

or two to make sure that it lends the peculiarities of that new institution.

Bill Russell:

What's interesting.

Bill Russell:

So I want to talk to you about deployment, but.

Bill Russell:

The, you talked a little bit about the highest, um, use case, the highest best

Bill Russell:

use for the first couple of, of, of things that you're gonna use it in your

Bill Russell:

health system, because the platform can really return almost a complete

Bill Russell:

return on investment with one or two use cases, but you still have the platform.

Bill Russell:

And I find that interesting in of itself.

Bill Russell:

What have you found to be some of the, some of the things

Bill Russell:

that people have deployed?

Bill Russell:

The initial.

Bill Russell:

So

Andrew Gostine, MD:

there's a, there's a lot of business strategy

Andrew Gostine, MD:

that goes around technology.

Andrew Gostine, MD:

And there's a lot of very interesting use cases that, you know, as a physician

Andrew Gostine, MD:

really interests me, but healthcare is still a business and we have to make

Andrew Gostine, MD:

sure that we're justifying the things that we're doing in the hospital.

Andrew Gostine, MD:

So we build business, use cases around some of what I would

Andrew Gostine, MD:

consider the first best use cases where hospitals are collecting.

Andrew Gostine, MD:

And we can show this is your baseline performance.

Andrew Gostine, MD:

And after you put in our fall algorithms, this is by how much you've reduced false.

Andrew Gostine, MD:

Well, the problem with healthcare is we don't collect data on most things.

Andrew Gostine, MD:

So if I could build an algorithm that reduced the amount of infections, but

Andrew Gostine, MD:

you have no idea what your baseline infection rate is, then I can't show you.

Andrew Gostine, MD:

You made X.

Andrew Gostine, MD:

You saved this many dollars and it will justify its existence.

Andrew Gostine, MD:

So all of the first use cases that we recommend to hospitals like reducing

Andrew Gostine, MD:

falls, reducing pressure ulcers, uh, bringing them up to compliance with new

Andrew Gostine, MD:

regulations for hand-washing is around things that we know they're measuring

Andrew Gostine, MD:

where we know they might be sustaining penalties, or they have a large expense

Andrew Gostine, MD:

to maintain some level of compliance.

Andrew Gostine, MD:

We go after those first to help them show to their board and decisions.

Andrew Gostine, MD:

That this is the quantifiable value.

Andrew Gostine, MD:

And then once the platform is in there returning that value from those first

Andrew Gostine, MD:

use cases, you can now use it for things that might be more interesting,

Andrew Gostine, MD:

might provide a greater impact to society, but are harder or more

Andrew Gostine, MD:

nebulous to quantify in terms of the

Bill Russell:

value.

Bill Russell:

So I thought the other thing that was interesting is innovation partners really.

Bill Russell:

I mean, when I think about the academic medical centers could really use this.

Bill Russell:

In a lot of different ways that we probably couldn't even imagine ourselves.

Bill Russell:

And, uh, you talked about sort of incenting that, that environment

Bill Russell:

of innovators to, can you talk about that a little bit?

Andrew Gostine, MD:

Yeah.

Andrew Gostine, MD:

So it kind of a two part answer.

Andrew Gostine, MD:

So I, I may be the world's best physician, most likely I'm not, but even the world's

Andrew Gostine, MD:

best physician is not going to think of all of the use cases for this technical.

Andrew Gostine, MD:

And the goal for this company is not to become the richest company

Andrew Gostine, MD:

in the world it's to fix healthcare.

Andrew Gostine, MD:

And the only way we're going to be able to solve as many problems as this platform

Andrew Gostine, MD:

can solve is if we get everyone to help us, if we crowdsource the ideas and

Andrew Gostine, MD:

the opportunities, and co-develop the solutions now for the institutions, most

Andrew Gostine, MD:

often academic or very large medical.

Andrew Gostine, MD:

That want to help with that and are very interested in helping us bring new

Andrew Gostine, MD:

solutions on the platform to market.

Andrew Gostine, MD:

They should totally be able to share and the financial gains from those solutions.

Andrew Gostine, MD:

And so we have revenue sharing agreements.

Andrew Gostine, MD:

We have cost reduction terms and all of the contracts where if they help us

Andrew Gostine, MD:

develop a solution, we will start spitting back revenue from other clients that are

Andrew Gostine, MD:

using the solutions they co-developed to chip away at the contracts.

Andrew Gostine, MD:

These.

Andrew Gostine, MD:

As kind of a way of saying you participated, you helped provide this

Andrew Gostine, MD:

value to the healthcare ecosystem.

Bill Russell:

The overused phrase of app store comes to mind, essentially,

Bill Russell:

you're an app store for computer vision solutions in the hospital.

Andrew Gostine, MD:

And I think we will ultimately evolve into something that

Andrew Gostine, MD:

is even beyond the applications that we develop, where people who research.

Andrew Gostine, MD:

Develop a very interesting algorithm to solve a problem, but have no

Andrew Gostine, MD:

way of managing a camera network of 10,000 cameras securely behind the

Andrew Gostine, MD:

health system, firewall with security compliance and firmware upgrades.

Andrew Gostine, MD:

We can be that portal for them to deploy their algorithms on

Andrew Gostine, MD:

the infrastructure we maintain.

Bill Russell:

The nursing shortage is written about a lot at this point.

Bill Russell:

And I think we're, we're looking at potentially half a million

Bill Russell:

in the next three years, right?

Bill Russell:

How does this help in that with regard to that?

Andrew Gostine, MD:

So we're going after things that nurses have to do

Andrew Gostine, MD:

now, but shouldn't have to do tomorrow.

Andrew Gostine, MD:

So in some of the literature I've presented here, we see that nurses spend

Andrew Gostine, MD:

about a third of their time documenting.

Andrew Gostine, MD:

So eliminating some of the things that don't really require a nurse to do,

Andrew Gostine, MD:

like documenting that he or she turned to patient, eliminating that from their

Andrew Gostine, MD:

workflow is going to make them more.

Andrew Gostine, MD:

It's also going to burn them out less because they didn't go

Andrew Gostine, MD:

to nursing school so that they become a stenographer in the EMR.

Andrew Gostine, MD:

They went to nursing school so they could be at the bedside

Andrew Gostine, MD:

taking care of the patients.

Andrew Gostine, MD:

So we're trying to bring the joy back to nursing, eliminate the

Andrew Gostine, MD:

nonproductive non-patient care aspects of their workflow so that we can help

Andrew Gostine, MD:

them see more patients, more timely and take better care of patients.

Andrew Gostine, MD:

The

Bill Russell:

lastly, I want to talk to you about.

Bill Russell:

It's deployment because you're not talking massive, expensive care bros, and you guys

Bill Russell:

even have a mobile solution to move in.

Bill Russell:

It seems like you could actually ramp this up pretty quickly at a health system.

Andrew Gostine, MD:

So we, we did that even in the middle of COVID

Andrew Gostine, MD:

where there was a lot of challenges of getting into the patient rooms.

Andrew Gostine, MD:We deployed:Andrew Gostine, MD:

In six weeks.

Andrew Gostine, MD:

So with the mobile systems, we can do that in a few minutes of bringing

Andrew Gostine, MD:

them into a hospital and adding them to the secure wifi network.

Andrew Gostine, MD:

When we talk about server infrastructure, for those that have

Andrew Gostine, MD:

a hybrid or a cloud presence, we can turn on new virtual machines

Andrew Gostine, MD:

for AI processing and a few hours.

Andrew Gostine, MD:

So the rate limiting step is typically camera installation.

Andrew Gostine, MD:

The rest of it is hours to minutes of the bringing new systems.

Andrew Gostine, MD:

So

Bill Russell:

people are going to ask me about security, talked about privacy.

Bill Russell:

They're going to ask about security.

Bill Russell:

You're streaming this information.

Bill Russell:

I'm not sure that this information itself has value to someone who's going

Bill Russell:

to hack it and that kind of stuff.

Bill Russell:

But if it did what, what's the, uh, what's the information around security.

Andrew Gostine, MD:

You know, just the, the first things we're going to do to

Andrew Gostine, MD:

keep this secure is always deployed behind the health system firewall.

Andrew Gostine, MD:

So the cameras for obvious reasons being in the patient rooms are by definition

Andrew Gostine, MD:

behind the hospital firewall, but even the server infrastructure or the

Andrew Gostine, MD:

cloud, we enter and deploy these on virtual machines in our client's cloud

Andrew Gostine, MD:

tenant, so that we're not streaming this outside of their ecosystem.

Andrew Gostine, MD:

So the first and second line of defenses are always the.

Andrew Gostine, MD:

Security measures the VPNs, that directly route things up to the cloud.

Andrew Gostine, MD:

If that's how they deploy us in terms of the data that we collect by not saving

Andrew Gostine, MD:

any video or in cases where we do save video, but de-identify, or anonymize

Andrew Gostine, MD:

the video, we're preventing that risk of any Phi leaving the health system with

Andrew Gostine, MD:

the data that we generate and structure for them from those unstructured.

Andrew Gostine, MD:

We send that into their enterprise data warehouses or their EMR is we're never

Andrew Gostine, MD:

holding our own version of the data.

Andrew Gostine, MD:

So we're trying to make sure that we're putting this data in a place that is

Andrew Gostine, MD:

super safe and controlled by the client.

Bill Russell:

Andrew, thanks for your time.

Bill Russell:

We're really excited to solution.

Bill Russell:

I'm looking forward to seeing what you guys

Andrew Gostine, MD:

do.

Andrew Gostine, MD:

Yeah.

Andrew Gostine, MD:

Thank

Andrew Gostine, MD:

you.

Bill Russell:

Don't forget to check back as we have more of these interviews

Bill Russell:

coming to you, that's all for today.

Bill Russell:

If you know of someone that might benefit from our channel,

Bill Russell:

please forward them a note.

Bill Russell:

They can subscribe on our website this week, health.com or wherever you listen

Bill Russell:

to podcasts, apple, Google, overcast, Spotify, Stitcher, you get the picture.

Bill Russell:

We are everywhere.

Bill Russell:

We want to thank our channel sponsors who are investing in our mission to

Bill Russell:

develop the next generation of health.

Bill Russell:

VMware Hill-Rom Starbridge advisors, McAfee and Aruba networks.

Bill Russell:

Thanks for listening.

Thank You to Our Show Partners

Our Shows

Related Content

1 2 3 295
Healthcare Transformation Powered by Community

© Copyright 2024 Health Lyrics All rights reserved