This Week Health

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.

Want to tune in on your favorite listening platform? Don't forget to subscribe!

Thank You to Our Show Sponsors

New Shows for 2022

Insights - This Week Health
This Week Health Town Hall
Keynote - This Week HealthSolution Showcase This Week Health
Newsday - This Week HealthToday in Health IT - This Week Health

Related Content

1 2 3 137

Amplify great thinking to propel healthcare forward and raise up the next generation of health leaders.

© Copyright 2022 Health Lyrics All rights reserved