I Don't Care

On this episode of I Don’t Care, Host Kevin Stevenson talked with Dr. Moira Scheike, Founder of Cubismi and a board-certified radiologist specializing in cancer imaging. She invented 5D medical imaging technology. Cubismi is an interactive digital diagnostics pioneer who personalizes actionable visualizations and precision insights to transform and empower each professional interaction and patient journey. The duo talked about the cause and effect of the decline in the radiology job market, and how it can be reversed, and 5D imaging technology.

When it comes to imaging, the practice of radiology relies on outdated technology. When it comes to the digital transformation in radiology, 90 percent of the data is imaging. The industry also hasn’t benefitted from a digital transformation, which has left it open to high error rates and failures in disease detection. Schieke believes the field is poised for innovation and investment, both of which she argues is vital for rejuvenating the sector.

“We can think about it from two angles: what can we do about in the here and now, and immediately to address what are our major pains for the radiologist and healthcare systems dealing with huge problems around diagnostics,” Scheike said. “...in the long term, the big long term view, is we all know we have this vision for the future, a precision medicine future.”

The technological future Scheike refers to involves cloud computing and artificial intelligence. The challenges lie in stepping through and dealing with the current problems and then getting into the future. Another major problem is that the radiology job market is declining, with little investment being directed into the field over the past decade.

Cancer treatment has evolved dramatically in the last decade. With new and innovative ways to fight this disease, patients have options, but only a select few are NCI-designated. Discussing what NCI means and how it influences her organization’s care, Lauren Lawrence, Vice President at Karmanos Cancer Institute joined I Don’t Care host Kevin Stevenson.

Karmanos, based in Detroit, is one of only 51 programs that have the comprehensive designation in the U.S. Lawrence explained, “It actually came from the National Cancer Act of 1971 and is awarded based on rigorous research standards that have depth and breadth, including basic, translational, clinical, and population science.”

Lawrence, who has been with Karmanos since 2013, has a long history of healthcare leadership. In her current role, she has responsibility for strategic initiatives, budgets, program development, physician recruitment, improving market share and patient access.

"Having expert knowledge together in one place can extend survival rates and quality of life for patients.” -Lauren Lawrence

Because Karmanos has a multi-disciplinary approach to cancer, they have experts that come together as a team and use their collective knowledge to design a customized treatment plan. “This reduces time from diagnosis to treatment, which builds patient confidence and improves satisfaction, which helps them have a better outlook,” Lawrence said.

One of the key pillars of being an NCI program is clinical trials. “We have Phase 1 trials, which 10 years later become the standard of care. We have 400 clinical trials occurring with a given day and serve over 800 patients a year,” Lawrence shared.

Another aspect of their innovative approach is work with genetic testing. “We have a partnership with molecular experts, and most every patient has genomic makeup testing to better target their treatment,” Lawrence added.

The genetic testing industry is booming. Consumers want to trace their lineage, but there are more exciting applications since genes can point to health issues as well. Discussing the evolution of the field, I Don’t Care host Kevin Stevenson spoke with Alex Mulyar, CEO of CRI Genetics.

“We started in the genealogy route, building up databases, and then began to get into health-oriented reports for weight loss and allergies. Now, we’re looking at more clinical applications like cardiology,” Mulyar explained.

The question became how to apply genetic information to a person’s health. Mulyar spoke about his own results around caffeine consumption. “I received the report, and my metabolism was low but my anxiety gene high, and the recommendation was to drink no more than two cups and never after 2:00 pm.”

The next step for the company was to look at using genetic testing in clinical settings. “We did a lot of internal R&D to figure out how to create a tool doctors could use. It became a blueprint of how people metabolize medications or react to certain things.”

The company is now taking learnings to apply them to cardiology. For example, those with naturally high cholesterol can often be fit and healthy. However, they wouldn’t know this is their genetic predisposition until after their first heart attack. “Doctors can do a simple DNA test and understand this, so they can prescribe statins to prevent heart attacks,” Mulyar said.

Further, cardiologists can also use it to understand medication. “If a patient metabolizes medication slowly, they may have dosages building up, or for those metabolize too fast, it could be the opposite,” Mulyar added.

On this episode of I Don’t Care, Host Kevin Stevenson talked with Dr. Dan Burnett, President, and CEO of Theranova, an experienced medical device developer with a track record of creating innovating and practical solutions to large markets with unmet needs. The duo dug into Theranova and spinning out companies after funding.

Acting as a medical device incubator or venture studio, Theranova builds medical devices, nurtures them, raises money for them, and once they get to the right stage, they bring on a management team and forge them into their own entity.

“Theranova is, essentially, an idea generator and a company generator,” Burnett said, “that averages a little over one a year in terms of companies we form and spin out. We’ve had 17 in the last 15 years.”

They focus on various healthcare areas, and it just depends on where they see a need. However, they have been honing in on mechatronics and advanced sensing technologies and using those to gather proprietary data streams, which they believe will revolutionize medicine.

Where they once let go of companies quickly, Theranova is holding onto companies longer and longer. Previously, a company would spin out with Series A financing, become its own company and leave Theranova.

“Increasingly, Theranova is investing in these companies, and we’re getting grants and angel capital that allow it to stay inside of Theranova longer,” Burnett said. “By the time it spins out, it is of greater value than the initial spinout stage.”

Listen to hear more about where Theranova sees itself in five to ten years.

Treatment of diseases like cancer and HIV is hitting a new frontier with cell-based therapy. This new therapy invigorates the medical world, but it’s not widely accessible yet. Discussing the breakthroughs in these treatments, I Don’t Care host Kevin Stevenson spoke with immunologist Dr. Chris Xu, CEO of ThermoGenesis, a medical device company that’s a pioneer in the field.

“Cell-based therapy came about 13 years ago, and we’ve been fostering the field around cord blood, with 90% of FDA approved cord blood stored in a nitrogen system we developed,” Dr. Xu explained.

That was the company’s beginning, but it has aspirations to do much more. That requires a shift in treatment perspective. “We’ve long used drugs to treat illnesses, but cancer is much more complex. The newly approved therapy takes a patient’s T-cells, which are part of the immune system. It reprograms them to recognize cancer and fight it. It’s the future of medicine,” Dr. Xu said.

"Using someone’s T-cells turns their body into the best defense mechanism against disease.” - Dr. Chris Xu

Thus far, Dr. Xu reported that patients with leukemia and lymphomas have a 93% response rate. He also noted that cancer treatment is just the beginning. Over 1200 trials targeting every type of cancer are ongoing.

HIV is another disease where cell gene therapy has promise. “We discovered that a small percentage of the population doesn’t carry the receptor for HIV, which is necessary for the virus to enter a cell. We can modify cells not to have it, making the patient HIV resistant.”

While the promise of new treatments is here, Dr. Xu noted there are two big impediments. One is cost, with treatments costing as much as $500,000. The other is that patients may no longer have T-cells due to radiation, chemo, or other issues. That’s why he recommends storing cord blood for future use.

At one point in his career, I Don’t Care Host Kevin Stevenson spent some time on the pharma side of things, in between working at hospitals.

Today he dives back into that world with Donovan Quill, President, and CEO at Optime Care, a nationally recognized pharmacy, distribution, and patient management organization that creates the trusted path to a fulfilled life for patients with rare and orphan disorders.

“What we try to do is create a holistic program for those patients where we combine all the services you would see in a pharmacy in a patient care model,” Quill said. “We try to create a one-stop-shop for patients to really get the care they need from a support standpoint, from affordability, and also to distribute their products to them in their home or site of care.”

“Our patient populations we treat here at Optime care range from 16 patients nationwide all the way up to a couple of thousand.” - Donovan Quill

Orphan disorders and drugs are a bit different from regular pharmaceuticals. Typically, an orphan drug is a treatment for a condition with less than 200,000 patients in the U.S., according to the FDA definition. But, what they do at Optime Care is treat disorders that are even more rare, or “Ultra orphan,” according to Quill.

“Our patient populations we treat here at Optime care range from 16 patients nationwide all the way up to a couple of thousand,” Quill said. “We really try to focus on the patients who need a little extra care.”

Most of the time, the patients they treat have a disorder they’ve never heard of and are treated with a product they can’t pronounce, Quill said jokingly.

Healthcare is a complex industry, and its processes often lag behind other sectors for a myriad of reasons, but its embrace of technology is rising. EHRs have been around for decades, but workflow management remained an untapped challenge. Not only did a solution need to create structure, adherence to HIPAA guidelines is also critical. I Don’t Care Host Kevin Stevenson spoke with Dr. Michael Docktor, a pediatric gastroenterologist at Boston Children’s Hospital and Co-Founder and CEO of Dock Health on this topic.

Docktor described himself as “techy” and was inspired by the world of apps and how an idea could become something deployable to the masses. He built his first app with engineers on potty training. “I learned about the process of design and user interfaces.”

With this experience in his background, Docktor soon began to ask big questions about tech in healthcare workflows or lack thereof. “I was thinking why aren’t we using these tools and became a mobile evangelist, bringing in new clinician facing tools, later becoming the clinical director of innovation.”

The focus on streamlining workflows securely became his vision. “EHRs are very clinically oriented, but the administrative and operational aspects of healthcare are ignored. If I order a therapy, there may be multiple downstream tasks to do this with different stakeholders with no structure or accountability,” Docktor said.

Dock Health is taking on this gap, tracking all the tasks from pacing an order until completion. It also helps organizations understand bottlenecks through data collection, which enables them to refine the process. “Workflow management didn’t exist in healthcare. Educating this world about how technology can transform drives efficiency and offers visibility,” Docktor added.

How is artificial intelligence changing the healthcare industry? Does using AI improve health outcomes and reduce costs? To discuss the use of this technology in healthcare, Carol McCall, Chief Health Analytics Officer for ClosedLoop.ai joined host Kevin Stevenson.

“Healthcare is finally becoming a big-data industry,” McCall said, pointing out that there is now so much data in healthcare it’s almost too big to know and becomes a burden. That’s where machine learning comes in. ClosedLoop.ai provides an intuitive end-to-end machine learning platform for healthcare organizations to predict health outcomes and target resources.

For example, McCall explains that health providers who are trying to prevent unplanned hospital admissions can use an AI platform to look at factors in their patient population to predict health outcomes. This allows providers to reach out to patients and help reduce the likelihood of hospitalization.

AI can be an essential part of the push toward value-based care. “If people want to succeed in value-based care they really have to have the ability to produce better outcomes with a much higher degree of precision. They have to be able to anticipate when something bad might happen because you can’t prevent what you can’t predict.” McCall said.

Stevenson and Carrol delve into various use case scenarios for AI platforms from the coordinated care of ACOs to assessing specific risks of patient populations and integrating data for more predictive power. “Data and analytics are really becoming the center of healthcare,” Mcaall said.

Technology and healthcare are a marriage made in heaven. As technological advancements evolve, so does the ability to treat patients in a new and innovative way. These tech and healthcare innovations are conquering the toughest of tasks when it comes to patient care.

On this episode of I Don’t Care, Host Kevin Stevenson talked with David Preiner, CEO of Medivolve, which seeks out disruptive technologies, ground-breaking innovations, and exclusive partnerships to help combat COVID-19 and generate remarkable risk-adjusted returns for investors. The duo talked about tech and healthcare, Preiner’s career in startups and entrepreneurship, which has spanned over a decade.

“Wouldn’t it be interesting if we could take that same concept that’s been used to treat some of the most complex problems in healthcare … and bring that approach to every American and make it very accessible" - David Preiner

Preiner has bootstrapped three companies and has spent a significant amount of time in entrepreneurship. Wanting to find a little bit of life balance, he started to get curious about biology. This led him on a path to the Harvard Extension School, where he dove headfirst into the subject. He eventually landed at Medivolve when the CEO position opened up.

“Medivolve has a couple of really key assets that made me curious about a problem,” Preiner said. These two things were an issue with COVID-19 collection sites, as well as pharmacy acquisitions.

One of the things he learned in his studies is how to treat patients. As a tech at Harvard Extension School, he noticed how important it was for healthcare providers to have a baseline of care for patients. When taking diagnostic tests, then adjusting medication, and then reperforming diagnostics so that doctors could see if a patient improved.

“Wouldn’t it be interesting if we could take that same concept that’s been used to treat some of the most complex problems in healthcare … and bring that approach to every American and make it very accessible,” Preiner said.

Listen to learn more about how Preiner wants to improve healthcare through tech and data.