Innovation Unleashed Podcast

As the coronavirus continues to hold us in its grip, our nation is required to social distance and children are expected to go back to school virtually, the Internet, more than ever, has become our bridge to the outside world.  It is an economic lifeline to workers who are fortunate enough to do their jobs from home. It connects us to the news of the world. It helps sick patients hoping to chat with a doctor via a video appointment. It provides entertainment and critical education to our young people. But the harsh reality is that broadband isn’t available to everyone. According to the Federal Communications Commission, high-speed internet is unavailable to roughly 25 million Americans and more than 19 million of those Americans live in rural communities. Nearly one in five Americans only have access to the internet through smart phones.  Although these numbers have improved in recent years, the gaps remain prevalent, despite the fact that internet service has become as critical as a phone or electricity in our homes.

This inability to build digital infrastructure has intensified the divide between urban and rural areas. This divide has become especially evident as 44 million students across the country have been affected by school closings due to the pandemic. Schools have asked families to switch their children to online learning, but, because of a lack of broadband accessibility, millions of children are being left behind.  18 percent of children in remote rural areas have no home broadband and according to the Pew Research Center, nearly one in five students between kindergarten and 12th grade do not have computers. This aspect of the digital divide is referred to as the “homework gap” and is an academic encumbrance for young people who lack access to digital technologies at home. Black teens, as well as those from lower-income households, are especially likely to face these school-related problems as a result.

Who will fix these problems?  How fast? When? We are so very fortunate to have one of the world’s foremost experts on the challenges, scope, costs and intricacies of making broadband available to everyone with us today. Our guest on this episode, David McCourt is a “telecom revolutionary” according to The Economist, and his company, Granahan McCourt, is the largest independently owned designer and builder of telecom Public Private Partnerships in Europe and one of the most prominent investors in telecommunications globally. David has recently forged the largest Public Private Partnership in Europe to provide full-fiber to every home, farm and business in Ireland.

Many companies, like many people, in our country are experiencing devastation and loses…. and are panicked about the long-term implications of the coronavirus. The virtually immediate economic recession caused by the Covid-19 shutdown and subsequent global pandemic mandates have caused devastation for businesses large and small. Our very way of American life has also been threatened and changed by this humanitarian crisis. Perhaps forever.

Based on assumptions being made about the pandemic causing “the demise of commuting to work,” “the end of retail shopping,” and “the collapse of globalization,” many executives are bracing for and assuming that business operations will never be the same. According to today’s guest, survival in business, during a crisis and otherwise, is achieved by building in both the short and long term. At the same time.

David Cote is Executive Chairman of Vertiv Holdings Co, a global data center products and services provider. Previously, as CEO of the industrial giant Honeywell, he grew the company's market capitalization from around $20 billion to nearly $120 billion, delivering returns of 800 percent and beating the S&P by nearly two and a half times. In his new book, WINNING NOW, WINNING LATER: How Companies Can Win in the Short Term While Investing in the Long Term, he provides a fascinating, been-there-done-that explanation of how he deployed a series of fundamental principles and practices to transform Honeywell at a time when it was flailing and failing. David believes that the idea that CEOs must choose between winning now and winning later is wrong: They must find a way to do both. Thinking short- and long-term has to work together since you need today’s profits to fund tomorrow’s successes. His insights and lessons learned are a perfect prescription for the challenges that businesses are facing today.

There are many incredible people working every day that share a passion for bringing innovative healthcare solutions to large populations of people.  A new area of focus in the effort to do so is called Inclusion Health. Inclusion Health is a developing approach that aims to target extreme health and social inequities. Inclusion health focuses on target populations have common adverse life experiences and risk factors such as poverty, homelessness, imprisonment, drug addiction and childhood trauma that ultimately lead to social isolation. Subsequently, these populations have extremely poor health, multiple illnesses, and are likely to experience premature death. Likely, these people also face numerous barriers to actually accessing health services that they need.

Many times the people that become socially isolated are suffering from something called tri-morbidity: physical sickness, mental illness and addiction.

The Inclusion Health movement aims to highlight these issues and the magnitude and consequences of extreme health inequity in our society, the need for preventive and early intervention approaches, and find ways to improve access to essential health services for individuals harmed by social exclusion.

We are very fortunate to be joined on this episode by an individual that has dedicated his career to helping people that are suffering from social exclusion and all of the health issues that come with that. Stuart Fisk is a passionate and devoted healthcare provider that works to eliminate healthcare inequality.

Stuart Fisk is the Director of the Center for Inclusion Health of Allegheny Health Network and a nurse practitioner with the Positive Health Clinic at Allegheny General Hospital.

Fisk has been involved in HIV activism, research, nursing, and prevention since 1988, and has provided hospice, nursing and medical care for persons living with HIV disease since 1992. He has dedicated his career to helping socially and economically marginalized people and is often asked if his work can be disheartening. He says, that the work isn’t sad, the broken system aimed at serving people in need is disheartening.

After finishing nursing school, Stuart Fisk then worked as a hospice nurse in San Francisco’s gritty Tenderloin district where single-room occupancy hotels served as housing for members of marginalized populations, many with HIV/AIDS who were not getting care. He credits those people for really teaching him not only how to be a nurse but more importantly how to be a human being. That dedication to people fuels his work to this day. Fisk moved to Pittsburgh, PA in 1996 and started to work with the then West Penn Allegheny Health System which is now the Allegheny Health Network. He started an HIV program in 1998.

The idea for the Center for Inclusion Health, formed in 2014, came from his desire to identify populations within the system facing significant barriers to care and change things throughout the system to better serve them.

In 2016, Klaus Schwab, Founder and Executive Chairman of the World Economic Forum wrote that “like the revolutions that preceded it, the Fourth Industrial Revolution has the potential to raise global income levels and improve the quality of life for populations around the world.”

He continued: “In the future, technological innovation will also lead to a supply-side miracle, with long-term gains in efficiency and productivity. Transportation and communication costs will drop, logistics and global supply chains will become more effective, and the cost of trade will diminish, all of which will open new markets and drive economic growth.”

And so the term Fourth Revolution was coined as a way of describing a future based on the blurring of boundaries between the physical, digital, and biological worlds. It’s a combination of developments in artificial intelligence (AI), robotics, the Internet of Things (IoT), 3D printing, genetic engineering, digital platforms and other technologies. The Fourth Industrial Revolution is about more than just innovation-focused change. It is also an opportunity create an inclusive, human-focused future. According to Schwab, “the changes are so profound that, from the perspective of human history, there has never been a time of greater promise or potential peril.”

The COVID-19 Pandemic is certainly putting this theory on change and the future of the world to the test. It has quickly forced all of us to become more reliant on technology and has put us in the position to be more open to experimenting with inventive solutions to the new problems that this global change has created. 

Even before the pandemic, today’s guest believed that the world of innovation is in need of a refresh. Alexandre (Alex)  Lazarow believes that this refresh comes from what he calls the “frontier” - - the growing constellation of startup ecosystems, outside of the Silicon Valley and other major economic centers, that now stretches across the globe. The frontier is a place where startups often must cope with political or economic instability and lack of infrastructure, and where there might be little or no access to traditional investors.

Alex has spent his career working at the intersection of investing, innovation, and economic development in the private, public, and social sectors. He is a venture capitalist with Cathay Innovation, a global firm that invests across Africa, Asia, Europe, and North America. Previously, Alex worked with Omidyar Network, a philanthropic investment firm that has invested over a billion dollars in hundreds of startups around the world. He has served as a strategy consultant with McKinsey & Company, a financial regulator with the Bank of Canada, and an M&A investment banker with the Royal Bank of Canada. 

His new book on innovation in the future, Out-Innovate, was published by Harvard Business Review Press. It was one of the three finalists for the best book proposals exploring emerging business themes, a competition co-hosted by McKinsey and The Financial Times, organizers of the Business Book of the Year Award. Out-Innovate was named a "Top Book To Inform Your Technology And Innovation Strategy” by Forbes, “The Hottest New Business Book” by Tech Collective and was the #1 Release in Venture Capital on Amazon.

 As we continue to adjust to living with the uncertainty about the future and experiencing the reality that the Coronavirus pandemic is changing the world forever, we are also experiencing something else.

We are experiencing innovation.

Entrepreneurs, creative thinkers and change makers are jumping in to help. All around the world, people are shifting focus and pivoting efforts. Start-up companies began quickly using 3D printing technology to create lifesaving ventilator parts to meet unexpected, extraordinary demand. Gin distilleries shifted production to make hand sanitizer. Artificial Intelligence (AI) has been quickly used to scan online articles all over the world, every day to gather and analyze public health information. Drones are delivering medical supplies to remote or quarantined areas and infectious hot zones. Video doctor appointments and telemedicine are helping patients get the care that they need, without leaving the house or putting doctors at risk of infection. Germ-killing robots are sanitizing high-traffic public areas allowing for the safety of workings while observing social distancing.

All of these technological answers have been created to solve problems…..and problem-solving is always at the heart of innovation. Although horrible and scary, a crisis presents innovators with an opportunity to think and create fast, impactful change. All while working in the service of people and organizations for the greater good and maybe even the bottom line. In the midst of a crisis, the ideal that “failure is not an option” aligns everyone’s energy toward clear purpose in resolving the crisis which prompts a groundswell of new ideas and out-of-the-box thinking.

Today we are fortunate to be joined by a world-recognized innovator that is known for inspiring out-of-the-box thinking, driving innovation, motivating engagement and generating energy toward the innovation goals of an organization. Not unlike a crisis, disruptive, innovative thinking in an organization forces change and intense effort – the speed of creative-thinking, decision making, and facilitation all surge intensely and forces an organization to quickly think differently, to fail or succeed fast, to learn, and to progress…..to innovate.

Alex Goryachev is an entrepreneurial go-getter. He takes risks, thinks ahead, and loves making way for new innovations. Over the past 20 years, he’s made it his business to turn disruptive concepts into emerging business models. In his new book, Fearless Innovation: Going Beyond the Buzzword to Continuously Drive Growth, Improve the Bottom Line, and Enact Change, Alex explores how, no matter their function, leaders and managers can cut through the noise to understand change and deliver real results.

For him, it’s all about a passion to create a strategy and then drive it home to “get things done.” And as Cisco’s Senior Director of Innovation Strategy and Programs, he has plenty of opportunities to put this passion to the test. He sparks internal innovation by providing employees at all levels the chance to share their big ideas, many of which make their way into the company’s innovation engine. Alex also carries the torch for co-innovation across Cisco’s ecosystem.

At Cisco, Alex spearheads several award-winning international programs and initiatives to accelerate innovation – whether that impacts operations, businesses processes, or technology. Alex is an award-winning Silicon Valley veteran whose resume reads like a brief history of tech disruption. He is a sought-after speaker on innovation and a regular contributor to Forbes, Chief Executive Magazine, Information Week, and other leading media outlets.

The complexities of disease require sophisticated approaches for understanding and treating them. On Innovation Unleashed, we often introduce listeners to the latest approaches and technology solutions for big global challenges. On today’s episode, we are going to  explore Computational Healthcare,  an emerging method of using computer models and sophisticated software to figure out how  human disease develops - - - - and how to prevent it. Using digital tools, computational biologists leverage experimental and clinical data to build models that can unravel complex medical mysteries through quantitative approaches for understanding the mechanisms, diagnosis and treatment of human disease through applications of mathematics, engineering and computational science.

Central to the challenge of how to use computers to improve healthcare is to develop computational models of the molecular biology, physiology, and anatomy of disease. Computational Healthcare can provide insight into and across many areas of biology, including genetics, genomics, molecular networks, cellular and tissue physiology, organ systems, and whole body pharmacology.

Close your eyes for a moment (unless you are listening while you are driving) and think of your kitchen table…imagine a half made puzzle of a picture of a snowy landscape.  Now complete the puzzle in your mind.  You can see the whole picture, even though you only started with an idea and half the pieces in place.  Computers can look into every aspect of biology and medicine…see how the pieces come together and tell us how to build the puzzle.   Computational medicine gives us enough of the pieces to see a much clearer view of the big picture of what causes disease and how to treat it.  Computers have changed every aspect of our lives…today we are going to have a chance to learn how they will change our health and wellbeing.

Today’s guest not only uses computational medicine to lead research to solve big healthcare problems, he also works to educate the next generation of scientists in this field. Dr. Chris Langmead is a Professor in the Carnegie Mellon University Computational Biology Department. He is a globally-recognized Computer Scientist with expertise in Machine Learning as well as modeling and simulating biological systems. His work stretches from drug and protein design … to clinical applications in acute and chronic illness. Dr. Langmead’s research is focused on the development and application of passive and active machine learning algorithms to address critical challenges in Medicine and Bioengineering.

Innovation demands trialing and attempts to change entire industries with novel approaches. By nature, innovation is immersed in unusual levels of risk and failure. Typically, we associate entrepreneurs with the ability and fearlessness of facing risk and failure to build innovative technology solutions and companies. But building and leading an innovative future-reaching healthcare organization within a system also requires a certain fearlessness and a similar spirit or an INTRApreneurial spirit.  An intrapreneur is defined as “a person within a large organization who takes direct responsibility for turning an idea into a profitable finished product through assertive risk-taking and innovation.”  But unlike an entrepreneur, an intrapreneur doesn’t own the product or service that they innovate; the system or organization owns the creative ideas and end products created by the individual(s). INTRApreneurs in healthcare organizations often do this work as part of a calling to help society, create solutions, change industries and impact humanity. This episode’s guest is an Intrapreneur working on the cutting edge of healthcare innovation and has spent her career matching her passion of caring for patients with a desire to implement novel technology solutions to create tools for better patient care at the right time and place.

Dr. Tufia Haddad is an Associate Professor of Oncology at the Mayo Clinic College of Medicine and Science, and a Consultant in the Department of Oncology. Her clinical practice and research program is dedicated to breast cancer. She currently serves as the Chair of Digital Health for the Department of Oncology and Chair of the Breast Medical Oncology Practice at Mayo Clinic Rochester. She is the Medical Director of Remote Patient Monitoring services for the Mayo Clinic Center for Connected Care, and she is a member of the Mayo Clinic Advisory Board to the Office of Augmented Human Intelligence. As an oncologist and clinical investigator, she is an active member of the Mayo Clinic Cancer Center, Women’s Cancer Research Program, and she has received federal funding in support of biomarker discovery and early phase clinical trials in drug-resistant breast cancer. In the field of digital health, her interest is in the transformation of healthcare delivery models and development of clinical decision support with novel connected health and artificial intelligence technology solutions.  Dr. Haddad has authored over 50 peer-reviewed manuscripts, book chapters, and editorials.

Dr. Haddad received her Bachelor of Sciences degree in Biology, magna cum laude, from Marquette University. She completed medical school at Creighton University and is an Alpha Omega Alpha honor society member. Her Internal Medicine residency was completed at the Mayo Clinic (Rochester, Minnesota), and her fellowship in Hematology, Oncology, and Transplantation at the University of Minnesota. She received student humanitarian, individual excellence in medicine, and teaching awards throughout her training, as well as several educational excellence awards while on faculty at the University of Minnesota and the Mayo Clinic College of Medicine and Science.

In everyday life, when we use the word Crisper we are likely referring to something that keeps produce fresh in the refrigerator…or something to do with the marketing of the beloved potato chip. But in the scientific and healthcare world, it is shorthand for "CRISPR-Cas9 and stands for "clusters of regularly interspaced short palindromic repeats." CRISPR is possibly the most impactful area of science to be invented since the discovery of DNA.  We are going to learn more about CRISPR, but to do so we just need to remember that DNA is the molecule in all cells that codes for life … and sometimes death.   Within many kinds of bacterial cells, some sequences have a unique feature…they read the same in one direction as they do in another. It turns out that there are some molecular scissors that have evolved to cut these sequences … and some remarkable scientists have learned how to take those enzymes and re-program them to cut and edit almost any piece of DNA.  When you mistype a word on your phone, you or autocorrect and make things right…in the same way CRISPR technology can make things right when targeted to a specific genetic problem.  Molecular biologists of my generation were brought up to think this was impossible…but today, through the work of pioneers that will surely win a Nobel Prize, Genome editing is much more than possible…it is central in how we think about solving some of the world’s most vexing problems.  

CRISPR allows researchers to easily alter the DNA in ways that can correct genetic defects, treat and prevent diseases, help combat opioid addition and even improve the ways that we grow food.

With all this incredible promise, though, genome editing desperately needs proactive versus responsive ethical debate. As we have discussed before on Innovation Unleashed…where there is a light…there are shadows…CRISPR can do immense good…but will also do immeasurable harm when misused.  Shifting the balance from shadows to light needs pioneers who understand how to harness the good without pretending that there could be bad.

We are fortunate to be able to talk about all of this with an emerging expert on all things Genome Editing. Dr. Samira Kiani is a Professor in the Department of Pathology at the University of Pittsburgh. Samira launched her own lab in 2016 after time at MIT where she worked on developing synthetic gene circuits to reprogram the function and behavior of mammalian cells using CRISPR.  In addition to her research work, Samira is passionate about people and how science affects their quality of life. Since 2017, she has been working on a documentary film about what our future looks like in the eye of genomic revolution. In parallel with the documentary film, she is building a communication platform called, “Tomorrow Land,” where she invites people, whether they are scientists or artists or the general public, to submit their opinions about how CRISPR is shaping the future of humanity. She is archiving short video clips that can be arranged together with the help of artificial intelligence. 

A remarkable team called BrainX comprised of physicians and technology innovation managers from Cleveland Clinic have partnered with machine learning experts from Carnegie Mellon University to explore and solve the puzzles of the human brain while also working to create the next generation of Artificial Intelligent applications for healthcare.

This team advanced through the prestigious IBM Watson AI XPRIZE, a $5 million global competition challenging teams to develop and demonstrate how humans can collaborate with powerful Artificial Intelligence technologies to tackle the world’s grand challenges. This competition is designed to show all of us how far we can go in undertaking cancer, poverty, climate change and more – with the help of Artificial Intelligence.

We are so fortunate to have the Founder of BrainX with us today to talk about his work leading innovation efforts that integrate machine learning and artificial intelligence in healthcare. This team of experts is constantly working on the evolving issues that are most important to patient care and have added COVID-19 datasets and  challenges to their important work.

The expert on this episode, Piyush Mathur MD, FCCM is the founder and team lead of BrainX. He is an Anesthesiologist, Intensivist and the quality improvement officer for Anesthesiology Institute, Cleveland Clinic. He is a leader in quality and patient safety who has innovated and successfully implemented many algorithms and tools in electronic health records such as difficult airway identification (EPIC),anesthesia awareness alert (DSS, Talis), antibiotic alert (ACG, Talis). Recipient of 3 innovation awards at Cleveland Clinic, he is leading innovation efforts integrating machine learning and artificial intelligence in healthcare. Current, projects include AIDE (Artificial Intelligence Diagnosis Engine), SALUS (robotic artificial intelligence patient safety system), BRAINS (Biologically Relational Artificial Intelligence Networking System).

Telemedicine is a big business; by 2025, it has been projected to exceed $64.1 billion in the U.S. alone. Televisits to doctors have increased at an extraordinary rate of 50% per year over the last decade and the current COVID-19 Shelter-at-Home requirements have changed everything. The Pandemic has forced primary care and specialty clinicians to adopt virtual care and telehealth so patients can still receive care while social distancing and medical resources can be redirected to the frontlines of treating COVID-19 patients. Because of this, the U.S. telehealth market is expected to reach around $10 billion by the end of 2020 with an 80 percent year-over-year growth due to the COVID-19 pandemic, according to recent reports.

Video and other forms of technology are increasingly being used in hospitals. In 2017, three quarters of hospitals in the U.S. were connecting with patients and other practitioners in this way, more than double the percentage in 2010.  The total Global number of televisits per year is approaching 10 million.  But…is telemedicine cost effective, is it time saving…and most importantly is it as effective as an inpatient visit…and where do we place the boundaries around this emerging field.  Some policy makers define telehealth as using technology so medical providers and patients can work together to improve health. Perhaps that is a little broader than saying “telehealth is the use of technology to deliver care to a patient without the physical presence of the treating physician”.

It makes sense that when doctors and patients are more connected in real-time and patients become more engaged in their healthcare decision-making process there can likely be better care outcomes, less return visits to the hospital, happier patients, and more profitable medical organizations. So…how do we separate the hype from the hope?  Well obviously, we talk to a real expert, and not a virtual expert…we talk to Dr. Jay Sanders

Known to many as the “Father of Telemedicine”, our guest on this episode, Dr. Jay Sanders was responsible for developing the first State-wide telemedicine system, the first Correctional telemedicine program, the first Tele-homecare technology, called “The Electronic House Call”, and the first Telemedicine kiosk. His consulting activities have included NASA, DOD, HHS, the VA, the FCC, State Governments, the Southern Governors Association, WHO, academic institutions, investment firms, Fortune 500 companies, and International Governments. In 1994, he introduced telemedicine’s capability to the Assistant Secretary of Defense that culminated in the initiation of the use of this technology within DOD. He was subsequently asked to serve as the sole civilian representative on the DOD Telemedicine Board of Directors with the Surgeon Generals of the Army, Navy and Air Force. During the Clinton Administration he represented the USA to the G8 nations for telemedicine, and was appointed by former HHS Secretary Leavitt, to the Chronic Care Workgroup.

Dr. Jay H. Sanders, is the CEO of The Global Telemedicine Group and Professor of Medicine (Adjunct) at Johns Hopkins School of Medicine.