Digital Health

Tyler Suiters  0:09 

Hey, everybody. I’m Tyler Suiters with the Consumer Technology Association. We're helping you get ready for CES, the biggest, most influential tech event on the planet. This week, one of the most important ways that technology is changing our lives for the better and that's digital health. We are talking about health and fitness tech like wearables. Medical applications like remote patient care. Even scientific innovations, everything from research, to surgery and training to do surgery. Also, wellness care for us is just getting more personal. We are all able to take better control of our own health. So this week, my friend Kinsey Fabrizio, who leads CTA's Health and Fitness Technology Division, which covers a slew of innovative companies from across the spectrum. She is joining me to talk to a pair of digital health insiders. One of them has a deep medical background. The other, is very much from the business side of the house. And together, they're giving us a comprehensive look at digital health today of course, but also where we're heading in the decades and even next few months to come.

Tyler Suiters  1:20 

David Rhew  1:50 

Tyler Suiters  1:52 

Also, Matthew Stoudt is CEO of applied VR and I say small business startup category that. Matthew, I know you all are growing by leaps and bounds. And we're it's good to have you with us today, too.

Matthew Stoudt  2:05 

Great to be here, likewise.

Kinsey Fabrizio  2:07 

Well, thank you for joining us guys. It is so great to talk about one of my favorite categories at CES, which is digital health. So first, I want to get into some of the great advancements we've seen in digital health over the last five years. Could you guys talk about some of your, in your opinion, your most promising advancements you've seen in digital health?

Tyler Suiters  2:28 

Dave, why don't we start with you?

David Rhew  2:31 

Sure, well today we're starting to see a convergence of medical device technologies and consumer technologies. And one of the things where it started off as where you could view your data on a smartphone or a smartwatch. And that was great. And I think a lot of people got very excited over that. Where we're seeing it move, is actually toward the point where your smartphone could actually control your medical device. Exciting developments that we're starting to see with the two partnerships, we're working with a company, Medtronic. One of the largest medical device companies in Europe. Basically enabling that to occur where both physicians and patients can use these devices. And this is where we're starting to move towards. The ability for the smartphone to be able to control medical elements that we hadn't previously even envision.

Kinsey Fabrizio  3:20 

That type of convenience is so important in consumers lives. Matthew, do you want to talk about some of the great advancements you've seen in digital health recently?

Matthew Stoudt  3:30 

Yeah, I'm gonna piggyback on what Dave was just saying there. We're big believers in the power of technology to enable people to take control of their own health care. And with the advances in wearables, and even the AI that's powering some of these wearables. The fact that we can now deliver these advanced technologies into the home, are going to be pretty powerful tools. Some of the work that we're doing even with Samsung here is where we're enabling patients to get access to dance pain management tools, now they can use with the comfort of their own home. We think they going to be great ways that are going to not only increase consumer and patient satisfaction, but also reduce resource utilization.

Tyler Suiters  4:11 

So let's step back for a sec. On that note Matthew, you and Dave both talked at least about one aspect of digital health, which is health in the home. Is that here the real Rubicon crosser? Is that what makes digital health so remarkably promising in your eyes, the fact that we're breaking down the borders between a doctor's office and a hospital, and caring access at home? 

David Rhew  4:39 

Absolutely, this is really the evolving landscape that we're seeing with value based care organizations starting to look at how you can manage the total care and really keep people out of the hospital, it's the most efficient way for us to reduce costs, keep them healthy. But in order to do that, you're going to have to engage them everywhere they're at. It could be on the go with mobile devices, but also in the home. And this is an area where we need to start thinking about what type of technologies do people use every single day.
Do these technologies have the ability to capture the data relevant, and be able to help provide some communications, but more importantly, that allows us to be able to draw insights. So we can be more proactive in preventing people from getting ill. I mean, the smart home and all the smart devices are great mechanisms for us to be able to provide that communication. But ultimately, it's going to be around the insights that we can draw from that and our ability to act on them in a proactive manner, that's going to lead to better health outcomes. 

Matthew Stoudt  5:41 

What Dave's stepping into as well, sorry I was going quickly on that. What David also stepping into is just the importance of data. That we're able to capture whether they're wearables that we have, or just the power of our own smartphone. The notion of getting that data in a usable format to boost the consumer, as well as to the doctor. I think it's going to be incredibly important.

Kinsey Fabrizio  6:03 

So thinking along those lines and having more access to data. Let's talk about artificial intelligence, and how that is impacting the way health care is being delivered today.

David Rhew  6:17 

Yeah, I will say that first and foremost, we're starting to see changes in the way that we address the issues around proactive care. How do you actually keep people healthy and out of the hospital. In many cases, we provide a mechanism through telemedicine or maybe remote patient monitoring. There's some basic analytics around that. But what's happening is these sensors are getting better. We're starting to talk about devices that may even be implanted in one's body, that we could get greater insight. We're talking about continuous monitoring, and then combine that with 5G and the massive computing potentials that we have on these smartphones and other devices. We now have an ability to be able to do more proactive care by using AI and machine learning to lead to more proactive care. But I would say that even beyond that, we're seeing AI being applied in other areas. One of the biggest challenges we face today with a lot of technology, it sometimes disrupts the workflow of clinicians. And we see this today in the electronic health record. And now imagine with some of the newer technologies of voice and image recognition, maybe with AR and VR. We may be able to improve the diagnostic capabilities of some of these tools that we have today, streamline that workflow and ultimately make things easier for clinicians. So, it's about helping improve the lives of patients and making things easier for clinicians.

Tyler Suiters  7:42 

Well, Dave, let's pull it back a little bit. From outside of orbit when you drop something like implantables and enhancements back into where we are today with artificial intelligence and AI. When you talk about Samsung, and AI maybe the most obvious example is voice recognition technology. And I think that's true for most of the consumer products we see in the AI applications. Where are you today in digital health care on AI, in terms of what's working for you? What is actually being implemented today that you can find? And maybe what's ahead in the next year or so?

David Rhew  8:18 

Yeah, I think today is just the beginning. We do have technologies to help with a voice recognition, as you're well aware. The big speech solution that we launched, and most recently showcased at one of our events this past week, or the last week. Showcase the ability that we might be able to then use voice and inner communications. Where one could actually transition very seamlessly from one environment to the other. That allows us to be able to think about workflow and in lifestyle, because people aren't always in front of their computer. They're not necessarily even front of their device all the time. They're moving around, they're transitioning. And as you do that, sometimes the workflow and all the communications that allow us to be able to have an understanding needs to go with us. And that's the type of things that we're looking at. So it's not just about understanding your voice, but it's also understanding the context of where you're at. Then as you move to another device, how do you transition that over, so that other device literally takes the ball and moves with that.
So these are the types of things that we're starting to look at, you know, combinations of how devices work together, applications work on them. And then including the really exciting elements of voice and image recognition.

Matthew Stoudt  9:37 

Would love to give you guys sorry you go ahead Kinsey

Kinsey Fabrizio  9:41 

No, no, you go ahead, Matthew.

Matthew Stoudt  9:45 

I would also love to give you guys another real-world example of what we're doing today with the use of AI, one of it is. And then also sessions combination of AI as well as so one of the big unmet needs that we have in American society today is all around chronic pain, something that afflicts over 100 million Americans on a daily basis, the 38 million of them are described as to their cell phones.
These are people that live with pain levels that are over seven on a daily basis. And we've developed a current pain solution, that we're actually using your own bio data to help drive the solution that you see in VR. We're using breath as that input, and then we're tracking HRV as the output.
 

Matthew Stoudt  10:33 

And if you teach someone, nothing else that but how to breathe properly. You can make a huge impact on terms of that person's ability to cope with their pain on a day to day basis. Now we use basic diet, dramatic breathing around this, but each person is going to respond a little bit differently. And so this is where AI can play a big role in not only helping an individual, where we can fine tune that person's breathing pace.
So that we can find that optimal zone for their HRV where their bodies at the most relaxed state. But then we can also use that across the board population so that each person that comes in and tries it, we're able to almost use precision medicine to help new people coming in to find that fast relief for them. For their chronic pain.

Kinsey Fabrizio  11:16 

Matthew, that's so fascinating. And you touched on virtual reality. I would love to hear from you and Dave, about some of the work you guys are doing with VR. Using it as an alternative to typical treatment protocols. Can you talk a little bit about that?

Matthew Stoudt  11:34 

Yeah, so virtual reality, is something that's actually been around for 30 plus years in a clinical environment. That's been demonstrated hundreds of studies that shows how it can actually be used to help abate acute pain. With the advancements in technology and everything else that's gone with the cell phone increasing its computing power. We have more computing power in a cell phone today. We have more computing power today in a cell phone than what we had to launch Apollo into space. And so with all of that computing power, we can now deliver an incredibly powerful analgesic into the home or the hospital in a very scalable way. Using the Samsung 7 or Samsung 8. So we've been doing clinical tests, major hospitals all across the US ranging from Cedar Sinai, to New York, Presbyterian, the Mayo Clinic and been getting amazing results. Last study we did in concept with Samsung, we got a 52% reduction in pain. We're just now at the tip of the iceberg in terms of how we can actually use this as a way to eliminate the opioid epidemic, which is just devastating America.

Tyler Suiters  12:51 

So let's take this as a bit of a case study then. You'll have two unique perspectives on this in that Matthew at appliedVR as a VR company. You are a solution in a sense, looking for problems to solve. And David, at a tech giant as innovative as Samsung is globally. You could address all kinds of problems with a variety of solutions. So let's start with you Matthew, as a case study is VR a fair example of technology, applications and digital health. And that we are innovating so quickly, that we'll find solutions as we go as technology develops as connectivity expands throughout our daily lives.

Matthew Stoudt  13:38 

Well, this is one example with digital health as opposed to traditional healthcare. When you think about the world of molecules, we're really able to get real world evidence. And actually, by getting our product out there and seeing how patients are using it. We're able to identify uses that we never would have thought of. I'll give you two simple examples of that. One, we had an innovative OBGYN who was using our product in his practice with women. And a woman presented she wanted to try to deliver naturally and he said, "Well, I've got this pain abatement tool from appliedVR, do you want to try it?" She ended up delivering naturally, she was in our VR device for Samsung. She was in there for two-plus hours, and the doctor literally had asked her to pick it off, if you want to see the birth of her child that then launched huge blocks of inquiries from literally all around the world about our labor and delivery platform. And we didn't even have one. So we ended up turning around and going out and building something that's specifically for that. Then another example of this is with our chronic pain solution. And with chronic pain as opposed to acute pain, you're not going to change or solve someone's chronic pain. What you're going to do is you're going to help them deal with their pain on a day to day basis cope with that pain. And then you also have to think about the behavioral health impacts that depression, anxiety, the pacification, the fear of movement and the sleeplessness. So it's not just about counter block in the pain, but it's about also going after all the comorbidities that exists with it. And so with our chronic pain solution that includes cognitive restructuring, CPG acceptance Commitment Therapy. With that program, we had a patient that was using it in her home, and every time she would go into it, whe would have these massive crying sessions and she thought maybe something was wrong with the platform or something was wrong with her. She talked to her doctor about it. We said what she was having was called a release. She is diagnosed with something called complex PTSD, and he said that typically in therapy, it takes years to be able to get to a release. And in this situation, she was able to get there after using our solutions only four or five times.
And that type of impact, I think, the more we get this out there, the more we're going to learn to identify amazing use cases that we never would have thought of on our own.

Kinsey Fabrizio  16:03 

What a big part of getting this out there will be getting the physician community on board. And I'm excited to talk about with our listeners that for the first time, CES will offer continuing medical education credits for the disruptive innovations and healthcare conference. And can you guys talk a little bit about how impactful that will be and how important it will be for providers to attend CES and get CME credits.

David Rhew  16:32 

I'm excited about it. One, first of all, I'm a physician. So for me, it's interesting to be able to think of CES as an opportunity to get CME. But I think it's actually a natural extension of what we more CES is moving towards. Which is looking at making this consumer technology more medically relevant. And as part of that journey, you're going to need to get physicians to be aware of the types of things that are out there. Helping to test and validate them, really become key leaders in this space.
We believe that the Health and Technology Fitness Division within CTA has really been a key driver for the journey towards combining healthcare with consumer technology. And to that point, I think many of the solutions that we're now talking about are not just about great technologies. But there's a lot of validation, clinical validation that substantiates that this is actually better than or just as good as existing medical treatments. So we now know these to be real medical treatments, they just so happened to be on a consumer technology device.

Tyler Suiters  17:36 

You're both CES veterans, right? You've been to a number of shows. You've had the important conversations, made those valuable connections that pay off. Dave, let's start with you. What is the balance that you need and you see at CES? Among medical professionals among technologists and innovators among the VC world or the investors. It's an amalgamation of industries or sectors within the industry that keep this thing going, right?

David Rhew  18:06 

Absolutely, we're seeing a maturation of the digital health industry. And that's reflected in what we're seeing and experiencing at CES. CES started out as an emerging showcase for cool digital health technologies directed at consumers. And now it's a forum where consumer tech companies, healthcare providers, medical device firms, the FDA, other key stakeholders and participants are able to discuss. Showcase and plan for digital health solutions that can make a meaningful impact on patients’ lives. It's an outstanding opportunity to network, learn more and ultimately understand what the future is.

Tyler Suiters  18:45 

Matthew, do you want to jump in here?

Matthew Stoudt  18:46 

Yeah, I really look at CES as a way of looking at those future trends that are not a future as you think what might was by that what I mean is, you know, we talked a lot about wearables. And so when I go to CES I find that it is an invaluable opportunity to go and in one shot, get to see about 30 to 50 different types of wearable technologies. That I can now have a meaningful conversation and say, how can I actually use this leverage to make an impact in people's lives. And it's that window into like, people call it the future. But it's a future that's now, that is so beneficial to us. At the same time, especially now tying back into this CMEs that are occurring. The more and more that we bring in industries that you typically wouldn't think about from a consumer perspective. Healthcare is definitely one of those. I think it's going to just make that so much more valuable for all different types of companies. The other thing is, I always think about innovation occurs not necessarily in.

Matthew Stoudt  19:49 

David is driving innovation at Samsung, we're trying to drive innovation in the world of VR and AR for healthcare. But also innovation occurs with the people that are independent shop, if you will. When you think about CES, almost as a bizarre way to go out there, and you see doctors walking around, and they see different types of technologies. That starts to spark in them the idea that maybe I could use this to help one of my patients, and then you see how that would then turnaround.
And they start coming back and have an idea, they want to take that idea to a Samsung and say, can you help me do this or come to an appliedVR and say, hey I want to build this, can you help me? That becomes a rich, robust fertilizer for driving continued innovation and everything that Dave and I are trying to do?

Kinsey Fabrizio  20:36 

So following up on that, when you think about your game plan for CES and getting ready to attend CES  2019. What are you especially excited to explore and investigate?

David Rhew  20:52 

Why don't you go Matthew?

Matthew Stoudt  20:55 

I'll let you go, you got it. You got it.

David Rhew  20:59 

Alright, well, I think most of you that have been to CES have seen that Samsung has a pretty strong presence there. It's a very important event for us. We use this as an opportunity to showcase some of the coolest and most cutting-edge devices and solutions to the market. And as we look ahead to 2019, I think we can expect to see more of those innovative solutions in devices. But perhaps a bit more focused on things that we're talking about right here, IoT, 5G, artificial intelligence and voice. Connecting that experience for both the consumer to around all the different things around them, as well as for the enterprise customer. And we're going to continue to see these advancements allow us to be able to streamline that user experience, whether it's on the home or on the go.

Kinsey Fabrizio  21:45 

So when we're walking around on the show floor at CES 2019, can we expect to see some great demos from Samsung and appliedVR together?

David Rhew  21:57 

That's our hope. Yeah, we are looking at working innovating. We've got some pilots underway. You know, hopefully, the timing will be right for us to be able to showcase some of that at CES 2019.

Matthew Stoudt  22:09 

And on the fly VR side, along with Samsung. Hopefully we'll have a few big announcements that we'll be making at that time. So looking forward to it.

Tyler Suiters  22:18 

We'll let you unbox all of that actually on the floor. And won't make you under the boat just yet. Simple question for both of you. And Matthew, let's start with you. What's next? When you think about the digital technology sector and digital health, what's next? What isn't here that is, in your mind on the way? And has you most excited?

Matthew Stoudt  22:41 

Yeah. So again, just going back to that connection of mind and body, you'll hear that as a repeating theme for us. I think what we're looking for is how do we tap deeper into the mind out of the equation. And so we think about devices that can actually read the brain waves that are going to telephone, or another way that we try to get in to understanding the individual person and how we can make an impact on that individual.

Tyler Suiters  23:14 

Dave what about you, what do you expect to discover at CES 2019? And I'll extend that to 2020. If you need a larger window, for what do you think is on the horizon?

David Rhew  23:25 

If you just looked at the trend, we're going to see more advanced sensors, better diagnostic capabilities, noninvasive measurements of things that we hadn't seen before. The ability for us to be able to apply artificial intelligence and machine learning to apply the data that comes directly from one's devices. As well as potentially pull data from the electronic health record. In claims data, I think this whole issue around open standards and trying to create an opportunity where consumers are in charge of their own health, and using these devices around them to be able to gather that information and communicate it with others. Tremendous amount of opportunities, we're really excited to be a part of many of these solutions. We really are excited to see all the things that are planned for 2019 and beyond.

Kinsey Fabrizio  24:15 

One last question I want to ask, we planned to have a VIP physician tour on the show floor this year taking doctors around to see the health and wellness tech exhibits. In your opinion, how impactful is that to physicians? How do you think they will react on the tour?

David Rhew  24:35 

Well, I think first of all, it's a great idea because CES can be a bit overwhelming. And not even knowing where to go and where to start in understanding how this technology fits into one workflow or one practice, is oftentimes the big challenge. So if there's a way that one could direct people in a very logical way throughout the show room, tell them how this is relevant to them. Highlight the key parts, make it faster for them to see the stuff, understand it and I think ultimately you're going to get greater interest in the things that they see.
So part of it is just because it's just such an overwhelming experience that it's hard to know what to see and where to focus on. But if we can do that. We can provide that level of structured guidance. I think that's going to be highly effective, and particularly for this audience that are newcomers to this where they may not necessarily even know where to start.

Matthew Stoudt  25:32 

But I'd go one step beyond that Dave, it's not only about navigating what can be completely overwhelming. And I totally agree with that. I also think it's if we can find a way to create a mouthpiece for them to get the word out as well. Because when you think about driving behavior change within the clinical environment, it's really about going after some of these key emulators. Getting them to turn around and talk about what they saw and how they see it's going to impact their own practices or how it can impact other practices. So I think that this is a fantastic idea to be able to go out there and help get the word out.

Kinsey Fabrizio  26:12 

You mentioned behavior change, which is such an important component of technology integration into healthcare. Can you talk about some of the things that you all are doing to lead to behavior change and consumer engagement?

David Rhew  26:28 

Oh, this is a great topic. And I'll tell you, this is something that we've learned. Both from experience and also from failure, that simply putting out medical, or I should say consumer devices, such as wearables, doesn't need to improve health outcomes,

David Rhew  26:44 

Why would somebody want to use this device on an ongoing basis? In some cases in the data, you already kind of know how many steps you took or kind of where you're at. It doesn't provide that ongoing value proposition. So what we realized is that the customer experience the consumer experience. Why they would actually want to use this [inaudible]. Perhaps one of the most critical things we need to start thinking about. And this is the stuff that we have ultimately started to realize that we have to design it in our products. Also, as you push it out, provide programs around this.

David Rhew  27:22 

So a couple of examples with a smartwatch. For instance, one of the things that we realized in a population that typically does not use technology. We're talking about seniors over the age of 85. What we did recognize is that they actually want to live independently. So you put a mobile pers or personal emergency response system on your smartwatch. With one push of the button, you have an ability to literally have an ability to reach out to anyone if you ever have trouble. "Help me up, I've fallen and I can't get up".
These types of ways that we have learned to incorporate these elements that are intrinsically tied to the motivation of why one would want to use it continuously and every day are so critical for us to be able to understand that how this can serve as a platform for everything.

David Rhew  28:10 

Such as medication reminders and other ongoing communication. So engagement is a critical first step, and it needs to be tied into how we develop it and deploy it.

Matthew Stoudt  28:19 

Behavior change is actually the basis of our founding. We came out of market research firm and traditional market research. We think about how people make decisions, we like to think they're made rational. The reality is that we make them based on an unconscious of the emotional. Now when you think about applying this to chronic disease conditions. And again, I'll go back to the chronic pain as an example of this.
In this world, it's about getting people to do something on a repeated basis. And it's adherence in the world of medicine, right? How do you get someone to adhere to their protocol. We like to think about this through what is called the three E's. It's got to be easy to use, it's got to be engaging and those two lead to it's got to be effective. Will then translate into efficacy.

Matthew Stoudt  29:04 

On the first one as Dave mentioned, this is an older population that you're going after, and especially the eldest of them are definitely not the most tech savvy. So you've got to have something that is just ready to go out of the box. If it's complicated. Is it hard to use? They may do the first time, but they're never going to do it again.
Second thing then is, it's got to be engaging. How do we make this feel like as easy as taking a pill versus the feeling like you're getting up and having to go do a chore at the gym. So it's a book that taps into behavioral dynamics. And that taps into connecting to the emotional and the nonconscious giving that person rewards for completing different things. So that they feel better at that nonconscious level. Both of those things. If you deliver on those two things, you're going to have a product that's effective, that delivers that efficacy. And that's ultimately how you change that behavior.

Tyler Suiters  30:01 

Matthew Stoudt is the CEO of appliedVR. Dr. David Rhew is the Chief Medical Officer for Samsung Electronics, America. Gentlemen, great conversation and looking forward to seeing you at CES in just a short while.

David Rhew  30:16 

Thank you so much.

Matthew Stoudt  30:17 

Great, thank you.

Tyler Suiters  30:19 

All right, next week everything 5G. If you know that term. And if you don't, you're going to know it awfully well. This is not just what 5G is, but it's all the innovations that will ride on what is going to be a lightning fast network. So of course, consumers are going to love it, right? Better connectivity, faster downloads and low latency. But this is also going to be a game changer for businesses.

Steve Koenig  30:46 

You need reliable connections and so forth. And when you have that, that introduces a whole host of other benefits and that introduces greater efficiencies, better choices and maybe speed to market.

Tyler Suiters  31:02 

Hey, thanks everyone for joining us yet again. And a reminder to you before we leave to subscribe to this podcast. That way you can catch all our episodes, including the episodes that we are bringing to you from CES 2019. Speaking of, January 8-11 in Las Vegas. Those are the dates for CES 2019. And we have the info you need all at CES.tech. That is CES.tech. As always, I am totally propped up by our two podcasting superstars, our producer Tina Anthony. Thank you, Tina. And our engineer extraordinaire, John Lindsey. You all are the best. I'm Tyler Suiters. Let's talk tech again soon.