At athenahealth,
we know your ambulatory practice wants healthier, a
healthier business, healthier care teams, and healthier patients.
But the complexities of modern health care tech
make it hard for you and your care
teams to focus on what matters
most? That's where athenahealth can help. Our AI
native all in one solutions reduce administrative burdens,
streamline billing and payments, and deliver critical insights
when clinicians need it most. That means fewer
clicks, more time for patients, and stronger bottom
lines.
Practicing medicine is complex, but running a practice
can be that much simpler with athenahealth.
See how simpler is healthier@athenahealth.com.
This is Laura Dierda with the Becker's Healthcare
podcast. I'm thrilled today to be joined by
doctor Tom Wynne, chief medical executive and director
of minimally invasive surgery at Baptist Health Heart
and Vascular Care, part of Baptist Health South
Florida, and professor and chair of the department
of cardiovascular sciences at FIU. Doctor Wynne, it's
a pleasure to have you on the podcast
today. Thank you for having me. Absolutely. Absolutely.
Now I'm excited for our discussion today because
we are gonna get into some really cool
things that you're doing at the heart vascular
care right now, talking about some wearable technology
devices, some other things that you're doing that
are really interesting when you think about heart
disease and, providing care to patients.
So let's dive right into it. Can you
tell us a little bit more about how,
you're thinking about wearable devices and improving detection
of earlier cardiovascular
issues?
Yeah. Absolutely. Thanks for having me. The problem
with current medicine is that when we look
at patients, we look at snapshots in time.
For example, when you look at a patient's
vital sign,
it's a it's a snapshot in time. It
could be in the morning, in the afternoon,
in the evening. But even then, that's only
three data points.
The advantage of having wearables is that you
can collect data
twenty four seven
and capture data and potentially capture changes
a little bit faster than looking at two
or three data points,
in in one in,
in one day.
The the other, unique element about wearables is
that
perhaps we can pick up on
certain changes in biometrics
that
we didn't think we should consider and look
at, and it could be a predictor. So
I'll I'll give you an example.
We look at heart rate a lot, but
something we don't look at a lot is
the heart rate variability,
or we don't look at resting heart rate.
Because to look at the resting heart rate,
it takes, you know, more more data
points. We're working with a project in collaboration
with MGH,
using wearables to predict postoperative complications
after cardiothoracic
surgery.
And what's fascinating
is that
the group has found
that there have been changes in one's biometric
after thoracic surgery that happens
before the patient even realizes it happens. So
for example, you know, let's say after after
thoracic surgery,
you develop a pneumonia,
and you don't realize it until day 10,
but there could be changes in your biometrics
that happen at day eight.
This is super important because now it allows
us
to
predict
when a complication might happen, but more importantly,
be able to intervene and address the complications
so it doesn't escalate.
That's fascinating to hear. You know, truly interesting
that we have the ability with the technology
and the biometrics to see some of those
things and and be more predictive.
Can you tell me a little bit too
about how these devices are playing a role
in preventing heart related emergencies?
We don't we don't have one, directly,
to prevent heart related emergencies yet. There there
are some projects that that
we're working on. I can't tell you about
the study at FIU
using devices and AI
to prevent to predict
whether or not a patient could get could
have epilepsy or how could have a seizure,
which is pretty fascinating. In patient with epilepsy,
they want to predict when a patient would
have a seizure,
could be very transformative.
Right now, we don't have any current
commercially available devices out there
to
predict
any heart related complications, but there's certainly a
lot of trials and studies out there that
are very promising,
that could potentially in the future predict,
when someone might have a heart related complication.
Got it. That's helpful to know and, you
know, really interesting that, you look into the
future, you can see some of these things,
playing out and being really meaningful.
Now I I'm curious. I wanted to ask
you a bit about heart monitors too. How
accurate are the wearable heart monitors compared to
some of the traditional clinical equipment that you
use when you're thinking about patients with heart
disease?
The it it depends on what heart monitor
you use.
I would say that they are reason reasonably
accurate,
but it's probably not as accurate as the
medical grade, the hospital grade heart monitors that
we have,
here in the hospital.
But it's accurate
enough.
It's accurate enough to
figure out what your heart rate is. It's
accurate enough
to figure out,
the changes in your heart rate. It's accurate
enough
to see whether or not your rhythm is
in normal sinus rhythm or if you have
some other funky rhythm, whether it be atrial
fibrillation or some other type of rhythm. It's
not perfect, but I think
it's good enough, and it's certainly better than
nothing.
That's a great point. And, you know, definitely
knowing what's kind of coming up and and
being able to monitor as closely as possible,
like you said, how many changes
with the heart monitor can make a big
difference in patient's care and how they're quickly
they're picking up on some of those
changes. Now in what ways can the continuous
heart monitoring reduce the hospital visits and health
care costs in particular? I know that's a
really big goal for a lot of,
hospitals and systems today, just figure out how
they can improve quality but also,
reduce costs.
No. Absolutely.
I guess the first thing is that sometimes
for us to
know that we're sick, it's too late.
And by the time you feel that you're
sick,
things you know, the cat's already, you know,
out of the bag.
These devices have the ability, again, to predict
something bad happening before it even reaches your
sensorium and and have you realize it.
From a
clinical standpoint, that's obviously good because it allows
it prevents a progression of of whatever you
might develop. But also from a hospital
financial standpoint,
it has huge
potential and implications to decrease,
the the rate of readmissions to hospitals.
You can imagine
that
we have a huge societal burden
of patients being discharged
and then being readmitted to the hospital,
especially if we can find a way to
prevent those readmissions
and capturing
the the patient's,
illness sooner, I I think this would be
transformative.
Huge health care costs and be able to
prevent readmissions.
In fact, it's actually one of our quality
metrics, hospital readmissions, something that we look at
very carefully
and we track.
That's helpful to understand that relationship between the
two and really being able to,
leverage the technology for better care as well
as to reduce the cost and and overall
spend. Now I'm curious too. One of the
things that we've been hearing more and more
about today is,
cybersecurity
and privacy for patient data, especially as more
technologies and wearables,
are in use. So how do you think
about that? What's important for patients as well
as clinicians to know,
when they're thinking about wearable devices and the
data privacy and security?
No. I think that it's it's very important.
It it's our data,
and we have to make sure that it
is secure
and does not get released. I think that,
this is an area that's new and growing
so fast that we need some some form
of regulation,
to make sure that the data is secure.
I think I think there are
guardrails out there already to prevent
patient data,
from being released, but I think we just
need to watch it very, very carefully because
it is it is our data.
The flip side of that is
you can imagine to do meaningful research
in this space, in the AI space, in
the machine learning space, we need a lot
of data.
And the more data we have access to,
the more efficient and more accurate the models
can be. So it's a little bit of
a balance because we need the data to
be able
to come up with these
breakthrough discoveries, but we have to be cautious
with the data and protect it in such
a way where it doesn't leak out and
get into the wrong hands.
That makes sense. And thank you for clarifying
just the state of the union of where
things are at with that type of data
and how we can move forward.
Now I I wanted to dig a little
bit deeper into as well,
a collaboration that you're doing with FIU,
using voice technology and
and whether,
it's something that can actually be the next
vital sign for,
patients when they're going to the doctor to
help identify some issues that could be upcoming.
So could you tell us a little bit
more about that?
I'm I'm super excited about about this collaboration
with FIU and an example of something that
we we couldn't do without FIU and FIU
probably couldn't do without us.
When we look at typical vital signs, your
heart rate, your blood pressure, your O2 saturation,
Those are kind of standard vital signs.
But the hypothesis is that couldn't voice or
could voice be an additional vital sign. May
I ask you, when was the last time
you talked to a friend or a loved
one and you said, wow, that person doesn't
sound right. You can really put your finger
on it, but that person sounds like they
could be sick. Or you yourself are sick
and you realize that there's something going on
with your voice.
You know, there's some there's some objective data
to actually support this. So if you imagine
that for me to talk right now,
it requires
all these neural networks to come into play
for me to formulate
a a relatively complete sentence. But that's actually
not enough. Once I have this sentence
in my mind,
eventually,
there has to be these motors that have
to activate it. It actually ends up yeah.
It actually end up activating about a 100
neuromuscular units just to be able to to
phonate
and and articulate and say is is to
say what you want to say.
In summary, it's this complex interplay
of your brain being able to formulate stuff.
And then after that, the muscles and the
firing to be able to articulate things is
why you're able to hear what I'm I'm
saying right now.
But something that hasn't really been explored or
studied at all.
So the hypothesis is that, well, instead of
a vital sign, a heart rate predicted when
the patient's not gonna do well, what if
we use voice?
There was a study that FIU did with
high school students,
and they got a large number of high
school students that had a good number of
baseline data on their voice.
Some of these and and a lot of
these high school students were athletes.
Then
a good
a small percentage of these students were,
athletes
and had concussions.
And they actually did the voice study after
they got the concussion. And as you can
imagine, their voices sounded very different.
So so that was a
a a proof, of concept scenario.
What we're looking at is,
let's say you have baseline information on someone's
voice.
They have surgery,
and then you record their voice daily
until and you can imagine right after surgery,
their voice probably won't sound the same. The
next day after surgery, it probably won't sound
the same. But at some point, their voice
should normalize
back to it was before surgery.
So we have now this presurgery, right after
surgery, time to normalization.
But let's say we continue to follow that
voice. And what if, you know, by day
30 or day 60, we realize that, well,
the voice is changing again. Could it be
a predictor or sign of something?
And that's what our our our hypothesis is.
That one,
let's define
when the voice normalizes after certain operations, certain
procedures.
But if later on, changes in your voice
could then predict
beforehand something bad is gonna happen to you.
So this is why we think it's super
exciting.
Imagine it's a lot easier vital sign as
well instead of having to purchase machines to
latch onto you to check your heart rate
and your o two saturation.
We could potentially have apps that listen to
you or you who are according to your
app, and then it be able to potentially
diagnose what's going on. So we're excited about
it. More to come. But, this is a
a a great study that we're doing in
partnership with FIU.
That's amazing to hear. And, you know, really,
really,
cool application of technology and ideas around how
you can take, some of the different symptoms
or or ways that our body reacts before
we even know it to,
something that's going on or something not being
right and and then being able to level
it up. And, really, ideally, as you said,
take care of some of the issues ahead
of time. And that brings me to my
next question is, you know, when you're looking
at technology,
I feel like the
capacity and capabilities are so much more complex
now, just because we have artificial intelligence or
predictive capabilities and more.
So is there anything else there that you
are really excited about when you look into
the future, and how do you see AI
and and other technologies continuing to evolve,
especially when it has to do with heart
care?
I think we're only at the tip of
the iceberg. I think our world now
will be
incredibly different
in the next three, four, five years,
for the better,
I hope.
We'll be a lot more efficient about making
decisions. I think we'll be a lot more
accurate about making decisions. I think we'll be
able to to predict
when things will happen.
I also wanted to offer
a word of warning as well. We recognize
that,
sometimes
too much information can be bad. You know,
let's say if there is a technology to
predict
your life expectancy or when things bad things
will happen to your life down to, you
know, the minute or the day, that could
be exciting, but is that something that we
really want to know?
There are technologies out there that can
replicate
your voice,
my voice, replicate my image,
and create AI agents so that you could
talk to me and or you with a
certain level level of expertise. So that allows
me to be allows me to scale and
be a lot more efficient. But then you
also can imagine that
it can if it got if if got
into the wrong hands, it could allow a
lot of fraudulent act activities as well where
it's someone that is not me
that is pretending to be me and
doing bad things. So I'm excited about the
future.
I think, overall, it's gonna be very transformative,
and the world's gonna change for the better.
But I do think and know that we
have to approach it with caution and with
appropriate guardrails,
to make sure that this technology,
won't get out of hand.
Got it. That's really, you know, interesting to
think about both the very real benefits and
then the the challenges and risks involved with
continuing to expand this technology,
and doing it responsibly, especially in the health
care setting. It's such a unique space and
and something that requires a lot of care
in order to get right, and high stakes
as well. I'm curious, you know, when you
look at, everything you're doing, I know a
really big part of, what you're doing at
Baptist Health South Florida as well as, you
know, many health systems across the country is
looking at some of the health disparities,
and trying to close that gap. How do
you see technology,
playing a role in being able to reduce
those health disparities and, make monitoring more accessible?
It's a equalizer. You know?
By by being able to access technology
to answer questions, to diagnose
patients,
to provide therapeutics
at a fraction of cost
could then now allow us to
spread a lot of what we know about
medicine
to people who wouldn't otherwise have access to
it,
and potentially
even decrease health care costs.
We we also know that
with disparities, there's
different levels of disparities in in medical knowledge
and medical understanding,
as you can imagine.
But now there there are technologies out there
that we can use and leverage and be
able to
translate and interpret medical information so that it's
digestible
not only for physicians,
so but it it also can be digestible
for,
a regular patient, or it could be translated
to, any other language. And I'll give you
an example. You know, when's the last time
you might have had
a complex study done? Let's say a CT
scan,
an X-ray,
an MRI,
and you look at it, you're like, well,
I don't know really what this means. Well,
there's tech and and the reason why is
a lot of that language is written in
kind of medical talk.
And there's technologies now where it can take
that information
and then now write it in such a
way where you can read it and understand
it.
But what's also powerful, it can do that
and then translate it to Japanese, Spanish, Italian,
French, whatever language that you want so that
you can actually digest it and share it
with others.
Wow. That that sounds incredible and and really
helpful and beneficial for patients across the board.
You know, those, like you mentioned, who might
have access issues, but then also just, you
know, for anybody to be able to better
understand their care and exactly what's happening, in
their bodies, I think that's critical.
I know we're about ready to wrap up
the conversation, but is there anything else you
wanted to mention or share with our audience
that you're excited about, some of the ways
that,
this technology in heart care is evolving, especially
as the patient physician relationship continues to evolve
as well?
You know, I'll I'll since I'm a surgeon,
I'll I'll end with a a surgical
note. You know, one of my my mentors
was Norm Shumway. He performed the one of
the first heart transplants in The United States.
And one of his famous quotes was, the
hardest thing about heart surgery is a chance
to do heart surgery. And what that mean
it it can mean a lot of different
things. But one of the things that it
meant was
when you get there, the actual part of
heart surgery is hard, but but the harder
part is
getting a chance to go to medical school
and and and and go through the training,
but then learning how to do it and
actually practicing
and getting there.
But what if
we can have technologies that allow us to
learn more efficiently, to be able to practice
more efficiently and have simulators
to do things more efficiently so that the
hardest thing about heart surgery isn't the chance
to do it. It's actually just a heart
surgery itself. You can actually make it a
lot more efficient to be able to learn.
So with that, there are technologies now
that can do a lot of the the
things that we do
autonomously.
Research that Stanford and Hopkins have studied videotapes
of robotic
surgeries.
And now after looking at thousands and thousands
of videotapes,
have had these robots be able to autonomously,
without human control,
do some basic things that we do in
the operating room, for example, to tie knots,
to pick up the needle holder, to manipulate
tissue.
And it's amazing that that it's able to
do this autonomously without a human controlling that.
And that's just the tip of the iceberg.
Then if we could do that, then when
when does it end? You know? And and
and this is an opportunity where where you
could potentially use robots to to do
operations
that, previously were done by humans. Again, still
at its infancy,
but a glimpse into the potential of where
health care and medicine and surgery might be
going.
That's incredible.
Doctor Wynne, thank you so much for joining
us on the podcast today. This has been
a fascinating conversation, and I look forward to
connecting with you again soon. Thank you. My
pleasure. Thanks for having me.
At athenahealth,
we know your ambulatory practice wants healthier,
a healthier business, healthier care teams, and healthier
patients.
But the complexities of modern health care tech
make it hard for you and your care
teams to focus on what matters most.
That's where athenahealth can help.
Our AI native all in one solutions reduce
administrative burdens,
streamline billing and payments, and deliver critical insights
when clinicians need it most.
That means fewer clicks, more time for patients,
and stronger bottom lines.
Practicing medicine is complex, but running a practice
can be that much simpler with athenahealth.
See how simpler is healthier at athenahealth.com.