1 00:00:00,640 --> 00:00:03,199 Philips is a health tech leader focused on 2 00:00:03,199 --> 00:00:06,000 innovation that improves the health and well-being of 3 00:00:06,000 --> 00:00:09,460 people. Our health care technology and informatics solutions 4 00:00:09,679 --> 00:00:12,639 help care teams diagnose, treat, and manage more 5 00:00:12,639 --> 00:00:16,244 patients with greater precision, speed, and confidence across 6 00:00:16,244 --> 00:00:19,225 the care journey. With Philips, clinicians are empowered 7 00:00:19,285 --> 00:00:21,765 with streamlined insights in the moments that matter 8 00:00:21,765 --> 00:00:24,904 for every patient. Better care for more people. 9 00:00:25,204 --> 00:00:25,704 Philips. 10 00:00:28,719 --> 00:00:30,800 Hi, everyone. This is Lucas Voss with Becker's 11 00:00:30,800 --> 00:00:32,479 Healthcare. Thanks so much for tuning in to 12 00:00:32,479 --> 00:00:35,280 the Becker's Healthcare podcast series. Fantastic to have 13 00:00:35,280 --> 00:00:37,920 you. Today, we're talking about how technology and 14 00:00:37,920 --> 00:00:41,359 collaboration are transforming stroke care. And I'm so 15 00:00:41,359 --> 00:00:41,859 excited 16 00:00:42,274 --> 00:00:45,155 for my two guests today, doctor Calder Peron, 17 00:00:45,155 --> 00:00:48,195 chief medical officer at Phillips, and doctor Sheila 18 00:00:48,195 --> 00:00:50,675 Martins. She's a stroke neurologist and professor of 19 00:00:50,675 --> 00:00:54,159 neurology of Universidad Ferradario Grande do Sol, and 20 00:00:54,159 --> 00:00:56,320 she's also the head of neurology at Hospital 21 00:00:56,320 --> 00:00:59,119 de Veno, the president of the Brazilian Stroke 22 00:00:59,119 --> 00:01:02,079 Network and past president of the World Stroke 23 00:01:02,079 --> 00:01:02,579 Organization. 24 00:01:03,280 --> 00:01:05,519 Doctor Martins, doctor Perron, it's great to have 25 00:01:05,519 --> 00:01:07,665 you. Thanks for being here today. It's our 26 00:01:07,665 --> 00:01:10,144 pleasure to be here with you today. Appreciate 27 00:01:10,144 --> 00:01:10,805 the opportunity. 28 00:01:11,344 --> 00:01:12,704 Yeah. It's so great to have you. I 29 00:01:12,704 --> 00:01:14,704 wanna start off with introductions here for our 30 00:01:14,704 --> 00:01:17,025 audience. Doctor Perron, if you wanna start us 31 00:01:17,025 --> 00:01:18,465 off here, can you share just a little 32 00:01:18,465 --> 00:01:19,905 bit about yourself and your work in health 33 00:01:19,905 --> 00:01:22,039 care? Of course. Thank you again for the 34 00:01:22,039 --> 00:01:24,200 opportunity. So I'm Carla Peron, as I mentioned, 35 00:01:24,200 --> 00:01:26,140 chief medical officer for Ad Phillips. 36 00:01:26,519 --> 00:01:29,420 I'm a gynecologist by training, Brazilian and American, 37 00:01:29,959 --> 00:01:31,959 and I work it as a researcher and 38 00:01:31,959 --> 00:01:33,899 and a medical officer in different companies, 39 00:01:34,280 --> 00:01:36,644 for the last twenty years. Had the pleasure 40 00:01:36,644 --> 00:01:38,424 to meet Sheila a long time ago, 41 00:01:38,965 --> 00:01:41,224 where we were working together on a research 42 00:01:41,364 --> 00:01:41,864 program, 43 00:01:42,405 --> 00:01:43,465 a clinical trial, 44 00:01:44,164 --> 00:01:44,905 in Brazil, 45 00:01:45,364 --> 00:01:48,164 to enable the introduction of mechanical thrombectomy in 46 00:01:48,164 --> 00:01:50,344 the public health care system. So that's definitely 47 00:01:50,405 --> 00:01:51,064 my passion, 48 00:01:51,859 --> 00:01:54,760 about stroke and how we can expand access 49 00:01:54,900 --> 00:01:55,640 to care 50 00:01:55,939 --> 00:01:58,659 for this disease that is preventable, treatable, and 51 00:01:58,659 --> 00:02:01,460 curable, but is still actually causing so much 52 00:02:01,460 --> 00:02:02,600 damage out there. 53 00:02:02,980 --> 00:02:04,500 Yeah. And I'm sure we'll touch on that 54 00:02:04,500 --> 00:02:06,420 here in a little bit. Doctor Martins, over 55 00:02:06,420 --> 00:02:07,000 to you. 56 00:02:07,965 --> 00:02:09,824 Sheila Martins, the stroke neurologist. 57 00:02:10,604 --> 00:02:13,004 I start to work with the stroke in 58 00:02:13,004 --> 00:02:13,885 2001 59 00:02:13,885 --> 00:02:15,985 after the approval of 60 00:02:16,365 --> 00:02:16,865 thrombolysis 61 00:02:17,245 --> 00:02:17,745 medication 62 00:02:18,365 --> 00:02:20,224 to treat the stroke in Brazil. 63 00:02:20,525 --> 00:02:22,305 And since then, I'm working 64 00:02:22,930 --> 00:02:25,669 in Brazilian stroke network NGO 65 00:02:26,210 --> 00:02:29,189 to support the Ministry of Health to implement, 66 00:02:30,129 --> 00:02:32,710 national policy and also to support, 67 00:02:33,409 --> 00:02:37,014 regional and local people to develop stroke systems 68 00:02:37,014 --> 00:02:39,175 of care. So I'm I'm working with health 69 00:02:39,175 --> 00:02:40,955 managers for a long time too. 70 00:02:41,574 --> 00:02:43,415 And, again, it's so great to have you 71 00:02:43,415 --> 00:02:46,155 both on because you bring such an interesting 72 00:02:46,215 --> 00:02:47,594 perspective to the conversation, 73 00:02:48,129 --> 00:02:51,169 a dual fold conversation from leading innovation within 74 00:02:51,169 --> 00:02:53,490 the global health technology company, of course, to 75 00:02:53,490 --> 00:02:56,449 shaping national stroke policy and care delivery in 76 00:02:56,449 --> 00:02:58,689 Brazil there. And I'd love to start off, 77 00:02:58,930 --> 00:03:01,965 with you, doctor Martins here. How would you 78 00:03:01,965 --> 00:03:02,465 characterize 79 00:03:03,085 --> 00:03:06,125 general knowledge of stroke today, and what's most 80 00:03:06,125 --> 00:03:07,264 important for people, 81 00:03:07,805 --> 00:03:09,905 especially health care leaders, to understand? 82 00:03:11,325 --> 00:03:13,344 Well, people don't know about stroke. 83 00:03:13,930 --> 00:03:16,490 General population don't know about stroke, don't know 84 00:03:16,490 --> 00:03:18,889 what is the stroke, don't know that it's 85 00:03:18,889 --> 00:03:19,389 preventable 86 00:03:19,689 --> 00:03:22,110 in eighty to nine percent of cases, 87 00:03:22,409 --> 00:03:24,650 don't know the stroke signs and that that 88 00:03:24,650 --> 00:03:25,710 it that is a 89 00:03:26,165 --> 00:03:26,985 very effective 90 00:03:27,284 --> 00:03:27,784 treatment 91 00:03:28,165 --> 00:03:30,905 if go straight to the right hospital 92 00:03:31,604 --> 00:03:34,564 the faster as possible. So we know a 93 00:03:34,564 --> 00:03:36,805 lot about this, but population don't know so 94 00:03:36,805 --> 00:03:38,729 it's so important to educate them 95 00:03:39,050 --> 00:03:40,509 and also health care 96 00:03:40,889 --> 00:03:43,849 managers because they don't know almost don't know 97 00:03:43,849 --> 00:03:46,090 about the stroke, don't care about the stroke. 98 00:03:46,090 --> 00:03:49,229 It's so neglected disease until today, 99 00:03:49,930 --> 00:03:52,349 and it's for this, it's so important 100 00:03:52,810 --> 00:03:55,485 to teach them and to help them to 101 00:03:55,485 --> 00:03:58,384 know what we know that is evidence based. 102 00:03:58,685 --> 00:03:59,985 We have strong 103 00:04:00,685 --> 00:04:01,185 evidence, 104 00:04:02,044 --> 00:04:04,465 clinical trials on our side 105 00:04:05,004 --> 00:04:07,909 to say that you should and we can 106 00:04:07,909 --> 00:04:09,449 treat the stroke patients 107 00:04:10,230 --> 00:04:12,469 if they arrive in the right side. So 108 00:04:12,469 --> 00:04:13,930 so important to have 109 00:04:15,030 --> 00:04:16,410 the health care leaders 110 00:04:17,750 --> 00:04:19,370 hearing from from us 111 00:04:19,895 --> 00:04:20,634 and implementing 112 00:04:21,175 --> 00:04:23,895 what we know that really will change people's 113 00:04:23,895 --> 00:04:25,115 lives. And for this, 114 00:04:25,495 --> 00:04:28,215 the also campaign this year is not only 115 00:04:28,215 --> 00:04:31,175 for population, it's also to aware the health 116 00:04:31,175 --> 00:04:31,675 managers 117 00:04:32,055 --> 00:04:32,555 that 118 00:04:33,129 --> 00:04:34,430 every minute counts, 119 00:04:35,529 --> 00:04:38,670 to recognize and treat the stroke, but also 120 00:04:38,810 --> 00:04:41,529 every minute counts to take action and to 121 00:04:41,529 --> 00:04:44,589 change the reality and implement the best treatments. 122 00:04:44,970 --> 00:04:48,384 And every minute counts. Our actions today can 123 00:04:48,384 --> 00:04:50,725 change the life forever. So, 124 00:04:51,105 --> 00:04:53,985 it's really important to to be in touch 125 00:04:53,985 --> 00:04:56,785 with them, to help them to to see 126 00:04:56,785 --> 00:04:57,285 this. 127 00:04:58,159 --> 00:05:00,899 And you've mentioned the the importance of education, 128 00:05:01,199 --> 00:05:03,599 the importance of of having folks know what 129 00:05:03,599 --> 00:05:05,360 a stroke is, how does it work, how 130 00:05:05,360 --> 00:05:06,879 do we communicate about it. I was wondering 131 00:05:06,879 --> 00:05:08,159 if you could talk a little bit more 132 00:05:08,159 --> 00:05:09,379 about from your perspective, 133 00:05:10,000 --> 00:05:11,919 what are some of the biggest challenges and 134 00:05:11,919 --> 00:05:12,419 opportunities 135 00:05:13,039 --> 00:05:13,394 you 136 00:05:13,875 --> 00:05:17,074 see in how stroker is delivered today both 137 00:05:17,074 --> 00:05:18,935 in hospitals, but, of course, 138 00:05:19,394 --> 00:05:20,615 also in the community? 139 00:05:22,034 --> 00:05:25,154 Well, the biggest challenge is one challenge is 140 00:05:25,154 --> 00:05:25,410 this, 141 00:05:26,209 --> 00:05:27,170 the lack of knowledge, 142 00:05:28,290 --> 00:05:28,790 about 143 00:05:29,170 --> 00:05:31,029 the stroke in the population. 144 00:05:31,810 --> 00:05:32,949 The other is 145 00:05:33,410 --> 00:05:36,850 hospitals are not prepared. Of course, we improve 146 00:05:36,850 --> 00:05:37,425 a lot 147 00:05:37,985 --> 00:05:40,004 mainly in Brazil, but still, 148 00:05:40,464 --> 00:05:43,685 there is several hospitals not prepared to receive 149 00:05:43,745 --> 00:05:44,564 stroke patients. 150 00:05:44,944 --> 00:05:45,925 Someone's cannot 151 00:05:46,305 --> 00:05:47,845 understand that is, 152 00:05:49,104 --> 00:05:49,925 our responsibility 153 00:05:50,384 --> 00:05:51,284 and the responsibility 154 00:05:51,904 --> 00:05:53,125 of the health managers 155 00:05:53,479 --> 00:05:55,740 to implement and to give the best treatment 156 00:05:56,120 --> 00:05:59,019 of, stroke for the patients. We cannot 157 00:05:59,560 --> 00:06:03,339 accept more that patients are treated as, like, 158 00:06:03,720 --> 00:06:06,459 thirty years ago. We really need to implement 159 00:06:06,519 --> 00:06:09,465 everything that is evidence based and save the 160 00:06:09,465 --> 00:06:11,085 people's lives and also 161 00:06:11,465 --> 00:06:12,925 decrease or avoid 162 00:06:13,305 --> 00:06:14,845 disability. So challenges 163 00:06:15,384 --> 00:06:17,725 and knowledge, challenge the infrastructure 164 00:06:18,105 --> 00:06:20,425 that is so important. I need at least, 165 00:06:21,460 --> 00:06:25,879 hospitals with CT scan, emergency room, personnel trained, 166 00:06:25,939 --> 00:06:28,660 and sometimes, I don't have neurologists. I cannot 167 00:06:28,660 --> 00:06:31,399 implement. Yes. You can implement, and telemedicine 168 00:06:31,860 --> 00:06:35,014 now can help the hospital and the doctor 169 00:06:35,014 --> 00:06:37,735 in the hospital to treat patients with more 170 00:06:37,735 --> 00:06:41,834 basic thrombolysis and also identify patients that have 171 00:06:41,975 --> 00:06:44,935 more severe stroke and treat these patients to 172 00:06:44,935 --> 00:06:49,095 a more comprehensive center to mechanical thrombectomy that 173 00:06:49,095 --> 00:06:49,649 is more, 174 00:06:50,689 --> 00:06:51,990 stabilized treatment, 175 00:06:52,290 --> 00:06:53,829 but needs more specialized 176 00:06:54,129 --> 00:06:57,350 hospital with more structure. We can do this, 177 00:06:57,410 --> 00:06:58,709 but we need to 178 00:06:59,089 --> 00:06:59,589 convince 179 00:07:00,610 --> 00:07:03,329 people and health managers that it's feasible to 180 00:07:03,329 --> 00:07:06,095 implement. And for this was so important, 181 00:07:06,795 --> 00:07:08,095 a clinical trial 182 00:07:08,634 --> 00:07:10,095 we performed in Brazil 183 00:07:10,714 --> 00:07:11,535 with support 184 00:07:11,835 --> 00:07:12,335 of 185 00:07:12,875 --> 00:07:14,495 industry. That time, Meditronic 186 00:07:14,795 --> 00:07:15,535 was a 187 00:07:15,915 --> 00:07:16,895 huge partner 188 00:07:17,449 --> 00:07:19,850 that help us to set up together with 189 00:07:19,850 --> 00:07:22,430 minister of health a clinical trial in Brazil 190 00:07:22,810 --> 00:07:25,870 for this treatment that was not approved yet. 191 00:07:26,250 --> 00:07:28,750 And, in Brazil, we spend seventeen 192 00:07:29,050 --> 00:07:31,550 years to approve the more basic thrombolysis, 193 00:07:32,274 --> 00:07:33,414 intravenous thrombolysis. 194 00:07:34,035 --> 00:07:36,694 So you can imagine a more comprehensive with 195 00:07:36,754 --> 00:07:38,294 a set of brain catheterism. 196 00:07:39,154 --> 00:07:41,875 We we convinced the minister of health to 197 00:07:41,875 --> 00:07:44,535 create a clinical trial in public health system 198 00:07:45,310 --> 00:07:47,790 sponsored by the Ministry of Health and with 199 00:07:47,790 --> 00:07:50,769 industry partners to donate the devices. 200 00:07:51,629 --> 00:07:54,129 So with this, we had our clinical 201 00:07:54,509 --> 00:07:58,414 trial about thrombectomy in Brazil, and this changed 202 00:07:58,555 --> 00:08:01,454 the national policy for stroke incorporating 203 00:08:01,834 --> 00:08:02,495 the treatment 204 00:08:03,274 --> 00:08:06,074 for free for the patients. So this is 205 00:08:06,074 --> 00:08:07,134 magic because 206 00:08:07,514 --> 00:08:09,435 Brazil, we have 200,000,000 207 00:08:09,435 --> 00:08:09,935 people 208 00:08:10,370 --> 00:08:11,529 and one of the, 209 00:08:11,970 --> 00:08:15,169 only global systems that pay everything for the 210 00:08:15,169 --> 00:08:17,409 patients. The patient don't need to pay anything, 211 00:08:17,649 --> 00:08:20,050 in stroke care, but, of course, you need 212 00:08:20,050 --> 00:08:20,789 to incorporate 213 00:08:21,089 --> 00:08:23,649 the treatment. So this is a a game 214 00:08:23,649 --> 00:08:26,285 changer and so important for us. It's so 215 00:08:26,285 --> 00:08:29,024 important model for other parts of the world. 216 00:08:30,125 --> 00:08:32,605 Doctor Perron, we talked about partnership there a 217 00:08:32,605 --> 00:08:34,445 little bit, which is certainly really key, from 218 00:08:34,445 --> 00:08:37,004 an industry perspective as well. I wanna touch 219 00:08:37,004 --> 00:08:39,750 on a specific part of partnership, which is 220 00:08:39,750 --> 00:08:40,250 technology. 221 00:08:40,629 --> 00:08:42,309 That's a lot of, a lot of what 222 00:08:42,309 --> 00:08:43,909 partnership is. A lot of folks bring in 223 00:08:43,909 --> 00:08:46,950 bring in, companies for technology specifically. I wanna 224 00:08:46,950 --> 00:08:48,649 talk a little bit about AI and informatics. 225 00:08:49,429 --> 00:08:53,024 How does that those aspects, that technology help 226 00:08:53,024 --> 00:08:55,184 in addressing some of those challenges that doctor 227 00:08:55,184 --> 00:08:56,325 Martin's just outlined? 228 00:08:57,024 --> 00:08:58,544 Yeah. So I think there's a lot of 229 00:08:58,544 --> 00:09:00,625 things that AI can do, definitely, and we 230 00:09:00,625 --> 00:09:02,404 are seeing that trending up. 231 00:09:02,945 --> 00:09:05,024 What what it expects us in the future, 232 00:09:05,024 --> 00:09:06,540 I think it's a big question mark, and 233 00:09:06,540 --> 00:09:09,500 everybody's very excited to jump into that next 234 00:09:09,500 --> 00:09:09,980 step, 235 00:09:10,300 --> 00:09:12,860 of the development for AI. But as today, 236 00:09:12,860 --> 00:09:15,420 you heard doctor directly from doctor Martins. Right? 237 00:09:15,420 --> 00:09:15,920 So 238 00:09:16,540 --> 00:09:19,754 every single minute counts in stroke care. So 239 00:09:19,754 --> 00:09:23,034 early detection of the symptoms, not necessarily an 240 00:09:23,034 --> 00:09:25,054 easy one for us to kind of, 241 00:09:25,595 --> 00:09:27,595 teach the people out there in the community. 242 00:09:27,595 --> 00:09:29,615 So AI is already being used 243 00:09:29,995 --> 00:09:31,454 to help to identify 244 00:09:31,834 --> 00:09:32,334 symptoms 245 00:09:32,970 --> 00:09:33,949 and and trigger, 246 00:09:34,490 --> 00:09:35,789 the the first responders 247 00:09:36,329 --> 00:09:38,570 that this can can be potentially a stroke. 248 00:09:38,570 --> 00:09:40,730 It's already there. When you get to the 249 00:09:40,730 --> 00:09:43,610 hospital, as as as doctor Martins pointed out, 250 00:09:43,610 --> 00:09:45,449 we need CT scans, and we need to 251 00:09:45,449 --> 00:09:47,149 get all the these images 252 00:09:47,804 --> 00:09:50,384 being quickly identified as a potential stroke, 253 00:09:51,325 --> 00:09:54,845 ischemic or hemorrhagic stroke. Also identify which kind 254 00:09:54,845 --> 00:09:57,024 of vessel or where is the occlusion. 255 00:09:57,965 --> 00:09:59,965 AI is already there as well, being used 256 00:09:59,965 --> 00:10:01,825 today as we speak to facilitate, 257 00:10:02,399 --> 00:10:03,139 that diagnosis, 258 00:10:03,759 --> 00:10:05,860 not only in the hands of, experts, 259 00:10:06,319 --> 00:10:06,980 but also 260 00:10:07,360 --> 00:10:09,779 through telemedicine, through ability to connect, 261 00:10:10,159 --> 00:10:12,079 people from different places to look at the 262 00:10:12,159 --> 00:10:15,855 those images and identify the patients, that should 263 00:10:15,855 --> 00:10:18,654 be eligible to the the the most effective 264 00:10:18,654 --> 00:10:19,154 treatment. 265 00:10:19,855 --> 00:10:22,815 And after we actually realize the procedure, whatever 266 00:10:22,815 --> 00:10:26,654 is IV thrombolytics or mechanical thrombectomy for those 267 00:10:26,654 --> 00:10:27,394 large occlusions, 268 00:10:28,149 --> 00:10:30,070 you also need to make sure you monitor 269 00:10:30,070 --> 00:10:32,490 those patients after a discharge 270 00:10:33,110 --> 00:10:35,450 to ensure that a a new, stroke, 271 00:10:35,909 --> 00:10:38,230 can be prevented. For example so we have 272 00:10:38,230 --> 00:10:38,730 AI 273 00:10:39,429 --> 00:10:42,169 in Holter systems that are monitoring cardiovascular, 274 00:10:43,445 --> 00:10:45,845 signal and help us to identify, do we 275 00:10:45,845 --> 00:10:47,785 need to do something else for those patients? 276 00:10:48,325 --> 00:10:52,105 So, today, AI has been largely used already 277 00:10:52,165 --> 00:10:54,804 by physicians in different specialties that are, kind 278 00:10:54,804 --> 00:10:55,544 of identifying 279 00:10:55,845 --> 00:10:57,304 and treating stroke. 280 00:10:57,690 --> 00:11:00,090 But I really see that for the future, 281 00:11:00,090 --> 00:11:01,850 this can even be a a more game 282 00:11:01,850 --> 00:11:04,970 changer. I think you heard doctor Martins alluding 283 00:11:04,970 --> 00:11:07,769 to how challenge is for us to create 284 00:11:07,769 --> 00:11:09,230 and develop the infrastructure. 285 00:11:10,054 --> 00:11:12,054 Right? As a Brazilian, I can tell that 286 00:11:12,054 --> 00:11:13,975 when Sheila and I connected for the first 287 00:11:13,975 --> 00:11:16,554 time in that initiative around the the collaboration 288 00:11:16,615 --> 00:11:17,995 to run the clinical trial, 289 00:11:18,375 --> 00:11:20,235 I really thought this cannot be done. 290 00:11:20,615 --> 00:11:23,014 Right? Because the infrastructure is not there. The 291 00:11:23,014 --> 00:11:25,519 personnel is not there. The awareness in the 292 00:11:25,519 --> 00:11:28,559 population, the reimbursement is there's so many barriers, 293 00:11:28,559 --> 00:11:29,699 and definitely technology, 294 00:11:30,159 --> 00:11:31,459 AI, informatics, 295 00:11:31,759 --> 00:11:32,259 connectivity, 296 00:11:33,199 --> 00:11:35,120 was part of the solution and to make 297 00:11:35,120 --> 00:11:37,485 that a successful story. So I think that 298 00:11:37,485 --> 00:11:40,544 is the critical part of how we actually 299 00:11:41,085 --> 00:11:44,144 reduce significantly the impact of stroke worldwide. 300 00:11:45,004 --> 00:11:47,004 Yeah. It's certainly a critical enabler to be 301 00:11:47,004 --> 00:11:49,245 able to make that process easier for people 302 00:11:49,245 --> 00:11:51,424 and for organizations at the same time. 303 00:11:52,379 --> 00:11:53,899 For both of you, as you look ahead, 304 00:11:53,899 --> 00:11:55,360 as you look towards the future, 305 00:11:56,220 --> 00:11:59,580 what does an effective collaborative model for stroke 306 00:11:59,580 --> 00:12:02,620 prevention and treatment look like? And what are 307 00:12:02,620 --> 00:12:05,259 some of those partnerships or innovations that are 308 00:12:05,259 --> 00:12:07,279 going to be most critical 309 00:12:08,054 --> 00:12:10,855 to achieve them? Doctor Martins, we'll start with 310 00:12:10,855 --> 00:12:11,754 you on this one. 311 00:12:12,615 --> 00:12:14,235 Well, it's fundamental 312 00:12:14,774 --> 00:12:17,355 because we we need a lot of help. 313 00:12:18,855 --> 00:12:22,740 I think what's so first, I'm I I 314 00:12:22,740 --> 00:12:25,080 like to see patients. I still, 315 00:12:26,179 --> 00:12:29,059 have my outpatient clinic, assist patients at the 316 00:12:29,059 --> 00:12:29,559 hospital. 317 00:12:30,179 --> 00:12:32,019 But I saw first that, 318 00:12:32,500 --> 00:12:33,559 it's so important 319 00:12:33,860 --> 00:12:34,360 this 320 00:12:35,345 --> 00:12:35,845 management 321 00:12:36,225 --> 00:12:37,285 of stroke care, 322 00:12:38,384 --> 00:12:41,184 understand how to create the stroke systems of 323 00:12:41,184 --> 00:12:43,985 care and teach and to be in touch 324 00:12:43,985 --> 00:12:46,465 with the health managers to help them to 325 00:12:46,465 --> 00:12:49,105 support them to be available to support the 326 00:12:49,105 --> 00:12:51,870 organization of stroke systems of care. The other 327 00:12:51,870 --> 00:12:53,329 thing was I saw 328 00:12:53,789 --> 00:12:56,769 working like this, I saw that I need 329 00:12:57,149 --> 00:12:59,329 a clinical trial. I need research 330 00:13:00,110 --> 00:13:02,429 to prove the concept and to show that 331 00:13:02,429 --> 00:13:05,250 it's feasible and cost effective in the 332 00:13:06,384 --> 00:13:09,585 regional, in the system we are working. And 333 00:13:09,585 --> 00:13:10,245 this was, 334 00:13:10,625 --> 00:13:14,325 really game changer because we show in our 335 00:13:14,465 --> 00:13:15,445 public system 336 00:13:15,825 --> 00:13:17,924 support sponsored by the government 337 00:13:18,250 --> 00:13:21,290 that the treatment was feasible and cost effective. 338 00:13:21,290 --> 00:13:24,170 And first, for this was so important to 339 00:13:24,170 --> 00:13:27,070 have the industry partners together. 340 00:13:27,690 --> 00:13:30,570 This first step first, before this, when we 341 00:13:30,570 --> 00:13:32,509 start to create the stroke network, 342 00:13:32,964 --> 00:13:35,865 we are planning the national policy for stroke. 343 00:13:36,325 --> 00:13:38,904 The same Medtronic and Carol was together. 344 00:13:39,445 --> 00:13:42,404 We sponsored the teaching course, a national teaching 345 00:13:42,404 --> 00:13:45,225 course. So we had a Brazilian stroke network, 346 00:13:46,259 --> 00:13:46,759 government, 347 00:13:47,060 --> 00:13:49,000 Ministry of Health of Brazil, and Meditronic 348 00:13:49,460 --> 00:13:50,440 for a national 349 00:13:50,740 --> 00:13:52,200 teaching course to educate 350 00:13:52,660 --> 00:13:54,360 everybody, primary care, 351 00:13:54,899 --> 00:13:55,720 pre hospital, 352 00:13:56,340 --> 00:13:59,800 hospitals, acute care, and rehabilitation. So we create 353 00:14:00,100 --> 00:14:00,840 a a strong 354 00:14:01,214 --> 00:14:03,475 teaching course in person and virtual 355 00:14:03,934 --> 00:14:07,054 that was fundamental for the first step teaching 356 00:14:07,054 --> 00:14:09,855 them on how to create an organized system 357 00:14:09,855 --> 00:14:12,754 in the in the entire country. Second super 358 00:14:12,894 --> 00:14:13,860 important partnership 359 00:14:15,459 --> 00:14:17,939 clinical trial. Without the industry, you could not 360 00:14:17,939 --> 00:14:20,539 do the clinical trial because you didn't have 361 00:14:20,539 --> 00:14:23,539 enough money. The government gave gave us part 362 00:14:23,539 --> 00:14:25,700 of the money, and we we need the 363 00:14:25,700 --> 00:14:27,559 device to prove that the treatment 364 00:14:28,100 --> 00:14:31,195 works. So this was fundamental. And now after 365 00:14:31,195 --> 00:14:34,014 approval, we need so so much, 366 00:14:34,554 --> 00:14:37,774 education, not only the basic because to to 367 00:14:37,914 --> 00:14:41,034 organize the clinical trial, we have built the 368 00:14:41,034 --> 00:14:43,259 stroke system of care in Brazil. We train 369 00:14:43,580 --> 00:14:45,120 everyone together. The ambulance 370 00:14:45,580 --> 00:14:46,480 needs to know, 371 00:14:47,820 --> 00:14:50,080 what patient should go for a more comprehensive 372 00:14:50,299 --> 00:14:52,320 stroke center where we are implementing, 373 00:14:53,100 --> 00:14:55,600 the more comprehensive treatment, mechanical thrombectomy, 374 00:14:55,980 --> 00:14:59,295 or for primary stroke center essential stroke centers 375 00:14:59,295 --> 00:15:00,195 only for thrombolytes. 376 00:15:00,575 --> 00:15:02,735 So we need to reorganize these with the 377 00:15:02,735 --> 00:15:05,715 health managers. We need to train the neurologists 378 00:15:06,014 --> 00:15:08,595 and the emergency physicians to assist this patient 379 00:15:08,815 --> 00:15:11,460 and and go with them to cath lab, 380 00:15:11,620 --> 00:15:13,639 and we need to teach the neurointerventionalist 381 00:15:14,179 --> 00:15:17,000 because that time, few of them had experience 382 00:15:17,059 --> 00:15:19,620 with the treatment. You it it was so 383 00:15:19,620 --> 00:15:20,120 fundamental 384 00:15:20,500 --> 00:15:23,059 to train them for a better care for 385 00:15:23,059 --> 00:15:25,800 the patient. And now we need more neurointerventionalist 386 00:15:26,420 --> 00:15:28,945 to be feasible to expand the treatment in 387 00:15:28,945 --> 00:15:31,284 the entire country and not only in Brazil, 388 00:15:31,584 --> 00:15:33,924 in Latin America, and the entire world. 389 00:15:34,544 --> 00:15:36,705 It's a holistic approach, which is so important. 390 00:15:36,705 --> 00:15:38,865 Right? It it takes so many different factors 391 00:15:38,865 --> 00:15:40,644 into account, including the technology 392 00:15:41,480 --> 00:15:44,120 with, dark with doctor Perron just mentioning how 393 00:15:44,120 --> 00:15:45,639 important that is to be able to enable 394 00:15:45,639 --> 00:15:46,839 some of this. And and I wanna come 395 00:15:46,839 --> 00:15:48,839 to you, doctor Perron for for this, as 396 00:15:48,839 --> 00:15:49,339 well. 397 00:15:49,879 --> 00:15:52,279 What are you seeing as most critical in 398 00:15:52,279 --> 00:15:54,524 the future to be able to to build 399 00:15:54,524 --> 00:15:57,084 that collaborative model for stroke prevention and treatment? 400 00:15:57,084 --> 00:15:58,625 What does that look like for you? 401 00:15:59,004 --> 00:16:01,485 Yeah. So I'll summarize. I think mark doctor 402 00:16:01,485 --> 00:16:03,084 Martin has already covered a lot of things. 403 00:16:03,084 --> 00:16:05,164 If the in my view are three pathways. 404 00:16:05,164 --> 00:16:07,404 Right? The first one is really collaborate very 405 00:16:07,404 --> 00:16:09,539 closely from the industry perspective 406 00:16:10,000 --> 00:16:13,299 with magical societies and hostels for the technology 407 00:16:13,360 --> 00:16:13,860 development. 408 00:16:14,319 --> 00:16:16,959 Whatever new solution, we created needs to be 409 00:16:16,959 --> 00:16:19,839 very much aligned with the specific need that 410 00:16:19,839 --> 00:16:21,059 we have in front of us. 411 00:16:21,524 --> 00:16:24,804 So technology development. The second one in my 412 00:16:24,804 --> 00:16:26,904 view is as as doctor Sheila mentioned, 413 00:16:27,365 --> 00:16:29,605 how we partner to ensure that we are 414 00:16:29,605 --> 00:16:32,404 not only covering the clinical trial perspective to 415 00:16:32,404 --> 00:16:34,745 prove that those products, that we are developing, 416 00:16:34,804 --> 00:16:36,745 those technologies are safe and effective, 417 00:16:37,179 --> 00:16:40,399 But also that from the cost effectiveness perspective, 418 00:16:40,940 --> 00:16:43,100 it is feasible for the hospitals and the 419 00:16:43,100 --> 00:16:45,740 providers to adopt it. Because it may be 420 00:16:45,740 --> 00:16:47,580 amazing, but if there is no room for 421 00:16:47,580 --> 00:16:48,320 the economics, 422 00:16:48,860 --> 00:16:50,940 then, the health care system will struggle to 423 00:16:50,940 --> 00:16:54,345 adopt. And the third one, it's definitely how 424 00:16:54,345 --> 00:16:57,545 we partner not only between industry hospitals and 425 00:16:57,545 --> 00:16:59,565 providers, but also beyond that 426 00:16:59,865 --> 00:17:02,205 with nonprofit organizations, with governments, 427 00:17:02,904 --> 00:17:04,605 with different types of societies, 428 00:17:05,589 --> 00:17:06,149 to help, 429 00:17:06,950 --> 00:17:07,450 incorporate 430 00:17:07,829 --> 00:17:09,990 those technologies and those solutions in the health 431 00:17:09,990 --> 00:17:11,589 care system. So I think today, we do 432 00:17:11,589 --> 00:17:14,309 have a very good example. Mhmm. We are 433 00:17:14,309 --> 00:17:16,569 all part of a global stroke coalition 434 00:17:17,204 --> 00:17:18,565 that is a group of experts, 435 00:17:18,964 --> 00:17:20,744 between nongovernment institutions, 436 00:17:21,444 --> 00:17:21,944 industries, 437 00:17:22,724 --> 00:17:25,464 like, Phillips and Medtronic and other companies, 438 00:17:26,325 --> 00:17:28,964 patients and and other experts that are coming 439 00:17:28,964 --> 00:17:31,304 together to really work around the globe, 440 00:17:32,130 --> 00:17:34,609 to kind of reduce the burden of stroke, 441 00:17:34,849 --> 00:17:36,690 in The US and outside of The US. 442 00:17:36,690 --> 00:17:38,789 I think that is a a great example 443 00:17:38,849 --> 00:17:40,769 of a good what a good collaboration look 444 00:17:40,769 --> 00:17:41,269 like. 445 00:17:41,970 --> 00:17:44,049 It often sounds like a cliche, but it 446 00:17:44,049 --> 00:17:46,224 really does take all of us. It's one 447 00:17:46,224 --> 00:17:47,904 of those things that I like to say, 448 00:17:47,904 --> 00:17:49,904 and it is an important model in terms 449 00:17:49,904 --> 00:17:51,684 of partnership and innovation itself. 450 00:17:52,224 --> 00:17:53,984 Doctor Martins, doctor Perron, thank you so much 451 00:17:53,984 --> 00:17:55,345 for being here and taking some time to 452 00:17:55,345 --> 00:17:57,184 be with us today. It's been a fantastic 453 00:17:57,184 --> 00:17:58,404 conversation. Thank you. 454 00:17:59,059 --> 00:18:00,819 Thank you so much. Thank you very much 455 00:18:00,819 --> 00:18:03,220 for the opportunity again, Lucas. Appreciate it. It's 456 00:18:03,220 --> 00:18:04,579 great to have you. And we also want 457 00:18:04,579 --> 00:18:06,500 to thank our podcast sponsor, Philips. You can 458 00:18:06,500 --> 00:18:08,819 tune into more podcasts from Becker's Healthcare by 459 00:18:08,819 --> 00:18:12,679 visiting our podcast page at beckershospitalreview.com.