It's so important for leaders at the top of organizations to keep learning,
stay sharp, grow their networks,
help our audience better do this in a more simplified, personalized,
and meaningful way. Becker's Healthcare has launched my bhc,
it's your trusted Becker's healthcare experience and more with content,
connections, events, and learning opportunities.
Join the community free of charge@www.my dot becker's hospital
review.com and we'll see you there.
Welcome everyone to the Becker's Healthcare podcast series. I'm Ryan Mohammed,
she her pronouns with Becker's Healthcare.
I'm thrilled to have with me today Dr. Ryan Mader of Corwell Health Doctor.
So nice to talk with you today. How are you?
I'm great. Thank you for having me on.
Yes, of course. I'm so glad that you're here today. Uh, to begin,
would you mind please introducing yourself and telling us a bit about your
background?
Uh, sure. So, uh, my name is, uh, Ryan Mader. I am a, uh, practicing,
uh, interventional cardiologist, and I serve as the, uh,
director of the cath lab and the section chief of interventional cardiology at
Corwell Health in, uh, grand Rapids, Michigan.
Perfect. Thank you. Um,
and so the next question that I wanted to talk to you about is how can tele
robotic surgery close the gaps in access to care and health disparities
a across the u us if you have an answer for that.
Yeah, so, um,
I've been working on tele robotic research now for almost a decade.
And, uh,
the problem that we're trying to address with this research are really these
disparities that exist, uh, not just in the United States,
but around the world in rural, uh, underserved locations,
where the type of care that is delivered is not the same as we deliver in
places, you know, in urban settings or suburban settings.
And so the goal of this is to try to, you know,
develop tele REbotics to eliminate those geographic disparities in care. And,
and one of the issues, you know,
that exists right now in the United States is that if, if you're a patient, uh,
living in a rural area and you present to a hospital with heart attack or
stroke, the type of treatment that you get in that rural hospital is gonna be
significantly different than the type of treatment that you're offered,
you know, in an urban or suburban hospital. And that's unfortunate because,
you know,
the state-of-the-art treatment for a heart attack is to go into the heart with
catheters, find the blockage, and,
and do an intervention where we do angioplasty and stenting to open up that
blockage. And many rural hospitals just don't have the, uh,
either the expertise, uh, or the technology to,
to do that and offer that to their patients. And so, um, you know,
when you aren't offered a, you know, stent procedure, uh, you know,
for your heart attack, uh,
and you just get medications alone that's associated with the higher risk of,
of death, uh, it's associated with, you know, uh, having a larger, uh,
heart attack and more damage done to your heart and a higher risk of,
of living a life with, uh, congestive heart failure in the long run.
And so there are substantial benefits to opening up, uh,
blockages in the setting of a heart attack with, with, uh,
stents and angioplasty. And unfortunately, that's just not offered, uh,
everywhere right now.
And so that's something that we're trying to develop the ability to deliver to
those, uh, rural areas, uh, by using tele REbotics.
Wonderful. Yeah,
I'm so glad you discussed the challenges in the location of the treatment. Um,
I'm sure that could be a very challenging time for the patients impacted as
well. And for you, doctor,
where do you see the physician ment of tele robotic surgery trending right
now? What are the opportunities and the risk?
Yeah, and so, well, the research that we've done, you know,
today really shows that we have the technical ability to do this now. And so,
uh, we started this research again almost a decade ago now,
where we showed that it was feasible to use a robotic system to fix a
patient's heart, even when we weren't sitting in the same room as the patient.
So in that initial research,
we actually wheeled the robotic controls out of the,
the room where the patient was and,
and showed that we could successfully fix that patient's artery, uh,
despite not being in the same room as the patient. And that was the,
the first study that, that we had done, uh, to explore, you know,
whether tele robotics was gonna be a way that we could potentially treat PE
patients from, you know, over long distances. And, you know, whereas, you know,
heart surgeries are traditionally done with the physician standing right next to
the patient. That initial, uh, study that we conducted,
we were about 55 feet away from the patient. And, and that was a major leap, uh,
you know, forward in, in demonstrating the, the, you know, potential of,
of this, uh, tele robotic therapy. Uh, we did subsequent research then that,
uh, you know, evaluated whether we could do this over distance of miles.
And so we developed, uh, ex vivo simulator models,
and then we did some animal work where we were, um, stenting, uh, live animals,
uh, from distances of over a hundred miles away and,
and showed that that was successful. And then, uh, in, in 2018,
a physician in India, Dr. Taja Patel actually, uh, you know,
used the setup that we had developed and tested here in Grand Rapids and
actually, uh, stented, uh, five, uh,
humans from a distance of about 20 miles away showing that it was successful.
Uh, and so that was a, again,
I think another major leap forward showing the feasibility of doing long
distance, you know, tele robotic procedures, uh, on living humans.
And then we spent much of the time in 2019 in a collaboration with, uh,
the robotics company and with, uh, Verizon Wireless to actually study, uh,
you know, is to ask the question,
is there a distance that is too long right now to reach a patient using tele
robotics?
And so we set up a transcontinental model where I was sitting at robotic
controls in Boston and actually controlling a robotic arm in San Francisco.
And, uh,
and over that distance across the country showed that we could actually do,
you know, a heart, uh, based, uh, procedure, not on, not on a living patient,
but on actually a simulator and showed that we could do it completely
successfully. And so, you know,
because we were able to do that successfully in that model, we think that,
you know,
we can reach almost any location within the continental United States that has
adequate, you know, uh, internet, uh, capacity. Um,
and so we're designing studies now to really look at this, uh, you know,
and really take this to the next level where we might eventually be able to
offer this, uh, inpatients.
Yeah. Thank you so much for sharing, you know, some of your research.
I know that that can take a long time to conduct, but the results you, you know,
shared certainly show hope for many. And as you know,
technology is helping many healthcare professionals and patients around the U S
A, um, however,
what advice do you have for surgeons who are on the fence about telerotic
surgery?
Yeah, I, I think we're gonna see greater and greater adoption of, you know, of,
you know, all aspects of telemedicine. And I think the,
the pandemic really catapulted, you know,
US healthcare and healthcare in other countries to, to adopt, you know,
telemedicine, you know, technologies to, to deliver care at a distance.
And, um, you know,
that I think that was one of the beneficial things to come out of,
out of the pandemic as awful as it was. But, you know, I, I've,
I've seen greater adoption not just within the healthcare community,
but also within, you know, kind of, uh,
patients where patients I think are more willing than ever to, to, you know,
accept, you know, telemedicine as a, as a viable treatment option. And,
you know, tele robotic surgery is just a, a, a, you know, an offshoot of,
of telemedicine. And so I, I do anticipate that even, you know,
for physicians who may be on the fence about this,
that I'm hopeful that with the research that we do in the future,
that we'll be able to demonstrate that this is an a,
a safe and effective therapy,
and eventually be able to convince those physicians that this is something that
they could provide, you know, patients who are far away from them.
Wonderful. Yeah. Thank you so much for those final thoughts. Doctor,
this has been an amazing discussion. Uh,
so I wanna thank you so much for coming on Becker's Healthcare and I look
forward to connecting with you again soon.
Great. Well thank you very much for your time.
Thank you.