Guest: Waqaas Al-Siddiq, CEO, biotricity, www.biotricity.com, explains how automation of the IoT (Internet of Things) is set to help businesses refocus their attention and efforts on getting more solutions out to customers, while reducing the amount of time spent on smaller, remedial tasks.

Al-Siddiq was featured as a guest on The Peggy Smedley Show to highlight a need for medical remote-monitoring solutions. He identifies challenges associated with leveraging the Internet of Things in the healthcare industry, as well as potential benefits.
In early October Al-Siddiq and host Peggy Smedley address the next generation of wearables for healthcare—and the impact they will have on both patients and practitioners. He talks about what Biotricity brings to the medical industry. Al-Siddiq also came back to the show on December 6 to continue the discussion.
To hear this interview on The Peggy Smedley Show in its entirety, log onto www.peggysmedleyshow.com, and select Episode 474 (10/04/16) from the archives.

 


Smedley: You’re going to alter the connected healthcare market. In fact, this is a space that is going to grow at a compound annual rate of 33%. You see real potential. Let’s talk about that why you see so much potential in healthcare.

Al-Siddiq: You know I see that there’s a couple of things that are driving the marketplace today and part of it is absolutely the healthcare system and the fact that it’s just costing us more and more dollars. Not only that, you’ve got therapeutics that are allowing us to live longer. So we’ve added probably about two decades to our life spans in the last 50 odd years. We’re living longer, but we’re suffering from chronic illnesses.
You have the healthcare system bringing so much cost associated with a small percentage of the population, as opposed to really focusing on preventative care. So it’s this whole reactive approach to medicine. Now this is kind of becoming front and center with the Affordable Care Act and this whole problem on a global landscape. I find that we’re at a precipice where the healthcare system has to shift, otherwise it’s not going to survive and you see a lot of technology companies that are still focused on the old concept of diagnostic medicine within the hospital.
I think that the connected aspect of it is what’s really going to allow us to drive innovation and response. The key thing is if someone’s actually having a situation, can we respond to it effectively and quickly? By being connected, we can grab that data, we can shove it off into some remote environment, we can analyze it and we can actually deal with response if we verify that there’s a problem. I feel that today we’re just coming into a world where technology has come to a point and connectivity has come to a point where we can really make an impact on this healthcare landscape.

Smedley: When we look at this, when we take this data from real-world experiences, we can change, not only what we’re doing on the medical side, but we can change what happens on the insurance side where we can harvest information. We can validate information. Do you think all of this that’s happening in the cloud has the potential to change the landscape of healthcare in a way that most of us can’t even imagine? Is that the concept behind this?

Al-Siddiq: You know, it’s a good point. I think that there’s aspects to it that we understand, maybe 20-30% at a broad level, and I think the real interesting thing is, as they say it’s a layer of onions, it’s behind the curtain. There is a hospital, a renowned hospital in the United States, and I was just connecting with it. I was working with it on looking at outcome improvement on cardiac patients. We know the cardiac patients. Once they’ve had a heart attack, they’re 70% more likely to have another heart attack. We know they don’t comply, so it’s costing the hospital a lot of money… I said that’s interesting you’re using the best technology. You’re an innovative hospital. How do you not know the dollars that are being spent?
To your point, which is about the cloud, as all of these things start getting connected, they will be able to actually quantify this problem at a very clear number. What is the actual dollar cost? We’ll be able to see that. And not only will we be able to see that, we will be able to see the overall approach of medicine to one patient. Today you have diabetes, you go and you see your endocrinologist, you go and see your GP. The data is fragmented. You’re not seeing a holistic view of this as a patient. If you have a cardiac condition, cardiology doesn’t see the diabetic information.
As all of this gets connected you’re actually going to have the hospital looking at things from an outcome and from a healthcare team perspective, as opposed to just a singular physician who’s a specialist or a general practitioner who’s dealing with aspects of this patient’s care, not looking at the patient holistically.

Smedley: If we look at this in a bigger picture, we want to say that remote monitoring can save lives, but it also saves money, and hospitals care about both. Is that correct?

Al-Siddiq: Yeah, absolutely. I would add to your point which is, save lives, reduce cost, but also improve lives. When you’ve had a heart attack or you’ve had a major diabetic event, your quality of life goes down. If we could have predicted that, if we could have anticipated that, if we could have introduced a change to that, we could avoid the body going into such a stressful situation, which essentially can have a long term effect on you. They say that 90% of muscle damage caused in a heart attack can be reversed if you can respond within 90 minutes. But, we don’t respond within 90 minutes. Once you’ve explained that muscle damage, it’s irreversible after that point in time. To your point, not only will we be able to say here’s the exact dollar cost that has been saved, here’s the exact improvement. Here’s the number of lives we save. Here are the number of lives we were able to go in and impact and maybe reduce the stress that was caused or improve the outcome and really tangibly articulate that.

Smedley: Are we worried about regulatory issues? What is holding adoption back?

Al-Siddiq: It’s a very good question. One of the things, of course, is reimbursement. You’ve got a lot of these novel companies coming out with great technologies and they’ll get FDA clearance, but getting FDA clearance doesn’t actually mean anything from a reimbursement, or a business model perspective. So they’ll get reimbursement, they’re a great novel technology, but the problem is there’s no economics behind it. What happens is a company will ultimately fail unless they can convince insurance or a hospital that there’s a cost savings around this, which is a much harder position to take and a much harder sales tool as opposed to saying look here’s technology that fits within insurance and we have reimbursement. One aspect of it really is around the economics of it, the reimbursement, is there a way to bill for this? Because as soon as there’s a way to bill for this, then it’s a much easier selling point for a hospital or for a physician.

The other issue why I think some of this stuff has taken very long, is, of course, the regulatory component of it. The FDA itself is a very conservative animal. They’re looking at things primarily from a patient safety and from a risk perspective. So when you’re introducing a new technology, you really have to prove that there’s going to be no adverse effect here. They are always going to take it from the devil’s advocate approach. So now you’ve got this connected device, you have all of this data, and you’re going to say that I’m going to be able to determine that a patient is going to have an arrhythmia before it happens. Or, I’m going to be able to reduce response time. Well is a doctor now going to depend on you to produce that? If the doctor is going to depend on you, could that introduce a doctor not making the best decision? When that happens, the regulatory guys get very, very cautious. The regulatory hurdle of course is another aspect of why when you look at healthcare, everything’s five years behind, as soon as you think of technology and applying it in the healthcare industry.

The third component is the physician. Your physicians are burdened because there are too many patients, not enough practitioners. They’re very, very busy, they’ve got hectic lives, and we keep on burdening them with more and more data and more and more information. The physician is the third person that you really have to understand in the healthcare food chain, right. What helps them is that there’s three things that have to align for them. One is what is the clinical value that you’re providing them, in terms of the diagnostic relevance to their patients? Can you give them something that really is clinically valuable? If it’s a diabetic patient, can you give them some information about the person’s sugar history. If it’s a cardiac patient, can you provide some statistic around their heart health that is actually medically relevant?

Smedley:Let’s talk about your product. Let’s talk about why you decided to introduce your product?

Al-Siddiq: Biotricity, as a company, we really wanted to focus on chronic illness and connectedness as you know. The reason we looked at mobile cardiac telemetry is because it truly is one of the unique connected markets in the United States where mobile cardiac telemetry was provided and created specifically to deal with risky patients. You’ve got a patient, they’re suffering from an arrhythmia the doctor wants to get more data from this patient, or he just did a procedure on him and he wants to know if the procedure worked. The problem that happen is that if you put the monitor on for a short period of time, the probability that you will find your anomaly is low. You want actually more data, but as you have more data, you increase patient risks. Mobile cardiac telemetry was created because we said what we want is we want an intelligent device that is connected and that can respond in case there is an emergency situation.

Traditionally, the device was really about just transmitting information, not intelligently but to a call center and a call center can just go in and just read this information and then respond. We said, this is an interesting market where we can really bring in intelligence, we can really bring in the connected aspects of it and create a complete solution for the physicians so that the physician can utilize (it). Today the physician just doesn’t have that time of infrastructure in house, he needs to go outside and then go to a provider who can provide that. That’s the key reason why we got into the market and why we thought it was an important market, because it facilitated and aligned with our vision of the company, which is to look at chronic illnesses and connectedness in healthcare.

Smedley: I saw the numbers that 20 million Americans live with some form of cardiovascular disease, I mean that’s staggering.

Al-Siddiq: It’s a crazy amount. Not only that, I’ll give you another stat, which is insane. They’re saying that by 2030 it’s going to cost the United States a trillion dollars related to cardiac. That’s one in every six healthcare dollars in the healthcare system associated with cardiovascular, the number one killer and it’s going to boom.

Smedley: How do you get the consuming public to feel more comfortable about using devices like this?

Al-Siddiq: Our approach was that we will come from the diagnostic side. Bioflux is the first product, it’s really designed for cardiology and metro-physiologist to use this device on a risky patient. They put it on the patient, the patient goes home and it collects data. If there’s an emergency it will send it to a call center to deal with an emergency situation. If there is no emergency, then the patient comes back and it creates an analysis and a report. Our idea is that as soon as the patient is hooked up from this cardiologist or electro-physiologist, he’s introduced to biotricity and he understands that biotricity is really a medical device company.
Our second product is really focused on your point that you just made, which is how do we get a consumer to use this after the test. What we do with the second product is, we take the technology from the first one, simplify it, and put it in the hands of the consumer for self-use. Since they know of the company, they’ve used it, the doctor has used it on them, there is a level of confidence that automatically comes. Because they’re like, “Hey, this is the device that has been created by the company that was used on me to diagnose me.” It is the accuracy and the FDA clearance and all of that provides that comfort, because the problem with patients is if they take something off the shelf, how do they know the information that’s coming to them is really accurate if it’s not FDA cleared, if it’s not being recommended by a physician?

Smedley: Bioflux is different. It is advancing information and testing that’s giving patients information that they’ve never had before and it’s going to save their life. Is this correct?

Al-Siddiq: Yes! To your point some people who understand the industry and are astute, they of course understand this. I would think the majority of people we have go through this explanation and something that we have been trying to put out there and articulate as clearly as possible, because to your point, yes people are like, “Isn’t this a Holter monitor right?” They don’t understand that in a Holter, there is no intelligence. There is no communication. If something actually happens to you and you’re by yourself, no one knows. If it’s not communicating, there’s no response right. In this case, it’s actually actively monitoring and transmitting so it can actually deal with that exact situation, and as soon as they understand that then the light bulb goes off.
Smedley: As you look at all this technology, what do you see is coming next? We’ve got about thirty seconds. Is the technology just this the beginning of so much more to come?

Al-Siddiq: Yes! I would think right now what we’re doing is that we’re impacting this idea of emergency response. I think the future is going to be that we’re going to have integrated or implantables. We’re also going to have predictions. We will actually know even if the arrhythmia occurs or before the person drops.
This idea of machine intelligence and predictive response, the situation hasn’t even occurred and you’re having a response. I think that’s where the future is going, and more and more integration with our own biology.