Before and during this pandemic, millions of people are going to clinics and hospitals and be lucky enough to be connected to some very precise, very accurate and also very expensive clinical monitoring gear.
And then typically you're discharged and often you've got nothing better monitoring you then an apple watch if you're lucky.
And yet we're in the middle of a pandemic that has all kinds of signals that we have to figure out To know the course of this thing.
Peter Van Haur might have the answers for us.
He is CEO of VitalConnect.
They make something called the Vital Patch, which recently got an FDA emergency authorization, we're gonna talk about in a moment here.
And they're very focused on monitoring heart signals.
And we've talked about a lot of sensing technologies here on NOWWHAT.
But this one goes right to the heart.
Peter, tell me what the VitalPatch does, and how it does it.
It's kind of this sort of dual oblong-shaped thing.
Sure, sure, Brian, thank you very much for having me on your show.
And first a real heartfelt salute to those men and women on the front lines in today's pandemic, we wouldn't be able to do what we do without your help at the tip of the spear.
So I just want to say thank you very much for that, as it relates to vital connect and the patch that we provide.
I'll show you the patch.
It's about four inches in length.
It about 12 grams in weight, and it affixes to the patient's body just above the heart.
Back in 2011, this, our company dates way back, we have a thesis that we could take the environment of an ICU setting All the bells and whistles, all the monitors, all of those machines that ultimately provide the caregiver, the necessary vital signs to understand the position that they're at in terms of the patient getting better, or the patient getting worse.
We've essentially miniaturized the ICU From a monitoring perspective, to a bio sensor, the size of a dime.
That circle there is a bio sensor that has the ability to monitor in real time, an ECG.
Typically think of an ECG with multiple stickers on your chest and wires coming off your chest.
We're gonna do a continuous ECG Off that bio sensor, as well as continuous temperature recordings, continuous respiratory rate, continuous heart rate variability, we also have the option to the ability to monitor activity, posture, as well as SPO to body weight and blood pressure,
So are you doing everything through that sensor that you're showing us or is there some other sensors that have to pull in things like blood oxygen?
So the first eight that I had mentioned, we have the ability to monitor off of that bio sensor.
with Bluetooth connectivity, we're able to connect with Any type of SPO2 monitor which is the ability to measure the amount of oxygen in a patient's bloodstream, certainly you can't weigh yourself or get a weight off of a bio sensor so we connect with a Bluetooth scale.
And then thirdly, we have a Bluetooth connected blood pressure cuff that if necessary, we connect With that.>> Okay, the eight vital signs I've mentioned first and really the key ones that you would otherwise see in an ICU can be done off that bow sensor in the comfort of a patient's home and I can share the logistics of that.
So with all these sorts of signals you've got but your purpose as I understand it correctly, is very.
Heart aim very cardiology centric.
Is that right?
Yeah, we started off in the market of trying to remove the patient from the hospital and get the same level of off.
Observational care that they would otherwise have in an ICU setting or a telemetry setting.
But do this in the comfort of the patient's home.
And that's what I find so interesting is that so many people go into an acute care situation in the clinic They're dealt with with massive amounts of data and all the hands on therapies and then you fall off a cliff when you're discharged, at least in terms of monitoring as I see it as a lay person, that all of a sudden you're virtually in the dark, you know, maybe you've got some kind of a quote fitness wearable, but even that's pretty rare.
Most of the time, you're just doing occasional Follow-up visits.
It seems like you go from being totally lit up to almost dark as a data node very starkly when you leave the hospital.
Yeah, I'll give you a perfect example of that is there's a rapidly evolving
And it's already evolved but it's rapidly increasing a heart procedure.
It's known as a tab or trans aortic valve repair.
What this is, is the ability to give a valve repair without doing open heart surgery.
They actually go up with a catheter through your groin and they can repair your heart without having to open your chest cavity.
And what we're seeing is the patients are able to get this done.
And within 24 hours to 36 hours, you're actually seeing the patients discharged from the hospital, which is exciting.
I mean, just that in itself is an amazing technique.
It really is it really.
Really is, but the one piece that a lot of these physicians that are performing these procedures are concerned about is heart block.
For whatever reason, 8 to 20% of the patients that have this procedure
We'll go into some level of heart block.
And this will happen within the first four to five days.
So if you're discharging patients 24 to 36 hours, you typically don't see your patient for a follow up visit until day seven.
And we refer to that window of four to five days where you're at home As you would said, have fallen off the cliff as the as the window of risk.
Our technology this patch can be placed on the patient.
Patient goes home and they remain tethered to the healthcare environment.
If that patient is showing signs or symptoms of heart block, or signs or symptoms of leading to heart block, we can immediately detect this, get the information to the caregiver or the physician, and get that patient the necessary care that they need before they go into heart block, which could be potentially fatal.
I know that sometimes when I talk to companies that make consumer electronics oriented heart monitors, they'll talk about being equivalent to a certain number of leads or traces compared to a clinical machine.
Where do you fit in that level of equivalence?
Yeah, we fit into a single lead ECG.
Which is not quite what you would get at the ICU so we don't claim to be 100% equivalent to the ICU.
We're about as close to the ICU as you can get.
Without needing the absolute necessities of the ICU.
We're equivalent to say a high sophisticated telemetry floor on a in a typical hospital.
Now let me ask you how this relates to COVID-19 because I've been reading a number of articles, we all have been seeing them, I remember one Stark Quote From one medical practitioner saying, I was dealing with a couple of COVID-19 patients and their hearts literally exploded.
There's something going on that seems to be cardiac related to this syndrome.
Until and unless that's figured out, what is your ability to be helpful in this pandemic.
Right so as you know, we weren't cardiovascular centric company.
And we were moving along as a company, a small company out of Silicon Valley and growing and doing quite well.
When COVID hit for the most part, our business was shut down.
Elective surgeries were shut down.
Yeah, that valve replacement procedure I told you about was was really happening in very small increments only in emergency situations.
So our company pivoted and as you know, our technology has the ability to do many things.
And what's important with COVID-19 or at least at the onset was a couple of things.
How do we separate a COVID-19 positive patient from folks that are not called COVID-19 positive, particular healthcare professionals and others, their family members and other folks of society but It's very important that we monitor these patients to ensure that their signs and symptoms are not accelerating to the point where they may need the ICU to get on the ventilators that we've heard so much about in the news.
So there are cardiac indications that are at this early point related to the onset or management of COVID-19.
Yes, and this is why so the first thing that physicians are going to care about is what is the patient's respiratory rate?
What is their temperature?
What is their SPO to how much oxygen is in the blood and as you know, we can monitor For all three of those things either in the comfort of the patient's home or in the hospital if they're in a quarantine covid floor.
Secondarily, the way this virus attacks the body is in three areas.
It attacks the proteins that are in your.
Airy space, which is why it becomes a respiratory illness.
It attacks the heart because this protein that it's attracted to is in the heart muscles.
And thirdly, it attacks the kidneys.
And so as this virus is attacking the patient, oftentimes there are cardiac related comorbidities that are created because of this.
17 to 45% of patients that contract COVID-19 will actually also develop cardiovascular issues.
We can detect those issues and quickly get them the care that they need before it becomes too late.
What's interesting is you don't necessarily have to track all those through the patch.
Some of you do, some you don't.
But sounds like your platform is where a lot of this comes together.
Yeah, so our platform is set up with multiple algorithms, which gives us the ability to have what's known as predictive analytics.
Yeah, we're taking data points from all those different vitals.
And we're looking at those through the powered algorithms that are smart people back in Silicon Valley.
Our engineers have developed it, we're able to predict ahead of time The path that a patient is going down, what we have is early warning scores.
So as those patients fall outside of the bounds that a physician is comfortable with, they would immediately get an alert that we can immediately get to that patient before it's too late or before it becomes a major issue.
Now, I'm certainly not medically trained in any way, but I go to a lot of medical tech conferences and I hear from a lot of MDs and a lot of people involved in the care industry a pretty deep skepticism about AI and algorithms.
I think part of it is they feel that they're being told a machine can do their job better than them, or part of it is they say, we're gonna take this slow and make sure that these algorithms are actually as smart as they say.
How are you dealing with that skepticism out there especially during something as critical as a pandemic?
Sure, I'll tell you I think we're somewhere in the middle.
I'm quite friendly with many very accomplished physicians, many kalos across the country.
And I will tell you there there is absolutely as much of an art Medicine as there is a science there, I don't think you can fully replace the human element of treating a patient.
There will always be an art to this and a human element that these amazing physicians and nurses have that a machine just can't replicate.
However, With that being said, I think AI provides a significant complimentary tool to help that physician improve their art.
And I'll give you an example we've recently been published in a publication known as circulation for heart failure.
The name of the study is link our algorithm in our patch Actually predicted a heart failure patients readmission to the hospital 10 days ahead of when it actually would have happened compared to a control group to a treatment group, through AI and through the predictive analytics that we have around these patients.
We knew 10 days ahead of time that if nothing was done, this patient was destined to be readmitted to the hospital because of congestive heart failure issues.
He recently received an FDA emergency use authorization.
I understand that's related to what's going on around the pandemic.
First of all, what is that authorization and what does it mean to what your products can do?
Yeah, so the actual authorization is to treat COVID-19 patients that are being medically treated with drugs such as hydroxychloroquine or other drugs that have the capacity to induce what's known as a prolonged, QT interval.
That is a very fancy word for arrhythmia, which is a fancy word for a regular heart.
There was very well documented that these drugs although showing signs that they can be helpful in COVID in some instances.
These drugs such as hydroxychloroquine have the side effect of creating irregular heartbeats.
Our technology has the ability to monitor for the key signs and symptoms of COVID, respiratory rate temperature as well as pulse oximetry.
But it also has the ability to pick up and detect 22 different arrhythmias as well as a atrial fibrillation those are irregular heartbeats, and the fluttering of the heart.>> Yeah.>> The drugs, as well as COVID in of itself, have been shown to create, or drive the inducement of these irregular heartbeats.
And the [UNKNOWN].
And so what the FDA has done is said VitalConnect, you're the only technology on the planet that has the ability to simultaneously monitor the key signs and symptoms of Covid.
Respiratory, temperature, SPO2 while simultaneously watching for the all important Prolonged QT interval, irregular heartbeat, as well as atrial fibrillation.
And so we have now a giant push to monitor patients that are positive of COVID-19 that has been proven that are at risk for significant parties.
Okay, so you've got an authorization to look for both problems caused by the actual illness, or caused by some of the treatments for the illness.
Okay, let's bring this thing home now literally and figuratively.
What's the roadmap for this to be used at home currently, let's say someone's discharged from the hospital and they are wearing this patch.
What does it connect to so it can stay in touch with my provider, let's say in that seven day window you talked about for that Valve procedure.
Sure so what will happen is, upon discharge the patient will be providing this patch is just like a band aid as an adhesive on the back.
They'll go home with that patch and they'll go home with a tablet such as a phone.
And the tablet acts as a relay.
So the patient is rehabbing in the comfort of their home.
They're probably spending a lot of time in bed so the relay sits on the bedside table.
The information is being collected at the patch site It's being sent to the relay which can be a phone or a tablet.
And that information is then sent to a cloud and Amazon cloud.
From that cloud, we have the ability to watch the patient.
And we also have the ability to send a URL, a web link to a caregiver that can access to the cloud from anywhere in the world.
And monitor that patient while they're rehabbing in the comfort of their own.
And I assume you've got a pretty nuanced set of alerts so that caregiver is not just getting a bunch of here.
Here's a portal to information, but here insights that I'll only bother you with when you need to know Yeah, so we have what's known as an intake form and we do a pretty extensive deep dive with the physician prior to, to understand what his desires would be to to get an alert.
So if a certain irregular heartbeat were to occur, he'd like an alert or she would like an alert.
If others occurred, not such a big deal, call my office in the morning.
Okay, so it's quite tuneable to that particular physicians art.
It sounds like.
You got it.
Let's talk about big picture, I am very fond of the concept of sensors like yours and others.
And the platforms under them becoming universal.
They're still medical equipment right now.
They're still used when I have a condition or an issue and then, we think of them as being niche and out of our purview.
But to me, we should all be wearing sensors of some type that are multi signal all the time.
Why don't we want to be in front of everyone's health trends?
There's no reason not to.
So what stands in the way of that vision in the future?
You know, I think we'll get there down the road.
And I think right now we are understanding how much information, is enough information, and how much information is too much information
One of the questions that we receive quite often is.
How often will I be getting alerts?
And how much information will I receive because I have a full time job as a caregiver.
And now if I'm getting consistent flow of information from all these patients that are patched, how do I manage both?
And so I think there needs to be we need to figure out what is the healthy balance of alerting The extreme cases that need care, eliminating the noise, and then allowing physicians and caregivers to provide care on a daily basis in their day job if that makes sense.
Yeah, I mean, but the fact that most of us go to the doctor once a year is ridiculous to me, I know it's traditional But that'd be like I drive my car and only one day a year does the dashboard gauges work.
And the rest of the year.
It's like, well just trust that things are going okay when it runs out of gas, you'll know because the car stops moving.
We wouldn't do that with our car.
And yet we kind of live that way.
And so I'm really curious about how we can get to the point.
What do you think stands in the way is it technology?
Is it cost is it care provider?
Acceptance or is it merely a filtering job like you were just describing?
Well I think the filter is a part of a we have the technology.
Technically if you wanted to put a patch on once every three months and take all your vital signs, we could do that.
And in fact, that might not be a bad idea looking at it.
And if there's a sign or symptom of a problem, then you come in and get the care that you need.
I think there's a component around logistics how do we get the technologies to the masses and public?
Who's going to look at that information on a quarterly basis?
And what are the costs around that?
And will the insurance companies cover it?
So the healthcare is no is a very dynamic environment and it's always around logistics.
Who watches the people that who pays for it?
Yeah, a lot of it I now have fits into codes and procedures.
Healthcare is like, as you've mentioned several times such a very tightly packed industry.
There's not a lot of time to muse and to try new technologies.
What do you do to argue either now or in normal times for practitioners to say take the time?
the time To figure out what we're doing and see where it fits.
How do you get them to take a breath to even consider something like this?
So I'll give you an example of that.
Speaking with a prominant physician out of New York at Columbia, has roughly 10,000 patients within his census.
Doesn't see them every year, obviously, but has treated them and has them in his census.
15 years in practice as an attending physicians never done a telemedicine consult.
Finally took a look at our technology and and said during COVID I was forced to do telemedicine visits or consoles.
Post COVID I will never do a first console again, without telemedicine.
If you look at what it does you have a patient that drives an hour from Westchester County to downtown Manhattan.
Spends $50 per parking, spends an hour at the hospital for the console and then an hour back home.
It's a three hour event and $50 and the physicians rush to move you through the clinic.
That room for the next.
So with a telemedicine experience with our technology that does the vitals.
Everything is available to them that they need, that they otherwise would have in the in the consult room.
You can spend the full half-hour or hour that was dedicated to that patient because you're not making room for the next patient and working on your labor, your pull through.
And the patient likes it.
The patient hasn't wasted three hours of their day and spent $50 in parking.
So, these things are happening and I see this market moving swiftly towards a telemedicine environment and COVID-19 was simply the catalyst to get us there.
And we're seeing that story of capitalization all around this story and folks, you know, I've.
I've been banging this drum for a while not just since the pandemic the future of health is absolutely sensed and this is perhaps another piece of that.
Peter van our CEO of vital Connect