Revolutionizing Patient Care with Butterfly Network's AI-Enhanced Ultrasound Innovations

Prepare to be transported to the frontiers of medical technology as Dr. John Martin, Chief Medical Officer at Butterfly Network, joins us to unfold the marvels of AI-enhanced ultrasound imaging. His passion for the Butterfly IQ3 is palpable as he shares how this pocket-sized powerhouse is changing the game in healthcare. With features like automated bladder scanning and B-line counting for lung conditions, we're talking about a quantum leap in patient care, making diagnostics quicker, more accurate, and widely accessible.

But it's not just about the gadgetry; it's about the human impact. From the bustling cities in developed nations to the remote corners of developing countries, we traverse the globe examining the transformative effects of point-of-care ultrasound. Dr. Martin recounts the dramatic advances in maternal and fetal health, the closing of gaps in medical imaging, and the ripple effect that Butterfly is having on medical education. Imagine a generation of medical professionals with the power of advanced diagnostics literally at their fingertips.

Finally, we celebrate the evolution of Butterfly Network, revealing the collective drive and vision behind this healthcare revolution. Dr. Martin offers a window into the strategic leadership and synergy at Butterfly, akin to the unity of a top-tier sports team. We don't stop at human care, either—our journey extends into veterinary medicine, where Butterfly's ingenuity speaks volumes for our silent companions. All this, woven together with Dr. Martin's own experiences, underscores a story of innovation that's reshaping not just medicine, but the world as we know it.

More at https://linktr.ee/EvanKirstel

Transcript

Speaker 1: 0:02

Hey everyone, really intriguing and important discussion today with Butterfly Network who are, through AI and design thinking, making a huge impact in the medical imaging field and beyond. With John Martin Doctor, how are you?

Speaker 2: 0:18

I'm great. Thank you very much. Hi, Dr Martin. I'm the Chief Medical Officer of Butterfly. I'm a vascular surgeon by trade and still practice. I've been with Butterfly actually for now seven years a pre-release of our very first product, and Butterfly Network is the company that's brought to you the world's first single probe whole body ultrasound system with its really innovative ultrasound on chip technology. What I'm also happy to share is we've come so far from just the device itself. We have one of the most advanced and best in class integrated system to manage workflow through the system. So our software to integrate into our systems and a comprehensive education package and a whole host of artificial intelligence tools now and partnerships that really give you a comprehensive use of ultrasound in the clinical setting.

Speaker 1: 1:29

Wow, so much to unpack there and we have a lot to cover over the next half hour, but seeing is believing. Maybe we can watch a quick video from your website. It's really amazing to watch and the viewers can get a sense of what we're talking about here. Let's take a look can get a sense of what we're talking about here?

Speaker 4: 1:47

Let's take a look, you asked. We delivered the new Butterfly IQ3. It's the answer in point-of-care ultrasound, with the sharpest image for easier, clearer answers, ready At your fingertips. We've raised the bar by delivering best-in-class image quality with double the processing power and optimized clarity for definitive and rapid diagnosis. We advanced imaging capabilities beyond expectation and added new automated tools for you to get instant and consistent answers on the first visit, because every second counts. We accelerated charging and extended scan times so our device is ready when your patients need you most. With you in mind, we refined the ergonomics and designed a smaller, more functional shape, putting you in control of every exam where precision is key. Putting you in control of every exam where precision is key. To support the most challenging cases. We focused on swift image acquisition and brought you the world's first IQ Slice technology on handheld point-of-care ultrasound to capture multiple rapid views at the click of a button. You asked for better, faster, easier ultrasound. We answered with cutting-edge innovations to support you through every scan Butterfly IQ3, the clear answer in point-of-care ultrasound.

Speaker 1: 3:14

Wow, what an amazing device. Something like a tricorder from Star Trek. But I'm giving my geek side away. Irma, do you have a first question maybe?

Speaker 3: 3:25

Yeah, of course, really great video, and we're going to dive into several aspects of the uses of this technology, but first into technology itself. Can you tell us about specific technological advancements that allow this device to provide whole body imaging at that kind of quality that we just saw in the video?

Speaker 2: 3:46

Yeah, and I think what's really important to distinguish between ultrasound that's been around for 50 years and butterfly. Every other ultrasound system in the world uses something called piezoelectric crystals essentially rocks if you will and you have to have different size and shapes of those, cut in a specific configuration to different frequencies and beam configuration. So linear, phase and curved array and various frequencies. What Butterfly has done is put it on a computer chip. So much, like you saw, digital camera, next generation DNA sequencing.

Speaker 2: 4:16

When things move on to a chip, the world changes, and so I kind of tongue in cheek, like to say we've gone from the stone age with piezoelectric crystals to the digital age with butterfly and, candidly, it's that level of advancement that's transforming the way healthcare is going to be delivered. Instead of a test that you order and patients wait for, we can talk a little bit about waiting. It's a pet peeve of mine in healthcare. Literally in your pocket you pull out the answer to a clinical question by scanning yourself as a clinician whether a doctor, a nurse practitioner, medical assistant, depending on the application and it totally transformed the way medical care is being delivered. Anytime you put something on a chip, the world changes. It's been proven over and over again, and that's what's happening with Butterfly.

Speaker 1: 4:59

Well, amazing to see it in action, and you've been at this for, as you say, many years, including at AI, well before it became top of the Wall Street Journal every day. But how are you specifically integrating AI in enhancing the capabilities when it comes to ultrasound diagnostics?

Speaker 2: 5:16

If you look at the way you want to learn ultrasound, there's two critical things. First of all, you have to have an affordable device. So now we've done that and for the first time, having a device is personal, not a system or practice organ product. The second thing is how do you capture an image? So maneuvering the probe to get exactly the right image. And then the last step, if you will, is how do you interpret that image?

Speaker 2: 5:39

Artificial intelligence tools are now helping at image acquisition and image capture. So, from use case to use case and different applications, that's where artificial intelligence tools are now helping at image acquisition and image capture. So, from use case to use case in different applications, that's where artificial intelligence tools are being leveraged. The first of which we released is a bladder scanner. Typically, with bladder scans, you have to move back and forth over the bladder and then a calculation is made With Butterfly. You put it in one spot, it scans automatically because it's fully digital, and spits out a number. We then followed that with a great application to count B-lines, and B-lines are an artifact in the lungs that appear when there's pathology. We saw it during COVID where we were a leader around the world, very common in congestive heart failure have been shown that if you measure the number of B-lines, it can predict readmission. So instead of a doctor counting them on a screen, it automatically counts them using artificial intelligence.

Speaker 2: 6:25

But maybe one of the more exciting developments of following in those footsteps, we know we can't deliver every single artificial intelligence tool for the use cases. It's just too much to do and literally even though we are the leading provider of handheld ultrasound, we're too small a company. So we introduced something last year called Butterfly Garden and what that is. It's much like the App Store. It gives these developers of artificial intelligence tools around the world the ability to develop their application and then run it on our platform, so that we can now accelerate the adoption of all these different tools. We've got multiple partners now Just introduced one recently called ThinkSono, which is a deep learning application that's now in our education platform for people to learn how to do DBT. But there's many, many more to follow. So artificial intelligence tool is going to play a very important role going forward.

Speaker 3: 7:15

That's great and such a wonderful segue to my next question, because we know that butterfly network devices and its technologies is deployed around the world. So I'm curious what were the specific challenges you faced in bringing this advanced medical technology to the global market?

Speaker 2: 7:35

You know it's interesting, you have two different sets of problems. In the developed world, ultrasounds kind of ubiquitously available, and we could tweak that a little bit because it's actually not the case in rural America and different places. It's not there. But in general, if you're in the developed world you can get an ultrasound. In the developing world you can't. And so two different problems and the one convincing doctors to practice differently and healthcare systems differently In the developing world. They're so hungry for it. So it's a matter of how do you get devices in hand, how do you train people to do it and how do you create sustainability.

Speaker 2: 8:11

Going forward, we've had some terrific partnerships with the Gates Foundation. In our first big deployment, 500 probes in Kenya training nurse midwives and within 30 days 30 days over 90% of them had at least one patient in which they detected a life-threatening problem that allowed them to alter care. There is no question that it's altering maternal fetal mortality in that setting, and we just did 500 more in South Africa. So there it's just a matter of how do you get the right system in place. They're hungry for the technology and really with good partnerships, whether it's with NGOs like the Gates Foundation or the hundreds others that we work with, or it's actually working with partners like Gussie, who does education, training of those people over there. It's really setting up the right kind of partnerships In the United States, in the developed world. It's how do we convince people to change the way they practice medicine?

Speaker 2: 9:16

Well, such an important topic and let's talk about that Obviously a win in the global health space, in developing countries, but talk about under-resourced areas in the US, these healthcare deserts, which developing world, and those villages, and Lord knows they need the help and support. We sometimes forget that maternal fetal mortality in the United States is really not something to brag about. We've got a long way to go before we get to where we should be and a lot of that is around imaging. If you look at, for instance, the federally qualified health centers across the United States 1,400 of them, and if you add community clinics that are similar to them but not necessarily federally funded, 14,000. Very frequently they don't have imaging available to them. They have to refer outside the organization and any time with that patient population you've got to send them out. The chances of them coming back go down, and so we've got a great focus on how do we partner with them.

Speaker 2: 10:07

And we've got one that's developing here in maryland, a chop tank health systems that have got butterfly. We're going to train their people and try to set up that model that in fqhc. You can improve the quality of care in that environment and expand the availability of this incredible technology. What makes butterfly so uniquely suited for this? It's affordable. I mean literally you can afford this. And because the typical applications that we treat are easy to learn. People can catch on. You don't have to learn everything. Learn very specific use cases that can be impactful and then, if you start to couple it with these artificial intelligence tools that are coming, you're going to see a rapid transformation, dealing with the whole issue of health equity, which is such a front and foremost on all of our minds today.

Speaker 3: 10:51

Well, that's phenomenal, dr Martin. So you obviously already touched upon how using this device for medical training and education is helping healthcare delivery. But can we talk about in general, how is your technology perhaps changing the general medical education and training kind of across the board, and maybe differences between how it's done in the US and globally?

Speaker 2: 11:19

Well, I think this is great. I feel like you know it's baseball season and I feel like I was expecting a fastball and you just delivered one right down the middle. Baseball season and I feel like I was expecting a fastball and you just delivered one right down the middle. So medical education is actually the key, because it's one thing to convince an old doctor like myself, who's practiced this way for 20 some years, to say oh, by the way, you have to change. It's completely different to go to medical students who are now in school and learning for the first time a methodology to practice medicine. And if you look across the country and there's various estimates, but anywhere close to two thirds to three quarters of the medical schools in this country excuse me are now teaching point of care ultrasound in their curriculum. You also then have the next level, graduate medical education, where residents are now required to learn how to do point of care ultrasound education, where residents are now required to learn how to do point of care ultrasound. So as we look going forward, the whole next generation of doctors are going to emerge into our practices, whether it's academics or private practice, with a skill. With this little guy right in their pockets. It's going to transform medicine and then it's going to be up to us to catch up to the kids, and I think that's such a critical part of this.

Speaker 2: 12:24

Butterfly is in the majority of those schools. You know we've got a number of schools now that are double digit, that have one-to-one models, where every student comes in, gets their own. And what's the best way to learn? Have your own. How did we learn how to use a stethoscope? We had our own. Now they're going to have their own butterflies and this model is now expanding across the country and, what's really exciting, it's the students that are demanding it. They're picking their schools based on do they train on point of care, ultrasound? Do they have butterflies? Do I get my own? And that's where I want to go to school.

Speaker 1: 12:56

That's amazing. It's like when you first got your laptop. It was an eye opener, door opener for so much versus using the old computer lab in school. So you know, you've led this category, you've done so much to innovate and think out of the box. What's next over the next few years, in terms of not just your solutions, maybe, but the point of care, ultrasound technology, space.

Speaker 2: 13:22

Well, I think the most exciting thing is you're starting to see, medicine doesn't change easily. It holds on to its dogma like a dog with a bone what my wife would say at the SPCA. We don't change easily, and so what we've seen, though and I think this is really important, and I share this with every dean and every CEO this is inevitable. Once the students, the residents, the professional societies now, which have created criteria, and if you look at the literature, the publications are growing rhythmically, the die is cast for the future, and I think anything on a chip's proven that in the past. The question is how quickly can we get these organizations to change and to adopt? It's not easy to have, like at the University of Rochester or Indiana, a thousand probes within the system. How do you keep track of all those images? That's where our software plays such a critical role. And then, how do you actually have an education platform to teach all those doctors that are out there? That's where the education products that Butterfly has produced. We got a new one out, really very cool. It's called ScanLab, and it's an entire education platform that allows people to practice asynchronously, have really good tools to show you how good is my image, nice reference tools to use, and it's something that people are just thrilled to see. Because you can't always have your tutor at your hip we don't have enough of those. You've got to be able to practice on your own, and ScanLab makes that possible. So I think what do we see going forward? The world, the acceleration of adoption, is going to start to happen. That the sheer numbers of people that are out there that are doing this, and I think the next big step is you're going to see patients demanding it.

Speaker 2: 14:57

If you look at the data that's out there, who likes to wait in an emergency room? Nobody. And if you actually look at the average time and this is generally across the board just for a chest x-ray picture for a moment, the next time you're in an emergency room and you're sitting there waiting for a study, everybody has leased themselves or had a family member there. The anxiety that's there, the cost that's wasted, the inaccuracies, if you will, of guessing what's wrong with somebody. That disappears when you have a butterfly in your pocket. It literally conquers time. The average time for chest x-rays is over an hour. If you come in short of breath, what is it like to wait an hour to get the answer am I in heart failure or do I have COPD? Because the treatment's completely different. How different is it? If I just have the doctor pull out a probe, instantly scan my lungs, I know exactly what you have you have heart failure. Here's the Lasix minutes later, you're feeling better.

Speaker 2: 15:57

That's where we're going and we get healthcare to embrace that Because the clinical data is better. The economic data is now emerging that it's more efficient and more cost effective. The patient satisfaction data is clearly there. The real advance forward. It's going to move, move, move and I think probably the next step after that is because ultrasound is on a chip. You're going to start to see different form factors, patches, wearables that allow us to take care, not just starting here in the advanced institutions or even the developing world, but into the home with patients actually seeing themselves. That's the future and we've already started clinical studies doing exactly that.

Speaker 3: 16:33

Oh, this is just so exciting and fascinating and you're giving us a glimpse into the future. I want to go back to this idea of a grassroots movement. You mentioned that this device is now in several or many medical schools and students are demanding to have it, and you mentioned patients will start demanding to have it as well. So, of course, we've seen the power of these grassroots movements and patients demanding better options for themselves and clearly to be adopted. Like you told us some examples, you needed to show clinical documentation and proofs of this working. So can you talk a little bit more about how patients can learn about the availability of this and how can they put pressure on the system to have this more widely available?

Speaker 2: 17:30

So I think that's a really interesting challenge and where to go, and we talk a lot about this at Butterfly as the moment, from where you have, I mean look, for instance, let me pause for a moment when has the pharmaceutical companies gone? I mean, you can't watch TV for more than 20 minutes where there's not an ad for some drug that direct the consumer market. I think we haven't quite gotten there with this medical device yet because I don't think it's as ubiquitous as it needs to be. But I think we're approaching there and I think where can people go? Go to Butterfly Network dot com and learn about butterfly.

Speaker 2: 18:01

Ask your doctor, do you do point of care ultrasound? Do you have a butterfly? And of course, I always tell my family and friends that call me. If they say no, say why not? Don't you want to know? I don't want you to hand me an x-ray slip to go to an x-ray place, I want you to hand me the answer. That's what I want to do, and so I think we're not quite there yet. We got to help doctors get to the point where they can confidently scan and interpret. But we're rapidly on that journey.

Speaker 2: 18:30

You know, just this year, starting in July, family medicine residencies will require learning the skill of point of care ultrasound. That's a big step forward, because what's the cornerstone of healthcare in this country? The family doctor. And so as they begin to emerge from their three-year residency programs with that skill, I think you're going to start seeing much more ubiquitous use. But it's in urgent care centers, it's in emergency rooms, it's in doctor's clinics. We even have it on ambulances now across the country, where you come into the ambulance you sort of break, the medical technologist is quickly scanning you. Home health companies are taking it into the home. So I think you're going to just start to see that grow and grow, and grow and grow and I think, like raindrops in the pond, those circles will start to coalesce with one another and then across the country healthcare will change.

Speaker 3: 19:17

Isn't that a butterfly effect then?

Speaker 2: 19:19

I think it very much is.

Speaker 3: 19:21

And how appropriate is the name?

Speaker 1: 19:23

Yeah, touche Irma. By the way, butterfly great, you guys do amazing marketing and I remember your booth at CES so well. It was just like so eye-opening. Talk about the team you've built to stay on the cutting edge of digital health. You have a big team here in Boston and elsewhere. What are you doing to build the team, scale up and take this to the masses?

Speaker 2: 19:50

Well, I think one of the most important steps was the addition of our new CEO, and I hesitate to call him new now because it's almost a year. Joe DeVivo joined us with a really interesting background, both in telemedicine which is critically important as we go into the home as well as medical devices. He's been in the healthcare business quite a long time and transformed a number of companies, so I think that's a big step forward that senior leadership with experience that knows how to kind of drive change in healthcare. He was sentinel in the world of robotics at the beginning, with some technology and certainly telemedicine, and all the way back to the first days of laparoscopic cholecystectomies and stuff with with US surgical, so it's got a long history of understanding how health care changes. I think that's a big piece. But if you back that up, we've got critical scientists that have been here for a long time. You've got Nevada Sanchez with his brilliant mind, the co-founder of the company, carl Thiel, rob Schneider I could go on and on and I'm going to change a lot of key people that are the cornerstones of the new technology, as we brought out with IQ3, the new chip, and then you couple that with experienced physicians that we have with Davinda Ramsey, peter Weimersheimer, shashida Shah, who have diverse experience talking doctor to doctor, because it's so important.

Speaker 2: 21:04

If you're going to change behavior you have to have that credibility. The whole clinical team, the product team, the marketing team, the sales team it's quite the key is much like a basketball. Now what's coming into shape and maybe the best example is Hoosiers you had a whole bunch of individual pieces but they all came together and maybe, joe ismy, that the last piece of the puzzle that came in, that made that that team's thing. And now the mighty butterfly is really beginning to catch its legs. As we've gone through a number of transitions through the last few years, you're starting to see an acceleration of the way this team is functioning and I think that's the exciting part of the evolution of butterflyfly.

Speaker 3: 21:44

Certainly exciting and talking about team and all the things and parts coming together, let's talk about maybe a boring aspect of this, not as exciting but so important. As a patient advocate, I advocate for safety and security of patient data. So, with more and more ubiquity of this device and this technology, how are you ensuring that safety and security of patient data?

Speaker 2: 22:10

So we have you know from the very beginning, one of the other innovative things with Butterfly is it used the cloud. You know the ultrasound imaging data went to the cloud and then into the system. It was critically important that we had security experts and our data is secure. And we've gone through, if you will, the lobotomy from institution after institution to ensure that our data was secure, our process was secure, and we've successfully done that. I certainly am not the right person to speak to all those different levels of things that we've passed. What I can speak to as a clinician is that the major health systems in the country almost every one of the top 100 have our products understand that we are secure. We've done the necessary things to make sure of that and we will continue to do so going forward, because it's such a critical part both for the health system side as well as the patient integrity side.

Speaker 1: 22:57

Well said, really important to check that box. And we understand you're not just focused on human beings, but your wife and partner are advocates for animals as well. First of all, can veterinarians leverage butterfly devices? And also, what does your wife do? I understand there's some dogs barking in the background, maybe at home.

Speaker 2: 23:25

At this moment I'm hiding in my office so they don't. I'm very blessed to have a wife who's the president and executive director of the SPCA of Anne Arundel County. But I can tell you that my original decisions to come to Butterfly was very much at the advice of my wife, who generally, like all really good partnerships, really the best advice comes from the other one. But the very first thing she said to me as we were going there I need this for animals because ultrasound is a critical part of making the diagnosis, not just in humans but in animals as well. And the real difference with animals is they can't talk to you, they don't get to tell you this hurts, that hurts, and so imaging is even more important.

Speaker 2: 24:05

So butterfly very early linked into the vets that we have a whole great vet division. We're in pet goes and a lot of different places across the country and there's really a great growth of our pet business because ultrasound is such a critical role. It's really interesting and I get to play it out every day because my, my wife will say, hey, can you run down to the shelter do a quick ultrasound on an animal? And I said, well, I'm not the certified one, but I can give you a tentative till you get a real one. But I'm getting pretty good with the dogs and my poor dogs in the house get tortured regularly with ultrasounds.

Speaker 2: 24:38

I think the key part of this is understanding that whenever there is a diagnostic dilemma human or animal up to two thirdsthirds to three-quarters of the time it's simple imaging that answers the question, and you can think of a lot of different ways Are you pregnant, do you have gallstones, do you have pneumonia? I can go on and on. Is your bladder full, yes or no? That's a really big thing. With animals, probably the most common scan I do for the shelter is looking at their bladders. Are there stones in there? Is there urine in there? Because you can't just tell the dog, hey, can you give me a urine sample? It's just not that simple with dogs. And so I think understanding that ultrasound imaging is beneficial for both man and man's best friend, for woman and woman's best friend, and I think that that's a critical thing that we've learned. I live it every day, you know, in our relationship between my nonprofit that does cardiovascular screening and hers, which does animal welfare. Butterfly does the same thing for humanity and for vets.

Speaker 1: 25:36

Wow, that's a wonderful mic drop moment there. Do you have any travel coming up, any events, meetings that uh worth uh calling out at the moment?

Speaker 2: 25:47

well, butterflies scattered all across the country, so that's exciting. But maybe personally, I know I'm dating myself. I'm going back next week to my 40th medical school reunion, so I'm going back to the school and maybe what I'm most excited about is I get to tell everybody. Guess what I did. I did a few things in medicine. I built a program, I was the head of heart and vascular. But what I really did, was this. And.

Speaker 1: 26:12

I don't be fun Wonderful.

Speaker 2: 26:13

I've seen friends and colleagues I haven't seen in 40 years, and so it'll be exciting Plus it'll be great to be.

Speaker 1: 26:17

Where is that? Where are you headed?

Speaker 2: 26:20

What city and town the famous Parkland Hospital?

Speaker 1: 26:24

Ah, okay, Well, that was a movie I just watched the other week a month about Parkland.

Speaker 2: 26:31

So really interesting. No, I was trained by those very people that you were watching in the movie. Those are the people that actually trained me. Oh, that's interesting. Wow, that's a whole other episode but sadly we have to let you go. I've heard about my time at Parkland.

Speaker 1: 26:46

Yeah, maybe we can act after your reunion.

Speaker 3: 26:48

It would be very interesting what reactions you'd get.

Speaker 2: 26:51

I'm looking forward to it. It'll be fun.

Speaker 1: 26:53

All right, well, thanks so much everyone for watching and thanks John and team for the incredible work you are doing, much appreciated. Take care everyone Stay safe.

Speaker 3: 27:03

Thank you very much. Thank you, Dr Martin.