Exploring the Future of Healthcare: Digital Health, AI, and Innovative Technology with Dr. David Scher

Do you ever wonder about the future of healthcare? Would you believe that once, a life was saved in the middle of the ocean thanks to remote patient monitoring? Join us with Dr. David  Scher, a pioneer in digital health and AI, as he shares his inspirational journey and recounts this remarkable tale. Dr. Scher's insight into the development of digital health tech, and the crucial role of clinicians and patients in this process, is invaluable. We also delve deep into how AI can enrich healthcare delivery and caregiver involvement.

Our conversation with Dr. Scher continues as we discuss how technology can alleviate healthcare's pain points, including process and financial issues. We ponder the role of social media in building relationships and raising awareness in the healthcare field. Looking to the future, we explore the potential of wearable tech to revolutionize patient care. Dr. Scher's extensive experience and perspectives offer key insights into the importance of robust partnerships between healthcare providers and tech companies. Tune in to this episode for a fascinating exploration of the intersection of technology and healthcare.

Transcript

Speaker 1: 0:01

Thank you, Thank you, Thank you. Hey everybody, Evan and Irma here with Avira Health. Today we have a fantastic guest digital health guru.

Speaker 2: 0:14

Dr David Leigh Scher Doctor how are you?

Speaker 1: 0:18

Very good, thank you, pleased to be here. We're delighted to have you today. Really followed you for many years on the field of digital health, so thanks for being here and we're going to dive in in a moment, but perhaps you have so many threads happening at once as a physician, as a teacher, as a thought leader writer, maybe introduce yourself, because I'm having a difficult time.

Speaker 2: 0:47

Sure, I am a recently retired cardiac electrophysiologist and have been involved in digital health for a number of years, and it basically all started about 14 years ago. I was a pioneer adopter of remote patient monitoring. Specifically, I was an investigator for the first wireless monitoring of implantable defibrillators in 2000. And that was a big deal, because prior to that we had no way of knowing what was going on in this device of patients and quickly evolved into something that has become standard of care. I also took that data and interoperated it with my electronic record system at that time in 2002, and that was an IT kind of situation that didn't exist prior to that.

Speaker 2: 1:50

I then became very interested in digital health in general and started an award winning blog that I wrote for about seven years and actually stopped writing, because the goal of the blog was really to introduce digital health and educate people, both lay people and people in industry, about what digital health was, the implications for it from a clinical standpoint, some technical aspects, but also integrating legal, social and other kinds of angles with digital health. And so I've been doing that along the time, advising companies about the development and adoption of digital health technologies. Right now, I'm chief medical officer of a company called SpeechMed, which I can get into at a later time, but I am very active. I'm a board member of the Philadelphia chapter of HIMS and have been a reviewer for the annual conferences for a number of years.

Speaker 1: 3:08

Wonderful, wonderful journey.

Speaker 3: 3:10

That's quite a journey, one of the OG's of digital health, it seems. I would like to dive into that, but first could you tell us what inspired you to specialize in your particular field and maybe you can share some memorable case or patient story that had a significant impact on you?

Speaker 2: 3:32

Sure. So I went into cardiac electrophysiology, which is the specialty of cardiac rhythm disturbances, because I found that electrocardiography and heart rhythms were very interesting. This is dating back to my medical school days in the 1980s and I actually did some research in those days with Holtem monitors, or 24-hour rhythm monitors, and that sort of got me interested in this. I also saw patients that had sudden cardiac death and at that time the defibrillator was not really in use or it wasn't approved. That whole concept of treating patients with arrhythmia is really interested me.

Speaker 2: 4:24

Probably the most vivid example of remote monitoring I can tell you is extremely interesting. I was encountering a number of patients in the I believe it was late 80s or early 90s with problems with their pacemaker when it would suddenly fail. I had a patient who had this specific model of pacemaker and this patient was on a cruise ship in the middle of the Atlantic or Pacific and I had that patient had an episode on the ship and gave them my phone number and they called me and I had them send over the patient's remote monitoring from the pacemaker and discovered that it was an affected device. They helicoptered the patient out to a hospital in some other country and then the patient was airlifted to the United States, and so this literally saved the patient's life.

Speaker 2: 5:32

In addition, the remote monitoring of these devices was recommended to be standard of care after accidentally or incidentally, I should say a defect was found in a specific model of the wire in the defibrillator, so it actually resulted in recalls and the use of remote monitoring as a way of developing a quality control surveillance of these devices.

Speaker 1: 6:11

Wow, what a story. So that highlights the importance of involving clinicians and patients in the development of these technologies and you often share a lot about breast practices also for startups to effectively involve different stakeholders like patients. I guess you call them a stakeholder, Absolutely. So what's your world view there? How did that evolve over time?

Speaker 2: 6:36

So a lot of digital technologies were and are developed by well-meaning people, certainly many of whom have had family or personal health issues that prompted the idea to develop these technologies, and certainly that's very admirable. But the situation is that many of these companies do not include patients themselves or clinicians in the development of this technology. So by the time the viable product is proposed, or even before that, there are things that are missed a lot of times very fundamentally without having a clinical perspective in the development of that process or a patient's perspective. You know, we talk about user experience and there's no more important user experience than somebody using a technology to have their health monitored or to monitor their own health. And in addition to that, I always stress the importance of involving the caregiver. So technologies that are developed should be available to the caregiver itself, the caregiver as well as the patient, to have, you know, seamless and complete care of the patient.

Speaker 1: 8:02

Amazing. Yeah, beyond the scenario you described, are there other breakthroughs that you're watching with particular interest in cardiology or Jason Fields that are super exciting to you as you kind of look a bit forward?

Speaker 2: 8:16

I think that anybody who's been reading the headlines realizes that artificial intelligence is really. It's not just a soundbite and it's not just something that is that is fattish. It is part of healthcare today in certain ways and is going to be extremely more important as we go on. And the artificial intelligence is not going to take the place of physicians or clinicians. It's really going to augment and help the way people treat patients and involve caregivers. In cardiology specifically, there is a big interest in artificial intelligence in interpreting electrocardiograms, but not just looking at the electrocardiogram itself, but actually taking that data and translating it to real patient disease states. In other words, looking at an electrocardiogram and determining if somebody has perhaps structural abnormalities of the heart. This has been shown with hypertrophic cardiomyopathy. It's being used in heart failure and other things. But the artificial intelligence can also be used in evaluating the algorithms that are developed through remote patient monitoring to predict things that will happen instead of just analyzing them.

Speaker 3: 9:53

This is a really great example of using technology in healthcare medicine and this is a great segue to talk more about AI or other tools as potential ways to reduce clinician burden and burnout. I know you are a member of the HIMS task force on clinician burden reduction. Could you talk about that role and how do you see this evolving with the use of AI and other technologies potentially helping doctors?

Speaker 2: 10:31

Sure. So the biggest fear that clinicians had and still have with regards to digital technology and remote patient monitoring is the potential deluge of useless data that's coming to the clinician, and so artificial intelligence is really the solution to this, in the sense that it can filter out data that is not relevant. More importantly, to identify trends in data, to identify problems before they occur, rather than just looking at the data itself. And it's the same thing as blood pressure. You shouldn't treat one sole blood pressure, you have to look at trends, and the same thing goes for heart rates. It goes for anything.

Speaker 2: 11:22

With regards to remote patient monitoring, there are monitors that are placed in the heart itself, in blood vessels, to monitor heart failure, and you don't treat just one point. You really want to look at the trends. So what the artificial intelligence is doing is really decreasing the amount of analysis that a human has to do and alert people on an actionable basis, in other words, data that will come that is going to have somebody change medication or treatment, rather than just have that data in and of itself. And another example of that is just a basic analysis of diabetes. So we used to treat single blood sugars, which patients do, but as far as the clinician goes, the hemoglobin A1C, which looks at blood sugars over a few months, is much more valuable data than just a single point in time.

Speaker 1: 12:27

Incredible, and tell us what SpeechMed does exactly and your mission there.

Speaker 2: 12:33

SpeechMed is a company that, about more than 10 years ago or 15 years ago, developed technology that translates anything in health care, and it's different than Google Translate or other artificial intelligence processes which, by clinical studies have shown, have a 67% accuracy rate, and if you're looking at health care, 67% accuracy is not really what you want.

Speaker 2: 13:06

What we have is patented technology which combines human and AI, and we have a patient-facing app as well as clinician-facing dashboards which allow the patient to get all their information in their own language, including medication reminders, appointment reminders. We're actually developing a process now where patients who are being prepped for things like colonoscopies or heart procedures can get those preparation instructions in their own language and monitor the progress of their adherence to these protocols to avoid, you know, patients either not showing up because they didn't understand something or some other reason. So the patient is getting the instructions and reminders in their own language, and it's really a technology which addresses both health literacy, and we do text to audio and audio to text for even people who speak English in the United States who are illiterate. It addresses disabilities, such as patients who are blind or who are otherwise disabled, and so this is really a technology which I feel addresses the issues of equity and divides in healthcare that are brought about by health illiteracy.

Speaker 3: 14:47

Interesting. So this is one example where this technology helps both patients, obviously, but also providers, who can now better communicate with their patient population. Absolutely, and I know you are advising a number of startups. In fact, I first got to know you somewhat through your board of NQ Medical and I did some consulting with them. So do you have advice for startups? How can they effectively engage with providers or other stakeholders that would directly benefit from that technology? Other ways, like advisory groups or other ways to get engaged with potential stakeholders, to show the value of technology?

Speaker 2: 15:31

So that's a very interesting question and it goes really to the point of how does a technology company get their product out there, and it's not an easy question. Probably the biggest issue is how to get through a front door, and that front door may not be the best way to go. It may be a back door. So it all depends on what pain point the technology is addressing. In other words, if it's addressing a process issue in the emergency department, then going through the emergency department head might be one area. If it's a nursing issue, it might be more beneficial to go to an organization of nurses or the chief nursing officer of the company. The pain point may be financial, so the best way to go is possibly to an insurance company or a healthcare enterprise financial person to see where this technology may fit in.

Speaker 2: 16:47

One of the problems also is determining what the return of investment is, and that's the first question that a lot of potential adopters have In digital health. That return of investment may not be directly financial. In other words, there may not be a possibility of saying you're going to save X amount of dollars. But it may solve questions like efficiency. It may solve questions that we're addressing with these preparatory procedures, where you have less cancellation of patients, which then becomes a financial issue. So it all goes to what problem you're solving, and it may not be a return of investment, but you need to be solving somebody's problem that's worthwhile, whether it's from a process standpoint or a pure financial standpoint.

Speaker 1: 17:38

Such great advice. So, in addition to being a practitioner and teacher, you're also a content creator. You're active on social media, to say the least. You've had this fantastic blog. What's your advice to startups or others who should be using social media more effectively to engage and community build and connect on these networks?

Speaker 2: 18:04

Yeah, I think that that should not be understated, and I certainly don't want people looking at social media in the same way of influencers, for example. It's always good to influence people, but the best way to influence people is really to bring to the table educational and awareness and not just be a hard sell. So, for example, pharmaceutical companies have digital health officers and want to be involved in digital health, but they don't really get out there and speak to patients and caregivers. In other words, the best way to increase digital health use is really to increase awareness of the disease state itself, of the difficulties in management.

Speaker 2: 19:00

Direct to consumer advertising of a drug is really one thing, but it has nothing to do with reality as far as what happens when that patient is prescribed the medication. How are they going to adhere to taking it? Because it's obviously important to do that, and the other thing is, if patients are having problems with medication, for example, it would be much easier for them to go on a pharmaceutical company's app and tell them I'm having a side effect to this medicine and it may be serious. Not that the company is gonna be exchanged for the clinician, who obviously needs to know first, but in this way, surveillance of patients. Post-marketing surveillance of device and drugs is critical, and digital health can certainly play a big part in that, even in over-the-counter medications.

Speaker 1: 19:57

Yeah, now we see that as well. All kinds of new platforms. I've really been enjoying the TikTok community around the MedTech, except for the plastic surgeons perhaps, who are maybe getting a little over their skis.

Speaker 2: 20:16

But LinkedIn itself has been incredible in the sense that it allows for the volume of videos and data and links that others may not. It's also seen by me as a more professional way of interacting from a formal standpoint and certainly to increase networking. Twitter is actually very good if you wanna convey something on the fly or it's more immediate than LinkedIn, but there is a role for definitely for social media in developing relationships, whether it's during the development period or during the sales period.

Speaker 3: 21:08

Well, there's definitely been a pioneer of blogging in the early days and using social media effectively, and you're also you're still rooted in the practice of medicines through teaching your brawler pen, and so my question is what advice would you give to someone considering a career in medicine? I know it's a medical profession might have gotten a little bit of a setback through pandemic, although there was a Fauci effect and more people went to apply to medical school, but now is the rise in burnout. A lot of nurses and doctors are quitting. So what are your thoughts on the profession and anyone who's still interested?

Speaker 2: 21:56

So I have two main thoughts on that. Number one is if you go into medicine whether it's as a physician, a nurse, a PA the most important thing is to look at this as a calling, much the same as somebody in the clergy, because if you're looking at this for purely financial reasons or other reasons, it's never gonna work. So you really have to this has to be you know a big part of who you are and what you wanna devote yourself to, more than looking at this as a job. That being said, once you're in medicine, the stresses and everyday stuff that you go through which is not insignificant, I can tell you that should be augmented by increasing your interests in other things.

Speaker 2: 22:51

So when I was practicing, I got involved. I was the chair of an IRB, which is an institutional review board which looks at reviews, all clinical trials that are submitted by physicians and then institution. I was the cardiology representative of a Medicare carrier advisory committee. I was an investigator clinically in multiple clinical trials, including NIH trials so, and I loved all of this. I didn't get paid for any of that, but it was very important to me to increase my well-roundedness as a physician. I'm not saying that everybody needs to do this. But interest outside of your practice in healthcare increases your awareness of why things happen in healthcare, how they're affecting you, how you can potentially change it and add things to the system itself. Oh wonderful thoughts.

Speaker 3: 23:57

I think it's just perspective, yeah.

Speaker 1: 23:59

Well, we're getting to the bottom of the hour here, but before we go, I'd love a little of your thoughts on the future in the field of digital health and wearables for the next few years, anything you're particularly excited about personally, professionally. We all got our Apple watches, many of us, or our rings or other gadgets. What's on your mind so?

Speaker 2: 24:21

I am extremely happy about where digital health is now. In other words, it's out there and people are aware of it, and it's taken a decade to do that. But that's what healthcare is about. Healthcare is the slowest moving machine there is, but if something is worthwhile, it's going to come out and all of this is being adopted. I went to Canada recently on vacation and saw an advertisement for the Cardia mobile electrocardiogram device. So it's not just in the US, it's global.

Speaker 2: 25:00

And the other thing is there's a huge movement, and it's going to happen in the next decade, of moving a lot of healthcare to the home and it's called the home as hospital. So a lot of that is going to involve monitoring and digital health technologies and I really look forward to that being the biggest impetus of the adoption of these technologies. We saw that during COVID, with telehealth came in and really was very thriving. It's a lot less now and that all has to do with the business and reimbursement issues, but the hospital being at home is going to address those financial issues and, I think, going to make it a lot easier for companies to have the technologies adopted.

Speaker 1: 25:52

Wow. Well, the future is bright and thanks so much for sharing your time and your insights and we look forward to continue connection on LinkedIn and Twitter and thanks for watching everyone and we appreciate any feedback you might have on the socials and spreading this to a wider audience. Thanks so much, dr. We'll see you at him, so one of the events upcoming, I'm sure Absolutely. Thank you Thanks so much Good to see you. Bye-bye everyone.