The Intersection of Diagnostic and Therapeutic Imaging and its Resulting Effect on Patient Care

hi welcome everyone good morning good afternoon good evening regarding where you're logging on from welcome to massmedic and triple wings webinar the intersection of diagnostic and therapeutic imaging and its resulting effect on patient care my name is nicole owens and i'm the director of marketing communications at massmedic for those of you who are not familiar with our organization we are a membership based trade association for the medical device industry and we work to bolster the ecosystem in new england with that i'm going to turn the conversation over to our moderator for this conversation bill dowd bill is the practice area lead for medical devices at triple ring take it away bill thanks nicole i very much appreciate the uh introduction and we're very happy here at triple ring to help host this webinar and we thank all the attendees for taking the time to join and hopefully we'll have a spirited debate and discussion and we can all uh come back out of the webinar with a lot of great new fresh information um as by means of introduction of triple ring in case you're unaware of triple ring is a co-development company and we stand side by side with innovators and entrepreneurs solve hard problems launch breakthrough innovative products and create new businesses and again it's our pleasure to be here we've assembled a panel of experts in the area of the topic of the webinar again the intersection of diagnostic and therapeutic imaging and its resulting effect on patient care i'm going to ask each of the panel attendees to introduce themselves and take just a moment or two to perhaps give a bit of background on their company and technology to set the stage for the discussion we're going to have so with that ryan would you mind starting sure thanks bill uh hello everyone my name is ryan didmore i'm the ceo of coordince medical and we're developing a focus ultrasound device to open up the blood-brain barrier to improve liquid biopsies and drug delivery primarily in neuro-oncology and neurology indications thank you very much jameel welcome hi guys i'm jimmy fashion co-founder and ceo of advanced mic bubbles um my background is in bio color specifically um ultrasound responsive bio color is called micro bubbles um which um we're trying to use to help solve fundamental challenges in cancer treatments um poor penetration caused by the blood brain barrier the two main chilean barrier so what we're optimizing is us micro bubbles to help improve the penetration of drugs right where you want them to go and minimize off-target toxicity to healthy tissue thank you jamil howard welcome thank you thank you for having me and thank you to massmedic for putting this on my name is howard heckler i'm the chief business and strategy officer here at loomiscell we've developed a combination product the lumicell direct visualization system to enable the detection and removal of residual cancer real time during surgery consists of an optical imaging agent an intra cavity scanning device and tumor detection software that guides the surgeon on exactly where to cut and we just completed our pivotal trial and are looking forward to a launch hopefully mid next year excellent thank you very much kristen um you're up next last but not least hello everyone i'm krista molina and i'm with phillips which is a leading player uh in the health tech space i lead a business called enterprise care collaboration which provides informatics solutions for health systems clinics and insurers to connect patients and providers um enable patient engagement as well as transitions of care and before that i led strategy and business development for healthcare informatics portfolio which includes includes the enterprise imaging solutions and radiology cardiology and oncology our electronic health record and population health management solutions excited to be here thanks excellent again thank you to our panel for the time you're going to spend in today's session um maybe a couple of rules of the road before we get started um the first of which is i've got a series of questions that i'll be asking i'll address the start of each question to one of our panelists and then we'll ask that as they complete their answer for that question and we have a bit of a open forum until that question has been sufficient sufficiently addressed and then i'll move to the next one and then that way all of us have a chance to participate in the conference and for those of you that are attending the session today i'm sure there'll be questions or perhaps requests for additional comment or information as you go so what we'll do is following the series of questions and roundtable debate we'll save the last 15 minutes or so of today's webinar session and we'll be able to then address each of those questions so if you have some and you'd like to submit them please use the the chat function the q a and the chat function to ask your question we'll compile them in the background and then make sure we address as many of them as we can before our session times out so again thank you all okay so in terms of our first question for today i'll be addressing this one to howard howard what are the main drivers of innovation in your area of expertise which involve the intersection of imaging and therapeutics which of course is the title of our session today thanks bill um i guess there are a number of drivers uh and i'll be absolutely curious to hear what uh the other members of the panel have to say um the first thing that jumps out at me is increased investor sentiment and interest you know for those who have spent time in imaging you know you look back five years ten years ago it was often you know the red-headed stepchild and now suddenly there's a lot of investor dollars coming in there i think it has a lot to do with a more personalized approach to medicine a desire to find the right patients on the front end for trials the right therapeutics to give them on the back end uh you know targeted radiation the variety of other things where it's increasingly recognized that imaging is the solution to that you know the second point here is that and it dovetails with this is that there's an evolution to these treatment paradigms and you see it every five to ten years right uh there's a period before radiation where it was just cut cut cut then there was radiation and it was and now increasingly we've backed off that because we've recognized there are subsets of patients like the elderly or of other comorbid morbid uh conditions where we may not want to use radiation and so at least you know for lumacell for example the ability to find cancer and remove it the first time particularly in patient populations where perhaps you're planning on not using radiation we have found to be a powerful part of the story um and then the final point i'll make is that uh you know i think ai is increasingly another enabling factor um uh you know ai was in a very different place uh 10 15 years ago and um as ai evolves um it further enables imaging it further enables it you know it's it's a it's a catalyst and uh you know a growth factor for i think everything that we uh we touch right now yeah howard if i could add to that you know yeah in in glioblastoma and primary brain tumors we're using ai now in a lot of the academic centers to better identify recurrence so when a patient occurs you know there's a question of if it's necrosis from the radiation or is actually a tumor growth and so there there's a quite a bit of an investment in that and so that's really important from a patient perspective of getting quick diagnosis of recurrence so that we can start the next therapy and you know last year we also another example of clinical need um we saw this driven by pharma which is the development of psma therapies which one was approved today or i mean this last last couple months but um we saw as the addition of a psma pet imaging uh and that has restaged prostate cancer metastatic prostate cancer and high risk prostate cancer where where we can now identify a patient as having a an upstaging to a metastatic disease if they have this psma pet light up and so it's better than the bone scans at doing that and that's really made a big difference uh as you think about the pharma world and developing drugs so that we we now have a new definition of what a clinical stage is and advanced prostate cancer hi just to to i think build on some of that and howard mentioned the the personalized care as well um and you know where i'm really focused now is on how do you engage that patient how do you empower these patients to really be uh educated and and really take ownership over their own health care journeys um we've heard of the rise of consume consumerism and in health care and so we see better clinical outcomes when the the patient is is has the the tools at their hands to be able to make better informed decisions and have those discussions with their their clinical care team um so i think that that's also really important of um that they're making those informed decisions and are actively participating in in their diagnosis and treatment decisions and it's not just as individuals we're seeing it in the patient advocacy groups as well right you've sort of got on the one hand if you look over a time span of five to ten years the hospital margins have gotten worse and worse and so the dollar has gotten tighter and tighter but at least when i when i look at it i see a counterbalance in the power of patient advocacy groups right breast is a perfect example where there's um an increasing amount of uh power at least i call leverage and share a voice and it's able to counteract that that i think some of the um some of the fiscal concerns that can at times limit innovation so that's another thing i agree it's part of that personalization but it's sort of um a crowd-sourced uh uh personalization to to more powerful groups i think those are excellent comments jamil do you want to jump in sorry yeah i guess i'm just going to add maybe you know in for my for my field right there's a lot of push in the direction of combining the the approach of uh taking an agent that's used for imaging that can also be used as a therapeutic and and sort of combining an image guided therapeutic approach so it's uh the idea that you can for instance if a microbubble which is used as an ultrasound diagnostic image can also be useful uh for treatment then maybe you don't have to use an expensive instrumentation like mri to guide the process and that could be you know uh potentially use where mri is not as widely available you know some parts of the world um and ultrasound is portable and cheaper as a means of guiding therapies so just something that could be you know driving innovation some um and wider access of this type of technology excellent comments i appreciate the the debate so far as we transition let's say to another question what i was hearing is that we're seeing a large increase or uptick in the the effects and the effort of patient advocacy as it relates to new technologies in this area we're also seeing i would say almost record levels of investment with companies being funded you know at higher levels and with different multiples than i think we've seen in the past if we say okay those are the drivers into the marketplace maybe if we look at it from the other direction 180 degrees um and i'll address this to kristen to start um kristin what do you see as the obstacles and by that maybe clinical regulatory as they play into our discussion that must be addressed uh to see to have the patients really see or benefit from these clinical developments and opportunities sure so so as i mentioned with the consumerism of healthcare that you know patients are expecting to have that amazon type experience and um they're they're looking for the the convenience the ease of use timely communication you know between their their care providers um but the reality is you know healthcare is a regulated world so any communication um you know we have hipaa and and other you know the fda or eu mdr depending on on the location but working with health systems that are now very much viewing their patient population as consumers and are more and more talking about patients as as a consumer way i think one element that we've seen especially with the pandemic is the rise of remote patient monitoring and telehealth and virtual care options um but it's one thing when you're monitoring a patient within the four walls of a hospital and you can control those parameters but when you set those patients up outside there's so many other variables that cannot be controlled so um really how to solve for some of those challenges uh what's reliable what's not what use cases um what patient populations you know what type of monitoring or or digital solutions are appropriate for for which patients um is is really important to to work through and navigate so that you can prove those clinical outcomes but that you're always putting the patient safety as as first and foremost um but with that we very successfully have seen our customers reduce the the number of in-person visits for example for kidney transplant patients that require one to two years of follow-up they're able to use remote um virtual care options monitor those patients and in this case it's an academic medical center that is drawing patients from a very wide geographic um region so to be able to reduce the number of times that those patients need to come in travel a long distance and you know sit in the waiting room and do the the follow-up has a tremendous impact on patient experience and in turn on the staff satisfaction levels and uh you know the overall patient retention within their health system um so it's really about creating that win-win but nevertheless adjusting these clinical and regulatory it all needs to be done in the context of of you know ensuring patient safety and delivering those clinical outcomes howard i think i saw that maybe you raised your hand you'd like to build on that uh well i i think i unmute by accident because my finger twitched but but sure um i i i was gonna um sort of add to that and say you know in the same way that i brought up you know ai previously um and you know digital health it it as much as it's a blessing it's also a curse right because uh the fda is still figuring out um what it means uh uh same thing we'll get to when we talk about reimbursement um you know as we think of um you know uh our ai at loomis cell and the extent to which it guides the surgeon and helps them accomplish what they need um you know there were a lot more discussions with the fda on uh how to craft those trials um and uh you know even as we think about interacting with uh the payers so um again i think you know anytime you talk about new opportunities that adds um that brings to light also as as the opposite of new opportunities are areas that aren't settled yet um and you know there are times when you're dealing with regulators and payers and others that you would you know rather have uh defined uh answers and so i think you know we're still learning in that regard but you know again on the positive side the fda cms and others are so incredibly engaged working so hard and so excited about you know these new imaging technologies and what they can do to the standard of care that you know we found our interaction with them to be really quite positive and constructive ryan or jameel would you like to comment yeah i'll just add that you know i'm always very focused on the clinical trial and the strategy to get through the fda process and demonstrate clinical benefit to the patient and sometimes we have indications where the predicate device that you're compared to is is not as good as the device you're putting on board so then the question is is how do you prove it's better and and designing the studies in the right way and to howard's point aligning with the fda is is really important that there is a consensus across the teams to to figure out what is the right way to design the trial and execute the trial but unfortunately these trials can be very difficult to run because they require real objective endpoints um to be measured and that could involve other interventions and and that could take a ch take time to recruit patients and and be costly yeah you know just jump on that you know um there might be certain you know outcomes that you've been able to prove in a preclinical space that you think could be really beneficial but maybe the fda uh may not necessarily um allow for such uh trials right so it's like being able to decide you know what is the most important um team one approved in terms of taking the technology into the clinics and even though we have you may have certain ambitions for how far you want to push the technology you have to be so realistic because fda is looking out for you know patient safety right let me start off with this first show this uh before concept before you you can think about trying um this other more fine the sky approach um so it's it's just you know the fda they are um we are going to look after the patients first and foremost so it's um um it's it's just important that um being able to navigate this clinic the uh phase one clinical trials to show that the technology if you have introduced something new like houses um trying to use it in the new new and um unique way you want to be able to try to you know show that your technology is safe first and then convince the fda to allow you to take more chances on the more um the more potentially advantageous uses of the technology um and so it's just it's just and we've had some really good discussions with afd about different strategies and they've been very helpful so far excellent thank you thank you danielle um again we heard some interesting um pieces of data the first of which in uh kind of relationship to clinical studies or regulatory obstacles you know the idea that uh telehealth has become so prevalent now and i think post-pandemic it's you know something that really loosened up in a factor or in a speed that nobody could have anticipated before that and i think it opened up both new opportunities and new challenges for the regulatory agencies the companies that are producing and inventing technology to figure out how all that plugs together in this regulated world um so kristen if you don't mind i'm going to come back to you for a second question on this because you brought up the idea of the regulated world but the other part of um let's say agencies that either regulate or in some way affect um the industry reimbursement is a key part of it and i think that when we look at how companies are able to plan out what type of payments might be available for a very innovative groundbreaking technology it's difficult at times so i guess i'm interested to hear what do you think are the critical success factors reimbursement or other lines that are being addressed by you know companies big and small as you're looking to bring innovative technology to the market right so i think and and that was actually something that we saw in the pandemic that with telehealth that supported was they took they kind of removed some of the barriers they've reimbursed at the same rates um and uh kind of allowed uh the across state borders for for doctors to be able to service so to um in some cases temporarily but now looking for how do we start to really take this out of more of that urgent crisis pandemic mode into a more sustainable way and when we talk to our customers they're now looking at how can they use virtual care technologies to scale and to be able to serve more more patients and in a more effective way using a hybrid model you can't replace in-person care 100 percent but like the example i gave you can find a more you know just as effectively or more effectively treat patients um in a way that also helps your health system to scale you don't have to build more uh physical buildings or have more staff on board or create more more staff um you know staff hours and in that concept um i think some other you know critical success factors are uh you know interoperability um but again i you know if you're talking about a specific device or a digital solution or a therapeutic solution um you know what are the important elements to be successful and then to have the roi so if the end is if it's you need to be you know reimbursed procedure or or treatment um then you know what are what is your stakeholder ecosystem look like what do you need to be successful and have those proof points if you're trying to drive operational efficiencies um or you know have better clinical outcomes you need to be able to have those proof points to to go to your customers to show that there is you know an roi whether it's going to be safe cost savings increased revenue um you know your staff will have reduced hours doing one element because they're going to be able to to do something else by using using the solution so i think that those are some of the the the important elements to be able to uh to be successful um that are our big challenges still to to solve in many cases ryan and i have have talked for about you know the the importance of doing reimbursement work early um i mean seriously if anyone's logged in and listening you can't start early enough you really can't um for some reason reimbursement tends to be the thing everyone pushes towards the end they think it's about commercialization and so they worry about it when they get close and by then it is far too late um you need to be thinking about it now uh no matter how early you are you need to be putting the time and the work and the resources in and by the way it will make a huge difference as you talk with investors it will make a huge difference as we you talk with strategics you know as we talk with investors in strategics right now for a fairly large round i i'd say either the first question or the second question um sometimes even before what's your pivotal data is what's your reimbursement path and the fact that we've done work over the past few years that we have the right partners we're working with that we've done the the uh the analysis uh the interviews the all the things that go into being able to say that we understand what our pathway is and we feel confident has made a huge difference and i would say particularly with imaging which again in in that world of diagnostics you know there was an element of imaging and payment that was often commoditized and so particularly as you think that intersection between imaging then and therapeutics the ability to understand where you fall whether you're going to be reimbursed as a device or for example for us because we have an optical imaging agent we get reimbursed as a drug there's uh there's incredible value to really understanding this understanding how you might parallel path and how you can create the most value for potential uh investors in strategic so um you know again if you take one thing away from this um if you're not already started working on reimbursement do so you'll you'll be happy you'll you'll thank us for it later completely great howard and and i think when you parse that down even further it becomes who are this reimbursement stakeholders right so in your demographic population you know maybe half of them a lot of cancer care about half of the patients are under medicare and their charge is reasonable necessary which is different than the safe and efficacious of fda but the commercial pairs which represent the other half have very different charges in with their own groups and so they'll be looking for guidelines they'll want to make sure that the medical guidelines have adopted and have recommended your device uh then they'll also want to see that there's some sort of health economic benefit for the patients and they tend to lag medicare in these settings so it's really important to bring up front just as howard had said to think about when you're developing your evidence your clinical evidence you know what is the evidence required to prove safe and applications for the fda but at the same time what are the studies you're going to do specifically for both uh cms and commercial payers because oftentimes they can be very different we've had experience in our and my career working on different studies for commercial payers than even medicare and so you know a lot of it's evidence generation that you're going to have to invest in and making sure that you're investing enough and have the plan to address those uh and be you know straightforward with your investors on the amount of investment you need to run those trials excellent thank you very much for the for the input um i'll change over to jameel for this next question um jamil we've been hearing about a lot of you know different things that are external to uh you know companies such as yours whether it's reimbursement regulatory environment whether it's you know a huge amount of investment coming into the area um but besides for example with investment you know besides the resources the cash the infusion to you know to get you from a to b you know what do you need what does your company need to help you achieve your goals as a business it's an excellent question bill so um um now now in our early stage um and even though we have really nice um pre-clinical data one of the things that keep me awake is the unknowns when you go through a process of taking a technology like hazards which has been conventionally used for one application i want to try and use a completely different application searching for imaging to drug delivery it it's it's it's very helpful to have a sort of a strategic or partner investor who understands the potential challenges and pitfalls that you're about to face in taking us always experience taking a similar type of product like ours and going through all those phases from the pre-clinical to the clinical phase you know uh where are the pitfalls in the phase one and phase two trial do you pick the right indication or you know you put the wrong indication that sort of messes up um the entire um strategy or or or part for your company was looking at so it's it's good to have the right kind of um investor or the the right kind of support uh mechanism that um that has the experience going through that process and dealing with the regulatory huddles and one of the things we have to think about is you know we're most likely going to be a combination of products because we're taking a bubble just acting like a device combining with a drug and then you have to deal with two hours of the fda so see the average and see there and then um so um being able to navigate that that process now get a successful clinical trial on the clinical outcomes and then also being able to bring in strategics for instance you know we if in our company we're trying to show uh with uh potential pharma partners right you know we can take your drugs the library of drugs that are filled in the past because of chemotoxicity or because you can't penetrate a barrier and without technology we can peer paint it by training with our with our platform we can make those field classes now become more relevant then the question is how do we foster partnership with such strategic such as we can work out something together we um bring it bring it to the clinics to help improve outcomes in cancer so it's just having to just cause a long story short just to have a right kind of pattern investor that can sort of uh guide us through this process you know hiring director of talent and advisors thank you i open this up for the other panelists to jump in as well yeah i'll just maybe add to the aspect that what we're all trying to do is is remarkably difficult especially in some of these diseases and so that the team that you build not only internally but externally is really important and so investors play a key part of that in terms of networking to different strategic uh you know partners but the physician teams that you have um are really important regulatory advisors uh reimbursement buyers um you know i always say i can't have a big enough network and it's really important to have you know an investor group that is really behind the company thinking a lot about the company and and helping helping the company to find the right partners to help develop the product the right way hi and i i just wanted to add maybe a couple thoughts um having spent uh better part of my career actually on the uh m a side of um with first with ge and now phillips so i've looked at a lot of these companies so if the the ultimate goal is an exit and selling to a larger strategic i think um one what was talked about on the reimbursement or a you know a clear path to a proven business model um is is going to be really important that uh with early customers that have kind of worked out some of the kinks and learned from that and then have have a proven scalable business model in play so if it's if it's something that falls within the reimbursement that um that there's clarity on on how that will factor in um as well i think talked about the the team and uh both kind of the internal and the team of experts that have been built um and then i think ultimately kind of how does this fit in with with the customers in with their workflow um how are they going to adopt it it's not just about a piece of technology but um you know how is this really going to fit into their current way ways of working and practices of care uh and and have those elements been really kind of thought through um if there's going to be changes in how they're delivering care and and then how will that adoption uh be built out has that been kind of well understood or thought through excellent jamila do you have a comment i saw i saw you and i muted okay i just wanna make sure i didn't speak over you okay great um as as another approach to that or another way of looking at it you know we've talked a lot about the regulatory side the reimbursement side we've briefly touched on commercialization i'd like to maybe go a little bit uh into that here with some time remaining um you know commercialization of this technology is the ultimate goal of the high-tech companies represented on this panel as well as those in the audience based on uh ryan your background what what types of pitfalls exist out there for you know companies inventing novel technologies uh that we haven't spoken about yet yeah i i mean this is a huge challenge to commercialize well and to develop a marketplace especially as an innovative product a lot of times the you know technology is developed by an engineer because they've come up to with some discovery a novel intellectual property and you try to develop it into a market need and that's unfortunately the wrong way to go you have to start with the market need um and when we think about the market need the next pitfalls is you know as a as you start to do your clinical development you're interacting with physicians at tertiary academic centers and what happens at those tertiary centers is very different than what actually happens at the community practice you know you know in cancer care about 85 percent of patients are treated in the community and so that's the marketplace and understanding that these are small businesses that uh you know they have different incentives physician incentives different time constraints put on them comparative to an academic and so understanding your market well also recognizing that you know i've seen it many times where if if you uh you know tried to disrupt the way these p physicians practice uh your your technology may not be adopted um i like to say there's no inertia greater than the standard operating procedure of a physician they're they're creatures of habit and so you need to understand that understand them deeply to know how does your device improve their life how does it improve their staff's lives how does it make their patients lives better it's not just one aspect of it it's the whole environment from ordering the product uh you know to getting serviced there's there's a whole ecosystem about really satisfying the need of the community physician and that's where i often see companies maybe they have great data but they cannot translate that over to commercial success and so you have to start with that very early on and then design your clinical trials as we discussed around reimbursement about fda approval all the aspects of that but ultimately at the end of the day the interaction between the patient the nurse the physician is really what's going to be the the winning key to the product to add on to that um everything ryan said and in addition you have to pressure test it over time right there's that factor of time we're in companies that will take more than a year to get a product to market particularly if you think about changing imaging modalities then the intersection with therapeutics these are not things that will be in the market 12 months after we after we you know after an engineer designs it so you have to be willing to constantly pressure test to make those small pivots those small iterative pit pivots so that you don't find yourself much farther down the road and now it's a 180 degree turn and those are the companies that succeed that are constantly reevaluating and saying am i meeting my unmet need am i meeting what the payers want am i meeting with the fda wants and checking in with those stakeholders not just saying well i think it's still the same because ultimately what i think what jamil thinks what kristen thinks what ryan thinks none of it really matters it's it's what the market thinks um and so if you're not talking to the market you just create an echo chamber and um there there are warm fuzzy places to be right up until the moment the bubble pops and then not so much um so you know uh again completely agree with everything ryan said but just keep in mind that that idea of of all of this evolving over time and that we are in companies that will be around for three five ten fifteen years and we should never rest on just one snapshot of anything great points right and i again agree on kind of the inertia and that um you know it's how does it fit into to my existing workflow um but right now we i mean we know the number one challenge facing the healthcare system is the staffing shortages and burnout and so i think even now more than ever it is it is really critical and understanding you know how do you get that adoption what is that going to mean um so like ryan was was talking about that uh that's really kind of the the um more the mindset and and some of the the influence of what what you're bringing um to to the table and and then how are you going to make the life better easier faster with whatever it is you know for the clinicians for the the nurses for the patients uh is really critical yeah i mean i i found it you know you know just picking back in on the points of panelists i said i found it very helpful you know speaking to the end users or potential end users of our products and just trying to gauge their feedback on how they would want to be able to use a technology like ours in this new application so being able to leverage already existing ecosystem for how for instance you know bubble ultrasound contrast agents to use uh so not having to create this whole completely disruptive training process if you can take what they already know and just mix um and you're not um overly um changing too many things for them at a time it's it's very helpful right so if the the same training on how to you know inject the product how to you know treat the patient if you can if your technology can be synergistic with what is already existing like i'm very helpful in easing that transition um yeah that's great you know thank you for the comment um in terms of our time we've got about five minutes left so i'd like to maybe ask a general question that each of the panelists could uh could answer i've kind of absorbed this question as we've been talking so uh it's not something that we've um pre-prepared but what i would like to know is and we've talked about a lot of things that have happened over the past years that are happening today in this space um but where would you describe that this intersection of therapeutic and diagnostic imaging is going to be 10 or 20 years from now i mean to me there's no wrong right answer here but just from your perspective from the company that your representative and your personal let's say experience you know what are we going to be looking at is it going to be a star trek world of you know lay down on the table and you can diagnose and treat everything within 30 seconds you know are we going to have to really focus on training and educating patients and clinicians and technicians on how to use the equipment once technology takes another leap forward again just general interest in the last five minutes you know maybe have a little round table on that so ryan do you want to get started yeah i'll give it a shot um so you know we're developing a product and i think you know howard has the same aspect of this as well too which is that the imaging is a component of the therapy opportunity and so it you know bringing care together uh is is really going to be the aspect of this where we can actually you know interact with the device so our device will use ultrasound diagnostic ultrasound to guide the ability to open up the blood brain barrier exactly where the physician wants to do that so it's integration of systems and i i like to think that you know over the next years we'll see more and more of that where imaging uh will interact with the therapy i can definitely champion brian's device and you know it's it it's sort of you know predicting the future of what's you know so envision of uh the potential of a technology where you have a um a completely non-invasive way to treat a patient um so whether you're trying to perform uh surgery or in our case we're trying to drug delivery you know having surgery without a knife right you know you're not cutting through a healthy tissue to treat the disease tissue in the case of drug delivery being able to concentrate the drug right where you want it without causing terrible side effects to the patient so being able to eliminate chemotoxicity you know um and i think that's kind of hopefully why i see the future again with this technology i think it'll largely mirror where you see uh molecular diagnostics has gone right where you started off with a whole lot of molecular diagnostic tests that frankly didn't have clinical benefit it was just more information and that was okay initially because doctors wanted more information patients everyone wanted more information but ultimately then the other side were the fiscal concerns and the constraints and so over time those molecular diagnostics the ones that won are the ones that have been tied to uh you know uh coupled with a clinical uh benefit right a treatment and i think you'll see the same thing with imaging to ryan's point that the ones that will win are the ones that are part of a more comprehensive therapeutic approach uh the ones that because particularly as hospitals are only going to have tighter margins reimbursements are going to get more challenging and and over time it's it's only if you can take your imaging modality and tie it to something that is directly going to benefit the patient rather than just more information um that that you're going to win so i think you're going to see the you know a lot of these um i think you'll see it for imaging and for the enabling ai and even for digital health right there's lots of stuff out there and that's super exciting and everyone's throwing money out but you know fast forward five ten years you're gonna start seeing the consolidation then as it really drives towards the the most important so what's right i i guess if i if i did look into my crystal ball i think as we are more and more of our health data is becoming digitalized and we have not only imaging data but we have genomic data we have digital pathology data and then behavioral insights into who we are as a person how do we take all these data elements and not just make that you know whole bunch of uh noise but really drive those insights to really enable the the future ambition is personalized medicine that achieves value-based care and not teaching every treating everyone as somewhat of you know based on some best case that's for the population at whole but we actually deliver the best population care because it is personalized but that is really going to mean taking all of these data elements applying ai and other advanced technologies so that it's not an overload of information but that we do get that right insightful information to enable personalized care excellent thank you kristen any other comments on the future of where we're going all right excellent well i i must admit i i've really enjoyed this last 45 minutes with with the panel and i just want to take a moment before we look to transition to the question and answer period to first thank the panel members for their time the preparation that they put into this session and uh to the free kind of open exchange of information during during our call today so thank you very very much um secondarily to that i just wanted to encourage our audience members uh to please submit your questions um we have some uh we can i think we'll have time to get to a couple more but uh if you'd like to submit those please do so with the chat function and we'll make sure that we cover them again time permitting here at the end so with that i'd like to turn this over to our host from massmedic to facilitate the question and answer all right great conversation everybody i think tracy you actually want to take the first question hi everyone my name is tracy i'm the marketing communications manager at triple ring um so we got one question from the audience and i would like to ask the panelist so um this question is from mary uh marianne heno she's the ceo of lengtheners um lentils they launch a new ai technologies it's called pylorify which is the artificial intelligence enable software uh program that can read the images and also it's already fda clear so her question is a key additional consideration is how will the application of the diagnostic change patient management so um is anyone want to take this question i can start i i'm not familiar with this particular program but i think i would i would go back to some of the points that i think i and my my other panelists made about how does this really fit into the stakeholder ecosystem what are you dependent on the uh oncologist or the the other um primary care doctors that are the care team that's taking care of this uh patient how are they going to use how is the uh pylorify uh solution going to be prescribed um what's the education around that do you need to go into the health systems and then inform those those um oncologists to or the urologist to prescribe and use this particular ai reading program um so i think if you really map the entire journey of where do you fit in and then um you know how is the workflow going to change from what is happening today to um how is the care team going to use um your solution and then who do you need to to kind of work with and inform in order to to be successful so that the um better outcomes are are kind of proven with with the solution that's a good point there you know it's an entire team that treats um instances of cancer but they're very different stakeholders and they have very different interests and so you know um sometimes it's the pathologist sometimes it's the surgeon sometimes it's the medical oncologist sometimes radiation oncologist um and so you know you don't just have to know your your it's not just about a commercial sales call and who is your initial you know call it's about um who are all the decision makers um and some of them are going to be ones where they will actively champion other ones who could simply stand in the way if they feel threatened rather than seeing this as an opportunity to give better care um and so a lot of it has to do with you know that messaging because they're all they're all very engaged i i've never seen a you know group of um in oncology you find teams that work so incredibly well together and are so dedicated to the health of the patient um and so that can be a great thing because you have an opportunity to interact with and engage with with a you know an entire group but that also means you have to interact and engage with an entire group um and you know um if you're not if you're not playing to patient management um you'll get crushed by it you'll it'll roll right over you so um i think i think it's a great question mary and and you know um if you're not thinking about it uh it will it will seriously limit your ability to drive new uh imaging modalities yeah i'd like to add that you know the specialization in the tertiary centers is getting almost ridiculous the the understanding of these diseases and the subspecialties you know now if you go to if you have breast cancer there's different specialties of breast cancer uh from a physician perspective and they'll actually refer you to back and forth and so a community physician can be overwhelmed with the amount of knowledge to know in a particular disease you know if you take urology an example you know they go from kidney stones to prostate cancer to bladder cancer and and there's just a tremendous wealth of knowledge so we have an opportunity to create solutions that you know are trained by some of the best physicians out there and some of the best practices out there in that specialization and democratize that to the community center and i think that's really the key focus of a lot of the imaging solutions that are coming out is how do we democratize care thanks everyone um since you only have 10 minutes left um there's no more question from the audience so i would like to ask a general question to the panelists um it's open question um so there might be a lot of like entrepreneurs incubators and like new business like want to enter the world so what would your what would be your general suggestions for people who want to enter the imaging world like develop a new technology just your general it can be ai digital health what would be your general suggestions for people to enter this world well that's a probably about our answer because there's so many different things to think about um but yeah a few a few of the high level things is is you know again we've stressed on the market need and and coming up with a business strategy that addresses you know how to how do you eventually commercialize at the end of the day get through the clinic the fda and reimbursement but there's also an uh a reality of the investor sentiment in terms of there are technologies and spaces that are in vogue and so you know thinking very hard before you start about you know how do you position the company what what does it mean to the investors what are what are they looking for and do you have an operational plan that scales at the appropriate times and is conservative appropriate times because you know the reality is if you can't raise capital um you're never going to see that product uh get to the end of the day so it's a combination of of really you know looking at 360 around the product solution and all the stakeholders they have i think something we actually haven't mentioned previously but again it syncs with a lot of what you're saying ryan is if you're at that very early stage it's also about um who your par partner with during the development so which is to say man it's so important who that first kol is right who that first surgeon is that first sight because you know we've got barbara smith is our lead pi she's a leader in the breast cancer world and she's been with us in god i think you know 13 years or something and you know she's been there through ups through downs guiding us giving us information making those introductions to other surgeons and so you know picking the right sort of partners in that regard those clinical supporters is a make or break decision and it's one that you know if you get it right in the beginning it impacts everything else you do and if you get it wrong uh yeah it won't end well i guess i would ask um so i i am not an entrepreneur so i have worked in large companies um but i i do think i i have led a a venture an internal uh corporate venture but as part of the the umbrella here but something that i found a couple years ago that i find incredibly helpful that fits whether it's a product strategy a business unit a new initiative um it's actually from um salesforce when they started the company it's a framework called v2 mom so v stands for what's your vision the second v is what are your values um then you have m for your measures how are you going to do that the o is your obstacles and then m is your metrics and you can google it and it'll it kind of walks you through that but um for me that's always a very nice framework because if you can walk through it gives you that strategic plan and you can make it you know as short or as long as you'd like to but those are really the critical elements that when you're walking through and building your strategic plan so that's a tool that i have found really helpful over the last couple years that i highly recommend and as a sort of a first-time entrepreneur i think one of the things has been stressed to me is having the right team um you know if you're going into adventures surround yourselves with right team of co-founders and advisors that can really help you know watch your back and make sure you're making the right steps and not taking the wrong steps so it's it's very important to be to have the right team and starting out a new venture you know what you can extend what kristen said and and what camille said in that whether you use v2 mom or you use some of the other frameworks that are out there have a framework um have a guide point that you come back to at various points and check in am i am i staying true to what i said and if i didn't why am i why am i changing um and and that's going to guide you through a lot of those those challenging moments um and so you know which framework is better i i don't know i'll look into v2 mom it sounds interesting but but what's most important is have a framework right um when you talk with uh potential clinicians when you talk with investors when you talk internally to people in your company it it it defines you it's the glue that holds you together to a certain point um and it's the lack of a framework that you know chris and i i i did a lot of the same stuff when i was at medtronic and you could instantly tell who had the framework versus didn't right those companies that would come in and they would just be scattered and haphazard and it was and it it it permeated everything they had done previously and that they were going to do and the ones who had a framework those were the ones where you could trust what came before and trust what was going to come really one just concluding thought on that is i've always found in my career that you know the true north of the organization began you start going in different directions and is patient care and if you put the patient outcomes at the center of what you do and that's the true north of your organization you won't go wrong and and we just have to be resilient uh through the obstacles that we have but if you're making a difference in a patient's life in the united states the you know you'll get you'll get rewarded for that great point you do have something to add so joe again i'd like to thank the panel for their help today just a couple of concluding comments we thank all of the attendees here um that listened to our webinar today we hope you're able to internalize and uh take home some valuable pieces of information um again my name is bill dowd i'm with triple ring technologies our tagline is that we resource innovation so these types of sessions are very important to us and to provide the resources to entrepreneurs small companies and others is absolutely our pleasure and our desire to do that and we do it through our offices in the bay area in california the south end of boston toronto and a small new office in copenhagen so our team of over 130 scientists and engineers are available to help in any way we can whether it's to these panelists here on the session to any of the people that have listened from their offices and at home and anyone else that might see us on the recordings so again thank you all very much for your time today wow i wish you a good day thank you thanks so much bill thank you thank you everyone at massmac bye-bye thank you everybody for joining us um everyone who registered for this session today will receive a recording after the program and thank you again to triple ring for sponsoring this and to the panelists for joining us today it's truly an honor to bring you this program meaning we can't do it without our sponsors so thank you very much have a great day thank you everyone bye

2022-04-15 18:53

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