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THE NEXT LIST
Innovations in Medical Technology Examined
Aired July 6, 2013 - 14:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
ANNOUNCER: They are innovators, game changers, people pushing themselves, moving us all forward. They are the next scientists, musicians, poets, the next makers, dreamers, teachers, and geniuses. They are the "NEXT LIST."
DR. LESLIE SAXON, USC KECK SCHOOL OF MEDICINE: I'm continually interested and fascinated by how much athletes, patients, everybody wants their own data because they want to learn and be better and have better outcome.
UNIDENTIFIED MALE: You can get this information all the time real time.
DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: What do you think about that?
UNIDENTIFIED MALE: It's amazing what technology, where it's taking us, man.
GUPTA: The technology around me measures the body's most basic functions like pulse rate, respiration, blood pressure. That's valuable information that Dr. Leslie Saxon wants all of us to have access to as easily as we have access to our e-mail.
SAXON: The kind of first principle of digital health is access to your own data. I imagine that anybody in the public who wants to check on their health status that this will be completely standard, part of just checking yourself, like you check your sports scores.
UNIDENTIFIED MALE: She's somewhat fearless terms of being an advocate for patients.
SAXON: In your case we're treating blood pressure or we're treating arrhythmia.
GUPTA: Dr. Saxon is chief cardiologist at USC's Keck School of Medicine. She is working to make health care more convenient, personal, and available in real time.
UNIDENTIFIED MALE: This will be a hospital you carry in your pocket.
SAXON: She's doing this by collaborating with business, engineering, medical, and film students.
UNIDENTIFIED MALE: She is the definition of a vanguard's vanguard.
UNIDENTIFIED MALE: She is a little bit of a pioneer.
UNIDENTIFIED MALE: She pushes the people at the leading edge even further.
UNIDENTIFIED MALE: She's been able to spark conversations that really go toward what should be done versus what's being done.
GUPTA: With all the talk about changes to health management, Dr. Saxon believes now's the time we need to rethink the way health care is consumed.
SAXON: Wouldn't it be great to get a call from your smartphone to tell you your doctor needs to talk to you about something you don't feel yet.
GUPTA: I'm Sanjay Gupta and this is "THE NEXT LIST."
SAXON: You asked me what the benefit is to having medical information. It's almost like saying what's the benefit to reading Tolstoy? What benefit do I get from reading some of the best novels that have ever been written and being educated enough to realize the gift of that? It's just being more evolved.
My name is Leslie Saxon. I'm the chief of the division of cardiovascular medicine at USC and the executive director for the Center for Body Computing.
The Center for Body Computing is an innovation institute that's dedicated to realizing the future of medicine through wireless communication. When we started the center a Lot of people came and said I'll do this for you, Leslie, but just once. It was really science fiction and they kind of laughed. And then that science fiction became science fact, and year after year we have the products and cases and technology. We were able to do some key things and get buy-in.
DR. DAVID ALBERT, INVENTOR: We simply snap the case onto our phone and then we have an app and I can take this app and then simply apply my fingers to the back and what we get is you're seeing my electrocardiogram, that's my heart's signal.
I'm Dr. David Albert and I invented the iPhone EKG. I collaborated with Dr. Leslie Saxon on bringing wireless health into the 21st century.
The case talks wirelessly to the phone, which then transmits it immediately to the worldwide web where securely a doctor literally on the other side of the world could diagnose an athlete or a patient instantaneously within five seconds of me finishing.
SAXON: Turn it over? That's your beautiful EKG. Basically just by putting your finger on the electrodes you can get a single EKG. And all I have to do on my iPhone is launch an application.
ALBERT: Five years from now every phone will be a smartphone. That's going to be how people interact with their physicians. That's going to be how you deliver health care.
SAXON: What we like to do in this center is take a beautiful break- through technology like this and apply it across large segments of the population. Yes, do it scientifically, but also try to imagine on it. You know, what is the best use case for this for a USC athlete or a professional athlete or a cardiologist? How can we educate the next generation of patients? It's changed my practice and changed my life in a lot of ways.
ALBERT: We had her numbers up there the whole time you and I were --
SAXON: We were in the red zone on overdrive.
GUPTA: When we come back one of my most challenging workouts, and technology Dr. Saxon hopes will change sports forever.
RUSSELL: There you go, reaching straight down. Sanjay, looking good, looking good.
We're going to be putting this device on Sanjay and so we measure the heart rate and respiration rate or what we call the physiology. So what we're going to see here in the gym today is Sanjay against different types of athletes so we've got some ball players, a football player.
My name is Brian Russell. I'm the CEO of Zephyr. I work with Leslie to measure patients and professional athletes.
To measure somebody we need to put it on them unencumbered so someone like Leslie can look at that data while she's in clinic and logon and see that data anywhere in the world.
SAXON: This gives us an amazing amount of medical grade data. It's a very much more sophisticated way to assess somebody's fitness real time and allow them to create a plan around their fitness but around metrics that are usually worked on, like explosiveness, jump height, things like that. It's a way that we're monitoring elite athletes to provide them and their coaches with more feedback.
GUPTA: Are we done warming up yet?
So what did you just put us through?
SAXON: It was a lot of fun. First of all, congratulations. You hung in there. So a lot of different workouts with different measures, so the goal is to tell you something, tell the trainers something. Tommy Haas, the tennis player, is just amazingly fit. Where he seemed to tire a little bit was in the side stepping with the ball. So in terms of where he could improve his strength or work may be to focus on that.
Nick, baseball player, super strong guy, very explosive, almost like does he need to work on that much, maybe more cardiovascular. NICK SWISHER, CLEVELAND INDIANS: Everything is getting more and more precise which can help to you elongate your career or make it the best it can be. After the workout this guy needs to do more cardio and stretching.
GUPTA: These are athletes and peak performers trying to get even better. What about the average person?
SAXON: I think it translates into the average person. We're all trying to improve something. We don't start at this level unfortunately but being able to incrementally do a prescription. Here's where you are now. We can set it up for success.
GUPTA: USC is a big prominent sports school. How does that play a role and work for you?
SAXON: We love the athletic department. Our athletes, we're trying to give them their heart rate and the body measures so they can figure it out, and hopefully prevent injuries so they can play through college and maybe beyond that.
UNIDENTIFIED MALE: We had a lot of injuries for the last three seasons, and that was the interest in the heart rate monitors. My name is Ali, and I'm the women's soccer coach at the University of Southern California. Dr. Saxon came in and made a presentation to the head coaches. With the heart rate monitor they were able to come up with a formula that gives them a training load. And when that number gets to a certain level, the athletes are more susceptible to injury. So we back off, which has been hugely beneficial.
SAXON: Why does an elite gifted athlete need to get so badly hurt, maybe get out of the game and have to rehab? We really want to use this to figure out how to keep them at it longer.
GUPTA: When you have a day like today, does it validate more of what you've been talking about?
SAXON: It does because every time I end up going back to the hospital and that's my base. They inform each other so much. So what I see here I think will work for any patient.
This is my patient Ken Masuda. He's been my patient for how long?
KEN MASUDA, PATIENT: Seven years.
SAXON: Seven years. We go back a ways. And he has arrhythmia fibrillation, and often when somebody gets heart failure they need to be hospitalized and get IV therapies. This device has the promise of by tracking the pressure daily and acting on it, having to eliminate the need for hospitalizations so we're hoping it also improves patient survival. What Ken does from home is he holds this over the device.
MASUDA: Once in the morning and once in the evening, I put it up to my chest. It tells me my blood pressure right now is 136/81 and I push enter. SAXON: And twice a day it reads the pressure of his heart, and wirelessly over the screen we give him a prescription of what to take. That's called a dynamic prescription. So that's not a one-size-fits- all approach to patient care. That's a tailored approach where he's on background medications, but depending on what the pressure is we're able to act twice a day.
The other thing that's really big here is that when you're a patient getting this, you start to learn your own condition.
MASUDA: I always take this with me and keep it fully charged.
SAXON: I want his quality of life to be good. He's an active guy, likes to do a lot of different things, including go hang out with his buddies and drink occasionally. So that's OK. We want him to do.
In my view moving the needle on health care meaning getting good health care outcomes doesn't mean a 1940s model of health care, where there's a single doctor that does everything in a low tech environment. It means the ruthless efficiency of digital applied over very large populations and saving the most talented, high-end people, which are the highly trained physicians, to really take care of those people who need them. It means that instead of going for your annual checkup or to a doctor when you're sick, you get a phone call that says you're about to get sick.
GUPTA: Is the harder group to convince the physicians or the patients?
SAXON: There's no question the physicians are the hardest group to convince. I've had to struggle a little bit with the prevailing mindset. We have to show them how these digital solutions allow them to be better doctors. I think that's an obligation that we have.
GUPTA: Up next, Dr. Saxon puts a new sensor to the test.
UNIDENTIFIED MALE: All right, here we go.
SAXON: There is a challenging team and a defending team. You have eight players that go super-fast for an hour and a half. It's an incredible outlet. Even though it really pains my body at 53 and hurts walking down the stairs the next day, you're working on your skill set.
I'm proud to be wearing the first shine during the athletics. The shine is an activity sensor and tracker. The disc lights up with motion as you move so you know you've completed your day's activities by just getting a light around the circle.
UNIDENTIFIED MALE: She'll be the first person outside the company we're going to let wear the product.
I'm Sunny Boo, CEO of Mystic Wearables, and Dr. Saxon is on adviser to our company. It's a wireless tracker that you clip on. Literally you just shake it and it tells you basically how well you're doing, like how many steps you actually took or how long you were swimming and whatnot. We make it so simple you lay it on the phone and that's it, the data transfers.
SAXON: I've been thinking about it for patient applications, just telling a patient all you have to do is light up all the lights on the disc when you come home from the hospital.
GUPTA: Do people say Dr. Saxon, it sounds good, but it sounds like a gimmick?
SAXON: Yes, they do. Go put the iPod on the defibrillator, I get that all the time. On the other hand, we have been massively unsuccessful in chronic disease getting the patients to comply because it's too hard and it's such a burden. So why not make it fun to take their drugs as a game versus some kind of anti-septic, dictatorial prescription.
One of the reasons we're at Karten, as much as I love the engineers with doctor implanted devices, they're very engineery and they're not really interested in the user experience for the doctor much less the patient. We felt the need to engage the design and never firmly understood that.
STUART KARTEN, KARTEN DESIGN: Our current health system is in disarray. Right now it's very hospital focused, and the movement that she's pioneering and where this is all moving is it's really going to follow patients and people.
SAXON: We've really created some groundbreaking products. This is called a flexible electronics. They're imprinted on this plastic. So imagine that you can put on your body tattoo on your body computer, and suddenly for a week I've got my little power pack on and many of my functions are being monitored. This is the device we followed and done a lot of research in its premarket stage, and now it's approved. It really just sticks on, you can wear it for a week, and it's completely wireless and goes to a cellular device so constantly transmitting data, fluid status in your lungs.
GUPTA: It seems little sci-fi, this idea we can predict things before the patient would themselves. Is that imminent? Is that really going to happen?
SAXON: We're investigating a number of devices where we measure, for instance, pressure in the heart, and we know that goes up two weeks before patients get syphilis.
KEN PERSEN, SOFTWARE ENGINEER: The patient sees the physician is connected to their smartphone.
SAXON: We were able to develop and make technically work an entirely new way to ask implanted devices questions, know what they're doing, and communicate that to patients, all remote. PERSEN: In today's scenario a patient might have to travel a couple hours and sit in an emergency room for another hour and a half once they arrive. With this technology we give them the capability to self-interrogate, self-manage, and then interconnect with a physician, so it's an immediate and extraordinary time savings.
SAXON: The patient doesn't have to go anywhere, so it saves $1 billion. But to me most importantly it completely changes the game on patient safety. We know their hearts are damaged. We've put in a $20,000, $30,000 device, and now let's really use it to manage them. This is the first system in history that can do that in a real time way.
GUPTA: There's always obstacles to these things, talk about the health insurance industry, for example. If they don't buy into this and they say it's too costly.
SAXON: I don't pay a lot of attention to them. I try to do what's right. I think the consumers will pull the insurers along as well. We've actually seen a lot of openness. Insurers are looking for new ways to keep people healthier.
A lot of my inspiration and ideas come from, like, my children, who are digital natives and using things all the time from the gaming community.
ROSE SAXON: I really like social networking and stuff, so once she sort of got into that realm, it was -- I just sort of started coming up with ideas and sharing them with her.
My name is Rose, and Dr. Saxon is my mom.
I was like, well, what if we did something if you saw someone that you thought was cute or something you liked and then people could see how your heart rate would go up. It would almost feel like a digital truth or dare.
SAXON: What if you could stamp every one of those interactions with your heart rate as a window to how you were feeling and what you were experiencing. Then suddenly we have heart rate data on millions of teenagers that we have never had access to before. So I'm learning all the time from all these other disciplines and trying to think about it through a health lens.
GUPTA: Coming up, your next doctor's appointment could be in your car.
SAXON: One of the most important collaborations we have is with the USC School of Cinematic Arts, being able to take both their creative take on technology and their ability to tell a story and engage and entertain and apply that to mobile or wireless health care could be. It seems like the winning formula.
ELIZABETH DAILY, DEAN: I think her work is critical. The important thing I appreciate about Leslie is she understands the real importance of being able to tell stories, because that's what people remember. And if you want to get compliance from a patient storytelling is one of the best ways in the world to do it.
SAXON: I've always been a person who didn't just love medicine or science. I also love film and I love literature, and my brother is a film producer, my husband is a writer. I like sports. So I was always looking for a way to integrate what I did with the things I'm passionate about.
ED SAXON: I think there's an opportunity for storytellers to work with doctors and researchers to literally change the way health care is delivered.
My name is Ed Saxon, I'm a film producer. Most famously I produced a movie about a doctor called "The Silence of the Lambs."
UNIDENTIFIED FEMALE: Dr. Lecter, my name is collar Clarice Starling. May I speak with you.
ED SAXON: In "The Silence of the Lambs" it's can a woman save another woman. In your health narrative, as you're working with a device, it may be, can I lose weight? Can I make my family more healthy? You're looking in each discrete case for a storyline that people can connect to emotionally. This is going to make me stick around longer.
SAXON: Scott put it in a car basically.
PROFESSOR SCOTT FISHER, USC SCHOOL OF CINEMATIC ARTS: Leslie found out about the stuff we were doing with BMW and developing a persona for the car, figuring how do you turn the character into a character. And she got excited about how can we do that around devices?
SAXON: I'm a cardiologist, I love the heart. The heart is the center of the soul and everything else. So we started with heart. We can take any sets in ideally. It should be agnostic, but start with something like your heartbeat that changes on the minute, like the car, the responsiveness, seems intuitive, and the technology was here.
DANIEL GRIEN, DESIGNER, BMW: We have a quick prototype, a steering wheel where we changed the stitching. So we integrated the heart rate sensor within the steering wheel. Are you stressed, are you relaxed, things like that we want to monitor. And this is where Leslie came into play with the Center for Body Computing.
SAXON: You're having this great experience in the car, and then in the background, passively, if you need to access it, you're also learning about your own health and wellness. So imagine I've had a long day. I get into my car, I turn it on, I grab the steering wheel. It immediately goes to the right temperature because I'm warm, I'm tired. It then measures my biometrics without me being aware of it and plays a song that it knows tends to bring me into a zone that I've identified and it's identified is good for me.
People are not going to learn themselves or participate in their health and wellness without having these experiences create habits and follow them everywhere and enhance the relationship with everything they do in their life. Medicine can no longer be segregated and someplace you can never access. It has to be entertaining.
This car with this product is an unbelievable opportunity. For everybody to love this, it has to be easy and seamless experience where suddenly I'm getting the mash-up of the music I like, the driving experience I like.
I try to live every day as I could go broke tomorrow, and in some cases it's really true. If you live with that urgency, that means you have to get stuff done. What's next is getting some of the products we've had a big part of out to the marketplace, then I see this world of possibility.
A big dream for me is being able to say at the end of the day we brought experts to people, we taught the world about health, and we used tools we had, and we saved money, and we had all that money left over to do all these amazing things like cure cancer, understand genomics, designer drugs. That would be just an incredible accomplishment. And then I'd like to focus on French. At any rate, the journey's been worthwhile.
GUPTA: Dr. Saxon's quest to integrate medicine with the digital world isn't far-fetched. She estimates smartphones that send health data to doctors could be in patients' hands in five years. Imagine having an exam and a diagnosis without ever having to leave your home or your car? Dr. Saxon is finding wireless solutions that bring her closer to patients, transforming the way they live and giving them the power to monitor their own health. That's what earns her a spot on "THE NEXT LIST."
I'm Dr. Sanjay Gupta. Hope to see you back here next week.