Join us for an exclusive interview with Toby (Walter) Eadelman, Chief Technology Officer at AvaSure, as we unpack key takeaways from the 2024 AvaSure Symposium.
This session will delve into the transformative impact of AI-powered virtual care platforms over the past 15 years and explore future trends in healthcare technology.
This session offers a unique opportunity to gain insider perspectives on the rapidly evolving landscape of virtual care. Whether you attended the Symposium or are new to the concept, you'll come away with valuable insights on how AI-powered platforms are reshaping healthcare delivery.
Toby (Walter) Eadelman, Chief Technology Officer, AvaSure
Megan Antonelli, Chief Executive Officer, HealthIMPACT
Welcome 0:00 Welcome to Digital Health talks. Each week, we meet with the healthcare leaders making an immeasurable difference in equity, access and quality. Hear about what tech is worth investing in and what isn't. As we focus on the innovations that deliver. Join Megan Antonelli, Janae sharp and Shahid Shah for a weekly no BS deep dive on what's really making an impact in healthcare.
Megan Antonelli 0:30 Hi everybody. Welcome to Digital Health talks, where we explore the cutting edge of healthcare innovation. I'm your host. Megan Antonelli, founder and CEO of health impact. Live today we're diving into the transformative world of virtual care with Toby Edelman, Chief Technology Officer at avasure, fresh from the 2024 avasure symposium, Toby brings us insights on the transformative impact of AI powered virtual care platforms and the history of that over the past 15 years, with experience spanning From automated tech to healthcare. Toby offers a unique perspective on how technology is reshaping patient care. Whether you're a healthcare leader, innovator or simply passionate about the intersection of tech and medicine, you're in for a great discussion. Let's jump in. Hi Toby. How are you?
Toby (Walter) Eadelman 1:17 I'm great. I'm glad to be here. So glad you could be here. And I know I'm sure it was a busy couple of weeks. It was early in October, but before we jump into everything that happened at the meeting, tell our audience a little bit about your background and how you came to avisure, and you know what sparked your passion for healthcare innovation? Great. Yeah, so that's a fun story. I actually was in automotive before I got into healthcare, which you mentioned a few minutes ago, and the way that I got started really into healthcare, was kind of a unique story. But before I get to that, I'll share a little bit about my time in automotive. I was working in the area of Bluetooth and hands free in cars. At a time when there was no hands free in cars, we were the first introduction of a widely spread hands free system. And so we were developing that even before there were Bluetooth phones. And so we just had a old Sony Ericsson phone, flip phone with a Bluetooth dongle on it, and we were trying to figure this out, just starting from those days, and a lot of the challenges that we had back then were not really what we thought were going to be the challenges. So we thought, for instance, that voice recognition was going to be a challenge, but in reality, the real challenge was around the hands free audio in the car. And so there's always so many things you learn when you're starting out in an in a new industry or a new technology that surprise us along the way. And so it's really a great adventure. And the way that I got involved in in the healthcare industry is I've always had a little bit of a connection to healthcare, because my wife is a nurse, and at the time she was a nurse, now she's a nurse practitioner. And so I've had kind of a peripheral view of medical industry, but traditionally, I've been in automotive and I had this dream where I was going to build my house from the ground up. And so I was building my house, the one I'm in now, actually, and it's kind of a family tradition. My grandfather did it, and my father did it. And so I had wanted to do it as well. And as I was doing it, and the kids were running around, you know, playing and having a good time, and all the neighborhood kids were there. And there was, there was a Father that would come and pick up his his son every day that been playing with my kids. And, you know, after a while, we got to talking. Well, after I finished the house, he showed up one day and was knocking on my door, and I opened the door, and he was standing there, and I was like, Hey, Brad, what's up? And he was standing there with a box of parts, and he was like, I've got this idea for a telesitter, and I think we can really make a big difference and just change the way that that patient safety and falls is treated in the hospital. And so I invited him in, and just as a neighbor, you know, just helping out, we talked it over, and I agreed to help him create the first proof of concept for this product. And so we actually developed it in my garage here, and we we created that first one, and then he went out and he ran with that, and he sold it, and it took off. And just has completely changed the industry. And so that's how I got involved in medical. Was joining him after that took off.
Megan Antonelli 4:32 Wow. Well, that's amazing. I mean all of that, right? I mean both from being the, you know, the beginning of, you know, sort of putting Bluetooth in cars, which, of course, now is something we just, you know, if it's not working, we get really up set about, we didn't used to have it. But then to that and that, you know that many years ago, you know, really, that's quite, quite visionary. So Brad. Brad is the founder, I assume, of action.
Toby (Walter) Eadelman 4:59 Sorry about that. Yes, Brad is the founder of avisher, so, yes, nice,
Megan Antonelli 5:03 nice. And, of course, building your house. My grandfather built their house way back when, but then it stopped. My dad did not build ours, but, you know, but that is, that's quite a, quite an endeavor. I just, I just refinished my kitchen. And I can't, you know, begin to think what building an entire house would be like. And I certainly didn't do it myself. I was just picking fixtures, and that was hard enough.
Toby (Walter) Eadelman 5:30 Absolutely, it's a, it's a once in a lifetime thing for me, I think. But yeah, it was an experience. I was glad I did
Megan Antonelli 5:35 right well, and like with, you know, I mean that just the technology and the things that have changed over the years. I mean, even with that, it's like the choices and the amount of things that, you know, it's just grown so much. But let's talk a little bit about, you know, the the meeting and, and, you know, kind of what you learn from, from the customers and, and certainly, the theme of the event was virtual care transformation over the last 15 years, which, of course, you know, we've seen so much in the last five years of what that looks like, and we can already see what's coming, you know, what were some of the things that came out of there as, really, those big, you know, kind of pivotal technologies, like, like the Bluetooth or, you know,
Toby (Walter) Eadelman 6:18 yeah, so, like, you're saying over like, the last 15 years, that kind of thing. So, yeah, I mean, we've seen a lot of changes, honestly, in the healthcare environment in the last 15 years. When we look back, you know, in with tele sitting in those early days, it was very hard to to really get people to understand how the impact that virtual care could have. And so as we saw that acceptance come, and the as we showed the impact and the fact that we have a solution that can actually change the safety environment in the hospitals in relation to falls, it really was the first thing that grew, and it became a lot of different adverse events that we could address. But then, as time went on and we got to COVID, and as much as I don't want to say that COVID is a good thing, because it was a really tough time that I would not want to go through again, it was very transformative in the acute care environment because of the fact that it really made people explore and advance virtual care and medical, virtual medical opportunities. And so we saw a big shift, honestly, towards more telemedicine, telehealth, a lot more of the acceptance of a camera and talking to somebody remotely. And so that's been a big change that we've really seen in the last 15 years around this, this the acceptance of virtual care in the acute care environment. And, of course, AI, right, we're all talking about AI, and it's, it's making a huge difference in our lives, but it's, it's just the beginning of what we can accomplish with AI, but that is obviously something that was discussed a lot at at our symposium, we have, you know, AI as part of our products, and so the opportunities to use those, and they were exploring ways that we could use this technology, and in addition to our normal parts of our product, of being able to have our episodic virtual nursing, telehealth consult part of our products, and then the patient safety part, and then the AI and all of these things coming together were just really a big topic of discussion.
Megan Antonelli 8:35 Yeah, it's really been sort of a convergence of these, you know, kind of technologies, and then the tipping point being the pandemic, where it was a necessity, you know, where, of course, you know, also reimbursement was, you know, sort of mandated. It had to happen. So then the pathways were completed, and it's amazing to see. And then the acceptance that's there, you know, probably to some degree, generationally, too around, you know, both AI and virtual, but also the consumer expectations, right? So, but it is. It's funny. So I know David Pogue was the keynote, or a keynote, at the at the conference, and he spoke for me years ago, I think, at our epharma summit. And when I think about it, he was talking about the iPhone and what it was, you know, he's saying at the piano about what it was going to do and how it was going to transform how we communicated, you know, with our physicians, how we managed our care. Think there was a joke in there about kids, and he's so funny. It was, I mean, he was my favorite. We had him come back, you know, year after year. But the one that really sticks in my head, I think, was the first one he did around the iPhone. So I'd love, what was he talking about this year, and how did he do it?
Toby (Walter) Eadelman 9:46 Yeah, David Pogue was, was great. I love to hear him talk too. He's, he's really great. But he was talking about AI, and, you know, he kind of started with, you know, I'm going to start positive, and we're going to bring you down. And then, you know, at the end. And it'll be positive again. And he kind of talked through, you know, this, this whole, you know, the good things and kind of the bad things about AI. And, you know, it was, it was really great, and he was really entertaining. And at the end, he even used an AI, interestingly, to write the song, you know, for about the obvious symposium there, and so that was, that was fun as well, to see that it actually did a pretty good job. So it was pretty entertaining. Yeah,
Megan Antonelli 10:28 oh, I have to, I hope they take, I hope they recorded it that shows out like, I hope they taped it like, No, they wouldn't tape it, but I hope they recorded it so that we can hear that. But it is. He's so funny, and just the way that he, you know, ties it all together is always really great and and very entertaining. So there at the meeting, you had a lot of your customers, partners. You know what came out of that, in terms of the discussions of how people are using the platform? And you know what got you, you know, really excited to see what people are doing.
Toby (Walter) Eadelman 11:04 Yeah, you know, it's, it's been like this for years, that the our customers get together, and they love to talk together, and it's really we encourage that more than like, we're not, this isn't a sales pitch or anything like that. This is like customers talking to customers. So they're the ones that are speaking in the seminars, and they're the ones that are speaking in each of the sessions and the breakouts. And we're just kind of, we're just kind of coordinating that, and, you know, helping provide answers and solutions. And normally the discussions, they go a lot of different ways. Majority of the time, they're talking about the money they're saving. I know there's a lot of discussion around ROI and and there's that's a big thing with with virtual care and virtual sitting, is that you do get a very good return on investment. And so they were sharing a lot about, you know, we saved money this way, we saved money this way. And with this money, you can do that. And with that money, we can do that, and they were expanding their systems based off of that. But that discussion happens a lot. What really kind of the one that jumps out in my mind is it was actually Mass General Newton Wellesley, and they have a phenomenal program where they're actually able to keep or to help monitor and keep adolescent eating disorder patients safe as part of their their eating disorder program. And one of the things that's that's really amazing to me about this is that due to using, you know, obvious sure to do that, they've been able to accept double the amount of eating disorder patients than they could before this by implementing virtual sitting and so that's been it's just met a huge need in their community, and that that right, there is a great example of ways that the system can be used just to provide additional services for a whole different, you know, group of people. And so there's a lot of discussion amongst the hospitals themselves, trying to figure out how, oh, how can we do that? And so there's a lot of really great discussion around
Megan Antonelli 13:05 so tell me a little bit more about that. Where are they like? Is that in the inpatient setting that it's set up, and what is it capturing? And where is it, you know, what's the clinical, you know, sort of interface with the docs and the the clinical staff.
Toby (Walter) Eadelman 13:23 So I don't know a lot of the details around clinical so you'll have to bear with me here. But the way it works from this is definitely inpatient care, and it it is, as I understand, it is more on the, you know, pediatric behavioral health side, and that they're using this to be able to monitor based off of, you know, medical orders that have been given for these patients to be monitored. And so instead of having to have, you know, a one on one person in the room, or, you know, checking in often, they're able to use the virtual sitting to be able to monitor multiple patients at once, and to be able to provide more of this service to more more patients, right?
Megan Antonelli 14:05 Yeah. I mean, it's amazing to think of the applications, right? I mean, as you you know, you know. And this is with healthcare. It's like, you want to start with the it, you know, ideally the biggest problem, or in some cases, the smallest problem, that you can really solve, you know, and then see where the applications are. And, you know, with fall prevention, and fall prevention has always been such a sort of big talking point in that it's a costly and, and, you know, often begins the cascade of indications of other things. So preventing that within the hospitals is huge, but the number of applications out there around the ROI though, tell me a little bit about, you know, we get into the conversation because, of course, there's, you know, we don't want AI to replace doctors or nurses. You know, we don't want jobs to go down. But of course, we have a huge nursing shortage. So where. Was the discussion around that, whether it's around kind of the the ethics or the working together, you know, often we hear about how, you know, AI is going to bring back the joy to medicine. You know, tell us a little bit about what those conversations came to for your for your the group that was there, yeah.
Toby (Walter) Eadelman 15:18 So a lot of the ROI discussions that were going on were not even related to AI yet. With AI being relatively new, there's not been a lot of widely spread use of it, at least enough to get the ROI calculations going on that. So this has mainly been around the virtual sitting, is where the discussions were around this, as well as to talk about, how do we get ROI on the AI side, how do we get the ROI on virtual nursing? These types of discussions were really the things that were going on in the symposium. But really the majority of the discussion was around, like you said, falls and stopping adverse events. Those were really, you know, the discussions that were going on. You know, healthcare institutions are highly cost conscious when they're investing in virtual care solutions, because of the fact that the expectation is that, if we're if we're going virtually right, this isn't in person. So we've got it. They've got to really prioritize those, you know, these solutions in order to really deliver a clear ROI. And so all of these hospitals really are, we're discussing how if they started with a virtual care program like virtual sitting, that's an effective way to to maximize their ROI. By doing this, then they they can rely on the one on one to one sitters for high risk patients and those things are things that really drain resource and limit staffing. So by doing that, it frees up people. It frees up resources, because one virtual safety attendant can oversee like, 16 patients simultaneously, depending on the acuity of their patient. And then that really frees up, you know, more of the unlicensed caregivers to assist at the bedside. And so you get an ROI from from the, you know, the reduction in falls and the reduction in adverse events, but also there's the reduction of one to one sitter use. And so by by using that, then you can take the funding from that, and you can use it to help fund your virtual nursing program, your AI programs that you want to roll out, things like that. And so that's a lot of the discussions was like, how do we really maximize that? Because you already get the ROI so easily from the virtual sitting program. How do you take that and now fund out the other areas that officer can help you grow in? And so there's a lot of discussion around that. There was some discussion around the class research that that came out, we were ranked number one reducing the cost of care. And so in that, in that award, they they highlighted two significant areas, and that was that we were, you know, greater than a 50% reduction in falls, and we also provided a 75% reduction of one to one sitter use. And so that's why they awarded us the that award. So that was another great thing that we were discussing. So, yeah,
Megan Antonelli 18:07 I bet congratulations. That is a great thing to discuss. I mean, you know, and I think around around that cost, tell me a little I know, you're, you're the technology. You were right there. You built it. What does it look like? How, what does it implementation look like and are, when hospitals go about implementing it, they typically are, I imagine are, you know, it's a specific use case and a, you know, a specific department, tell us what the sort of most common rollout looks like.
Toby (Walter) Eadelman 18:34 So the most common starting point that people take on it is truly about trying to reduce your one to one sitters trying to reduce falls. That's really the starting point that most people start from. We're seeing a bit of a pit. We're seeing a shift in that, and we're encouraging a shift in that to really expanding more with as you look to your program that you consider more of a device in every room, because of the opportunities for saving these falls, and that can help fund it by putting a device in every room. It also opens up the opportunity for ambient monitoring, as well as being able to provide the ability for you to do virtual care as episodic is what we call it, but it's effectively our telehealth system where you can even bring in family members, you can bring in, you know, multiple medical people remotely to be able to be involved in consults. There's lots of opportunities for that. And so all of those things together makes it so that makes sense to really consider a device in every room, instead of just our traditional, you know, mobile devices, where you would move the device to the patients. So depending on which of the types of implementations you're ready to go for as a customer, we then would work with you on the way it works out with our deployment of this is that we have a wonderful team that works. We call it our implementation team, and they come in, and we have a project managers, and we have clinical educators. We have technical deployment teams, and we work together to work not only on the cultural shift that it requires for this to be successful because of the fact that you're now handing off control to somebody virtually, and that that's a that's a big change for people that are like, we're it right. We're all alone. We have all of the responsibility to to learn how to trust, you know, the virtual safety attendance and how that will work. And so we do that. We do we also do training, not just for the people that will be using it, which, by the way, it gets used often, you know, in all departments in the hospital. But we do see it in the ED. We see it, you know, on med surg floors. We see it in a lot of different places. And so our implementation team works very closely with our clinical team, helping develop the processes and the cultural shift. Our deployment team coming on site and helping with, you know, the server installs either in the cloud or, you know, you can do it on prem, and then, of course, installing the software in the command center for the client stations. And then you also have, you know, the trainings that happen for all of the people that are going to be running it and operating it as well as we have this, what we call, kind of like an introductory service, where we actually go around with the devices and let people see them and hear them and understand what it will mean when this light comes on or when you hear this sound. We only have one alarm, actually, and that's what we call our stat alarm, and it's very unique because it's never false. And so we've, we've worked very hard to not contribute to the false alarm problems in the acute care environment. And so people know when they hear it what it means. And they come running because it's never false. There's a human behind it, and so it's, it's always, it's always right. And doesn't go up very often, but when it does, they come running, and it tends to be like a 13 second response time, so it's very fast. So once we get all of those steps done, the deployment team will either install the devices in every room, or they will, you know, set up the mobile devices for the customers, and the trainings done, the deployments done. We help them test their network together. We work on all of that together. And I like to say we don't leave until they're successful, because even at the point when the implementation team is done, our customer success team rolls in, and our customer care team rolls in, and they continue to work with them through throughout the life of that program to make sure that they they have are 100% successful, and they go after and are able to achieve the goals that they want. One other thing I'm going to add is you can start, you know, with just some basic falls, start to get that, you know, that, that ROI, but then start to, you know, bring in the AI, bring in the, you know, our episodic or our, you know, telehealth, you know, virtual nursing platform, and really expand that way. But there's not a whole lot of reason why we can't do it all in the beginning as well. So it really is. It depends on what you like and how you would like to work it, work it out and implement it. But that's kind of gives you a feel for it and how we work on that, and certainly
Megan Antonelli 23:13 what the priorities are right right now for each organization, which obviously there's a lot of them looking at, you know, virtual nursing, and how to, how to maximize that as well. So that's, that's amazing, you know? And I think, you know, obviously, you guys have been at a longer than a lot of the a lot of the others in there, so a lot of experience coming to that. I'm sure, in that, though, there's certainly challenges tell us a little bit about, you know, what you see is some of the obstacles ahead. You know, I think we came through the pandemic, and we've cut, you know, there's, there's been some, you know, accelerated advancements, and now, you know, expectations that it's there. But I know there's some regulatory challenges. There's always, you know, resource challenges. What are your customers seeing as as the biggest concern from moving forward here,
Toby (Walter) Eadelman 24:05 you know, it's, it's a great question, and not every, you know, every customer is different, but we are seeing some very specific, you know, questions that we are working to address. A lot of them have to do with AI. Truly, AI is going to be a big impact to this industry. We're a ways away from anything being truly 100% automated. And not that I don't have hopes for that technology, for the future, to be able to really provide a lot more opportunities. But at the same time, we're kind of really embracing where we're at in that AI requires human in the loop right now, and especially for what we do in the area around computer vision and ambient monitoring and ambient listening, and so it's it's really been kind of a exciting time, but a challenge. Seeing time as we work through kind of the myths around AI. And there's a lot of concern about, is AI going to replace my job, and is AI going to, you know, take over the world, and, you know, the whole Skynet thing and whatnot. And so there's, there's a lot of fears that people have around AI, and so we spend quite a bit of time discussing and addressing those, as well as the the areas of, you know, bias and being able to address all of those things. And we actually have a, we do have a patent that is pending specifically in the area of being able to anonymize our patients. And it's a pretty slick patent, and it it actually removes a lot of the bias that people are concerned about because we're it's a method of replacing the patient with something else in the room, someone else, and it's a very unique patent in the way that it does that. But the nice thing about it is it randomizes a lot of the different features of a person, and so like all colors get replaced with a random color, you know, for skin color and even body size and shape can be replaced. Whereas maintaining the posture and the poses and the way that people are standing and all of that we're able to anonymize the images so that we can use those images for the future, to be able to improve and advance, but at the same time, being able to make sure that we are protecting the patients and then anonymity. And so that's, that's, that's one of the areas, is that addressing bias. So we got some pretty cool things going on there. The other thing is infrastructure. Infrastructure is going to be a problem in the future, especially when you go, you know, device in every room, and we're transmitting just tons of data and and the having to have good infrastructure that can handle the amount of data that needs to be transferred, we're going to use a lot of processing power. If we go full AI, we're going to use a lot of storage and memory and all of these things. Right now, everybody's just starting out with AI, but as we expand, these things are really going to be consumed more and more as not just, you know, our area of AI, but the rest of the world. As we introduce more AI, this is going to be a challenge, and so finding ways to be more lightweight in the way that we do AI is significant, and that's an area that we've been working on, is trying to find the way to provide the best performance while trying to be as lightweight as possible, so that we have the least impact on the environment as possible as well. And then I'm going to squeeze one more in, and that is just the integration with other systems. You know, we've, we've had this challenge for a long time, but with AI now, there are so many opportunities that if we can integrate together, you know, we've, we've opened up our our video cameras and our audio microphones and speakers in the room by creating an open architecture that we can work with partners on so they can have access into the room for our video and our audio. And we see this as kind of another way that we can contribute to we can't solve every problem for everybody, but we can provide some of the tools that can help them be able to make and advance the technologies that really help keep people safe. So this is, this is kind of the top challenges, and kind of what we're doing around it. So,
Megan Antonelli 28:26 yeah, well, I mean, the infrastructure issue, the power computing issue, for sure, you know, I think we're seeing that, and it's, you know, and certainly the connectivity issue, right where we've, you know, we've been trying to solve interoperability for years, and now we have a totally different, you know, level where it's, you know, devices talking to the cloud, talking to the data, talking to everyone, right? So it's just getting getting harder and more complicated, but that's, you know, that's, that's the beauty of it. And I think, you know, even when you think back to the problem that you mentioned earlier, you know, in terms of hands free cellular in the car, right? It's always the unexpected consequences of the solution that maybe, or of the innovation that then create, you know, that much more innovation and need for that in the group. So, you know, I think it's great. Well, one thing we like to ask everybody is, you know, tell us. Leave us with one good thing. We like to talk. We have a, we have a segment on the show called five good things. But I'd love to hear, you know, coming out of the meeting, or even just as you look to the fall and what you guys are working on, you know, give us some, you know, what's your one good thing happening in digital health?
Toby (Walter) Eadelman 29:40 For me, the one good thing that I would say there's, there's a lot, but for me it's truly, I love to see just the advancements and all of the people coming together and collaborating on just creating ways to, you know, make these AIs work together better and be able to make people's lives better. Better and safer. And so really, that's my my one good thing is, is seeing AI and healthcare,
Megan Antonelli 30:05 yeah, it's amazing to see the progress for sure, you know. And it's exciting. And, you know, I think in healthcare, we always complain that it doesn't move fast enough, but it feels, I think finally, it's feeling like it's moving pretty fast. You know, the change is happening. I think, as you said, there's going to be some big challenges ahead in terms of, sort of managing the compute, you know, power to to what we're capable of, but you know, it will eventually bring us, you know, some significant improvements, which is great Toby, tell, tell our audience where to find you and how to get in touch.
Toby (Walter) Eadelman 30:46 Well, I'm an officer. How to get in touch. I guess you get in touch with me through LinkedIn is probably the best way to get in touch with me. And so I am there as well. I under you know Walter Toby Edelman there. So absolutely great.
Megan Antonelli 31:00 And is obvious, sure going to be at any meetings this fall or coming up as you look at at the next quarter? No, I'm
Toby (Walter) Eadelman 31:10 sure we will be. I'm not sure what they are off the top of my head. So I'll have You'll be busy
Megan Antonelli 31:14 doing, doing implementations and working with your customers. That's good. Well, thanks Toby. It's really been a pleasure to hear you know both about kind of the big takeaways at the meeting, but also, you know what avish has been working on, and you know it really, you know being a pioneer in this space and just the many applications. So thanks so much for joining us and listeners, as you've heard today, the healthcare landscape is rapidly evolving, driven by innovative technologies and visionary leaders like Toby. Remember, staying informed and adaptable is key in this dynamic field. So until next time, keep pushing the boundaries of what's possible in healthcare. I'm Megan Antonelli, and this has been digital health docs.
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