Discover how innovative contactless remote patient monitoring (RPM) platforms are transforming healthcare delivery. These cutting-edge, FDA-cleared medical devices accurately monitor vital signs such as heart rate, respiratory rate, and patient behavior without the need for physical contact, providing a seamless and stress-free experience for both patients and medical staff.
Joe Zaccaria, VP Strategy & Finance, Neteera
Megan Antonelli, Chief Executive Officer, HealthIMPACT
[00:00:00 ] VO: 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.
[00:00:30] Megan Antonelli: Hi. This is Megan Antonelli with health impact live and today we have a very special guest joining us. Joe Zakaria is the Vice President of Strategy finance at nutara, a leading company in contactless remote patient monitoring and a health impact partner, Joe has been with nutera since 2018 bringing his expertise and passion for revolutionizing healthcare delivery through innovative technology, remote patient monitoring offers a revolutionary approach to healthcare and enables continuous and real time monitoring of patients vital signs and health parameters beyond traditional clinical settings. Neteera is at the forefront of this transformation. A graduate of the Johns Hopkins University, Joe earned his BA in Political Science and was member of the varsity baseball team, no doubt, showcasing his dedication and teamwork skills, both on and off the field. Growing up in Long Island, Joe developed a strong sense of community and a desire to make a positive impact on people's lives. This led him to pursue a career in healthcare where he could combine his business acumen with his commitment to improving patient outcomes. So let's dive in and learn a little bit more about the future of patient care in the digital health era where RPM is set to play a pivotal role in enhancing the quality and accessibility of healthcare services. Hi, Joe, welcome to the show.
[00:01:48 ] Joe Zaccaria: Megan, thanks for having us. I really appreciate it.
[00:01:50 ] Megan Antonelli: Yeah, absolutely. Well, it's been great to finally get to know you and learn about your your background. You know an East Coast girl myself so you know, love Long Island and, you know, sort of the Baltimore area. Tell us a little bit about nutara and the, you know, the RPM platform, and how it's different from the traditional remote mon itoring solutions.
[00:02:15] Joe Zaccaria: Yeah. So, you know, we're, as you know, an Israeli company, and I think one of the things that we try to pride ourselves on is taking non traditional technologies and applying them to markets and opportunities where we think we can deliver change. You know, when we set out on this journey, we realized that there was this big gap. We called it the digital to analog gap, where the body is an analog being, but there was so much opportunity to do things digitally speaking, but we had to figure out how to connect those two seamlessly. So we set out on, you know, a technology that we know well in the sensor market, and we tried to pair it and deliver it as a platform, right? So something that you can start with but grow with, and it sort of allows you to take on, you know, newer technologies, newer capabilities, and deliver care in a non traditional way. You know, for us, the contactless nature was really key. We sort of had this, this thought that if you had to remember to wear it or charge it or bring it somewhere, ultimately you couldn't rely on it, so we set out with that in mind, and we needed to be able to deliver clinical grade information in order for it really to get an adoption in that space. I think some of the things that we tried to make sure was that it didn't require any specific activities by the patient or the clinicians to get the information we needed. You know, some of some of the other technologies out there require people to sit still, or they require them to wear something, or they require them to have a special clothing, or be in a particular area. We wanted to be as dynamic as possible, you know. So it was a real life situation where people had the opportunity to really get the most out of the technology.
[00:04:03] Megan Antonelli: Yeah, well, that's great. I think, you know, you think of when you're in a hospital setting, and how often you're kind of disturbed to to to get your get those vitals checked. So tell us a little bit in terms of for the patients. You know, I guess that's one key benefit of being contactless. What about nurses in the hospital, the healthcare facilities themselves? What are some of those key benefits?
[00:04:28] Joe Zaccaria: I think the first one that typically comes to mind is, you know, people can't have eyes and ears everywhere. So what we wanted to do was, and we call it a DNA right? A digital nursing assistant, something that is kind of eyes and ears in a patient's room that allows the staff to be able to have peace of mind that while they're treating somebody else or taking care of somebody, that everybody else is okay, and if something changes, they have the opportunity to be reactive on it. And I think that you. That, that workflow where it's out of sight, out of mind, but also, you know, it's there for you, and you can rely on and trust on it, because of the certifications and the FDA qualifications that we've gone through, really just gives a peace of mind in the care
[00:05:17] Megan Antonelli: Tell me a little bit more about what that looks like. I mean, if you're a nurse sitting at the, you know, sitting at the command center, or, you know, where they're monitoring it. How does that, you know, interplay with their work workflow?
[00:05:28] Joe Zaccaria: Yeah, so, you know, I think one of the things we thought early on was that we had to deliver the information we had where the clinicians were accustomed to getting it. That's typically in an EHR. It's typically in a dashboard setting that they they may have at the nurse's station, or they may, you know, the newer models are also some some central command where there's a group of people that are kind of the the eyes and ears across the entire organization. So our thought process was, look, early on, people are going to be hesitant to go through this adoption into the EHR system. It's a it's a cumbersome lift. So we're going to create a dashboard, we're going to create a workflow, we're going to allow them to use our technology. But what we see is that we start there, and ultimately we evolve and deliver that data into an EHR or into a command center, where they can get more out of it, because it's where they live and breathe on a daily basis with their with their patients, right?
[00:06:24] Megan Antonelli: That makes a lot of sense. And certainly, you know, we hear about, you know, there's applications and the integration with EHR and how important that is. What about from the, you know, workflow, you know, for burnout, for health systems that are looking at their clinicians who are getting, you know, so many notifications. What does that look like? How are they? How are they getting the information within that platform that they're already in?
[00:06:50] Joe Zaccaria: Yeah, so alert fatigue is something I think we very early on, recognize that if we're just another beeping device, nobody's going to want this in their facility. It's not going to matter how helpful it is. We need to deliver actionable things that nurses could trust. And if the alarm went off, they attended to it, because otherwise they would just, you know, hit the ignore button, and then then it really doesn't do what it it needs to do. We again, we can deliver this in any way, shape or form. If you're using our dashboard. There's an audio and visual effect on the dashboard to show that Mr. Jones in room 200 needs attention. But at the same time, if it's coming through an epic platform where they were getting an alert system, then we can deliver it there. The goal is ultimately to get the information that's needed to the clinician, where they are, where they're accustomed to using it, without having to do something specific to natira and the way, you know, we think that the business should be done, right?
[00:07:50] Megan Antonelli: Amazing. So, and we've heard a lot lately about, you know, cyber security with the recent change in, you know, incident and and things tell us a little bit about, you know, how that data is moving from place to place, where you know, and how you guys are protecting patient privacy and data security?
[00:08:08] Joe Zaccaria: Yeah, so, you know, it's interesting, because normally when you think about patient privacy, you think about the in the hospital piece of the privacy, and that's core to what we do, right? There's no cameras in our system. There's no microphones in our system. It's a sensor that's measuring movements of the body. So inherently, the device is designed to be respectful of patient privacy. They can change. They can have, you know, they can be eating, they can practice religious things. There's nothing that they have to worry about from a behavioral aspect, because our sensor is not watching them, right? It's monitoring their movements. But to your earlier point about cybersecurity, in order to make our data as smart as possible, we have to use it in a way where we're processing it and getting extracting the most out of it. And we actually cybersecurity is something we try to differentiate ourselves from some of the competitors we have. We don't send any phi up to be processed, right? It's just a raw signal that we send up there. It's all encrypted. There's multi factor authentication. We're working with some really novel cybersecurity players on rights access and certain things to make sure that the people who are using the data and getting access to the data are, in fact, only the people that are supposed to have it. So we take that very, very seriously. Neteera,
[00:09:31] Megan Antonelli: That's great, and that's it gets into the privacy piece is really interesting to me. We've heard, you know, we're hearing a lot as now, you know, AI is being implemented and used by health systems. And there's a lot of discussion about, you know, where does the patient get a choice? You know, you don't give the patient a choice to say, you know, we're going to use a striker device versus a you know, but now we're getting into this discussion, and certainly we've seen it with Alexa, right? Alexa's in the room and some, do you want them off? Do you want them off? Yawn, giving people. Decision, you know, decision points, and you know, where does that come in to this? And do you have any thoughts, and have you, have you guys gone through that process in terms of that, or is it because it's a, you know, a monitoring device and, and, and not, you know, filming the patient, that some of that sensitivity is already managed?
[00:10:21] Joe Zaccaria : We typically the customers that we have, whether they be hospital partners or long term care, they typically have a designed process for that right to your earlier point. You don't get to choose whether you have a GE, you know, or a Baxter infusion or a striker or a Medtronic. It's the device that the hospital has chosen to use in the long term care setting, because typically, these are people's homes, to a certain degree, it's a different element there. But what we found is that once they understand that this is not recording them, and this is there to help the staff, and you know, for them to get interrupted less often and not get woken up in the night time or things like that. The families are really excited about it. The patients ultimately get very excited about it. But it's, it's really, you know, it's, it's a medical tool, it's a medical device, and it's intended to be used just like your traditional bedside monitoring devices, just a little bit easier, you know, for everybody involved, because of the passive nature of it, right?
[00:11:24] Megan Antonelli: So ultimately, certainly, in that setting, in long term care, it's a, you know, it's a patient value, right? I mean, they, they appreciate it. It's less work for them. It's less work for their caretaker. So that that benefit far outweighs the discussion.
[00:11:38] Joe Zaccaria: The other cool thing, which we we sort of, I don't want to say, stumbled upon, but we realized early on, is there's a lot of behavioral elements that our system catches just by virtue of how many times did somebody get out of bed or have they rolled over? Do they need to be moved by a nurse to avoid a pressure ulcer? Did they get up five times in the middle of the night to use the bathroom, maybe they have a UTI infection that nobody knows about. So we've actually found that there's some behavioral elements that we didn't even kind of design the system to be looking for, but once we realized that they were there, we then layer on our algorithms and our knowledge of sort of the patient bedside mannerisms, to get more informed information and paint that holistic picture, which is ultimately what we're trying to get to anyway, right? We're trying to get to a holistic patient view, where we're being proactive in the care, instead of reactive in the care, and giving, you know, clinicians and caregivers insights that they may have not already had, and things they had to ask and pry for are now kind of delivered to them, because it's being captured contactlessly,
[00:12:48] Megan Antonelli: right? So I mean, in talking about that, and in that holistic view, in terms of how the tool you know, obviously in a in an acute setting where you know something is needs to be managed right away, and the physicians and clinicians are alerted that value add is there. It's and other things that are more cumbersome for the patient, but from a more holistic view and a long term view, what are some of the, you know, values or benefits of the tool from that perspective?
[00:13:20] Joe Zaccaria: Yeah,so you know, to that point, we've designed it to sort of work in two ways, right? It's that long term patient view, what's happening day over day, week over week, month over month, what's happening from a baseline perspective is their resting heart rate gradually increasing. Is something going on? Is there? Their breathing becoming more laborious, that those subtle things that you don't pick up on on a week by week basis or a month by month basis, are typically indicative of something changing in the body. You know the body, if you got a fever, right, your underlying vital signs are going to change. So these are things that you may not pick up on acutely to your point, because it's happening gradually. But there are changes that need to be identified on the flip side, if something happens very fast, you want to know. And the alert mechanisms that we've designed work both ways, right? So we have absolute thresholds that doctors can set to say if their heart rate crosses 140 I want to know. If it falls below 50, I want to know. But at the same time, if their heart rate goes from, you know, 85 to 95 well, maybe that's just because they moved over, or they slid up and they got back from the bathroom. Like, we don't want to trigger something that's a change off of their baseline if it's in line with the expected behaviors. So we've designed the system to work both ways. Right? It learns the baseline, it establishes it so we're not triggering alerts that are not actionable and meaningful. But at the same time, there's that safety mechanism of if something happens, we know that we can act on it.
[00:14:52] Megan Antonelli: Great. Yeah, that makes total sense. What about from the patient side? Are they able to see the information? Information. Do they have access to to the information?
[00:15:02] Joe Zaccaria: Again, it really depends. I mean, I think a lot of people, you know, do you wear a smartwatch or, you know, I have an Apple Watch on? I think I like to look at the long term trends to see where I'm going from a health perspective. But sometimes the data is a little bit overwhelming. You don't really know what to do with it. So we give the customers the option to, you know, have the data shareable with the customers or the patients, but it's not something we actively push. Because I think the population we're trying to serve is not necessarily looking for that level of detail, but it's there if they if they want it. And I think, you know, as we move towards aging at home and hospital at home and home care and shortening hospital stays using this kind of technology. Ultimately, we want to be able to deliver that data to them in that manner, because that's going to be they're not going to have the clinical, clinical oversight on a day to day basis, but they're going to want to know what's going on, right?
[00:15:57] Megan Antonelli: Yeah, no, absolutely I have. I mean, I have all the devices. I have my Apple Watch and my aura ring, and it is, I mean, the the ring, I think, has been one of the more impactful, you know, knowledge. But yes, again, it's like monitoring health and and, and versus when you're monitoring when you're sick, it's, you know, you're looking for different indicators, and it's a different window, right?
[00:16:18] Joe Zaccaria: And so I, I would be willing to bet that the information that's most valuable out of your aura ring is probably what you get overnight and because you're not wearing your Apple Watch. And the cool thing about our technology, right is it's monitoring you while you're sleeping, and it's monitoring you when you're in the location where you typically are. So what that does is it removes a whole host of variables, and it allows you to really drill down to what is fundamentally going on at a baseline level, and then seeing where that change happens. And I think that's really where we try to be different, you know, from the competitors in the space.
[00:16:53] Megan Antonelli: Mm, hmm, that's great. Well, let's talk a little bit about about that and and sort of some of the, you know, maybe share with me a little bit of the of the case studies of where you've where you've been implemented, and some of the value propositions that have happened there.
[00:17:08] Joe Zaccaria: Yeah, so we all operate in three distinct arenas today, right? The hospital environment, in a in your typical nursing environment, a med surge, a step down, something like that, and that's where, you know, we don't see as many of the outcomes, because they're acted on early. And folks get to they get the care they need early on. It's that proactive versus reactive care that we touched on a little bit earlier. But in long term care, you know, we're really seeing these, these facilities are typically they don't have something before that we're replacing this is a new tool for them, and that's where we're seeing some of the most dramatic impact. It's what do we not know that we now know that we can act on and one of our largest customers and US did a study over a period of two months at six locations, and we delivered 174 you know, actionable alerts in that time, and 163 of them were able to be treated in place. So it's a 94 ish percent treat in place ratio, which is, I think, if you were to go to most operators the long term care and you told them we had the opportunity to keep, you know, 90 plus percent of their patients in in the facility, they'd be like, show me where to sign. It's it's not only good for the facility, it's good for the families, it's good for the patients. It's good for the bottom line. It's really it. It's a it's a cyclical impact across the organization. And then we actually we do some cool work in the drug and alcohol rehab arena, and this is an area we didn't really know a whole lot about going into, but we had a wonderful team that we worked with on site to really understand the nuances of their needs. And we've had a couple of instances where they have told us flat out, we would have lost this person if we didn't have the information you know, you guys provided us. And one that always comes to mind is something that I had never heard of before, which is acute encephalitis. They had a patient who was was kind of walking around and a little bit dazed, and they weren't sure what was going on. And then he got back into his bed, and they saw a pretty significant spike in his respiratory rate and a drop in his heart rate. And they went to check on him, and he really wasn't doing well, so they rushed into the hospital, and he ended up being diagnosed with this acute encephalitis, which is, if I'm not mistaken, a liver related disease. And they told us, if we hadn't known this in 30 minutes, you probably would have died. So there's, again, it's just this, this cute, acute, actionable information, and also these long term trends which people otherwise wouldn't have had access to,
[00:19:50] Megan Antonelli: right, particularly in that, in that long term care setting, the rehab setting, for sure. So tell me, I mean in terms of, you know, the challenges, right? I mean, there, you know, we like to kind of move beyond the hype of all these, of all these technologies, and look at like, where are, you know, when you're a health system, when you're a long term care facility, and you're looking at implementing these tools, what are the challenges that they should be aware of as they set forth into it? And, you know, how do they avoid those? You know, what could be, you know, sort of bottlenecks or barriers to implementation and adoption.
[00:20:29] Joe Zaccaria: I think it goes back to education, patient education, staff education, and just education of folks in the various facilities, like I said, specifically in long term care that you know, these are environments where they haven't had this type of insight before, and staff is a little bit weary about, what is the oversight? Is this something that you know they're going to be checking on me about? So it's really early education to get the staff accustomed to, what is this technology? What does it do? What does it not do? And the other interesting thing that we we found over time is especially in long term care, a lot of these people, this is their home. This is where they they live. This is where their family comes and visits them that, you know, there's, there's pictures of their grandkids on the wall, but the staff becomes their second family, right? So these are the people they trust and they look up to. So educating the staff to help give a level of comfort to the patients, which then translates to the families, allows that cyclical information where you get the data you want, you trust the data you want. You trust that this is there for your benefit and not a watchful eye, that you know someone's going to say, Well, you didn't do this, or you didn't do that. We're there to help. And in order to do that, we need to get everybody on board and understanding of that. That's really the biggest thing. I think the technology and the outcomes speak for themselves. It's just getting a non traditional technology in a non traditional environment, and people to just, you know, be okay with it.
[00:22:04] Megan Antonelli: Yeah, it, you know, I mean, people in healthcare, particularly, you know, there's that resistance to change and risk and and, you know, rightfully so. But it is, you know, it is funny that in this where that it is a tool, it's just, you know, no one ever questions whether or not you're going to use a stethoscope, you know, yeah, and yeah, and this is just a new way of doing it, and it's an, you know, new, innovative, novel way of doing it better, faster, hopefully even cheaper. You know,
[00:22:34] Joe Zaccaria: definitely cheaper, definitely cheaper,
[00:22:37] Megan Antonelli: you know. So it is. It's interesting that way. Well, let's think about that. So as they come and they, you know, they do get that education, and they do the implementation, what does this look like as we move forward into the future? You know, what is the the new, next smart hospital look like? What does, what does patient care with remote patient monitoring look like?
[00:22:59] Joe Zaccaria: From our perspective? We really want to see this, this shift to proactive care, identifying things earlier, intervening earlier, having less adverse outcomes, less readmissions. We want it to be a tool where the information that comes out you trust, the care you are able to then provide is at a lower cost and less burdensome to the to the patients. And then I think ultimately, what we believe is going to happen is the level of trust that's created from the system with the clinicians and the reduced adverse outcomes are going to give the facilities and the payers the comfort to send people home earlier or keep them home in certain instances. So we want to see shorter hospital stays. We want to see hospital at home. We want to see better telehealth products, right things, where we can say we have this cool device, we trust it, we know it's accurate. We're going to deliver care where the patient is. So it's less costly to the institutions, and it's less burdensome to the patients who need the care. And if you even think about like rural settings, right? This is the ultimate tool for a rural setting, because sometimes you could be two or three hours from a clinic, and you may not even need to go there. So there's this opportunity to really shift where the care is administered, but also where the monitoring takes place, and that the more you know you don't want to be in hospital. You'd rather be at home, right? There's the TV's better, the food's better, the bed's better. You want to get into the environment you're most comfortable. That allows you to get better quicker, but it also gives people the ability to understand what's going on and do we need to intervene? So I think you'll see that shift out of the out of the institutions and into the home, driven by the technology and the workflow enhancements that come with tech like ours.
[00:24:49] Megan Antonelli: Yeah, no. I mean, it really is. It's an amazing thing to think about as people want to be at home. I think I was, I was just reading Susanna Fox book about rebel health and. She talks in it about, you know, how, in the beginning, you know, as hospitals started, you know, people were still sort of passing, dying at home. Then for years, it was all in the hospital. And now it's shifting. People don't want to be in the hospital, even at their end of life care. And, you know, and then I also think about, you know, from a, from the Children's, you know, pediatric perspective, too. I mean, I happen to have a sister who has a young baby, and, you know, they're sending them home now with these, you know, sort of monitors for RSV, and she's very nervous about it. And they're great, you know. But they don't, they make you a bit more, you know, hyper vigilant about that. But they want that, you know, but I, I'm at this point where I'd like a radar device in our home to measure the child. So I know. So, so it's, it's an interesting thing where you go from not only for the chronically ill, but for the healthy, there's a value to having these, these tools. And we, you know, from a consumer perspective, are paying to put them on our hands regularly. So it is an interesting thing to think about the future state where that is monitored continuously, and what that would mean.
[00:26:07] Joe Zaccaria: You know, anecdotally, we've been approached by a couple people in the pediatric world, particularly in like the NICU settings or the PICU settings, where, you know, the first the work that those, those people do, they're, they're, they're like the true miracle workers of all miracle workers, there's a calm about them when, when you meet them, that's really remarkable. But what, what we're finding there is that the little guys that are in that setting, it's, you know, it's traumatic for everybody, but when they get better, and when they get home, all of a sudden there's, there's nothing, right? You're used to having these, this watchful eye, whether it be staff or technologies or cameras on on the children. And then when they go home, you all of a sudden don't have that, right? It's, it's getting up in the middle of night. Are they breathing? I have two little ones, and I remember for each of them. There were times where they were sick, where my wife and I would get up in the middle of the night and walk in there just to just make sure, you know, put your hand on their chest. But this, this can
[00:27:09] Megan Antonelli: mine are 13 and 19, and I still do it,
[00:27:13] Joe Zaccaria: probably for different reasons, but it's sort of that intermediary where, you know, they no longer need an EKG all the time, but would you want to know that everything is stable, and if something does change, you have the ability to intervene? And I think that's where we are in that little sweet spot where we don't over, we don't give you too much information if you don't need it, but you're not blind, and it's really it's a cool dynamic to be able to deploy something so easily and so seamlessly that is dynamic and meant to grow and meant to be a platform, and meant to layer on new features and behavioral aspects that really is a I'm really, really excited for where we're going this and what the capabilities that we have in our back pocket are.
[00:27:59] Megan Antonelli: Yeah, well, that's amazing me, too, me too. It's exciting to see, and it's, it's awesome just to see, you know, finally, you know, we've been at this for a long time, technology and healthcare, and it is, you know, there's some real patient patient centric technologies that are going to change. You know, the the patient experience that you know both will have better health outcomes and better experience for the patient. So tell me a little bit, just in terms of, you know, as you talk to your customers, what advice would you give to them as they seek this out, you know, as they know, this is a great technology. We want to have it. How do I get, you know, how do I get the you know, champions within my organization to actually move on it.
[00:28:42] Joe Zaccaria: I think, you know, like anything else, you have to figure out what drives decisions in an organization. It's going to be a combination of getting the clinical team to to want something new and different, to deliver care differently. It's going to be to get the, you know, the finance team, to understand the cost reduction that can be associated, not only with the product itself versus a traditional monitoring device, but also what is the outcome? What are the outcomes? You know, are we reducing hospitalizations? Are we getting less ER visits? And that all factors into the scoring that that drives the, you know, the finances behind the organization itself. So I think, sort of the way our technology is is holistic. I think the holistic view at an organizational level of understanding that it can touch all different elements workflow, so staff burnout reduce, you know, getting nurses to back to working, back at top of license and and, you know, being by the bedside and talking with people, instead of just taking vital signs and getting to know them, getting the numbers in terms of readmissions and er trips down, and then also reducing costs. We're an environment where the cost of healthcare is skyrocketing, yet the quality of the care. Sometimes is going the other direction. So we're trying to thread that needle where we can deliver better care to more people, impact workflow and drive results on the bottom line,
[00:30:11] Megan Antonelli: Amazing. Well, I think that's all. That's all great. And I think all good reason to reach out and find out more and learn more. So tell us a little bit about how our audience can can reach you and reach the team at Neteera.
[00:30:24] Joe Zaccaria: Yeah. So neteera.com you can typically find links to get in touch with us. I'm available by email. You can, I'll share with you. You can put it in the show notes, and the folks can reach out to us, come visit us at conferences and various activities. We're happy to talk about it. We love what we're building, and we're excited for the future.
[00:30:44] Megan Antonelli: Yes, indeed, you guys will be at health impact in June, and I look forward to it. So thank you, Joe for sharing your valuable insights and telling us about the great work Neteera is doing, and thank you for joining us on health impact live.
[00:30:58] VO: Thank you for joining us for this week's health impacts digital health talk don't miss another podcast. Subscribe at digitalhealthtalks.com and to join us at our next face to face event. Visit healthimpactlive.com.