Podcast Transcript: Moving Mountains of Innovative Medicine

Moving Mountains of Innovative Medicine - Interview with Dr. Richard Zane

As Chief Innovation Officer for UCHealth, Dr. Zane is focused on the development of novel industry and venture relationships to bring innovative solutions to health care. By partnering with companies, from small start-ups to multinationals, and using the power of data science, remote monitoring and prescriptive intelligence, he is attempting to fundamentally alter and improve the way in which health care is delivered. In this podcast we look rethinking healthcare and the innovative projects Dr. Richard Zane is driving at UCHealth.

Sacha Heppell

Welcome to Who would have thought my name is Sasha Heppell, Chief Marketing Officer of SmartTab, I'd like to introduce our host Robert Niichel, our founder and CEO. With the background and leadership and management of pharmaceutical research and development, Robert founded SmartTab in 2016, combining wireless technology with pharmaceutical drug delivery, driving innovation of wireless drug delivery systems. Today, Robert will speak with a very special guest who is leading healthcare innovation at Colorado's largest health system and we will dive in to the future of effective virtual healthcare and the mountains of innovation happening at UCHealth. So with that, I'll pass it over to you, Robert, to introduce our honorable guest, Dr. Richard Zane.

Robert Niichel

Thank you, Sacha, we're in the middle of a digital transformation in healthcare. And today we are speaking with Dr. Richard Zane, Chief Innovation Officer at UCHealth Professor and Chair of Emergency Medicine at the CU School of Medicine. Dr. Zane is also an expert on emergency medical services and mass casualty response systems. So welcome Dr. Zane, welcome to the show today. Thank you for joining us. So let's start out with learning more about your background in the Boston area, Harvard Brigham and Women's Hospital, and then your progression to your role today here in Colorado.

Dr. Richard Zane

I started my career as an elementary school teacher to be perfectly candid. I went to college in Baltimore at Johns Hopkins and spent time as an elementary school teacher and football coach. I went to medical school in Philadelphia, I did training in Emergency Medicine at Johns Hopkins followed by two years on the faculty there at the School of Medicine, and then went to Boston in 1998 and stayed there until 2012. Then I came out to Colorado in 2012.

Robert Niichel

Yeah, very nice. What was the move, like from Boston, Colorado,

Dr. Richard Zane

It was far. It was remarkably interesting, it was a unique opportunity. I'm very fond of saying that it was a midlife crisis. But I've had a series of midlife crises that usually culminate in either a move or something with horsepower. It was remarkable because it really was the Wild West. And it was going from a place that was beyond the definition of established to a place that was new and up and coming. And I was asked to come and start and be the founding Chair of a new academic department at a hospital system that was just forming. University of Colorado Health or UCHealth was formed in 2012. And I was able to lead and grow in what was essentially a new organization.

Robert Niichel

Yeah, that that's wonderful, remarkable journey. Then let's talk about while you were at Brigham and Women's Hospital working as a Harvard University faculty member, you develop mass casualty and disaster care plans. These plans have been used successfully in the past for disasters, such as the Boston Marathon bombing Hurricane Katrina. The question then have these plans been used throughout the covid 19 pandemic in Boston or at the University of Colorado hospital?

Dr. Richard Zane

I think that components of the plans have most of the planning that I developed was in conjunction with AHRQ and with a company in Boston called apt associates. And these were really mass casualty planning tools and novel use of resources tools. So things like understanding your capability and capacity, how to adjudicate acuity how to postpone different types of elective procedures. And I think they've been incorporated into plans. I do not think that the plans that I developed are essentially pulled off the shelf open and said use this, but they have over time been incorporated into what is really the modern lexicon of emergency preparedness.

Robert Niichel

Yeah, very interesting. And then what does the next year look like for your team regarding COVID-19?

Dr. Richard Zane

I think that the next year, is anybody's guess, to be perfectly candid. A much of it has to do with what happens to the virus and whether it attenuates or not what herd immunity does or doesn't look like what a therapeutic is or isn't developed and whether a vaccine can be developed and then promulgated and deployed. So I think that I am very hopeful. I'm a glass 99.9%, full kind of guy. And I think that we, as a country, as a globe, and as a society have begun to understand what this virus is and what it's not, and have made inroads into how to have a normal life and really deal with this virus. Yeah, very, very interesting.

Robert Niichel

So then moving on at the CU health innovations department, you are leading many interesting projects from virtual reality to remote patient monitoring, can you tell us about some of your favorite projects that your team is working on?

Dr. Richard Zane

You know, my favorite project is really the from a very high level, discussing how you can bring intelligence and automation and technology into workflows. And that could mean everything or nothing depending on how you interpret what I said. But really, what it means is helping healthcare make better decisions, bringing data from different sources, whether it's the electronic health record, or from some type of a device that a patient is wearing, like an Apple Watch, or a BioIntelliSense BioSticker™, and thinking about how we can embed predictive and prescriptive analytics into decision making, and present a provider with more information and better guidance. And that from a high level is the most favorite thing that I'm doing. And on a micro level, it's really thinking about how we can move healthcare into the home. If we think about, you know, hospital care as a failure of outpatient care and outpatient care as a failure of primary care. How can we intervene and recognize illness before become symptomatic before it becomes permanent? And the way to do that is really, by judiciously deploying technology into people's everyday life, that will in a non creepy way, surveil and detect illness.

Robert Niichel

Yeah, very, very nice. So Dr. Zane, you've already had a very successful and accomplished career, what inspires you to keep going continuing with innovation and creating new solutions for healthcare systems that are delivered to UCHealth patients?

Dr. Richard Zane

I think that healthcare must be completely rethought. I think that the way in which healthcare has been delivered, as currently delivered, does not address the needs of patients. It really is primarily designed around the needs of healthcare and providers. And we need to do exactly what Amazon and Google have done. And think about what it is that patients need when they need it, where they need it, and how to deliver it in a way that's cost efficient and improves outcomes.

Robert Niichel

Yeah, that's a that's a very major step. So that is a very interesting answer. So the next question is, what is interesting to me, is how the systems that you have developed while in Boston and now at UCHealth have been deployed around the world. Can you comment on some of the challenges in these types of technology transfer and scale up activities?

Dr. Richard Zane

Well, you know, the, the delivery of healthcare is really people processing tools. And you can blame your tools. But it's really a pretty poor Craftsman that blames their tools. And a bad process will beat a good person, any time. So the delivery of health care is more than the technology. And it's more than just a person. It's really how you can incorporate technology and how you can incorporate and deliver in that last mile. So what is cultural adaption look like? What does change management look like? Those are the most important things and the biggest challenges. If it were all about technology, Google and Amazon, Apple and Microsoft would have solved this problem a decade ago. It's not about technology. It's about people. And it's about processes. And it's about being able to judiciously adapt and learn and create a learning environment.

Robert Niichel

Yeah, that's very nice. Very nice. And then moving on to one of your major projects as Chief Innovation Officer, the Virtual Health Center at UCHealth, can you tell us in more detail about the virtual health center?

Dr. Richard Zane

So the virtual Health Center is really a nondescript building, about two miles from campus that when you walk in, looks like NORAD or whatever this generation believes NORAD looks like sort of air traffic control. And what we've attempted to do is build silos of competencies across different spectrums and then essentially meld those silos together so that we can care both in a synchronous and asynchronous manner for the sickest of the sick to patients who have not yet become sick or not yet become symptomatic. So when you think about health care, health care can be in person, or it can be virtual, much like what we're doing now. It can be synchronous, or it can be asynchronous. So how do we take healthcare and not simply have it be a silo, which means in order to do A, B, or C, you must go to your doctor's office to do D or E, you have to have a test? How do we have the deconstruction of these different silos and traditional approaches to healthcare be melded together. So that is what we have attempted to do in the Virtual Health Center, I lament the term virtual health and tele-health because it's actual care. It's not virtual care. It's simply technology enabled or digitally enabled actual care. And that's what we're trying to do at the Virtual Health Center is bring remote patient monitoring, device integration into the workflow of providers, and most importantly, into the lives of patients in a way that they want it in their lives, being able to make better decisions in a timely manner that impact their lives.

Robert Niichel

Yeah, very nice. Very nice. So then, where do you see, what are your goals for the center, say, in 10 years? Just maybe in terms of numbers, or how many patients are treated with care, using these digital platforms? How does that roll out into Colorado in the next, say, 10 years.

Dr. Richard Zane

So in 10 years, I hope that every single patient, for every single encounter has a component of virtual care, whether it's 100%, or 1%. Technology and the virtualization of care will be embedded and woven into every single patient encounter every single decision.

Robert Niichel

Very nice, very nice. So let's move on to more of the Colorado landscape. So let's talk about we have many healthcare startups in Colorado. Some are part of the StartUp Health portfolio. Many of these companies aren't healthcare moonshots dedicated to bringing novel Patient Centered solutions to healthcare. How do you envision these startup companies throughout Colorado, with many of them in the catalyst health tech innovation center in Denver, working and partnering with larger healthcare systems, such as yours to accomplish these advancements in patient care?

Dr. Richard Zane

I think that for startups to be successful, especially in healthcare, there has to be a pragmatic understanding of how healthcare is delivered. And there has to be an understanding that, it's just a little bit different, meaning, it takes just a little bit longer. Conversely, healthcare has to understand that startups can't simply wait the nine years that it usually takes to embed and change and healthcare, because that is just not the pace of startups. So what I hope and what I advise startups is to understand the problem, don't have a preconceived notion of what problem you're trying to solve, until you've seen the problem, understand it, and worked with patients and providers to understand what a possible solution would be. Because if you come to me with a solution to a problem that you believe exists, and I don't believe exist, it doesn't matter how sophisticated or how slick you are, I don't really have time for you. But if you work with me and say, What are the big things that challenge healthcare that challenge your patients and challenge your providers, and think about what piece of it, you believe you can help us solve and work with us side by side, you are going to be successful.

Robert Niichel

Yeah, very interesting. And then as these companies grow, the bigger companies grow. What does that mean for Colorado as a hub for healthcare innovation.

Dr. Richard Zane

Colorado is now becoming a destination for digital health, there will always be Palo Alto, and there, they'll always be the Boston Cambridge tech area. But I think Colorado, specifically Denver is nipping at their heels. And, you know, in the last few years, Colorado has been number three for investments, venture capital investments in digital health, in the number of startups and the number of established tech companies that are coming to Colorado just increase every single year, whether it's, you know, two girls in a garage in Palo Alto, who moved their company here, to Google and Apple and, you know, big companies, I think that it is becoming a self fulfilling prophecy.

Robert Niichel

Yeah, very nice. And then the next question is, as you look at and evaluate, you know, yourself as you lead new projects at the University of Colorado, what's next?

Dr. Richard Zane

I think that, and I say this frequently, if it were easy, it would have been done already. And if it just took money Google would have bought it. So it's not easy and it's more than just Money. So the next big thing is going to be how we can incorporate different sources of what are obscure data elements and allow them to be ingested and develop predictive and prescriptive analytics. So essentially AI, for lack of a better term, but right now, there are different data sources, right? There are things that are available in the electronic health record discrete data elements that are germane to you, you know, what is your blood count? How old are you? Do you have a family history of diabetes, then there are data elements that we can obtain from your insurance company, which is really claims based data, which is not particularly sophisticated, not particularly sharp, but is useful, then there are other data like omics data? What does it mean, when your genome is sequenced in a certain way? What are the different proteins in your body mean? What does ohmic data look like? What does physiologic data look like? What does that Apple Watch you're wearing? What does it mean? When your heart rate goes up or down? When you climb stairs? What does it mean, when you have two hours of REM sleep? Instead of six hours of REM sleep? What does it mean, when you have two hours of REM sleep? You have claims data that shows that you utilize urgent care more than other people, and your genome says one thing and your you know, blood count is another and then what if we combine it with everything else? So the other kinds of data, what does it mean when you spend four hours a day searching for you know anti-diarrheals or searching for rash medications? One of the early projects and bioterrorism we looked at was, can we look at supply chain for pharmacies, when people buy more anti-diarrheals? Is that gonna predict some type of bio terror event. But we can do the same thing with other forms of data now, the most important confounding variable to predict how many readmissions you're going to have for heart failure is what your credit score is. So can we identify those other data forms? Can we put them all together? And can we build analytics to help us make better decisions? That's the next big thing.

Robert Niichel

Yeah, that's very progressive. That's very interesting. And then Dr. Zane, where can people follow your activities, and then connect with you as well.

Dr. Richard Zane

I'm on LinkedIn, on Twitter. And then we have the UCHealth CARE Innovation website, which has a direct link if you'd like to communicate with us or you'd like to collaborate.

Robert Niichel

Very nice. Well, that's really the, you know, set of questions that we had here. We'll go ahead and wrap up and say thank you for your hard work and ongoing efforts with all the innovation that you and your team are doing in the healthcare industry. I wish you all the best in your upcoming journeys and endeavors. And we're really looking forward to keeping up with all the initiatives that you're leading at UC health. So today, thank you again, Dr. Zane, and good luck.

Dr. Richard Zane

My pleasure. Thanks for having me.

UCHealth CARE Innovation Center:
https://www.uchealth.org/innovation

Connect with Dr. Richard Zane on LinkedIn:
https://www.linkedin.com/in/richard-zane-md-9b87b5a/