- I forgot that I have a ...
- Oh, you have a ...
Good!
- Yeah, it's always good to bring that with us.
Fits right there.
- All right, I think we'll get started.
- Boot it up.
- [Presenter] Good afternoon, everyone.
Thanks for coming.
This is the final lecture of our Sandbulte Ethics Series
for this academic year.
And I think that we're in for a treat.
I've known Mat for a couple of years
and he is dynamic and innovative and creative
and I think that we'll all learn a lot
from the following session.
It's my pleasure to introduce to you
Mat Johnson, CEO and founder of GeaCom
and inventor of Phrazer.
(applause)
Minnesota Business wrote the following about Phrazer;
Much tragedy in the world occurs because
good medical care isn't provided to those that need.
Often because of simple communication issues.
Even if doctors are at hand, they might be
prevented by language and cultural barriers
from understanding problems and
picking up on important cues.
Phrazer acts as a translator, record keeper
and overall communication enhancer
between patients and doctors who may lack
a common language or background.
I'm excited to hear that story.
The Sandbulte Center for Ethical Leadership
is dedicated to fostering robust discussions
of ethics and their applications in the Duluth community.
Matt is a great resource for all of us
that ask questions about ethics in entrepreneurship,
technology and healthcare.
And Matt's set aside half of this session
to ask questions so be thinking about them
and I'll look forward to a great dialogue.
Thank you Matt.
- [Mat] Thanks.
So the microphone good?
Everybody can hear okay?
Alright.
Okay well I hope this isn't too loud
it sounds echo-ey.
So as you can see I'm manager.
I'll tell you a little bit about GeaCom.
The name of the company is GeaCom.
We make the product Phrazer.
It was recognized with the Minnesota Cup
as best technology in the state of Minnesota,
the Tekne Award, several international awards
including the Edison Award for
best medical device in the world.
So I think we would be the first Duluth company
to receive any of these awards much less
big brad holders that we've had.
So it's been able to bring a lot of attention
to this space and this market and
when I look at your speakers in the past,
I see a lot of people who, they inherited
a leadership job at a company.
And looking at what I might be able to offer
in conversation and I think, a uniqueness,
might be the fact that I was able to found this company,
develop this company in this community
and grow this company to an international player
here in Duluth.
So there's a lot of things that
are different starting from square one
and we'll talk briefly about those.
And some of the things, as I get to the tail end
of the presentation, that I'll offer up
in areas of conversations, are the challenges,
the ethical challenges around funding, around patenting.
You know, what is it to own an idea?
And idea that's ultimately vital to peoples' health.
Is it fair to own that idea?
When you design, do you choose to design
with use of third-world countries?
Is that a good idea?
Is it okay to have a communist country
manufacture for you if they don't have
decent labor laws?
There are .. I mean it's just rife with dilemmas
and ethics as you go through this whole decision process.
Do you want to offshore anywhere?
Are you gonna co-locate in another country?
When you choose to sell your products at price rates,
are you gonna make those price rates adjust
according to the companies economic ... or the
countries economics that you're dealing with?
If you're trying to sell into a country
that has social medicine versus a capitalist country.
So I mean I could go on and on
when I thought about this topic,
there was just no end to the ethical challenges
that faced us at every turn.
So what I can do is start off
by sharing with you a little bit more context
of what I'm talking about.
A little bit more about who I am
and what we do.
How we got to where we are and then
get into the questions that come back
to the slide that we're seeing right here.
So I'm gonna start with a video that
one of our suppliers made for us.
It should give us a good look at ...
About a four-minute view.
- [Video Narrator] Today's busy healthcare environment
demands caregivers response quickly,
accurately, and equally to the increasing needs
of all patients.
For language barriers, lack of time
and cultural differences can become road blocks
to equal care ... until now.
Meet Phrazer.
An intuitive, world-first medical solution.
The ability to effectively and accurately
communicate between patients and providers
is a challenge that has existed for quite some time.
Phrazer is really the first example
of a device that can be handed to a patient
upon that patient's arrival
and it intuitively gages that patient
and gives him or her the ability
to give the treating provider accurate,
real-time information.
Phrazer can interact in any language
from Somali to Thai to Mal,
to American sign language.
Phrazer is able to work with 98%
of the people on the planet earth
in their own language, in their own culture
and provide better outcomes 100% of the time.
The breakthrough methodologies are so intuitive,
even the most disenfranchised patients
find Phrazer a great conduit to equal care.
I had personally used it with four-year-olds
who had no difficulty interacting
and completing the protocols entirely.
It is exciting to see what the device is capable of doing.
It's interactive, it's intuitive,
and they really have very little difficulty
navigating their way through use of the device
which is wonderful.
Caregivers can target any number of topics like;
emergency triage, chest pain, healthcare screeners
or a variety of patient education.
Patients interact in their native language
guided by culturally relevant caregivers
with cultural sensitivities.
(patient speaking in native tongue)
- [Phrazer] The patient consents to treatment.
- [Video Narrator] And Phrazer's usefulness
goes far beyond conventional medicine.
The device provides a critical bridge
across the language gaps in disaster relief operations,
military applications, and other types
of emergency care.
Phrazer has provided the first method
to ensure that you get 99.9% accuracy
in spite of language or regional backgrounds.
And in spite of this specific challenge.
Phrazer is the flagship product of GeaCom Incorporated,
a company dedicated to improving
healthcare for all patients.
When GeaCom needed support designing the one-of-a-kind
solution to meet the stringent privacy,
safety and stability standards of the medical industry,
their engineers turned to Micron,
a leader in memory and storage solutions.
When looking for partners to collaborate with us,
we had to find companies that are very innovative
and be willing to provide us with technology
and equipment that would suit our very particular situation.
From design to collaboration to work based on Micron
has been incredibly positive for the growth
of Phrazer technology.
For the confidence in our ability
to know whether we can meet market needs,
and for the confidence that, as we go forward,
we'll always have a strong partner
and be sure that the technology
required for better patient outcomes
is available to us.
Micron's team of experts worked with Phrazer to develop
unique solutions and enhance key elements in the driver,
including an SD card that handles
highly encrypted backup data.
The high speed band and RAM chips for processing
thousands of computations in real time
and the M-SATA M600 solid state drive,
encrypted with military grade encoding
for maximum data security and reliability.
These parts are used in all kinds of environments.
They're used in hospitals, they're used in critical care,
and it's really important that Micron provide
a technology and a platform that our customers,
a medical team in this case,
can feel really good about
and build it into their end product.
And it's truly gratifying for our team
to know that we are at a level where we can support
a product that is critical to patient care,
like Phrazer is.
The Federal Government mandates
healthcare providers offer equal care
to all patients regardless of race or nationality.
That requirement has been really
impossible to meet until Phrazer.
We are excited about how Phrazer
not only effects positive outcomes,
but for the first time, makes it possible
for medical systems to give people care
that every patient comes through here for.
- [Mat] There's quite a lot in that video to
refer back to our mission.
Now you know a little bit about what we do.
You know a little bit about the market space we work in.
You know that we work with partners who share our values.
So Micron, for example, is the largest
manufacturer of memory in the world
for phones and NAND and computers.
So there's a lot of Micron in this room right now.
And if they didn't share our values
then they wouldn't be working with GeaCom.
So there's a big series of things
that you can draw from that one short video.
I'll tell you a little bit about myself in brief
and then we'll talk about how we ended up
in the place that we're in now so ...
I graduated from International Falls in the late eighties
and went on to play hockey briefly with the Gophers in pro
and then ended up working as a consultant
to a number of companies that you guys are familiar with.
From 1992 to 2001 I wrote codecs for Apple computer
to make videos work on phones and on computers.
I worked with Ruth Wagner Industrial to help
build their business here in the Midwest.
With Honeywell I worked on automated landing systems
for commercial airlines.
So any time you're in an airplane,
and that airplane comes in for a landing,
part of the software I worked on
is what makes it land well,
without the pilot touching that yolk.
Kind of a scary thing but ... it happened.
I also worked with them on a modem
that's on the space station right now.
Spent some time with Kobayashi Robotics
from '95 to 2000 working on injection molding
post-mold robotics and helping them
make a foothold in the western hemisphere.
And with Cargill I worked on low VOC coatings,
polymers and resins that allowed people
to put coatings on cars without poisoning water.
And then the one that probably is the most relevant
to what ended up becoming GeaCom was
I worked with Medtronic on a his fundal pacing program.
They were having difficulties having surgeries
done properly around the globe.
They want to make a change to how pacemakers were put in.
And it's a very hard thing to do
when surgeons go to work every day,
they perform surgery, five, six patients a day.
Those patients go home and after a period of time
they recover, they live their lives,
as well as they can, the surgeon gets paid
every couple of weeks, you come back in and say
that's wrong, that's very wrong,
we've got to do it very differently.
Surgery has to be a little bit more complicated,
you have to do a little bit more with the patient.
Now that sounds very simple but it's not.
So you have surgeons in South Korea, Russia,
Sweden, China, other places, the United States
who all think differently.
They all see themselves differently.
They all work in different economies.
And they're working with patients who
also see their roles differently
so it was a really big challenge for us
to understand how is it that you can get this
world of surgery to match this world of patients
to ultimately match the world
of ethical performance over time.
How do you get their interest to broaden out
beyond the fact that they can perform a surgery,
get paid and feel good about themselves
at the end of the day and say, no
you've gotta do a little bit more, a little bit bigger,
you get paid the same but you gotta change your behavior.
That was a huge problem and
in the process of solving that problem,
I ended up doing quite a bit of research
in the market space.
So this is just to kind of give you guys
a level set on what we're working on.
So one of the pillars of society is healthcare.
So we all share in each others'
responsibility for healthcare.
You shouldn't be coming in a room like this
if you are extremely ill
or if you're contagious in some way, but people do.
We have interest in making sure that children
who are born, are born healthy
and live a healthy life, that they don't create
a burden on society but they add to society.
And so it's really one of the most important things
to everybody here, to every country,
to every community.
And when people recently learned,
and we knew this for several years now,
the number one killer is heart disease.
So most of us in this room will die from heart disease.
The second killer is a spectrum of cancer
I mean everything from leukemia to brain tumors
to colon cancer, that is a big, big problem.
The third killer is medical error.
That's a ... that's a shock.
One in three patients who goes into a medical system
experiences medical error.
That's an incredible cost to the country.
They estimate, the federal government estimates
for the United States, it's about a trillion dollars.
Annually.
So you can see that's a real problem.
That's why we had this recent
change in healthcare in this country.
And globally, it's pretty terrible.
In the US as many as 500 people a day
die from simple miscommunication.
On a global scale of course it's far, far, far greater.
Inequity across the globe in care,
inequity in process and procedure,
inequity in service is rife
but what really shocks people is
the inequity here in the States.
So we'll go briefly into that right now.
So if you look at the top half of this chart
this would be what the population
in the care world looks like.
So if you see, you see it's like a light
from that piece of paper shining into
the community there, 21% of the patient population
is a dominant race, the dominant culture,
the dominant economics and the dominant education.
That's what everything is designed for.
That's cause it has to be designed for that.
When you design things based on paper and procedure,
you have to design a number of assumptions.
And those assumptions have to fall back
on the dominant culture.
When you fold back behind that
the next biggest population is pediatric.
So 25% of your population are children
who, most of them, can't read and write.
Arguably, all of them are not in a position to cognitively
work with healthcare.
15% of your patient population,
but this is growing, is geriatric.
Now certainly, there's no question that
geriatrics have plenty of capability
but they're a whole different generation.
They have a different pacing.
One of our investors referred to it as
the golf course of healthcare.
When you go on a golf course,
you're gonna go around that course
as fast as the slowest players.
People do things at different speeds.
It's not that they're not good at it.
They do it at different speeds and
there's a significant marker that goes with geriatrics.
Behind that, this is a shocking one for the United States,
25% of our patient population in this country,
is functionally illiterate,
which is hard to believe when you're in a room like this.
And another 15% can't speak English at all.
So now going back to that parallel,
one in three patients experiences medical error.
500 patients a day die.
The least likely type of patient to die
or have a bad outcome is right in the gut
of that primary population.
That'd be me.
It'd be a lot of us in this room.
Females, you're gonna have a worse experience.
If you're not the dominant race,
you're going to have a more difficult experience.
If you're not the dominant culture
you're going to have a difficult experience.
And this is impacting everybody.
There is inequity in healthcare.
There isn't a way that you can go in
and ensure that you're gonna get
the same care as the person next to you
on the old convention.
So what our business does, what we designed,
is a methodology that gives that patient
a direct and complete control over their care
in their own language, in their own culture,
in their own race and lets them
get all the information they need
the way that they need it at that most important moment.
In real-time it talks to the staff.
It talks to the nurse, it talks to the physician.
But it extracts that information
so what goes to the nurse, what goes to the doctor,
isn't junk data.
It's pure information abstracted from
race, gender, culture, language.
It helps them make better decisions
without the prejudice of their upbringing and their culture.
So what we found out when we put this in place,
and we've had it running in places like Mayo Clinic
and here at Essentia, Health Partners in the Twin Cities.
In Canada, we've run it around the world.
We've had it in ... well, gee, we've been in Africa,
India, Sweden, Russia ...
lots of places
we found that everywhere this device goes
we're able to eliminate error,
we're able to get equal care across the board.
And that's a very sobering thing.
This next slide is one that I really
always have been very proud of.
For the first time in the history of US healthcare,
we can use the Constitutional civil rights,
that were put in place more than 51 years ago.
Such a dirty secret.
Right, if you weren't in healthcare
and anybody told you they can't meet your civil rights
every medical system in the United States
uses a legal clause called Undue Hurt.
We would love to give equal care for everybody
but the cost and the process is so egregious
we would ultimately collapse our system
if we didn't know better.
Therefore we're blaming undue hurt.
So for us, it's very exciting and very important
and very sobering to be able to change that
for the first time.
And what does this mean?
Well we've seen patients literally break down and cry
because they're so excited for the opportunity
to finally get equal care.
For the first time to actually be heard.
We've seen nurses, just actually about a month ago
in Canada, we were meeting and this one nurse
in a wavering voice explained
how proud she was to be the first system
in the entire country to give equal care.
Now they were servicing 68% of the population
didn't speak English.
They spoke Mandarin, Cantonese, Korean, and sign language.
A lot of them are from miles lost generation
so they didn't read and write.
So if you came in and you were
one of those population members,
you were gonna have a four hour delayed care.
And you were gonna have a worse outcome.
So this really matters.
And so we don't have to ...
I think you hear a lot of this,
I looked at some of the other companies
we don't have to build up a ... you know,
some sort of way to represent what our morals are.
We don't have to build up some sort of mission statement.
It is built into our journey as a company.
This is what we do.
And you cannot walk into a system and see things going wrong
and then make them go right without feeling it
deep down inside and knowing that this is a ...
This is a moral imperative.
When we take this product to the real world,
we're changing a behavior that hasn't changed
in more than five generations.
Since about in the 1860s,
the process of going to the doctor
has been almost identical.
So as soon as we centralize care,
you go in .. you wait.
You talk to someone, tell them who you are,
they tell you to sit down and you wait.
Eventually a triage nurse comes and talks to you,
gets some vital signs, asks some questions
and then has you sit and wait.
Eventually a clinical nurse comes and gets you,
walks you into a back room and you sit and wait.
A very isolating experience.
A very scary experience.
A very challenging experience if you
want to enforce better care, better understanding
and bring back that human interaction.
So what we have found out too, here in the United States,
we're all required now to have electronic medical records.
And so I can do a great imitation of a doctor,
and I'm sure you guys will all recognize this one.
Oh, you still taking that .... darnit
no seriously, they turn their backs to you right?
It's the craziest experience so what we're able to do,
is get the people to be able to spend time with you.
So it's not just about the patients.
These very important caregivers, who work their butts off,
finally get to work at top of licensure.
They finally get to look you in the eye
and start working with you and not working with data.
And that's important.
So getting more to what our topic is today,
so I put it this way ...
What is the company, what does a company do?
And what does a company become?
So we look at ourselves as an innovation leader.
We look at ourselves in Duluth as economic diversity.
If you look at investment in the state of Minnesota,
over 80% of the investment dollars
for private companies go to med tech.
There is one major med tech company in this region.
That's tough.
We're a resource.
City. Region.
So it's economic diversity that's very important.
So part of Life-Science Alley.
That brings a little bit of pride.
So something that you do, you can say
the only company in the world that does this, is this.
That's important.
When we were in the depth of that recession,
Mayor Nest spent some time in some of his speeches
talking about the company because it brought hope
that this was a solution that is immune
to the ebbs and flows of the economic changes in the world.
There is never gonna be a case
where you don't need better healthcare.
And I think, really almost too important
in this region is being an employer.
So I don't know that there would be another
community where there's just such a rabid desire
to see how many people you can hire.
But that always seems to be the number one topic
that people bring up in spite of what we do.
And what we do, we're a US manufacturer.
So we make these products.
So we design these from the ground up.
We choose where we buy these components.
We put these together.
We meet FDA regulations.
We meet FCC regulations.
We meet the adequate requirements
and we source from good places.
So we're actually a manufacturer
which there are fewer and fewer of all the time.
We make medical hardware.
We write our own software.
We have our own intellectual property.
And what we become and we hope to continue to become
is a force for innovation around the globe.
So we want to be able to ...
Not only be able to put product in place where it's needed,
so we work with places where people are very needy,
we work with places where people
have more economic ability,
but we want to start spawning a whole new set of ideas
about how best to communicate with people.
How best to work ethically between divergent behaviors.
A physician, a nurse is in a factory, essentially.
You are rolling by, they have seven minutes for you.
That's almost what it's like for them.
You on the other hand, are in one of the
most important moments of your life,
desperately seeking help, desperately seeking authority,
and any kind of solution to your pain and problem.
These things are opposite, polar opposites.
We find a way to merge those ...
That may be a path for other people to solve problems too.
And on the mission,
the mission is really what informs everything ethically
in what you do.
So what is the mission?
It's a total equity and continuity in quality of care.
For anybody who walks through the door,
what does it do?
It harmonizes patients, staff, performance.
It helps communities operate better.
And like I said in that conclusion of the previous slide,
it becomes a new, vast way for possibilities.
What we use, and I'm gonna explain this very briefly,
is a method called CITE.
So cite is an acronym, C I T E.
It stands for Communication, Information, Theory
and Empower technology.
So recently there's a lot of technology
that helps us understand how the brain works.
You get an FMRI, an XMRI, you study the brain,
you provide that patient with stimulus
and you see what happens.
You find out what trust is, you correlate with
the social sciences, you discover what makes him motivated,
what makes him pay attention.
Like I raise my right hand, everybody who saw me do that
the more I realize what kind of spirit you're bringing
fire to .. you know a very predictable pattern.
You can't help it.
When you're watching somebody looking for help
you can't help look at the rumbling because
you're looking for intentionality and meaning.
So communication theory is one of the gages of that person
who needs that immediate help understanding.
Information theory on the conversing side is
a staff member needs actionable information
not junk data.
Just pure actionable information.
The way I look at this is,
while I'm talking here, several of you are having daydreams,
you're thinking about something else.
But if I can give you pure information
that's interesting to you, you wouldn't do that.
It's like being on a conference call.
This part of the conference call is not relevant to me
so I'm gonna ignore it til I hear my name,
and then I'm gonna come back in to this conversation.
So staff has to do that because their rules are all noise.
Right now if you walk in and you try to look at
what it is to be a nurse or to be a doctor,
it is just pure noise.
You've got alarms going off,
you've got different people rolling through the ward,
you've got different staff members rolling in and out,
it is pure chaos.
I don't know how they do it.
So what we try to do is just give them pure information
and actionable information, it trends into
listen and react and perform against that information.
And so we're hoping that that reveals a whole new
fertile vein of innovation in the medical market
and other markets.
And another thing that we look at here too ...
So, okay, we know how to stop medical error
for the most part, it's a big deal.
We know how to give you equity and continuity of care,
that's huge.
So you're sitting on this opportunity,
where do you bring us?
so here we have some people in Canada ... refugees.
The death rate in that camp was over 50%.
The couldn't get out to the creek.
So they had refugees stuck in a camp off the grid.
Over here you have patients in Honduras
who have never seen healthcare before.
We like to put the picture of these two kids up there,
what they're actually listening to is oral hygeine
I think it's a pretty engaging protocol but
it does change right? So they make decisions
going forward about how to stay healthier.
So do we just put our stuff in places like Mayo or ...
Johns Hopkins or what do we, how do you do this?
Now that you have a solution it's almost like saying
we have a cure to a very concerning disease,
but we're selectively going to dole it out.
So that brings up another series
of ethical concerns and questions.
And also brings up Q&A session.
So there's so many things to unpack here.
So we go back to ... I have an idea.
Form a company, this is back in 2007.
Determine whether or not it's a good idea
to protect that idea.
Is it a good idea to file a patent?
If you file a patent do you find a mirror
through the entire world?
What if someone else wants to use it
and it can help other people .. what do you do then?
Do you license it or do you give it away?
We talked briefly again about designing and sourcing.
Here's an interesting thing.
If you can't buy a large enough volume of material,
they won't sell it to you.
You just can't go out and buy a few things.
A lot of the companies that sell components
won't sell unless you can buy at least 20,000 of it.
Or more.
I think it's really kind of a weird world,
about how do you actually make something?
So I think I'll take a break here and see if
anybody wants to start a conversation,
any particular direction so, opening it out to you.
Any questions?
Comments?
- [Melissa] I'm curious Mat,
since you formed your own company,
how you were thinking about embedding ethics in the culture
of the company and maybe some examples of
how that comes into play
in your daily decision making life.
I'm sure if you're going to international markets
the cost of this, you can set whatever that margin is ...
How do you weigh, you know, cultures that may need something
really cheaply, you know, how does that come into play?
- [Mat] Well I'm glad it's this sort of question.
(audience laughs)
So one of the things, I'll go back to
when I was working with Medtronic
and suddenly realized this serious problem it's shocking ...
I say it with as much gravity as possible
when you realize that there's not fairness in healthcare
it shocks you, right?
When you realize that they do these decisions ...
It's a big shock.
But you also realize it's a big world
with billions of people who've been
trying to solve this for generations.
So the first thing you have when you think is ...
Will this really work?
Is this really what I think it is?
And it means a lot of, it means a lot of evolution,
it means a lot of iteration.
It means, you don't just jump into an idea like this,
I mean, I think I got it, I think I got something.
It was a little bit of an evolution
that happens after that.
You don't start with this whole ...
I have an idea and I'm trying to see somebody's
life changing because of it
and I can already see the economic implications,
you're thinking, how do I structure this
so it can actually work?
And how can I structure this in a way
that we can test this in places where I know it works?
So take it to the US military cause they see everything.
They see everything.
Take it to places like Mayo Clinic.
Cause they see everything.
They'll tell you if it's novel.
And then start to develop structure around it.
Now getting into pricing.
Remember they're going through a trillion dollars.
Right, here in this country.
And every country ... in Canada, for example,
they have a national flow initiative
so they do use interpreters but they don't have
civil right like we do.
They are not required to provide an interpreter,
they are not required to provide equal care.
Only for sign language.
But they're still spending money.
They're still having difficulty, they have extra staff
to try to manage this population
that comes through their care unit.
In the United States we have complete reimbursement
for everything we do so they actually
make money off the product.
And so you get into a pricing question,
we could price it at four times higher maybe, right?
But we're trying to price it in a way
that works well, helps us get into the market,
and helps GeaCom become a better supplier,
you know, a better company because,
one thing about a good idea is
it only gets better if it's right by other people
using it and sharing back their rights.
By reflecting back what they know and you didn't know.
And so that's the state we're in now.
So getting to the third part of your question is,
we know that we're gonna have to go through
iterations of the product.
So the product we have right now
is called Phrazer Superior
and we're moving over to a new product
called Phrazer Spirit.
Phrazer Superior now then becomes a donation unit.
And so we can provide that product to third world countries.
We worked with Direct Relief International,
They will receive product and redeploy that product
anywhere in the world and help people.
And this is a model that we anticipate
will happen about every two and a half to three years,
you have to do an iteration.
You have a lot of product that you can retire
that's designed to last at least 10 years,
that can be redeployed into parts of the world
that cannot afford that product,
would get it for free.
And we can support that by
what we grow the other parts of our market.
So far, that's the only way we have found to do that right.
Does that answer your question Melissa?
- [Melissa] Yes.
How did you set the culture so that ...
You might have one guy over here on your staff
that says, Mat we can charge six times
what we're charging over here,
you'd make a whole lot of money.
How did you guide the culture?
- [Mat] The company's relatively small.
Internal culture is so built into what we do.
So occasionally you could be an engineer
at GeaCom working on a circuit board,
it's really not see able, but the person
who's point person in the market sees,
but they come back and we have staff meetings
every week, where everybody's in the room
and they share back that experience.
So that's just inherent in how you survive like this,
this is inherent in what we're doing,
this is a product that makes you
want to work for the company and
we try to share that information internally, strongly.
So when we go to a new place like Canada,
and say this nurse broke down,
everybody who wants you to know that matters,
and they all do.
They all care.
We're not the highest paying
company in the world, right?
So we're bringing them in because the mission matters.
Because division matters.
Because you can do anything and make money
but you can't always do something and make a difference.
And I think everybody in our company feels that.
Other questions?
- [Participant 1] I have a technical
question about the product.
When you said that it kind of
picks and chooses what to tell the medical professional,
wouldn't you think that might cause problems
in itself, if it's not telling the professional
exactly what the person is saying?
For example like, it could flag somebody
as mentally ill or something.
So how do you, how does it think
what to tell the person is feeling?
- [Mat] Great question.
So patients holding in the triage for example.
I'm gonna answer a little bit more carefully.
So when the patient comes into
the medical system with Phrazer,
within a minute and a half to three minutes,
they are being engaged with Phrazer.
And it's talking to the physicians and staff
within three minutes.
The opposite would be 45 minutes
before you see a caregiver.
That's the average in the United States.
So right there we have a bit of an advantage.
Secondly, this is not an economist.
So this device works in conjunction with staff.
It enhances staff, we're not removing staff.
We're giving them people who work at top of licensure.
So .. I'm gonna back up really briefly here.
So what we know about healthcare is
we have a physician's desk reference.
It's a book about this big, it's basically
your Childer's manual for human beings.
There's only two models, they're relatively
close to the same and so we want to know
a few things about our patient.
Is it possible a patient could be mentally ill
or have Munchhausen's and it maybe doesn't identify.
We have to rely upon the physician
to make that step clear, identification.
But, a patient in triage will say,
you know, in a long interview with the device
takes about three minutes,
show me on the body where you hurt.
Oh I hurt through my tummy right here.
Tell me what does it feel like.
Well it stabs.
How long has it been going on?
Well it's been going on for about four hours,
three and a half hours.
What's the pain like?
Well the pain level's an eight.
What the staff will hear is
patient has indicated stabbing pain,
lower left body, onset four hours ago,
stabbing, by the way.
They don't hear other things,
they just need to hear that.
There are much more complex interactions
but they work with us to determine
what information is actionable information.
That patient still comes to that staff member
the only difference is when they get to
that staff member faster, they know about the patient.
They already know of the proper treatments
that are in that patient's interest
and then they spend the time determining
if there's more they can do.
Anybody else?
- [Melissa] How do you measure your success?
How do you measure elimination of errors or
improvement of life?
Or death rates?
- [Mat] Well I wish it was a very simple world.
(laughter)
For example in the labs sometimes
you'll do colon cancer screening
and there's a thing called FIT kit,
just to give you one example.
And the FIT kit is a stool sample
that you send home with every patient.
And then the patient performs the stool sample
and mails it in.
So without Phrazer, we know that they are
running at about 68% return rate
and about a 50% usability rate.
With Phrazer the median went up to 95%
and then we brought it all the way up to 99%.
So you can actually measure it.
Exactly what comes across.
The second part of that is, we have real vision.
So one of the biggest things that is being watched
in the United States today is when a patient comes in
and you perform services, if that patient
returns for any reason in the next 30 days,
you're considered a revolving patient
with economic cause.
We can determine how many patients
have used Phrazer in Canada and came, have had to come back
for any reason versus not.
We also use methodologies known as teach-backs.
So when the patient is working with the device,
the device is teaching them as they go,
without them knowing it,
and then it confirms that knowledge has been conveyed.
There's another one that's really interesting
called Shared Decision Making.
Let's just say a young woman goes in,
has an examination for breast cancer.
It turns out that she has breast cancer, it's a concern.
Today, physicians would say well,
the best thing to do is give you a lot of chemo inspect it.
That is not an uncommon statement that they would make.
But the requirement of the law gives shared decision making.
Meaning, the physician doesn't have enough time,
but we have enough time to say
you have options.
Let's share with you what exactly are
the success rates of the different treatments.
Let's look at your culture and your faith.
Let's see what stage of life you're in
and if you have to be home with your children,
let's see how this correlates with your needs
and help make a shared decision
about how best to treat your cancer.
So in a lot of cases our measurement is
zero verus everything they need.
A lot of people die in the healthcare world
between the door and the physician.
As they wait for two to four hours sometimes.
We know that we have triage down in three minutes.
So things like that.
Also, there's a lot of people
who never get served in their own language.
So it's zero versus complete connection with the patient.
That could be a lot more complicated
in how we actually measure how fast
does a patient go through ...
we have a complete audit trail.
Did the nurse step in the room
when the nurse was supposed to step in the room?
Did the patient confirm that
they understood the information?
Did the patient actually go out and get
the medication necessary and follow the prescription?
There's a lot more reporting
and big data behind all of this,
but yes, there's complete audit trail for everything.
So if you're more specific, I can be very specific.
(laughter)
Yes
- [Participant 2] I look at your bullet points
and you're a decade into this process.
Could you describe some of the barriers
that you encountered?
Were they regulatory?
Any resistance to the concept?
What did you encounter on the way?
- [Mat] Oh boy. So ...
Started the company in 2007.
Wrote patents for an entire year
and started getting fundraising in 2008.
So I think everybody can do the math
about how that worked with the recession.
The compete collapse of the investment market
in the state of Minnesota ... we lost the
Minnesota Angel Investment Network,
we lost most of the VCs in this region.
Northern Minnesota in particular.
There used to be a foundation up here,
there used to be VC up here that operated functionally.
They both disappeared at the same time.
There was no funding support.
That was the step one, that was really hard.
Selling the project, that takes time,
you're absolutely right.
You get in to Regulatory sides so ...
To build something like this costs roughly,
estimated in a general market,
for a big company about a hundred million dollars.
To make this.
And that's a very challenging thing to do.
Out of Duluth.
So who's your really high density
circuit board company in Duluth?
There isn't one.
What if you want a Patent attorney,
well, when you get a patent attorney,
this is an interesting question for everybody here ...
Where do you think the closest patent attorney is?
- [Audience] Washington, DC?
Chicago? Denver?
- [Mat] Chicago and Minnesota.
But if you go to Minnesota, Minneapolis, I mean.
If you go to Minneapolis to get a patent attorney,
it's not that easy.
Cause guess who they work for?
Well they work for Medtronic,
they work for Boston Scientific,
they work for all the other medical companies
and they say, I don't know
this could be a conflict of interest
and they pay us a lot of money.
So even the simplest of things are the biggest of problems.
So everything from the funding to getting the IP,
to getting sourcing, I mean, it couldn't have been
more difficult really, that I could imagine.
And support structure, this is a really nice community.
I love the community but like I said,
it's hard for them to wrap their minds around
something that doesn't come out of the ground.
If I could find a way to make a back hoe
useful for today, how am I gonna get a loan for it tomorrow?
I can't figure that out.
I can't go out and say we'd like a machine
to do better 3D analysis, cause they won't fund that.
They don't know how to fund that.
So there's another problem.
The list goes on and on.
The medical systems in town here are not the most
integrated medical systems in the country.
So that's an interesting thing,
they're very good medical systems.
But you have to be structured to innovate or you can't.
I mean this is something that people don't understand.
You are smarter as a business, nine times out of ten,
doing fast law work because the cost of innovation
is set up to fail 70 - 80% of the time
and win less than, sometimes 15% is all you can win on,
but you win big.
And most systems cannot do that.
And so fast followers are what occupy most of this region.
There seems to be a transition but that means
we can't do it, we've been trying to make a partnership
with ... we have to drive somewhere you know like,
down to the Twin Cities or or down to Rochester
to do something because there's nobody as a structure
to make that happen.
And then the last, I think the biggest part
is still a challenge for us ..
We all have a picture of what healthcare looks like.
If I were to ask anybody here,
generally they're gonna haul away with
is healthcare relatively close to equal care?
Everybody would go oh yeah ...
Do you have a problem?
Oh some things I don't like ...
It never occurs to them, you didn't go see the doctor,
you sat and waited for three hours
and saw the doctor for seven minutes.
It's bottoming, it just slips out of people's heads,
like a cognitive dissonance.
It doesn't occur to them what just happened.
And so it's breaking that pattern,
that's ingrained into the social construct
in the way our society works.
Even at the doctor level, even at patient level,
you've just gotta prove the same thing
over and over and over and over ...
Kind of a repeated .. go to a hospital,
start at square one.
This is actually better.
No it's not gonna be cheating you and the patient,
it's enhancing you and the patient.
No it's not taking away jobs, it's creating vitality.
It just this long argument every time
and then once they finally get under way,
they're like oh my gosh, that was a great idea.
And it works perfect.
But yeah that's the ongoing problem
and I think we won't see ourselves overcome it
for a while yet.
That was a really good question.
- [Participant 3] So how many employees do you have
here in Duluth and what types of degrees
or preparedness are you looking for in employees?
- [Mat] So, I think we have eighteen in Duluth right now.
We also have employees ... we work with language staff
in the Twin Cities, manufacturing down in Winona,
development team in Baylor working the ...
We work with another development team in Vancouver, BC.
But in town here we work with engineers.
They have physics degrees, electrical engineering degrees.
People who also work with customers so account managers.
Right now we're really interested in working with people
or finding people who have a much deeper look
into the psychology of people
and the structure of interaction.
So guess what happens,
I don't have a lot products on the market,
we're starting to learn things that nobody's
ever looked at before.
This is now becoming the largest
communication theory study in history.
Will we do better with a male,
middle-aged male in pain when we use
a female caregiver who's over 50?
Does it remind them of something around security and safety?
Let's find out.
Will we do better if we're really blunt
on a conventional clinical meeting with that patient?
What can we do with that?
How do we see the subtleties of community?
Is it different five miles down the road?
And how do we start finding ways to react
to a person who has that matter?
There's just a lot of things that
we're being able to learn now
and we'd like to start applying
more into our communication theory side of the product.
- [Participant 4] When did you see
that there was like a need for your product?
Did you have a like, severe experience yourself?
- [Mat] Yeah, so when we were doing this
his fundal pacing thing for Medtronic,
we were doing real-time surgeries on
German Shepards, pigs and sheep.
We were letting surgeons around the world watch it.
We couldn't get anybody on the same page
because they were from a different structure of culture,
there are things that they were seeing different,
but I was suddenly realizing that
it's just not that simple.
You just can't have a piece of paper
that works for everybody.
It just doesn't work.
So that evolved very quickly into
how big of a problem is this?
And you find out it's the number three killer.
It's just, everything just starts opening up.
You start saying, I'm gonna start looking at this
in a different light.
How is this possible?
How can this be so important and so ignored?
And when you find that deliberate difference
is being felt by all these hospitals,
that shocks you.
And they have to, it's not that they have a problem
if there's something wrong with it,
they have to.
So yeah, that's pretty much where it kind of came from.
It seemed, you couldn't communicate well with surgeons
from different countries who all spoke English.
- [Participant 5] I was just curious, is this product,
has this replaced any job positions,
like for Triage nurses and consults,
have there been any criticism of it?
- [Mat] It's a really good question.
I think this comes to exactly the core
of why this type of conversation exists.
Why does the medical system exist?
What is the duty of that system?
It's the stability and security of the community
on a health level.
If you have something that improves efficacy,
what would you give up to get the better efficacy?
The answer to the question is,
generally, it doesn't replace.
But yeah, it'll eliminate scribes,
it'll eliminate translators.
We'll be able to see more patients.
But the reality in this community right now
is that we have an aging population,
we have way too few qualified healthcare givers,
with way too many patients.
So a lot of qualified nurses and doctors,
recently retired, very soon become our outpatients,
and there aren't qualified staff to work with them.
So we really have a serious problem happening.
But aside from that,
the bigger ethical question you're asking is,
is it more important to make sure that we
employ people than to make sure they're
all going to get the best outcomes?
That's a pretty scary question.
We think about making sure that we get equal care,
highest continuity and quality of care.
And if there's a barrier to that we can eliminate,
we'd like to eliminate that barrier
and I don't think of it as people being eliminated,
I think of it as opportunities to be blossomed out.
There are a lot of those opportunities in healthcare
that we don't do because we don't
have the time and resources.
If we can free up resources and we can free up time,
then staff can do better things with patients.
Anybody else?
- [Participant 6] I have a question about
in the video it said about you teaming up with Micron.
And I just wanted free advice about what was the ...
Out of that process that had you find them,
what made them stand out to work with over everybody else?
- [Mat] Well we needed a boundary,
we get close to a terabyte in every one of these systems.
So they have to be able to run completely offline.
And there are really only three major memory manufacturers
that can meet that demand.
And so it wasn't so hard to get to them
and see who they are and when we first talked to Micron,
a couple of their managers got really excited.
And as you saw in the video, their VP was saying,
just so proud to be part of a product
that can go into healthcare and show that
we can be that quality level.
And that was really important to us.
So they're out in Boise.
They do actually spend time here in Duluth sometimes.
They go to UMB, they come here, they give talks.
They're a very interesting company.
They were started out from Simplot, the guy who
had the potatoes ... the biggest potato farmer in the world
decided to diversify his economy.
So the number one potato maker
started the number one chip maker.
(laughing)
It's a very small market space.
When you get into areas like Qualcom, Texas Instruments,
Micron, Sierra Wireless, you know,
these players are just ...
there's a lot of overlap
you run into all these players once you start in the process
of making a product and certainly in 2008,
not a lot of people were making product in the States.
- [Participant 7] How long did it take
for you to see profits?
- [Mat] Just now starting to see them.
- [Participant 8] Since you focus on diversity
and equality for people, how did you reflect that culture
in your company so that it won't be made available
to our culture ...
how do you promote diversity in your company?
- [Mat] Internal diversity of the company ...
How do we do that here in Duluth?
Well, we always hire the most qualified
and capable people without any concern
for race, gender, culture, background.
We choose to hire people who can do the job best.
And this community is a community
that is very homogenous, very difficult to
see a lot of diversity but when you get into
the world of engineers, when you get into the world
of advanced degrees, you do see a lot of diversity
in this community than we do in the general community.
So you have opportunity to work ...
So in East India, we obviously find a lot of these
diversity to work for us, right?
When we're in Duluth, we obviously have a bigger challenge
for diversity but we do hire people
to do our language and consulting in pieces
from every culture and race that we possibly can
because our product services every language
in every culture.
So by the nature of what we do,
we rely upon every one of those cultures
and every one of those backgrounds
to make the product work well.
Well, maybe that's it.
- [Presenter] Well thank you very much
for your time today, it was fascinating, thank you.
(audience applause)
Mat's here for a couple more minutes
so if anyone wants to come down and say hello
and ask any other questions.
Thanks.
- [Mat] How was that?
- [Presenter] It was awesome.
I was fascinated, I had so many questions,
you know, IT background ...
How do you keep all that stuff on the board?
And how are you connected?
And where are you doing your analytics?
- [Mat] All sorts of smart technology.
For more infomation >> Making cards with INEXPENSIVE supplies - Duration: 8:43. 
For more infomation >> Legends of Deus - Dragon City (teaser trailer) #DragonCityStory - Duration: 0:18. 
For more infomation >> Blaze And The Monster Machines | NEW Game for Kids | Firefighters Jr Kids Game Video! - Duration: 8:54. 
For more infomation >> INDIA & MALAYSIA SEND ULTIMATUM TO CHINA ABOUT SOUTH CHINA SEA! - Duration: 3:56. 
Không có nhận xét nào:
Đăng nhận xét