Latest / CareTalk: Healthcare. Unfiltered. / Optimizing Healthcare Mobility with 5G Hybrid Networks w/ Michael Feld | Executive Feature

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Optimizing Healthcare Mobility with 5G Hybrid Networks w/ Michael Feld | Executive Feature · CareTalk: Healthcare. Unfiltered.

• 0:00
  Advanced computing and communications technologies offer tremendous promise for patient care, but turning that promise into reality requires high levels of specialized expertise that health systems just don't have in -house.
• 0:13
  But some hospitals, like Boston Children's, seem to have figured out how to make it all work.
• 0:18
  How do they do it?
• 0:26
  Welcome to Care Talk Executive Features, a series where we spotlight innovative companies and leaders working to advance the healthcare field.
• 0:33
  I'm your host, David Williams, president of Health Business Group.
• 0:37
  My guest today is Michael Feld, founder and CEO of Pixel Health.
• 0:41
  Michael, welcome to Care Talk.
• 0:43
  Thank you.
• 0:43
  Thank you.
• 0:45
  So Michael, you've been a technology leader for a long time, and I'm wondering if you could trace your early career and how that's led to where you are today.
• 0:53
  Sure.
• 0:54
  I'll be very brief.
• 0:56
  I...
• 0:56
  been involved since, well, pre -high school.
• 1:00
  My family is a company called Leviton, and so I go back to power and electrical distribution from day one.
• 1:10
  And then all the way up through the beginning of the internet, I worked with companies like BBN and some of the beginning networking firms that even predate Cisco.
• 1:21
  I worked with telephone companies and created and sold a number of firms.
• 1:25
  So I've always been involved in that.
• 1:27
  And then I basically fell into healthcare through technology, through telephony.
• 1:32
  And that's kind of a brief, you know, kind of overview.
• 1:35
  That sounds good.
• 1:36
  So this is back in the day, like the dawn of the internet, you're talking like, you know, DARPA, BDN, Bolt Berenick and Newman, not the fancy school in Boston.
• 1:47
  What was the, I mean, If you think back to the time, and this is like, you know, CPM before MS -DOS.
• 1:52
  Yes.
• 1:53
  Yes.
• 1:53
  What was the thinking?
• 1:55
  Was it was it expected?
• 1:56
  You know, we hear now like, you know, tech is dominates the stock exchange and so on.
• 2:00
  I mean, did it feel just like a little corner or did it feel like something foundational?
• 2:05
  A little of both.
• 2:07
  For some of us, you know, we saw this as so so many so many uses in so many different fields that it was sort of by definition foundational.
• 2:18
  but it also was small.
• 2:21
  Just linking computers together initially, eventually exploring messaging, very primitive messaging systems.
• 2:28
  It took a while to get file transfer systems working in large scale.
• 2:33
  So it was an incremental process.
• 2:34
  Now each iteration, each new thing we did, broadened the scope and it became pretty obviously, fairly soon that this was gonna transform how businesses and people interacted.
• 2:48
  Um, but it was, uh, it was a slow process.
• 2:50
  It wasn't obvious from the very beginning.
• 2:52
  Now, were you, did you have cap and crunch at home?
• 2:55
  I would have borrowed your whistle if so, but in any case, we'll leave that one unexplored for now.
• 3:05
  So let's bring you to the, to the present day.
• 3:08
  Um, and, uh, pixel health.
• 3:10
  Now, I think, first of all, pixel is a very interesting name for a company and you have some.
• 3:15
  imagery about pixels building a larger mosaic.
• 3:19
  Can you talk about that symbolism?
• 3:21
  Correct.
• 3:21
  And by the way, that's a great tie into your previous, you know, our conversation two seconds ago about how all of this, you know, kind of began and grew.
• 3:30
  Solutions are really rarely a unitary thing.
• 3:33
  There's rarely a magic bullet.
• 3:35
  The solution is really based on what every when you look at it, relatively simple components and how they interact.
• 3:42
  So, you know, That's what we mean by Pixel.
• 3:45
  We are a collection of capabilities and relationships that when taken together the right way, actively create solutions.
• 3:53
  And it appears that the structure of the company is multiple consultancies, if I've understood that right.
• 3:59
  Can you say how those fit together and why not just one unified entity?
• 4:05
  Sure.
• 4:07
  It started out, we started out after the One of the first companies I ever created was called FC .com, Feld Computing, and this was where I got a lot of my internet understanding and everything.
• 4:17
  I ended up selling that company in 2002, a large CLEC, at that point, kind of a new kind of phone company, and then created a company called Layer8, which was also sort of engineering around technology and telecommunications.
• 4:36
  From that, We just expanded into various parts of technologies.
• 4:42
  We still weren't related to healthcare, but we were doing things like setting up networks for large corporations, helping phone companies like at that time, Dell Atlantic and eventually Verizon with customer support and engineering issues.
• 4:56
  And we continued to grow.
• 4:58
  Around 2010, we encountered our first hospital and this was through a phone company relationship.
• 5:06
  And we realized that healthcare could really use a lot of our services and we were just entranced by it.
• 5:11
  By that time, we were like six people in the company.
• 5:13
  We were a very small firm.
• 5:15
  We changed our name due to a trademark fight with another layer eight and lost and became Vertitech IT.
• 5:24
  We grew with a number of hospitals.
• 5:27
  And along the way, we started doing more consulting.
• 5:29
  We started bringing on more than engineers.
• 5:31
  We had people that understood clinical workflows and some of the more specific non -technical parts of healthcare.
• 5:38
  We then began to acquire very small firms, a small consulting firm, a Microsoft specialist development firm, and so on.
• 5:48
  So we began to grow into these little tiny companies, all sort of focusing on general technology and specifically healthcare.
• 5:56
  about a year or two before the pandemic, we recombined all of that into Pixel Health.
• 6:05
  So for those who are interested in a corporate issue, there's something called GPMF Holdings, which owns all those little pieces.
• 6:12
  Those were all combined into one and a brand name for marketing purposes called Pixel Health was created.
• 6:17
  So we now have a broad capability.
• 6:20
  We can consult, we have an MSP, we sell product, we can do product creation.
• 6:25
  We do a whole range of services, but that's all now under the brand Pixel Health.
• 6:30
  Got it.
• 6:31
  You know what you're saying at the start of that answer there with the, the Selex that goes way back.
• 6:34
  There's the competitive local exchange carriers.
• 6:36
  If I remember that correctly.
• 6:38
  And, you know, a lot you think about how computing and communication started, it was very much sort of top down national monopolies, you know, with Ma Bell and IBM and, and part of the deregulation, I think is what led to, you know, some of this eventual.
• 6:53
  innovation and opportunities to do the things that you've done.
• 6:58
  Interesting point about that.
• 7:01
  The way we operate now is literally the opposite of that.
• 7:03
  We go bottom up.
• 7:05
  That top down control of that industry is really actually not possible in healthcare.
• 7:11
  One of the unique things about our company, and this extends to pretty much anybody doing healthcare right now, Healthcare is not a hierarchically, vertically oriented industry where you have top leaders and then kind of everybody below that.
• 7:23
  It's really a group of highly parochial elements across the country.
• 7:29
  And so if you're going to make change on a large scale that crosses those boundaries, it really has to be from the bottom up.
• 7:35
  You can't dictate a top down approach.
• 7:38
  That's why healthcare, I think one of the reasons why it's so hard to change because people have been applying this top down methodology to what really is a much looser confederation of organizations and therefore you need bottom up forces at each one of them all tied to a theme to move things forward.
• 7:55
  So it's a very different approach.
• 7:57
  You know, people that are not so familiar with the intricacies of healthcare, but look at it and say, well, you know, it's very slow to adopt technology and information technology.
• 8:07
  And you can see that at kind of the institutional level, but then you think, well, like the individual physicians that people that I know, like they're.
• 8:13
  you know, leading edge in terms of some of the early adopters of iPhones and sort of bring your own device and all that.
• 8:18
  And so I think it's maybe the combination of top down.
• 8:20
  It's been very, you know, very slow.
• 8:23
  And at the other side of it, you've got what you may call, you know, whether that's the parochial folks or just people that are, you know, they're doing an experiment and kind of on their own and there's a bit of a clash.
• 8:33
  Very, very, very astute.
• 8:35
  That is we think at the core of a lot of, um, issues around adoption, innovation, exactly what you just said.
• 8:44
  We find that individuals that we deal with, both in the IT and technology departments and the clinical folks, on a personal basis, very ready and interested in change.
• 8:54
  But that collective change doesn't necessarily work properly through the organization to the top.
• 8:59
  And I think that is because healthcare doesn't really work like in a highly accountable, a shareholder driven, a pyramidal sort of organization that many corporations are.
• 9:09
  in other industries, healthcare is very different.
• 9:11
  It's almost more like a municipality.
• 9:13
  It's a very different operation.
• 9:16
  So exactly what you said, that's very true.
• 9:18
  That's something that we think we have a kind of a unique way of dealing with.
• 9:22
  Got it.
• 9:23
  So if we step back and think about, you know, just sort of current challenges in healthcare broadly, how much of a role does technology play in addressing them?
• 9:31
  Because it's not normally what we hear about.
• 9:32
  It's normally, you know, is the Congress going to pass a certain law or drug companies going to do a certain thing?
• 9:38
  But what are the challenges and how much can technology help?
• 9:43
  Yeah, technology has an enormous role, but it's not universally applied.
• 9:51
  It's patchy.
• 9:53
  There are parts of technology that are pushed from the top down.
• 9:56
  Things like the government does this, the drive for EMR adoption for Epic and those kinds of things, electronic prescribing, all of those things are definitely pressures.
• 10:06
  from the top down.
• 10:09
  But much of the technology adoption is really way down in the weeds.
• 10:15
  It's creating linkages between systems.
• 10:19
  Many hospitals are really, if you look at them from a technology stack position, an enormous collection of somewhat connected platforms.
• 10:27
  There is definitely a theme.
• 10:29
  They all point to, let's say, the record system like Epic.
• 10:33
  But they're very different.
• 10:35
  The radiology, hacks type things, the laboratory things, the general business elements, there are enormous numbers of components and they don't all get adopted or supported or integrated properly or well.
• 10:48
  And it's not an indictment on the institutions.
• 10:50
  It's just a very, very hard thing to do.
• 10:54
  So yes, technology is an enormous component of healthcare, but it's not nearly as efficient or effective as it should be.
• 11:03
  So let's talk about maybe the pinnacle of the complexity and tradition and all that, which is Boston Children's Hospital, which also historically known as the Children's Hospital.
• 11:12
  Yes.
• 11:12
  How did you get involved there?
• 11:15
  Well, the the CIO of that hospital worked with us at some other hospitals in prior engagements.
• 11:22
  We tend to as a company, we've never lost a hospital.
• 11:25
  Every hospital that's ever worked with us is still a client.
• 11:28
  And there's a certain amount of fluidity amongst chief information officers among hospitals.
• 11:35
  So we tend to follow along with them.
• 11:37
  And when the CIO, a woman named Heather Nelson was hired by Boston Children's, we were directly involved.
• 11:47
  Her mission was to transform, frankly, to address many things we're talking about here, to address the adoption issue, to organize the technology, to bring Boston Children's technology and systems up to the excellence of their...
• 12:01
  their clinical operations, which are worldwide known.
• 12:04
  So I'm not explaining all the TLA three-letter acronyms that you're throwing up, but I have to say CIO has two meetings.
• 12:10
  It stands for Chief Information Officer and also used to stand for career is over.
• 12:15
  And maybe that's what you're describing in terms of the fluidity of the CIO role.
• 12:22
  In that case, let's just say that some CIOs go through the CIO process to become another CIO.
• 12:29
  Got it.
• 12:29
  Got it.
• 12:30
  Fair enough.
• 12:31
  So with Boston Children's, I mean, what makes them unique as an organization and in what ways are they similar to everyone else?
• 12:38
  Yeah, well, they are similar first, they're a hospital.
• 12:41
  So, you know, they're dealing with disease conditions, they're dealing with, you know, all of the diabetes is diabetes.
• 12:47
  Yes, there's different cases, children, pediatric diabetes is different than let's say adult diabetes, but there are enough similarities in what any hospital does that there's, you know, broad linkage between them.
• 13:00
  But when you specialize, whether you specialize on a particular type of patient or a particular set of diseases, obviously, you develop specialties and some of those specialties deviate from the norm across other hospitals.
• 13:14
  So in that sense, obviously being a pediatric facility, Boston Children's focuses deeply in areas that a general hospital won't do.
• 13:22
  Matter of fact, many general hospitals, many of our clients feed their more complicated, difficult cases, pediatric cases to places like Boston Children's.
• 13:31
  And how has children's traditionally approached technology?
• 13:35
  Well, first of all, like many hospitals, there's similar problems.
• 13:39
  Like we mentioned earlier about the difference between adoption at an individual level or as a corporate level.
• 13:46
  But there are a couple of differences to Boston Children's and many of our other clients.
• 13:50
  One is it's a very heavy research institute.
• 13:52
  So there's a great deal of activity in researching various diseases and cures and whatnot.
• 13:59
  And therefore, technology really is done differently there.
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  There is the use of technology for the provision of medicine.
• 14:07
  And then there's technology for research.
• 14:10
  Now, the technology on the research side is quite a bit different.
• 14:13
  It's certainly much more data -driven itself, because that's the coin of the realm is the data.
• 14:19
  And the research systems there are many different projects.
• 14:24
  And each project may have specific technical needs that really aren't shared by others.
• 14:29
  So you can look at Boston Children's as yes, a hospital, some basic technologies, but then these little offshoots of very unique technical requirements that are not common in other hospitals.
• 14:41
  So, you know, Children's has always tried to do things themselves when needed, whether it's technology or something else.
• 14:47
  So if you wander into Children's, you'll see pictures of cows grazing outside of Children's from 100 years ago.
• 14:54
  Yes.
• 14:54
  And a lot of people think that's because I was very agricultural in Boston at that time, which is not the case.
• 14:59
  And it's because tainted milk was a real issue.
• 15:01
  And that's why kids were getting the hospital.
• 15:03
  So they had their own cows so they could have untainted milk there.
• 15:06
  So I think some of that culture has actually continued to say, I got to build something special for my patients here, whether it's technology or a cow.
• 15:13
  That's right.
• 15:14
  Vertical integration is a part of the DNA of that hospital.
• 15:18
  They want to master really all of the components necessary to achieve success.
• 15:24
  And power to them, that's a very noble and appropriate goal.
• 15:28
  So you mentioned, of course, the CIO that you already had a relationship with and moved over to Boston Children's.
• 15:34
  What were the specific challenges she was trying to address as she came in that she felt that needed to turn to Pixel Health for help on?
• 15:41
  Sure.
• 15:42
  Like many institutions, let's kind of break that question into two parts.
• 15:45
  One, the parts of Boston Children's that are like other hospitals, and then the parts that are kind of unique to them.
• 15:50
  On the former, like many hospitals, they have a lot of what's called technological debt.
• 15:55
  These are older systems that are very expensive to maintain, are limited, don't integrate with modern systems very well.
• 16:02
  And like I said, this is not an indictment of any one institution.
• 16:05
  This is just a general condition out there.
• 16:07
  So she was tasked really with number one to address that.
• 16:13
  Any money that that hospital spends on technology that is not directly related to the benefit, and efficiently related to the benefit of the clients is money that could be better spent.
• 16:25
  At the end of the day, they're about curing children.
• 16:30
  So making IT efficient, using the right technologies, modernizing it, integrate it, those were her requirements.
• 16:38
  Technical debt was a major component of it.
• 16:40
  Another one was how do you decide where cloud technology, AI, there's a whole range of, call it buzzwords in tech.
• 16:49
  technology in general and in healthcare in specific.
• 16:53
  And she needs to chart Boston Children's way through those, which is precisely what she's doing.
• 17:01
  On the more specific part of Boston Children's, and this is where I'm sure we'll get into the discussion of 5G and some of the cool things that she's doing.
• 17:11
  Boston Children's provides, if you will, services and interactions well beyond the four walls of their hospital.
• 17:17
  So there have to be ways to get their clinical operations, their services, their communications, their operations outside of their buildings into other institutions that they share with like Dana Farber or something in another country.
• 17:29
  So building a network, a security environment, an operating environment that's not geographically or physically constrained was another major goal of hers.
• 17:39
  Great.
• 17:40
  So let's jump into 5G in a minute, but I want to start first with the question.
• 17:45
  about how this relates to what many hospitals are doing, including Boston Children's, which is to say, electronic medical record is very central and let's move to Epic, as I believe that they're on that.
• 17:56
  Yes, they're moving to it now, correct.
• 17:58
  Got it.
• 17:59
  Okay, so let's talk about 5G.
• 18:01
  That's not a three letter, right?
• 18:02
  That's just one number and one letter, but one of each.
• 18:07
  So what is the promise of 5G in healthcare?
• 18:12
  Okay, I need to step back a little bit because I got to put some context into this.
• 18:18
  The real issue in healthcare is mobility.
• 18:21
  That's the, if you want to, if you try to figure out what is the driving force that is moving some of this most advanced networking, which includes 5G, it's actually the mobility of operations.
• 18:32
  When a patient is in a hospital, especially with a child, there's a care team, there's a whole range of people that are providing services, different specialists, you know, nurses, whatever.
• 18:42
  And on top of that, there's all this automation.
• 18:45
  There's things that are taking vitals, there's alarms, there's telemetry.
• 18:49
  All of this information has to move and effectively be shared between these people in real time, regardless of where they are.
• 18:56
  So the basic need for networking there has to have the guarantee of if I send the signal to something, it gets there exactly when it should, unmolested.
• 19:07
  If I need to add five different things ad hoc into some sort of group, I got to be able to do that and my technology has to do that no matter where they are in the hospital, in the stairway, in the elevator, down the hall, walking on, they're in New York City at a conference, whatever.
• 19:24
  All of these things are kind of the, that's where medicine is moving to.
• 19:28
  So that's really at the fund, that's the driver, if you will, the primary driver for something like 5G.
• 19:34
  Now we need to also separate what most hospitals, consider mobility solutions.
• 19:40
  Most of them use Wi -Fi.
• 19:42
  And that's common.
• 19:42
  That's been around forever.
• 19:44
  Wi -Fi was never designed for mobility.
• 19:46
  So as hospitals have more and more mobile cases and things moving around and people moving around, they tend to push the Wi-Fi architecture past what its real design limits are.
• 19:58
  It has nothing to do with the manufacturers, the CISCOs, the Arubas, the guys who make this stuff.
• 20:02
  They all have the same problems.
• 20:03
  It's not their fault.
• 20:04
  It's the nature of the technology.
• 20:07
  Wi -Fi has been improving.
• 20:08
  and adding between Wi -Fi 6, Wi -Fi 5, 7, all these numbers you hear, they're trying to add mobility.
• 20:14
  But the foundation, the way Wi -Fi works actually limits what it can do mobility.
• 20:21
  Now cellular services have been the opposite of that.
• 20:23
  Since cell phones ever were invented, the concept was the phone's going to be moving around.
• 20:28
  So a concept of location and mobility was built into the architecture of cell coverage from its initial design.
• 20:36
  So as cell phone technology increased and developed, its ability to handle more complicated communications, larger bandwidths, lower latency, these are critical elements.
• 20:46
  There came a point, 5G is that point, where all of a sudden those abilities are now well developed and can be applied to this need that hospitals have.
• 20:57
  So that's really the, that's kind of the most basic reason why this is happening.
• 21:02
  And it's not just the Boston Children's.
• 21:04
  many of our clients are in the process of reviewing these technologies as well.
• 21:08
  Got it.
• 21:08
  Okay, so I heard about, you know, I've been hearing about 5G for a while.
• 21:13
  I think I heard first hospital I heard about really implementing a network was Cleveland Clinic.
• 21:19
  Cleveland.
• 21:19
  I don't if that was you.
• 21:20
  Little different.
• 21:20
  Yeah, 5G.
• 21:22
  But now I hear you talking about also...
• 21:25
  hybrid 5G network.
• 21:26
  So can you add on what is hybrid?
• 21:29
  I think people know about hybrid like Prius or coming into work half the time and not, but what is a hybrid 5G network?
• 21:35
  And why would you want that?
• 21:36
  Okay, so let's step back a little and just put some definition in terms around 5G, because then it'll make this a lot easier.
• 21:42
  Great.
• 21:42
  5G is basically the collected technology of this cellular location, all the kinds of things I just said.
• 21:51
  Now, how you deploy it determines, whether it's hybrid or not.
• 21:55
  For example, first of all, there's a frequency, a specific frequency that all these devices use.
• 22:01
  Now that frequency can either be something private that you can use within a building like Wi -Fi is a private frequency.
• 22:07
  You can't do Wi -Fi in the middle of the street.
• 22:10
  You'll get into trouble with the FCC.
• 22:14
  And there are cellular technologies that are private.
• 22:17
  And one of those, you may run this term called CBRS.
• 22:21
  It's basically a private version of this 5G technology.
• 22:25
  To be hybrid really means to say that what happens in your building, the 5G's you put in your building and the 5G that's out there in the wild are a continuous thing.
• 22:35
  So a network transmission communication that begins in a hallway A and B in your building and that one guy gets in a cab and goes to the airport, that communication can continue uninterrupted without any special technology.
• 22:47
  To do that, You have to have a 5G implementation in your building and you have to have a 5G implementation in the world.
• 22:54
  Now, we used T -Mobile for this particular customer.
• 22:57
  So T -Mobile's world system, if you will, we'll call it the system out in the wild, was extended in a hybrid fashion into the buildings.
• 23:07
  That's the difference.
• 23:08
  You could have created two completely isolated 5G platforms and then you would have needed to bridge across them.
• 23:13
  It's the fact that it's all under one system and controlled by, in this case, DeMobile, is what makes it hybrid.
• 23:19
  And does it extend to a patient being discharged and being in their home?
• 23:24
  Yes.
• 23:25
  That's exactly so.
• 23:27
  So following what you just said, imagine a situation.
• 23:30
  And I'm making this up.
• 23:31
  A patient has some disease.
• 23:32
  And with the disease comes a device that's connected to the patient that needs to be monitored.
• 23:38
  Now, if that's a life -critical type device, getting to that device anytime, anywhere under any condition becomes essential.
• 23:46
  If you were to do this with the internet and VPNs and the home internet linking to the hospital, there's all sorts of unknowns there.
• 23:54
  The system could fail and you would never be able to monitor it.
• 23:59
  And both the FDA and the FCC in some cases have rules and limits around these kinds of technologies.
• 24:05
  If you're going to monitor and work with these mission critical things, the network must support that.
• 24:11
  So in this case, if I build a hybrid 5G network and I have systems, including Epic and all the technology around it, Epic, that big record system in the hospital, all connected to the 5G network, and then I have a device or a handheld or something that goes out of the four walls to the person's home, but it's on the same hybrid network, it's communicating back to the hospital as if it was in the hospital.
• 24:34
  None of the machinery is aware that it's not in there.
• 24:38
  That's one of the key drivers of this kind of a network.
• 24:42
  Got it.
• 24:42
  I remember maybe two or three years ago before 5G was widely deployed and we're speculating about some of the reasons that might make a difference in healthcare.
• 24:50
  And if I'm remembering correctly, one of the big differences between 5G and 4G was much lower latency.
• 24:57
  Yes.
• 24:57
  Is that a fact and has that proven to be important?
• 25:00
  Yes, that is.
• 25:01
  There's a couple of reasons why this was very difficult to do with 4G technologies.
• 25:09
  One was latency.
• 25:11
  The other was the ability to carve out a little piece of the network and say, so what, it's called network slicing, but it's a little bit more complicated than that.
• 25:19
  But the general concept is what T -Mobile has said to Boston Children is, here is a little itty bitty piece of our entire network.
• 25:25
  It's yours.
• 25:27
  You can do what you want on it.
• 25:28
  We're guaranteeing.
• 25:30
  a certain amount of communication and control in that little area.
• 25:33
  We're encrypting everything.
• 25:34
  It never touches the internet.
• 25:36
  It's all your little network.
• 25:38
  That was basically impossible in 4G.
• 25:41
  There was no way to separate out the communal network into these specialized little chunks.
• 25:47
  That's built into the 5G capability.
• 25:50
  Got it.
• 25:51
  Now, privacy and security are certainly very important in health care, and especially when you're dealing with pediatrics.
• 25:55
  Can you contrast maybe a hybrid 5G network compared to Wi -Fi?
• 25:59
  Sure, absolutely.
• 26:01
  The good news is there is some similarity on the security.
• 26:04
  The best way to look at security rather than compare 5G to Wi -Fi is to say internet versus non -internet.
• 26:13
  Inside a hospital, security is maintained when talking between things in a hospital because those things have built in, if you will, encryption and security methods between them.
• 26:23
  Not a lot of intervening equipment is required.
• 26:26
  So for example, you know, when you're on a desktop in a patient's room recording some epic stuff, the operating system, the settings of the software inside the desktop assure that what the desktop data it's creating is encrypted and heading back to the data center in the hospital in the basement, where other stuff understands that equipment and then sends it back the other way.
• 26:49
  So in other words, there's an automatic safety, if you will, of encryption and security in the hospital simply because it's localized technology.
• 26:59
  The internet is non -secure by definition.
• 27:02
  If you want to use the internet to talk securely to something somewhere else, you must provide that level of security.
• 27:08
  You must have equipment on both sides.
• 27:10
  It must be set up right and whatnot.
• 27:13
  So in the sense that Wi -Fi is inside a hospital, it is essentially as secure as anything else.
• 27:19
  When 5G is inside a hospital, it's inside a hospital in the same sense that Wi -Fi is.
• 27:24
  There's little antennas in the ceiling that do Wi -Fi and other antennas that do 5G.
• 27:29
  When you're at the house and you're using T -Mobiles or any carrier's 5G network on your cell phone, that antenna on a pole somewhere is no different than the antenna in the hospital.
• 27:41
  So in that sense, they're functionally equivalent.
• 27:44
  So Wi -Fi to Wi -Fi within a building is equivalent to 5G to 5G in or outside the building if you build these hybrid networks.
• 27:53
  Does that answer it?
• 27:54
  Got it, yeah, well it's always a little more complicated than that, but so what about if a patient is using WiFi in their house as opposed to a 5G device?
• 28:02
  That may be secure, but that WiFi in their house must go through the internet.
• 28:07
  There is no connection between the house that is similar as in the hospital.
• 28:13
  Both the house and the hospital can have an internet connection, but as we said earlier, that internet connection itself is insecure.
• 28:20
  You must apply security over it, both at the house, with firewalls and VPN software and at the hospital with firewalls and VPN software.
• 28:28
  And unless you do it all right, it's not gonna be secure.
• 28:31
  And then even if you do it right, what you mentioned earlier, latency and other issues come into play.
• 28:38
  So Wi -Fi doesn't really deal with the latency.
• 28:41
  It doesn't, in an internet context, help the security component.
• 28:47
  What 5G does is it includes it by its nature, takes care of the latency and all those issues.
• 28:53
  And because it's a continuous technology between the hospital and the endpoint, there's no additional need for security.
• 28:59
  The security is inherently in the system.
• 29:02
  Got it.
• 29:03
  So we talked earlier about how the hospital has to be careful about what they're spending and where the funds are going.
• 29:09
  What is the overall magnitude of financial investment in an initiative like this?
• 29:13
  And how do they measure whether they're getting value out of it?
• 29:16
  It's first of all, it's very significant.
• 29:17
  This is not for the faint of heart.
• 29:20
  While I can't share the financial facts for Boston Children's, because it's inappropriate, what I can say, it is a multi -million dollar large scale commitment.
• 29:30
  Now, this goes back to our earliest conversation about like, what's different about healthcare, the fact that it's this disorganized kind of group of separate entities and there's the top down, all of that, that plays here because, While healthcare has to cover ROI, return on investment, value for the money spent, those are all real.
• 29:51
  But there are other, almost more important variables that drive very expensive decisions.
• 29:56
  And those are basically clinical outcomes, the patient outcomes, and clinician satisfaction.
• 30:02
  There's a lot of burnout between doctors and nurses, a lot of dissatisfaction in just the production of medicine.
• 30:08
  And technologies and systems that alleviate that are worth massive amounts to a hospital.
• 30:13
  So in the case of Boston Children's, we'll just call it X what they spent.
• 30:18
  They created a five -year agreement with T-Mobile for X dollars.
• 30:23
  Only a small portion of that X dollars actually saved traditional money.
• 30:28
  Like if we do this, we don't have to spend that.
• 30:30
  If we take the $10 from there and move it over to here, it'll only be $8.
• 30:34
  Only a small portion was that.
• 30:36
  However, because Boston Children's wanted to make sure that their internal communications were perfect, no matter where people were, moving and that was causing problems.
• 30:44
  There's a lot alerting telemetry issues that weren't working as well as they should.
• 30:48
  They needed to be fixed.
• 30:50
  So these elements that deal with patient safety, patient outcome, clinician satisfaction were probably a larger set of drivers than simply purely monetary functions.
• 31:01
  But when we added them all together, the net result justified the expense.
• 31:06
  This has been a very helpful explanation of the children's situation hybrid 5G networks.
• 31:12
  I want to end by asking you to look ahead a little bit and ask you what comes next for the industry and for Pixel Health as it relates to technology.
• 31:23
  Well, I think the industry is basically the continuation of the current trends.
• 31:26
  And I mentioned mobility as a huge driver.
• 31:30
  Whatever comes next, 6G, whatever it's going to be called, is certainly going to focus on interoperability between systems and carriers and entities.
• 31:41
  It's going to push bandwidth.
• 31:43
  Basically, things like AI, the ability to make decisions on huge data sets where those data sets are not necessarily all in one place.
• 31:51
  All of these issues are going to drive that mobility and its capabilities.
• 31:55
  So that's a big thing.
• 31:57
  That's going to push a lot of health care.
• 31:59
  You're going to see health care expand well beyond the four walls of a hospital.
• 32:03
  You're seeing ERGY centers.
• 32:04
  You're seeing CVS and these other places do health care more than just drugs and products.
• 32:09
  That's gonna continue, healthcare will move into your house, into your business, everywhere.
• 32:14
  So the technologies that facilitate that are going to drive and we're going to be at the front end of that.
• 32:19
  We want to take the T -Mobiles of this world, the epics of this world, our hospital clients, we have about 100 hospitals or so that we work with.
• 32:26
  All of these entities, we wanna be at the forefront of how these technologies are implemented to increase basically patient outcomes, clinician satisfaction.
• 32:36
  If we can move the needle.
• 32:37
  on those two things, if we and all of these technology partners can move the needle, you will see healthcare become less expensive, more efficient, just plain better.
• 32:48
  Well, that's it for the latest episode of Care Talk Executive Feature Series.
• 32:52
  I'm David Williams, president of Health Business Group.
• 32:54
  My guest today is Michael Feld, founder and CEO of Pixel Health.
• 32:58
  If you've enjoyed the show, please leave a rating and subscribe on your favorite service.
• 33:03
  Michael, thank you.
• 33:04
  Thank you.