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How are hospitals innovating with technology? · Technology Now

• MICHAEL BIRD Good morning, Sam. SAM JARRELL Good morning, Michael. MICHAEL BIRD now, if I were to ask you to describe some type of medical technology, what would be the first thing that comes to mind? SAM JARRELL The HP 80 20 A MICHAEL BIRD Ooh, Tell me what the HPE 20 A is. SAM JARRELL It is the world's first non-invasive fetal heart monitor. debuted in 1968. MICHAEL BIRD having had, two babies and I go through the process of you like listen to the heartbeat, that is such an amazing moment when you get that and it's like a little microphone, isn't it? SAM JARRELL wait, wait, wait. Michael, what? What is the first bit of medical tech you would think of? MICHAEL BIRD So the first thing that I think I thought of was the MRI machine. not that I've ever been in one, or actually seen one in person, but, MRI machines are pretty cool. now Sam, today, we are looking at the intersection between technology and medicine 'cause we're gonna be looking to how technology can help diagnose, discover, and treat catastrophic illnesses in children. I'm Michael Bird. SAM JARRELL I'm Sam Jarrell MICHAEL BIRD And welcome to Technology Now from HPE. SAM JARRELL So, Michael, we’re talking about medical tech this week. Why? MICHAEL BIRD We absolutely are. Medical tools are some of the oldest artifacts we’ve discove red. 5000 year old copper knives believed to be early Sumerian surgical instruments and archaic trephines – the bone drills used for making holes in human skulls during trepanning – have been found across multiple Neolithic sites so we know that humans as a species have been creating medical technology since some of the earliest civilisation. SAM JARRELL And I guess that as we created new materials or improved metal production and purification techniques, these medical devices improved with it? MICHAEL BIRD Yeah, exactly. Medical tools have continued to evolve along with society from these ancient devices made of obsidian or rough copper, to the highly pure steel used in needles or scalpels today alongside advanced medical machinery which we use for scans or treatments and that is exactly what we are exploring in today’s episode as I had the opportunity to chat to Keith Perry, Senior Vice President and Chief Information Officer for St. Jude Children’s research hospital. Now St. Jude was founded back in 1962 with the dream that ‘no child should die in the dawn of life’ so as well as being a specialist hospital treating catastrophic paediatric diseases, they are also a centre of research to try and find ways to improve prevention techniques and treatment plans in the future. Now just a note for this episode, given that St Jude Children’s Research Hospital is a paediatric hospital, we did want to give you, our listeners, a heads up that the interview in this episode will include discussions of illness and death so please do use your discretion if you wish to listen. SAM JARRELL Thanks for that Michael, and I am really looking forward to this interview however before your chat with Keith, I want to take a moment to explore one of the most iconic medical technologies ever created. ... It’s time for Technology Then. SAM JARRELL So let’s talk about one of the most common types of medical examination performed every year: the x-ray. MICHAEL BIRD Ah yes. SAM JARRELL According to a 2019 paper published in the Journal of the American medical Association, 55.1% of all medical imaging procedures between 2000 and 2016 across the USA as well as the state of Ontario in Canada, included some sort of x-ray . They were discovered in 1895 and it’s pretty fair to say they changed the world of medicine forever. Michael, have you ever had an x-ray? And follow up question – do you know what the ‘x’ stands for? MICHAEL BIRD Response Um, excellent. It stands for excellent, excellent Ray. SAM JARRELL Uh, not quite so, like many scientific discoveries, x-rays were found by accident. A Bavarian physicist called Wilhelm Roentgen was doing an experiment and he was surprised to discover some sort of green light was passing through the black paper designed to block it. Upon further experimentation, he found that this mysterious light passed through not just the paper, but most of the substances he tested with only dark shadows of some solid objects being able to block it. The ‘x’? Well if you’ve ever done algebra, the x is simply for something you don’t know. It's the mystery factor But it didn’t stop there. With more testing, Roentgen quickly discovered that these x-rays would pass through human tissue and could reveal the bones within. Roentgen took what we now call the first medical x-ray just six weeks after the initial discovery which showed the hand of his wife Anna Bertha Ludwig who, upon seeing the image, allegedly claimed “I have seen my own death” – Ooh, and we will link to that picture in the show notes if you want to see Death Yourself it yourself. I'm kidding. News of the x-ray spread around the world, catching on almost immediately as it allowed diagnosis of all sorts of issues without invasive procedures. In 1901, roentgen was awarded the inaugural Nobel Prize in Physics. X-rays were so popular that between the 20s and 50s, shoe stores even used them to find the size of people’s feet – although this practice was stopped after the risks of overexposure to radiation became apparent. The discovery of x-rays paved the way of more imaging techniques – MRIs, CT scans, ultrasounds, ECGs, the works, and all that, from an accident in a physics lab! MICHAEL BIRD I think we take it for granted that you break a bone or you know, there's, you know, something not quite right with your body. You can go and get these non-invasive tests, SAM JARRELL It makes me really grateful to live in the age that we live in. MICHAEL BIRD I 100% agree with you, that and anesthetics. Now, we still use X-rays at hospitals however the way the information we learn from them is stored and processed and used has changed drastically as new technologies have been discovered and invented so, to find out more about how one hospital uses cutting edge technology in medicine, I spoke with Keith Perry, Senior Vice President and Chief Information Officer for St. Jude Children’s research hospital and I started by asking what role does technology play at the Hospital? KEITH PERRY So we can't advance the mission without technology, you can't treat that child. in front of you without electronic health record. you can for a period of time, but when you think about sustainable and scale, that's where technology comes into play. And so I would say technology plays an extremely important part in advancing, not only our, academic and research mission, but also clinical care and administrative services as well. MICHAEL BIRD And, and so can you just sort of talk through the, like where technology specifically is focused on, you know, you talked about clinical and research. Is it sort of 50 50? KEITH PERRY So it's, it's a very blurred line for us. Yeah. Because like I said earlier, we wanna learn from every child. When we're seeing catastrophic diseases, so we're getting very sick children that were coming into the doors and becoming a St. Jude patient. we wanna learn from them. So most of our children are on some type of therapeutic trial. so trials in the context of clinical care is a very blurred area for us, and that data that is used to treat that child is then used in advancement of knowledge. So that's one piece of that blurred line that I talked about. But then behind that, um, when we talk about knowledge and discovery, you, we can't advance our understanding of disease without understanding at a cellular level, at a molecular level. And so we've got some really strong basic science programs that are, that are trying to understand how drugs and the combination of drugs and what's those protein structures and how do we deal with that at a molecular level as well. MICHAEL BIRD And, and, and what does St. Jude do differently as it relates to technology that, other hospitals do? KEITH PERRY That's a, it's a good question. 'cause, you know, I would say, from the perspective of. Doing differently. There's some great organizations out there in the world, that are really advancing, knowledge and how do we treat and understand the disease, and the complexities, of it. where I would say St. Jude is unique and different is we're solely focused. So our focus is on how do we eradicate paediatric catastrophic disease. Which, you know, narrows in our level of understanding and how we want to approach, our research, how we want to approach our science and how do we want to approach clinical care. MICHAEL BIRD I understand that, St. Jude has quite a bit of high performance computing. What, what exactly does a, a hospital use? High performance computing for, KEITH PERRY we use that in combination of things. So everything from how do we think about radiation dosing to how do we think about protein structures and how do we visualize, uh, what's happening with a cell, cancer cell or even a normal cell. To be able to, either align that data or take noise out of that data or to find some commonality and compare that image from one image to the other, MICHAEL BIRD And so what, what is a high performance computer, give you over say, you know, just some normal compute, like what, additional things can you do with it that you maybe couldn't have done before? KEITH PERRY That's a, that's an interesting question. So with catastrophic disease, for that family, for that child, what they want is time. And so there's a real sense of urgency that we have at St. Jude, around we need to advance every day. And so when you take that and put that into context of high performance compute versus traditional compute, we're pushing the, availability to get knowledge into the hands of our researchers and scientists and clinicians faster than we could in other means to give them time, either the clinician time to think about the problem differently. Or our patients and families time so that they're not waiting for a treatment plan to be developed, or a dosing calculation to happen. MICHAEL BIRD I've never really sort of heard of that from that perspective before. on this show, we've talked to other, organizations that have high performance computing and, and sometimes they say,we can get calculations faster, but I think that that the concept of the fact that you are, you are dealing with humans, real people, families, children, and actually if you can process that data, get answers faster, I suppose you're talking about a direct impact on somebody's life. KEITH PERRY Absolutely. So I'll put it into context. So if you're getting radiation therapy or proton beam therapy, there's certain number of calculations that need to be done in order to make sure that that beam is where it should be. And it takes high performance computers that are really aligned, in order to deliver those results sooner. So, you know, we used to have to do that over a week, and now we can do that over a period of time. So you as a family are not being told, well come back in a week and we'll have your treatment because that week there's an uncertainty and anxiety. Every moment of the day when your child or your loved one has cancer, that you really want to push and have a sense of urgency. MICHAEL BIRD I'd love to just talk about diagnosis. Um, can you sort of talk through how you are using technology to help with things like imaging and, and diagnosis? We've got KEITH PERRY Yeah, so we've got a fantastic. Radiology group, that is bringing, AI into, the pediatric space. The challenge in pediatrics is there's not that many cases and so we're having to collaborate worldwide or collaborate within the US and the aim is to help our radiologists to identify those tumors faster, whether they're growing or shrinking or staying the same, and then subtyping those images and classifications as well. MICHAEL BIRD And are you, are you developing. You know, particularly new technologies on site for this. I mean, you talked about ai, presumably the field of AI as it relates to medical imaging is probably moving quite quickly. KEITH PERRY I would say our uniqueness is, we're solely focused on catastrophic pediatric disease, so our. Focus is on how do we help, uh, around those diseases that, that we are, um, we have the most knowledge on. MICHAEL BIRD And working, communicating, collaborating with other hospitals, doing similar things. Is that, is that quite a vital process to this? KEITH PERRY one of the foundational components of, St. Jude is we recognize that we can't do this alone. So there's. And great work being done all across the world. And so we want to, be there to help and, not only be there as a resource for people, but to be there and, and use our expertise to advance the discovery as well. MICHAEL BIRD do you have to change the approach to using machine learning for diagnosis because it's a hospital specializing in pediatrics? KEITH PERRY I would say the answer is yes and no. So yes, from the perspective of what I talked about earlier with, from the pediatric, the cases are small so that we really need to. Focus our effort efforts on collaboration, no from, uh, it's no different than an adult cancer center that's having to, that's working with AI and how they, that you have to go through a process to make sure that, uh, you understand those results, that you validated those results and that those results are repeatable. Uh, and that's where you follow the academic process to, to be able to go through that, that particular study to. To validate your, um, your hypothesis, if you will. MICHAEL BIRD Yeah. So when it then come, when it comes to treatments, when, how are you using high performance computing to help develop new or bespoke treatments? so we're doing some really things around how do we think about the protein structure and how does that help with, Drug development, which is really kind of gonna lead us into that, bespoke drug treatment paradigm where we're able to, have drugs. so is that. is that where you sort of.of Understand the patient's, you know who they are. And you can say, right, this drug and this drug is perfect for this patient. Or maybe this, this combination of this drug is perfect for this patient in this dosage, KEITH PERRY that's a great way to characterize that. Now I will stay up front thatI'm not a medical doctor. I'm a technologist that, has been in the industry for a while, but I think you summed it up really well. MICHAEL BIRD what impact will that have on both patients, families and the wider, organization? KEITH PERRY As a non-medical person that has had somebody, with cancer in my life, it gives hope, right? So it gives hope that, the thing that's going inside my body, or that's going into my loved one's body is really developed and bespoke to them. and that gives us hope of life, if you will. MICHAEL BIRD Well, let's then talk research because, um, obviously St. Jude Children's Research Hospital has research in the name. what sort of research do you carry out? KEITH PERRY So our faculty are really questioning and challenging and interrogating, all types. I think they're interrogating. What's the direction? Based upon their knowledge, and that leads us into, future research endeavors. but it's all coming back to catastrophic pediatric disease, starting at the cellular level to the protein that I was talking about, protein structures all the way through clinical trials that kinda lead to that clinical care and treatment. MICHAEL BIRD And, and how, as an organization do you decide what it is that you do research on? KEITH PERRY What I would say is a combination of needs within our patients and the expertise of our faculty really guide us, uh, where we're, where we're going next, and the direction that we're heading from a research perspective. MICHAEL BIRD Okay and, and how vital is the technology in, being able to do this, this research? KEITH PERRY I think it's foundational. you can't advance most therapeutic trials or most clinical research without some underlying technology. whether that be high performance computer or how are you storing that data and making sense of out of that data. MICHAEL BIRD a and me medical research has been going on for, well in its current form, I suppose, for decades. I mean, arguably centuries. How has sort of technology impacted that? Is it just that the research can be done faster as we talked about earlier? Or is it the technology can actually achieve different results? KEITH PERRY I'm probably not qualified to say that we could get different results with or without technology. I will say that it's, it's been an underpinning, for as long as I can remember. But, in my career that. technology plays an extremely important part in advancing scientific discovery MICHAEL BIRD Because I think if you picture medical research or even just sort of, you just picture a lab, don't you, lab coats with microscopes, it's sort of hard to understand where does technology fit into that? KEITH PERRY yeah. Usually it's on the, the back end, so we're working with our researchers on, you know, the instruments that they're either using or developing themselves. Are producing data, that data has to go somewhere and you have to make sense out of the value of the data, but also the noise in the data that you have to find a way to eliminate. And so that's where computers come in, uh, and are really being used today, now that with advancements in AI and others. And so I, I just see it as foundational for our future. MICHAEL BIRD And So are you already seeing the benefits of this technology in in healthcare outcome? KEITH PERRY Yes. and I think that we're gonna see more and more each day. So I think that there's some great studies, Across the globe that are happening right now. So we'll continue to see the advancements in the use of technology, to further our understanding of disease and also how do we treat and how do we diagnose, treat, and then follow up on diseases in the future. MICHAEL BIRD do you connect with your, peers in other hospitals and sort of share ideas on how they're using technology or, you know, share how you are using technology? KEITH PERRY Yeah. Within the healthcare community in general, there's a, there is a sense of purpose that we all share. Um, we know why we're here, we know why, uh, how technology plays a role. And so there's really. Within the IT or technology community. Within healthcare, there's a really strong purpose of sharing and non-com competitiveness, if you will. I think just within the technology space, there's a sense of collaboration. MICHAEL BIRD So you are dealing with medical data, quite sensitive data in some instances, unless it's, anonymized. how do you think about security KEITH PERRY you can't ignore security.we have data that's identifiable. We have data that's de identifiable. We have data at rest, we have data that's, in transit if you will. All of that has to have some component of security to it. and our security team's really good because, you can, you can be dictatorial and say you can't do that. Or you can say, let's find a way to. Help make sure that the data is secure while at the same time advancing how information is shared. Because data needs to be shared and that's something that we take very seriously. And so our security team really walks alongside our researchers and understanding what are they trying to accomplish and then coming, behind them and alongside them on how's the best way to keep that data secure. MICHAEL BIRD because there's, that sort of all feels like a, a balancing… KEITH PERRY It's a risk management balancing act. MICHAEL BIRD You know, to some extent, you wanna just secure the data and not let anyone access it. But if nobody can access it, then you can't do anything with that data. The data's not useful. You may as well just not have it KEITH PERRY Correct. I tell people we're sitting on top of this data but that. Not doing us any good. That's not advancing our mission. So we've gotta figure out a way to, to be able to freely share that data, in a secure way that doesn't put patients', information at risk or jeopardize a research study. MICHAEL BIRD And so how do you share this data or, or any data outside of, outside of your organization? KEITH PERRY we've developed St. Jude Cloud, which is our. Our way of freely sharing our genomic data, and other tools and models with the world. And so we freely share that data with researchers across the globe. MICHAEL BIRD And on that, thank you so much for your time. It’s been a pleasure KEITH PERRY thank you. I appreciate it. SAM JARRELL Wow. Well, you know, despite the topic for that interview, I thought it was really nice that thematically it felt like it was just about buying people more time, more bespoke care and hope. MICHAEL BIRD Yeah. I've done quite a few interviews with people talking about high performance computing and, the question always comes with what does this bring you that your laptop won't, for example? And often they talk about, high resolution, you can predict more or you can get answers faster. But I found it incredibly humbling when he was like, yeah, you essentially give patients more time, you give their families more time. You get knowledge to the researchers and the clinicians faster. you can come up with treatment plan faster, having had children in a hospital, I know that feeling of that anxiety of you are just waiting for an answer. And I mean, even waiting 24 hours is horrible. So, yeah. You know how technology can be used to bring people hope I just find it quite humbling because I think we're surrounded by technology. This feels like it's a completely different level. SAM JARRELL Yeah, the ultimate customer being a child in the dawn of their life, it is an incredibly humbling and an admirable mission. he said they're solely focused on pediatric catastrophic disease. But the tech plays a role from, administrative pieces like records to the actual clinical care. And I imagine even though they're only focused on pediatric catastrophic disease, it probably has applications they learn that eventually extend to adult care. So everyone benefits, right? MICHAEL BIRD and I think actually maybe one of the things is that sharing data, and we talked about that balancing act of, there's basically two sides. Give everyone access to all the data, give no one access to any data, and trying to find a middle ground there. He talks about the St. Jude Cloud. I think we briefly talked about medical imaging, radiology, getting lots of data and, there's not loads of data for pediatrics. relative to say, people my age so they have to be a bit more clever. And I think they talked about collaborating with other organizations at the hospitals. So that was, that was really interesting because I think, again, you don't necessarily think about that when you think about medical research. the thought of that sort of collaboration, the sort of thought of that data's being pulled together so other families don't have to go through a similar situation, or if they do that situation is, you know, much less severe. Speaking as a parent, that's something that I think would, make things feel a, like a teeny, tiny bit better. SAM JARRELL Yeah, the, the tiny little silver lining that there is. MICHAEL BIRD The tiny, the tightest silver lining. Now, Sam, what Keith and the team of St. Jude do is amazing. so something I really wanted to ask him was how he ended up where he was. MICHAEL BIRD how did you end up doing this job? Like what, what made you want to do this, this role over, you know, any other sort of technologist type role? KEITH PERRY That's, that's interesting 'cause I tell people I fell into healthcare, several years ago and I just fell in love with that. you can call it an intersection, but it's that the disruptive nature of technology, which I kind of grew up in. That's my academic, journey. But then healthcare is extremely disruptive too. We know very little about disease and what happens with the human body and how different we all are, and just the marriage of those two was really unique to me and I really kind of fell in love with that. But I'll say what, what really motivates me is, uh, and I mentioned I've, my, I never met one of my grandmothers, one of my, my other grandmother passed away when I was nine. I've lost my mother and my sister to cancer. And so that drives me to how can I, as a technologist, uh, make sure that my purpose is helping to advance knowledge discovery SAM JARRELL Okay that brings us to the end of Technology Now for this week. Thank you to our guest, Keith Perry, And of course, to our listeners. Thank you so much for joining us. MICHAEL BIRD If you’ve enjoyed this episode, please do let us know – rate and review us wherever you listen to episodes and if you want to get in contact with us, send us an email to technology now AT hpe.com – subject line, Sam? SAM JARRELL Wilhelm Roentgen, however you think that last name is spelled. MICHAEL BIRD Yes, good luck. Good luck with spelling that, uh, and don't forget to subscribe so you can listen first every week. Technology Now is hosted by Sam Jarrell and myself, Michael Bird This episode was produced by Harry Lampert and Izzie Clarke with production support from Alysha Kempson-Taylor, Beckie Bird, Jody True, Alissa Mitry and Renee Edwards. SAM JARRELL Our social editorial team is Rebecca Wissinger, Judy-Anne Goldman and Jacqueline Green and our social media designers are Alejandra Garcia, and Ambar Maldonado. MICHAEL BIRD Technology Now is a Fresh Air Production for Hewlett Packard Enterprise. (and) we’ll see you next week. Cheers!