Latest / Becker’s Healthcare - Clinical Leadership Podcast / Dr. Ryan Madder, Section Chief of Interventional Cardiology & Medical Director of the Cardiac Cath Lab at Spectrum Health Butterworth Hospital in Grand Rapids, MI

Transcript

Dr. Ryan Madder, Section Chief of Interventional Cardiology & Medical Director of the Cardiac Cath Lab at Spectrum Health Butterworth Hospital in Grand Rapids, MI · Becker’s Healthcare - Clinical Leadership Podcast

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  Welcome everyone to the Becker's Healthcare podcast series. I'm Ryan Mohammed,
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  she her pronouns with Becker's Healthcare.
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  I'm thrilled to have with me today Dr. Ryan Mader of Corwell Health Doctor.
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  So nice to talk with you today. How are you?
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  I'm great. Thank you for having me on.
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  Yes, of course. I'm so glad that you're here today. Uh, to begin,
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  would you mind please introducing yourself and telling us a bit about your
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  background?
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  Uh, sure. So, uh, my name is, uh, Ryan Mader. I am a, uh, practicing,
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  uh, interventional cardiologist, and I serve as the, uh,
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  director of the cath lab and the section chief of interventional cardiology at
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  Corwell Health in, uh, grand Rapids, Michigan.
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  Perfect. Thank you. Um,
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  and so the next question that I wanted to talk to you about is how can tele
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  robotic surgery close the gaps in access to care and health disparities
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  a across the u us if you have an answer for that.
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  Yeah, so, um,
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  I've been working on tele robotic research now for almost a decade.
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  And, uh,
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  the problem that we're trying to address with this research are really these
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  disparities that exist, uh, not just in the United States,
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  but around the world in rural, uh, underserved locations,
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  where the type of care that is delivered is not the same as we deliver in
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  places, you know, in urban settings or suburban settings.
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  And so the goal of this is to try to, you know,
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  develop tele REbotics to eliminate those geographic disparities in care. And,
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  and one of the issues, you know,
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  that exists right now in the United States is that if, if you're a patient, uh,
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  living in a rural area and you present to a hospital with heart attack or
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  stroke, the type of treatment that you get in that rural hospital is gonna be
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  significantly different than the type of treatment that you're offered,
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  you know, in an urban or suburban hospital. And that's unfortunate because,
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  you know,
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  the state-of-the-art treatment for a heart attack is to go into the heart with
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  catheters, find the blockage, and,
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  and do an intervention where we do angioplasty and stenting to open up that
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  blockage. And many rural hospitals just don't have the, uh,
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  either the expertise, uh, or the technology to,
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  to do that and offer that to their patients. And so, um, you know,
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  when you aren't offered a, you know, stent procedure, uh, you know,
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  for your heart attack, uh,
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  and you just get medications alone that's associated with the higher risk of,
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  of death, uh, it's associated with, you know, uh, having a larger, uh,
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  heart attack and more damage done to your heart and a higher risk of,
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  of living a life with, uh, congestive heart failure in the long run.
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  And so there are substantial benefits to opening up, uh,
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  blockages in the setting of a heart attack with, with, uh,
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  stents and angioplasty. And unfortunately, that's just not offered, uh,
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  everywhere right now.
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  And so that's something that we're trying to develop the ability to deliver to
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  those, uh, rural areas, uh, by using tele REbotics.
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  Wonderful. Yeah,
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  I'm so glad you discussed the challenges in the location of the treatment. Um,
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  I'm sure that could be a very challenging time for the patients impacted as
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  well. And for you, doctor,
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  where do you see the physician ment of tele robotic surgery trending right
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  now? What are the opportunities and the risk?
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  Yeah, and so, well, the research that we've done, you know,
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  today really shows that we have the technical ability to do this now. And so,
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  uh, we started this research again almost a decade ago now,
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  where we showed that it was feasible to use a robotic system to fix a
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  patient's heart, even when we weren't sitting in the same room as the patient.
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  So in that initial research,
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  we actually wheeled the robotic controls out of the,
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  the room where the patient was and,
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  and showed that we could successfully fix that patient's artery, uh,
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  despite not being in the same room as the patient. And that was the,
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  the first study that, that we had done, uh, to explore, you know,
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  whether tele robotics was gonna be a way that we could potentially treat PE
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  patients from, you know, over long distances. And, you know, whereas, you know,
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  heart surgeries are traditionally done with the physician standing right next to
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  the patient. That initial, uh, study that we conducted,
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  we were about 55 feet away from the patient. And, and that was a major leap, uh,
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  you know, forward in, in demonstrating the, the, you know, potential of,
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  of this, uh, tele robotic therapy. Uh, we did subsequent research then that,
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  uh, you know, evaluated whether we could do this over distance of miles.
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  And so we developed, uh, ex vivo simulator models,
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  and then we did some animal work where we were, um, stenting, uh, live animals,
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  uh, from distances of over a hundred miles away and,
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  and showed that that was successful. And then, uh, in, in 2018,
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  a physician in India, Dr. Taja Patel actually, uh, you know,
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  used the setup that we had developed and tested here in Grand Rapids and
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  actually, uh, stented, uh, five, uh,
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  humans from a distance of about 20 miles away showing that it was successful.
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  Uh, and so that was a, again,
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  I think another major leap forward showing the feasibility of doing long
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  distance, you know, tele robotic procedures, uh, on living humans.
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  And then we spent much of the time in 2019 in a collaboration with, uh,
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  the robotics company and with, uh, Verizon Wireless to actually study, uh,
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  you know, is to ask the question,
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  is there a distance that is too long right now to reach a patient using tele
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  robotics?
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  And so we set up a transcontinental model where I was sitting at robotic
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  controls in Boston and actually controlling a robotic arm in San Francisco.
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  And, uh,
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  and over that distance across the country showed that we could actually do,
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  you know, a heart, uh, based, uh, procedure, not on, not on a living patient,
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  but on actually a simulator and showed that we could do it completely
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  successfully. And so, you know,
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  because we were able to do that successfully in that model, we think that,
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  you know,
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  we can reach almost any location within the continental United States that has
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  adequate, you know, uh, internet, uh, capacity. Um,
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  and so we're designing studies now to really look at this, uh, you know,
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  and really take this to the next level where we might eventually be able to
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  offer this, uh, inpatients.
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  Yeah. Thank you so much for sharing, you know, some of your research.
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  I know that that can take a long time to conduct, but the results you, you know,
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  shared certainly show hope for many. And as you know,
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  technology is helping many healthcare professionals and patients around the U S
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  A, um, however,
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  what advice do you have for surgeons who are on the fence about telerotic
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  surgery?
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  Yeah, I, I think we're gonna see greater and greater adoption of, you know, of,
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  you know, all aspects of telemedicine. And I think the,
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  the pandemic really catapulted, you know,
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  US healthcare and healthcare in other countries to, to adopt, you know,
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  telemedicine, you know, technologies to, to deliver care at a distance.
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  And, um, you know,
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  that I think that was one of the beneficial things to come out of,
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  out of the pandemic as awful as it was. But, you know, I, I've,
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  I've seen greater adoption not just within the healthcare community,
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  but also within, you know, kind of, uh,
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  patients where patients I think are more willing than ever to, to, you know,
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  accept, you know, telemedicine as a, as a viable treatment option. And,
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  you know, tele robotic surgery is just a, a, a, you know, an offshoot of,
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  of telemedicine. And so I, I do anticipate that even, you know,
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  for physicians who may be on the fence about this,
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  that I'm hopeful that with the research that we do in the future,
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  that we'll be able to demonstrate that this is an a,
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  a safe and effective therapy,
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  and eventually be able to convince those physicians that this is something that
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  they could provide, you know, patients who are far away from them.
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  Wonderful. Yeah. Thank you so much for those final thoughts. Doctor,
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  this has been an amazing discussion. Uh,
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  so I wanna thank you so much for coming on Becker's Healthcare and I look
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  forward to connecting with you again soon.
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  Great. Well thank you very much for your time.
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  Thank you.