John Bertrand, co-founder and CEO of Digital Diagnostics, on VatorNews podcast

Digital Diagnostics is an AI system for faster and more accurate diabetic retinopathy diagnosis

Steven Loeb speaks with John Bertrand, co-founder and CEO of Digital Diagnostics, developer of an AI diagnostic system that allows diabetic retinopathy to be diagnosed at the point-of-care in front-line care settings.

Our goal with this podcast is to understand how technology is radically changing healthcare: the way we screen, treat and measure progress and outcomes. Whether tech is helping or hurting our well-being physically and mentally. And whether we’re creating productivity that drives economic costs down while improving are overall health.

Highlights from the interview:

• Bertrand took over as CEO in late 2019, and what interested him was the company’s view that new technology should work within the existing healthcare framework. His experience in healthcare taught him that you'd have to be very careful with innovation and new technology since you're not looking to disrupt, you're looking to augment what's already there. When you bring an innovation to healthcare, you're actually putting patients lives at risk.
• Digital Diagnostics’ core product diagnoses diabetic retinopathy, and there’s a consensus within the physician community that if it's caught early it can prevent patients from going blind. The company works within the system, and found a problem that already existed to solve, rather than just trying to upend the whole way that we deliver care in the United States.
• Controlling glucose level or A1C has an impact and can damage or start to deteriorate a patient's vascular health over time. That manifests itself in a few places, including in the feet, with patients getting amputations. That same biological process also happens in your retina with the same vasculature following the same pattern in the body, but instead of losing feeling in your feet, you start to go blind progressively over time. 80% of all patients with diabetes will start to head down this diabetic retinopathy disease pathway over their lifespan, so every patient that has diabetes should be worried about getting this diabetic eye exam to test if this condition is starting to manifest for them. 
• Data from CMS says about 15% of patients with diabetes will actually get the test done. So, there's a condition, we know how to treat it, but it's really hard and obnoxious for patients to actually get it done. Digital Diagnostics takes this test that we already know works and automates it, meeting the patient where they're at to expand healthcare access and equity.
• Digital Diagnostics uses AI to get the results back in 10 seconds, as opposed to the typical 72 hours to multiple weeks that it takes now. Before they even get into the exam room, a patient will know if they're positive or negative, and the physician will make sure they have the treatment scheduled before they actually leave. What's really helping with compliance is not having this lag, but instead taking care of it all at once.
• While the company has the ability to track changes longitudinally in a patient's data over time, its diagnostic algorithm, the AI itself, is locked. That means it doesn’t change the AI in real-time based on whatever data has just been fed to it because it doesn't want the AI be biased by the last 1,000 images. From a safety and efficacy perspective, the company believes that you build your algorithm, it becomes static, and you validate that single static algorithm, and you use that continuously in any updates you submit and clinically validate through a trial with the FDA.
• There's a multitude of eye care diseases or conditions you can detect using this tech, such as age related macular degeneration, glaucoma, but there are other diagnostics you can find there, including hypertension, risk for cardiac events and Alzheimer's. All these are things manifest in the retina because it's one of the few places in the body, in a non-invasive way, you can essentially peer in and see what's going on from a biomarkers perspective.
• As COVID subsided, healthcare folks had a massive backlog of patients that needed standard of care tests that were deprioritized during the pandemic. There's was no way to dig out of that unless they started thinking about automation. There's been a general increase in interest in technologies like automation, remote health, whether that's remote patient monitoring, telehealth, or home care. These groups that traditionally didn’t embrace technology now realize they need it because they have to figure out how to keep up with the change that COVID introduced.

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