Danielle speaks with Shuo Qiao from Moving Analytics about remote cardiac rehabilitation. Tune in for a discussion of emerging healthcare technology and a look at how we can use data to inform important healthcare decisions.

welcome to a Virtual View, a telehealth podcast, brought to you by the

Upper Midwest Telehealth Resource Center.

Today I'm joined by Show Chow, one of the

founders of Moving Analytics.

Thank you for joining me.

thanks for having me here.

you're coming to us live from la

Yeah.

In LA or super hot?

I appreciate you taking the time to be here, at least virtually.

It's hot here too.

Yeah.

Oh, any summertime I heard is like global.

Nowadays every place is hot.

So could you tell me a little about yourself?

My name's George City, co-founder of movie analytics.

For me early days, I grew up in Beijing, China.

had, did my high school, college there.

And during my college actually had a chance to exchange for exchange

program exchange to India where I attended a school called I.

and the top school in India and I spent there for a year.

And and that's where actually I met Harsh which is my co-founder at that time.

He already graduated from IT Motors.

I met him through a professor where we were working on the same project

and I got introduced to Harsh and we talked, and then after that

exchange program, I went back to.

Worked for half a year as a Android developer.

And then, I applied school at u in the us which is, I got admitted to uic,

University of Southern California.

I came here and , I think it's a co actually Harsh,

is also in the same school.

When and you know, and we start, at that time harsh and they already.

Start the company and I basically, when I come to us, I'm also interested.

So we just draw forces and work on the same company together.

Yeah.

And when I come to the US I did my master at University of Southern California.

And before I finish the school, actually already, work with them together and after

the school and I obviously joined the.

Very

I usually talk to folks who were healthcare professionals first, and

then they moved into a telehealth or technology sort of role after that.

But you're opposite, right?

You were more into software first.

Yeah, that's actually interesting journey for me.

A lot of things happen in my life is unexpected, as I told you, like

I met harsh in India and somehow I met him again in the US and

then we work on the same company.

Yeah.

Small work.

And we, I don't have a house car background.

I was like doing engineering study, all stuff and enjoying it and actually

our company also, How's car, focused at the beginning also . And then, at the

beginning we were trying to build activity tracking app, which like step counter

also, you know, if you sit too long, we'll give you a reminder, tell you should

just stand up and doing some exercise.

Things like that.

Those kind of things we, that the things we are nearly trying to build.

But we work on that for couple of, a month and we thought that's not

a great direction we should go.

And there's not a lot of financial gain or a good business model there, and we are

already late in the market at that time.

There's a pretty good I have already on the market, rent, keep, whatever.

There's so many already competition in the market.

And then, it's also a coincidence, I think my co-founder a day went for a conference

where, He met a doctor, introduced this idea, why don't we use similar, exercise

tracking app for cardiac rehabilitation that could be, doing similar thing we were

doing, monitor activity at the same time.

We are, potentially save people's life, which is, really great.

And then we thought, that's really good idea and is a

great business model as well.

And Pivoted and get on the track of house car.

Actually, the three of us, all the three co-founders don't have any

house car background to begin with.

We are lucky to be, be able to work with, the leading house car professionals

in cardiac rehabilitation domain.

We are so blessed and we get introduc to them in the early

days and they are still with us.

And you they basically, our guidance, they're our get, to

navigate all the, healthcare world.

It's always nice when you can find sort of an avenue

that's like financially profitable, but also is good for people, like you

said, like saving lives and things.

Moving analytics.

You guys are a remote cardiac rehab program, right?

Yes.

Compared to traditional, patient have to travel half hour or

hour to go to the rehab center.

3, 3, 5 times a week.

Things like that is like crazy of, they have to work, they have to, a

lot of things happening in their life.

Like it's hard for them to drive that far away and attend those sessions.

And now it's, home-based cardiac reputation.

Just lower the barrier for them to a really large degree and they can

easily just, attend those sessions.

Yeah, that's one of the great things about

technology and telehealth, It just lowers those barriers to entry.

So what exactly does your program entail?

What kind of services does it?

Right now actually, we literally provide two things.

We provide our solution as a software is by serve and the hospital, the provider

can just borrow software lessons to manage their patients on their own.

At same time, actually, we had another service where we are providing

the service, not as the software.

We also provide service to manage all the, and to guide the patients through

through the, rehabilitation journey.

We do both.

And talking about the Fox 90, inside our.

Program.

That's a lot.

We cover vital science tracking so that, patients be able to track their

weights, blood pressure and report those progress to their care manager.

They will be able to also, have tat with their care manager and

we do call with chair manager.

And they can, have a lot of reading material as well.

So then they can learn a lot of things on their own.

At the same time, we also, have regular questioners send over to patients to

evaluate and assess their status of health, things like that so that we

and the care team basically have a better understanding of where are the.

As far as the recovery progress going.

So yeah, that's, those components super, important.

And patient basically be able to have care instead of during the time

in the hospital now they be able to access care, 24 7 even, other

features that we're currently over.

Gotcha.

Sounds there's a lot of data collection going on all through.

Yeah, there's tons of data and there's we usually collecting the data.

S sorry about that.

So we usually collect the data through two different channels.

The first one is we collect the data directly from the hardware.

We we send the patients with a package of hardwares we usually use that including

weighing scale by pressure monitor and the smart activity tracking tracker.

Yeah, and those stuff.

And for the back reminder and and the waiting skill.

All the data is transferred, seamlessly, directly to the cloud

without any Bluetooth connection.

With app, it's lower the barrier for the patients.

Hugely.

As all this step, step on the weighing scale, the data, after

the reading shows up, the data is transferred to our cloud directly.

No set transmission, whatever.

So it's just through 3D network.

So it's really easy for us to collecting the data through this hardware.

Another channel.

We collecting data, this create user feedback.

From the app we build a really user friendly interface.

It's actually called the Outer People.

We make our, UI really Easy to understand.

Also, the phone are really large so that they can easily relate things like that,

and they can report any vital signs.

They recorded or they witnessed or any symptom they felt and

to their doctor directly from the app with some easy, use ui.

So you mentioned that older people are engaging

with these technologies a lot.

A big part of the population that you're serving with this like aging populations

exactly.

That's where a lot of cardiac, disease happened with those.

Demographics populations.

But actually one interesting, I don't know how do I say it's good or bad?

I think it actually is bad trending right now is we saw the population

actually getting hard as disease, the population getting younger and younger.

I don't think that's a good sign.

Yeah.

You know that, that's crazy.

People in their thirties, get a heart attack.

Hard to believe.

But, and this really happened with some of the patients and they come

full doing, cardiac rehabilitation, things like that, which is shocking.

But seems not happening.

Yeah, I'm about to hit my thirties . I'm not ready to have a

cardiac monitoring program going on but if you're working primarily with these

older populations, I'm sure that there's challenges related to just technology

literacy because, not to generalize too much, but I know that there is just a

lower like level of familiarity with technology among older populations.

Yeah, there's some hardship.

That's why I mentioned, when we design the user experience, we try to make

the experience as easy as possible in the sense of if the user need

to come play some work in the app.

Instead of they have to click twice.

Can it design?

Just, they just click once, the fewer click they have to do click or swipe.

The fewer thing action they have to take the better, user experience are.

And that's why also we make our hardware without any, third party

connection like Bluetooth's, wifi, as long as the patient get the device

they put on the floor of, the wait.

And they stab on it, the data transfer, no setup at whatever.

So that's something, we always go for, just minimize the steps the

patient has to take so that they have, a better, experience and also

adherence to the program as well.

Okay.

Cause you can have the best technology in the

world, but with this kind of thing, if your patients don't know how to

use it, then it's an obvious issue.

It's not gonna be useful.

True.

That's why we also include some onboarding session.

Just, our care manager have to reach out the patient just at least for

the first couple of sessions to guide the patient through the journey

and make sure they understand what need to be happen and what they're

supposed to, what they can't expect.

Things like that.

So when we talk about cardiac rehab, what types of

conditions are we talking about?

Is this primarily for people who have recently had heart attacks, or is it

more related to heart disease and things?

Heart attack and some other heart disease as well.

Most of condition we are treating is related to C A D C O P D kind

of condition, and we also trying to get into heart failure as well.

Different condition, have different criteria and different treatment plans.

Before we get into any further different conditions, we, just trying to be careful

and make sure, we have the, we have collected all the, special requirements

and treatments and get the consent from the hospital and patient before we move

on, Things like that, and definitely we want to expand the program to more and

more population, different conditions.

Sounds like it's a really collaborative effort with a lot

of different moving parts and people.

Sure.

glad it's in the US there's the system, there's a payer, there's provider, and

there's a third party company like us.

And and doctor motivated to, have their patients.

And power the best car not in the hospital also, home so that their patients

get covered and, get the best car.

Also for the parents, they want, they want the patient, be healthier so that

they can also financially save money.

And yeah, like for us, definitely, it's a program that we can save people's

life and same time, good business model.

It's really just work it out.

Yeah, that's a sweet spot there.

But

healthcare, and healthcare in the US in particular is very reactive.

Like we talk about how we're reacting to symptoms of illness

and not really promoting wellness.

So I'm always excited about the concept of prevention and I think

prevention and technologies related to it are really promising in

developing health and just healthcare.

Ha.

Have you guys done any work related to prevention at all?

For sure.

I think that's where we are heading to and where the whole industry

is more and more shifting too.

And one good I know like in America, house car is gigantic and slow to

shave, to focus, things like that.

But, the good design Think more and more different healthcare

insurance company are shifting the focus to more value based care.

And when I say value based care means the insurance company and hospitals providers,

those, they try to more and more focused on, reducing the patients to come back to

the hospital so that, for example, Cardiac surgery, if they want, if the patient,

being, be part of a cardiac surgery, they.

Supposed to be, treated well and not come back in a short time.

If the patient come back in a short time, that means there probably

something wrong with the surgery or the hospital provider didn't do a good job.

So value based care, basically saying, Hey, if.

The patient come back to the hospital after surgery in six months, then

you not gonna get reimbursement.

So that basically triggered the shift that the hospital, the

provider are gonna be worried, Oh, we definitely want to do a good job.

So that patient doesn't come back in six months.

And that's basically give them more motivation to.

Do better in their surgery.

And also Prudentially provide home care so that, have extended care so that

they don't come back to the hospital and get, get the, the heart attack

again and get back to the hospital.

And if they don't get at the hospital in six months, then they get reimbursement.

So that's basically, as I said, another.

Trigger for them.

And then the reason for them to push harder to do that.

And that's why, telehealth is getting more unpopular because it's 24 7 coverage.

And also for the government point of view is, saving, taxpayer

money or the insurance money as well to push to value based care.

And that being, sad basically that.

Going one step further, basically that become prevention.

Instead of, after the disease, you want home care.

Why don't we do prevention?

There's no surgery happening in the first place, right?

So there's a, I know a lot of insurance companies start putting

out policy on that side as well.

And also different third party trying to, sell that solution to hospitals and pairs.

And I think that gonna be a trend at this moment.

We are.

That's not part of our, offering yet.

But we're definitely interested to push something like that out and to prevent,

patients to get into a hospital to get prevent them from getting heart

attack or at least delay that time as much as possible instead of have

to do the rehabilitation afterwards.

No, that's awesome.

And I'm sure from a patient perspective, Wanting to avoid the hospital too.

For sure.

to engage with these, all these emerging technologies.

Cause if you can go and, I don't know, take a medicine or do a, an

exercise regimen or something and avoid having a heart attack I'm

certain that's something that a lot of people would be interested in.

So we talked earlier about how cardiovascular diseases are the leading

cause of death in the United States, so telehealth and averaging technologies.

Do you think that's the key to changing that?

I think so.

Just, think about.

If a patient talking about, care how much time they can spend in the hospital versus

how much time they spend at home, most of the time they're spending at home.

And with telehealth, as I said, they get, 20 prudentially,

24 7 courage if needed to be.

And and also that's where the prevent.

. And also after surgery, the rehabilitation happens, right?

Both before and after.

And those are the cri critical, time moments and things that hospital heart in

the hospital setting, hard to intervene.

But, with healthcare intervention program or rehabilitation program, those kind of.

Time being covered and I'm talking about like telehealth in general, right?

That's basically just talking about, privilege, right?

If a patient have some a hardware monitoring device that can the, harvest

24 7, all Eva ECG right now, I know there's some portable device you can

just put, on your chest and monitor your.

Ecg, constantly.

That's something great, in innovation.

And and those data can be, sent over to a doctor, regularly reviewed.

And there are some emergence happens.

There's, alerts file right away to their, family members

even, er and that's basical.

Potentially save, lot of people's life and programs like, like us to

do more like a rehabilitation or even prevention and to guide the patient to

tell them, what's good practice, they should follow to have a better heart.

To how, either, mental health, things like that's gonna tremendously

contribute their house in the.

Yeah, I think that's a really promising way that

things could go in the future.

Aside from that

, what do you think the future of telehealth looks like in this space?

I think, the future, super promising and there's different

things I think are gonna hype tremendously change the landscape.

I think the first of all, I think right now a lot of third party can be like us.

We are doing treatment on one condition and the patient, probably all their

family members have different, third party telehealth app installed on their app.

And different, app actually collecting repeated data.

And also isolated between each other that they only know the data,

they know that they collected.

But I think in the in, potentially in short term, there are gonna be

a lot of data exchange in network where different companies be

able to retrieve other apps data.

That collected by other provider or app, third party app.

And also at the same time, they can share their data anonymously,

of course to the network.

So other, third party can use that or even the hospital can use that data

so that every single individual app be able to have the whole scope of

different data being collected, about this patient so that, the doctor and

the, even the third party app be.

Provide a much better guidance for the patient because they

just have better, more source of data coming from different angle.

And and it's beneficial for all the companies because the data is shared.

Any other company will be able to, to get that data as well.

Of course, you also have to share your own data, but I think that's gonna happen and

ultimately it is just basically helping the patients and rendering a better care.

And I think that's pr potentially something happened really soon.

And a second thing I think is more like hardware innovation.

With as I said, there is ECG monitoring on your chest, potentially monitoring

your ECG graph, all the time continuously.

That's something amazing.

Also, there's a trend that coming be able to implant some chip, under your

skin you still, you have to worry all the, activity tracker, apple

work, whatever on your wrist and you forgot to charge the other day.

Then you shut down.

You don't have the Apple watch for a day, right?

So you know, if you implant some chip, you know your skin, that's.

It's always there,

Yeah.

That's some amazing innovation that pr potentially coming on.

And you bigly track your, different vital science hearted

blood pressure all the time.

That's just amazing.

And they're pr potentially good innovation with virtual.

That, that's something par as well, instead that you have to

just do a texting to a doctor.

No, you have video call that, coming soon.

I guess there's a wording reality that you know, potentially more like

3D world, you can interact with a doctor, all the interact, the doctor

can, easily get you through a physical therapy through a virtual reality.

That probably is something interesting to see coming.

No, that's fascinating and I really like that you touched on the

concept of interoperability of different systems because I think that is something

that's going to be vital going forward.

Cuz just when you have all these different third parties and all these

different apps and things, if they can't talk to each other, then we've

got all these different pieces of a full picture of someone's health.

But until you put them all together, we can't have that.

Idea of how someone is actually doing.

For sure.

I'm looking forward to that day to come soon.

Yeah.

So one more thing I wanted to ask about.

So we talked a lot about how there are all these different third parties now that

are very specialized on one sort of thing.

So do you think that sort of specialization, is that

leading to increased innovation in different aspects of.

I think at least at the early telehealth, not still the early

stage of telehealth, I would say it is good that the different company focus

on different things because as they are specialized in that domain, the.

Can, think through what kind of, actually, this is a totally

new setting at home, right?

So as you specialize in this kind of category, you think about

really deep what the user really need for this kind of condition.

And you come up with, The idea, hard to come as with a generic, solution.

You basically come as innovation that, dedicate for this kind of solution.

And you definitely need those kind of people who spend those

effort to think about that.

And and to make sure the best or a better solution for this condition

of patients can be invented.

But I think going forward maybe, there are gonna be merge happening

or different, individual company, like for different condit.

Like us potentially just eight pan to other conditions like

seeing that potentially happen.

But I mean at that time I think it's already that state because

individual different specialized condition, the innovation already

like being explored more or less.

And then that probably triggered a time that you know, hey, they're probably just.

And murder of different condition company and they, or even just

collaboration that happening along with the data exchange, things like that.

Thank you so much for joining us today.

I think we had a fantastic conversation about what you do and what telehealth

might look like in the near future.

Thank you so much for joining me today.

Thanks for your time as well.