#400 Exploring the Future of Digital Health: AI, Wearables, and Empathy with RJ Kedziora

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Mehmet: Hello and welcome back to a new episode of the CTO Show with Mehmet. Today I'm very pleased joining me RJ Kedziora. RJ, thank you very much for joining me here today the way as I was explaining to you before we started. I'd like my guests to introduce themselves, tell [00:01:00] us a bit more about, you know, your journey.

Mehmet: And what you're currently up to and then we can start the conversation from there We're going to talk about health and ai a lot today. I know this for a fact But before we do this, I will keep the floors to you to introduce yourself

RJ: Yes, health and ai is an amazing topic these days so much interest as you can imagine as the listeners can imagine Um, my name is rj Kedziora.

RJ: I'm co founder ceo cto of a company called Estenda solutions You Got our start with a good friend, Drew Lewis back in 2003. So a little over two decades now, we are an ISO 1345 certified professional services organization focused on data related projects, custom software development, data analytics, and AI.

RJ: If you have data, We can help you. And we work with a mix of large fortune 50 medical device [00:02:00] companies, uh, smaller startups, helping them, you know, develop solutions very much on the patient focused side. We've never done anything with the billing data or anything like that. I don't find that, um, interesting.

RJ: And that's why I started this company to, you know, work on interesting, challenging projects. You know, my background. I came up through the software development ranks. I was lucky in the late eighties as personal computing became a thing to have a, a computer at home. And I played my fair share of games. I don't get me wrong.

RJ: I played a lot of games, but I really enjoyed getting into like, even programming and what can I do with this technology back then? Went to college in the early nineties for comp sci. And interestingly, as AI is such a hot topic now, when I was going into college in the early 90s, my goal was to get a Ph.

RJ: D. in Artificial Intelligence. It's one of those things that people forget. It's been around for a while. It's not something that's [00:03:00] new. And what happened is I got a job offer as I was getting ready to graduate college. And I was like, Hmm, do I take on more debt or go out into the working world and earn a living?

RJ: So I went out into the working world and started earning a living, but always had my hand in the areas of AI and expert systems and things of that nature before we got to You know, the gen a is that we were there, but, you know, worked my way through the ranks, worked at various different consulting companies, quickly realized while technology is important, it is much more about the people and the processes and what we do.

RJ: Um, and that sort of propelled my career over the years to make, you know, realize that difference. Um, and how do you apply the technologies to problem solving and challenges? So today, um, you know, 20 years into the journey that a standard solutions, which has been an amazing, um, you know, mix of those still software [00:04:00] development, custom software projects, but much more heavily focused on, you know, how do we use AI, um, and lots of questions around, you know, the use of gen AI these days.

RJ: It seems like. Everybody's interested in because it's making an impact in the world.

Mehmet: That's fantastic. Like just out of curiosity, RJ, like, because you mentioned impact, like, uh, have you decided to focus on the digital health, uh, innovation because it's, You know, we can see the impact on, on, on humans much faster than maybe other fields in, in, in technology.

Mehmet: Like, what exactly was the motive? I mean, to, to focus on that and also like, you know, I, I like, you know, what you said about AI, I'm going to come to AI, but how, how have you seen, you know, this feed specifically digital health evolved, you know, over the last, I would say 20 years or so.

RJ: Yeah, yeah, it's been an amazing journey.

RJ: I, I've worked on, [00:05:00] you know, prior to Estenda developed accounting systems, inventory management systems, even there was a sort of famous railroad car scheduling system years ago, I used to work at U S steel. And as you were producing that, the steel, I worked in the tubular division where they made pipes and, you know, you needed railroad cars in the right place at the right time.

RJ: Um, and interestingly, that was mainframe programming. So that was. There's not an AI driven system, but, um, very, you know, expert rule based of how do we get those railroad cars in the right place? Interesting challenges, you know, interesting work. You need those inventory systems. You need those accounting systems, but with digital health, there is that sense of giving back as we've developed solutions over the years.

RJ: And, you know, I've talked to the doctors and nurses, the educators that have used systems. Help develop, you know, there's just a lot of those stories of like, ah, you're using your software and we caught, [00:06:00] you know, this particular incidents and we're really able to help this patient, you know, so lots of those just sort of individual stories, but then also as we develop these solutions very much, you know, cutting edge innovation kind of thing, they have to go through clinical trials, you know, do they actually work?

RJ: It's one thing for me and a doctor, you know, um, to say, Oh yeah, this is going to work, you really got to. Tested. So we also have, you know, PhDs on staff to help drive those clinical trials and actually do the, you know, proper research to make sure that solutions work and if they don't, then, you know, you adjust them and, and you, you know, take another shot at it.

RJ: So, yeah, it's been fascinating. I, you know, the second part of your question is, you know, what's, what's changed in, in 20 years. Uh, that's probably a whole nother podcast of just what has changed in 20 years. It, it boils down to data, you know, so much of our life and what we do is about data. And [00:07:00] 20 years ago, getting access to the data was a lot more challenging and there wasn't a lot of data, which was interesting.

RJ: Healthcare is, you know, I think of it as the last industry to really embrace data. They've embraced technology. You know, look at the MRIs and the imaging technology that's out there and just the ability to create new drugs and do that research, you know, different methods for surgery and, you know, amazing things in terms of technology that, that the industry has created and continues to create.

RJ: But we're still wrapping our heads around the idea of data and how to manage that. So think back to the early two thousands, pre mobile phone, pre Facebook, pre any of these things kind of thing, which is interesting to say, um, and, and EMRs were not mandated here in the U S they were not frequently used.

RJ: [00:08:00] We were fortunate to get our start working with, you know, military healthcare and the veterans association here in the U S which did use. electronic medical records, but early on as we were trying to extract data from those systems, it'd be like Here's his database. Good luck. Um, you know, find what information you did and then, you know, how well was it coded?

RJ: Today, you know, almost every enterprise health system out there has an EMR, has data. I'll say it's easier to get the data today, but there's still a lot of challenges. And one of the big changes in healthcare. Is the advent of what's called the FHIR protocols, F H I R, Fast Healthcare Interoperability Resources.

RJ: And it's basically an API. To, to boil it down, it's an API to interact with your electronic medical record to get data out of the system. And what that API methodology enables in, in that shift over these [00:09:00] last 20 years, is so many more developers understand how to use an API to get the data, as opposed to that.

RJ: You know, methods that were used before then, and, you know, still, it's still in use today, but there's also still challenges in, in getting that data. How's it coded? You know, you think of your banking data and you can go anywhere in the world and, and access, access your information and your, and your, your money.

RJ: It is simpler money financials than, you know, healthcare data is, but it is still very much of a challenge of how that data is coded. In one system versus another. And the other aspect of data is just the invention of all the different wearables that are on the market now to be able to track information about what's going on in your body.

RJ: You know, your, your Apple watch now can track your, your heart rate and. All sorts of metrics or, you know, you can wear a ring, um, or continuous glucose meters, you know, use the finger stick, you know, 20 years ago was the [00:10:00] current state of the art for, um, helping somebody, if they have diabetes, understanding their blood glucose, you know, very much in time.

RJ: Now you have continuous glucose meters that take a reading every minute. So you really have this fine tuned look at what's going on inside of your body. And they're just continually innovating now. So. If anything, doctors, healthcare practitioners are probably getting overwhelmed with the information that is available now.

Mehmet: Right. So, before I jump to the AI, because I think this is the base for the question of the AI. I mean, before I start the discussion about AI and what's happening in the field of healthcare. But again, the base is the data, as you said. Now, you mentioned that, you know, maybe it's one of the. verticals, I would say, or like the domains that, you know, they have lots of data, right.

Mehmet: But, [00:11:00] you know, it's, I think maybe probably the healthcare is considered one of the highly, you know, privacy and, you know, governance, Um, you know, constrained, you know, vertical in the domain of digital technology, of course, because, you know, we talk about sensitive data. We talk about, you know, patients, maybe some critical, uh, and very private data that it's there.

Mehmet: Um, so. Managing patient data, you know, how much it is critical and how much is important for organizations to not only, you know, before utilizing the data itself, so to really safeguard it and make sure that they are compliant with. And of course, The first thing that comes to mind when you talk healthcare is the HIPAA, right?

Mehmet: So Walk me through that RJ especially for maybe [00:12:00] the folks who are new to to this field and new to this domain

RJ: Yeah, absolutely. So It starts with privacy of data and if you're in the EU, it's you know GDPR here in the US the the FTC has purview over just the general Privacy of your data. Um, so you always want to make sure that that your information is secure, particularly if you have like your billing information, credit card information, you know, here in the U.

RJ: S. Social security numbers coming. You need to protect that your first and foremost. Now we make the jump to health care in that data set and HIPAA. And here in the U. S., HIPAA is the privacy legislation around protecting health information. Um, so, I don't know, in my mind, it's not any more difficult than protecting data in other areas.

RJ: It's just more sensitive. So you do want [00:13:00] to be able to, you know, lock that down. You know, any system. You help create, you're going to start with, you know, a zero based trust system, you know, and build from the ground up, um, you know, security is the first thing you got to think about when you're developing the system.

RJ: Um, but it's about access and use of the data. So, you know, when you look at GDPR, it's the same thing. It's in HIPAA. They're not preventing you from using the data. It's designed to make transparent and let the owner of that data, the patient, or the, you know, just the person in general, when you're talking about GDPR, be aware of how that data is going to be used and consent to that.

RJ: Um, and that's really the core, core of that. And at HIPAA, a lot of people historically have used it to be like, Oh, I can't give you that data and have used HIPAA as a barrier. Um, or as a reason for not sharing [00:14:00] information, but that was never the intent of the HIPAA legislation. You know, it was, um, to protect the data, but, you know, to promote sharing and, um, make health care and the transaction of health care, Today, more recent legislation has, you know, put penalties in place if you are called information blocking nowadays.

RJ: So really, the government's really trying to push the idea of that information sharing and getting that data out in the world and making making it much more usable. Um, across everybody. Because the more that data can be usable, the better off you can be. But yes, the privacy, the security protection of that information has to be paramount.

RJ: Um, one of the interesting things I learned, you know, a while ago, you know, in the black market, you think about credit card information or your health card information. Health information is more valuable in the black market than [00:15:00] credit card information is. Um, and then you can go after and get drug prescriptions and do all sorts of things with it, with that information that you can't just do with the credit card information.

RJ: So, yeah, you do have to absolutely first protect that. And, and I mentioned, I started, you know, answering your question of referencing the FTC here in the U. S. That's one of the things is, is we talk to startups. If you're, you know, say, create a new ring to measure metrics or a new watch to measure, you know, metrics in your body, you know.

RJ: If you're not sharing it with healthcare practitioners, there's no healthcare practitioner or health organization in that picture. HIPAA doesn't come, come into play because HIPAA is first and foremost about that healthcare practitioner, but you are still bound by privacy regulations under the FTC. So I've had these conversations where like, Oh, we don't have to worry about privacy.

RJ: I'm like, yes, you do. You still have to worry about privacy. You still have to worry about security. You know, you're, you're, protect the data of [00:16:00] your users. Like, if you get breached, you're not going to have happy customers. So, you know, you do have to protect it no matter what.

Mehmet: Absolutely. So, and the reason I kept this conversation with this flow, because, again, now we're coming to the Let's say one of the main topics that we want to discuss with you today, which is AI and generative AI specifically in healthcare.

Mehmet: And thank you very much for, I like, you know, to remind people that AI didn't start with chat GPTs. AI have been around since the 1950s, you know, when, when they did the first conference ever. Right. So in Darwout and, um, but of course what happened, I think in November, 2022 forward, that was almost two years now.

Mehmet: So the world is not Same as it was before that [00:17:00] because of of course, you know open a eyes Release to the public chat gpt now. Here's the question rj So first, you know, what were your impressions when when you start to see you know chat gpt rolling out and having all these use cases and kind of use cases that you start to think immediately about that can be applied to

RJ: Yeah, and it is, it's, it's amazing where we've come in, in just two short years, you know, when it, when it first came to market and, and where we are today, it has advanced, it's gotten better multimodal capabilities where you can create videos.

RJ: I think the biggest thing in terms of where we are today, um, there was, you know, I'm sure the listeners are familiar with Oprah. I'm sure she's world famous. Oprah had a special [00:18:00] on AI and Jen AI about, you know, two weeks ago, as we record this kind of thing, if Oprah's talking about it, you know, it's a thing.

RJ: Um, and she had Bill Gates on, you know, founder of Microsoft, another very famous gentleman kind of thing. And Bill Gates. said in his lifetime, generative AI is the most amazing technology he's seen over everything he did over the smartphone, over the internets, generative AI is the game changer for the market.

RJ: You know, you put it up there right there with, you know, the printing press and electricity. invention in the internet, you know, smartphones kind of thing. It's, it's that game changing, you know, we're going to see a difference in the world. And what's interesting is it's happening faster and faster, which is probably the biggest challenge of, of where we are in terms of progress of technology.

RJ: It's. The internet made a difference in the world. [00:19:00] Smartphones made different social media have made a difference in the world. Some can argue for the better or worse, you know, thing. So Gen AI is now making an impact on the world. And if we look at healthcare specifically. It gets really interesting, and I just love the use cases and the potential for what is possible.

RJ: So, think about a doctor today, nurse, a healthcare practitioner, that is taking care of a patient, you know, maybe for 20 years. Or the individual has, you know, a chronic illness, or God forbid cancer, you know, and how are they going to treat that patient? So one there's just so much medical information now available on this person and we reference the wearables There's so much more data and information about what's going on with that patient in between office visits And that's not just when they come to the office.

RJ: What's their blood pressure? What's their heart rate? You know, when they come into the [00:20:00] office, it's like, what's been happening, you know, between those offices, it's so AI first can take all of that information and make sense of it and can summarize that information and provide that, you know, to the physician, to the health care practitioner, you know, here in the U.

RJ: S. We're challenged with our private health care system where we are. Doctors, you know, need to see patients, you know, sometimes it's, you know, they only have seven or eight minutes with a, with a patient. That's not a lot of time and to drive into an electronic medical record and find the pieces of information that are interesting, it's, it's hard.

RJ: Um, so let's use the power of AI and the technology, which leads us to the second component of this is, you know, with the advent of the EMR, they were not designed. To be really usable, not designed to be part of like a patient encounter. They were [00:21:00] designed for capturing information and billing purposes.

RJ: You talk to 10 doctors, 10 doctors, 10 of them are going to say, I don't like my EMR. They're just not well liked doctors, nurses, healthcare professionals did not get into. medicine to work, sit there and type on a computer. They got there to help people, um, to, to make a difference in the world. And so as EMRs have become more prevalent, you know, when you go, I've, I've experienced this, you go to your doctor and they're sitting there talking to you, but you know, for the most part, they're staring at the computer and typing, you know, some institutions, a lot of places that are brought in like medical scribes.

RJ: To, to help that, so then the doctor is not typing that information. But now in terms of a use case for the generative AI, that's proliferating pretty quickly, um, in the industry is, is the idea of ambient listening and note taking, and you see it in your teams and your go to meetings, your [00:22:00] Zoom calls kind of thing, all these technologies that are doing that.

RJ: It's listening and transcribing those notes. And so that's, I think of like the second really quickly. use of Gen AI that's being realized. And so now you have those two combinations. Gen AI can, you know, surface what's information is important. It can listen to the actual, you know, conversation and what's interesting.

RJ: It does things. It makes, you know, it's, you know, aware of what's going on. And one of the anecdotal stories I've heard a couple of times now is just, you know, patient talks about, um. You know, when they go to bed at night, their legs are restless and they have trouble falling asleep. So, you know, they take a shot of whiskey.

RJ: Not the best medical thing to do, um, but the the key is that the ambient listening technology doesn't translate that word for word. It translates to patient self Medicaid, which is a much more standard [00:23:00] accepted terminology. So it makes that shift in how it, you know, transcribes those notes. You know, it's adding value to that conversation.

RJ: And both of those use cases are very low risk, um, in the grand scheme of things, which I think is important as we embark on this journey of using gen AI, particularly in healthcare, because of the states you're dealing with the health and wellness of people. So you have those two things happening today.

RJ: Uh, which I find really interesting. I'm waiting. Um, you know, and I've said this in a couple of different, uh, sessions now and in conferences that I've been to. And, you know, talking that I'm waiting for the combination of those two, two things together to come together where the AI is listening, is aware of the patient's history and is aware [00:24:00] of the medical knowledge out there and can surface questions like today surfaces questions to the physician and the healthcare practitioner so that they can ask the patient.

RJ: You know, so if it's all of a sudden aware of, Oh, here's these combination of factors, maybe it means X, here's some questions you should ask the patient to help them out because the other aspect of medical knowledge is it's, There's just so much information that is generated every day in the medical field.

RJ: You cannot keep up with it. Humans cannot keep up with it. So use the powers of technology to do that. Uh, likewise, humans are not perfect. Um, so how can we use the computers to double check and provide additional information for the patients? So they're the, the biggest use cases out there today that, Are proliferating, you know, pretty quickly across the industry.[00:25:00]

Mehmet: You know, plenty of, of, uh, I would say promising use cases is, uh, uh, you know, and I think, you know, the sky is, is the limit RJ, right? Because, um, I had like a couple of people on, on the show, you know, and they were all like, They are all professional, uh, you know, doctors themselves. And, you know, the, the way they are thinking about it is really fascinating because it's not only about, you know, how it can help in the diagnostics.

Mehmet: And for example, in, you know, the kind of what we know about genitive AI, but also like empowering people who can not, or they don't have access to proper, to proper health care system where genitive AI, of course, it will not replace a proper doctor, but at least it can do the first. first frontier job, I would say, kind [00:26:00] of, right?

Mehmet: So it's really fascinating to see how far we've came. Um, you know, I've spoken to two people, you know, also in the pharmaceutical industry and, you know, they're telling me how fast now they can try to get a new drug, you know, for example, for certain diseases. And this is really, you know, like. It's, it's super power, right?

Mehmet: So, uh, plenty and plenty of, of options that we have here now. Um, the question to you, do you think that the healthcare industry is ready for this leap? Are they ready for it? Because I will tell you my, my theory, RJ, correct me if I'm wrong. Like healthcare is one of the and it's not nothing wrong with them I know because we were just discussing about the privacy and all this Historically healthcare are known to be like kind of Like not early [00:27:00] adopters, not even like, you know, with the mass, they are like the people who comes at the end.

Mehmet: So tell me more.

RJ: They are not the early adopters and I'd love to say they're ready for it. Um, probably not. No. Um, is any industry ready for the impact of Gen AI? Probably not. Um, the challenge in healthcare is the stakes of being wrong are so much bigger. So we all know Gen AI makes up facts from time to time and they're called hallucinations.

RJ: And, and if you're generating marketing content, Not any, you know, something makes it through because he still, you know, need a human to, to read the material. Should never just push it out there into the world. It's, you know, it's not that bad. There's been stories of where, you know, a car [00:28:00] dealership, you know, has uses, you know, Gen AI to talk to customers and.

RJ: And it agreed to selling a car for like 0 in, you know, okay, that's not great, but it's not hurting your life or, you know, or making, having a medical impact. And so healthcare does have to be a little more cautious than other industries. So I understand that idea of hesitation, but we also have to embrace it.

RJ: There are not enough physicians. There are not enough healthcare. Practitioners here in the U. S. If the world, you know, um, in the U. S. We have an obesity crisis. We have a mental health crisis. There are not enough professionals to treat the people that need the help. So we need to use the power of technology to meet the patients where they are to provide that care for for those.

RJ: [00:29:00] There's a need. Technology, as we know, is very Scalable. So, you know, and there are people creating, you know, mental health systems to, to help with all sorts of issues, but not even just help identify. You know, this, we were talking about, you know, the idea of ambient listening, various different companies are creating AI solutions, not, not strictly gen AI, but AI machine learning systems that can listen to how you talk, can listen to your cough to diagnose tuberculosis.

RJ: Can listen to just your con this conversation and be like, Hey, are you okay? Are you depressed? can start, can look at that type of information to better understand where you are in your life. And okay, now there's a point of inflection. Um, you know, Hey, you should go, you know, seek out a medical professional, or if you are under a physician's care, it can be a note to the physician to be like, Hey, next time you see this [00:30:00] patient, or maybe you should, you know, reach out to this patient and check in on them.

RJ: That you can monitor people. Much more closely like that in a very beneficial way. So yes, I think that the healthcare industry needs to embrace this technology from that aspect, from the aspect of just making mistakes and doing better. You know, there's a lot of talk about ethics. Ethics is interesting

Mehmet: in

RJ: health care.

RJ: And what I find interesting is so many organizations are creating ethics, ethical guidelines around AI. I'm like, well, those ethical guidelines exist already. Why do we need another set of ethical guidelines? Physicians are famous for first do no harm. You know, it's like, there's the core of your ethical guideline.

RJ: You don't need another thing to like tell you that it's like, do no harm. Um, but I flipped that on its head. Do we have an ethical [00:31:00] requirement to use this technology to help those people in need? Because we can't reach out to all of them. We We can provide the necessary care to all the people that need it.

RJ: So I, I like flipping it on its head and saying, we need to embrace this technology. We need to use it and get it out there. A

Mehmet: hundred percent. I agree with you on, on, on this RJ, because it's not like a kind of a luxury product that, yeah, we can use it. Like we can, you know, do something good. Like it's not like kind of a cosmetic operation that they're going to, we're going to apply for someone to look better.

Mehmet: It's, it's something that. Maybe it's gonna say that maybe we are sure because we started to hear these stories. We start to see this, you know, proofs that using AI machine learning, not only generative AI, generative AI is, yeah, it's one part of it, like, which can, you know, in between, just between, like, practice, I would say, talk to people in a sense, give them information.

Mehmet: Of course, they need to, [00:32:00] as you mentioned, take care from the hallucinations that can, you know, happen, which is, by the way, You know, people are working, you know, people in the AI domain are working hardly on, you know, reducing the amount of hallucination that can, that can happen. So this is work in progress, but yeah, I agree with you, RJ, like we, we need to embrace it and utilize it because, and by the way, it's not only a US problem, just, you know, because I have a global audience.

Mehmet: So I think. And that I think also again, like we discussed this on the show, uh, it's a global epidemic, which is stress, which is, you know, uh, people feeling overwhelmed, the mental health, all these are like a global epidemics as we can call them. And AI is indeed one of, you know, the many technologies that we might be able to use to help us somehow.

Mehmet: Of course, we're going to see. How things gonna progress, but I'm [00:33:00] positive on on this part. Now you mentioned something, you know, just a couple of minutes ago are Jerry guarding the when we were discussing, you know, the, uh, the data and the privacy. But I want to ask you from a different perspective, the wearable devices.

Mehmet: Right. So, so we know about the ring. We know about, you know, like many products or something that can track our sleep. Some, they track the blood, some, you know, and so on and so forth. Um, what are in European, the next big things in, in, in that domain, especially You know, because we're talking about sensors that kind of, you know, take the data, record it, and then feed it to the AI, right?

Mehmet: So what are some of the trends you're seeing currently? And the wearable, uh, device, um, technology.

RJ: Well, interestingly, [00:34:00] I can tell you the, the new thing that I just used for the first time today. Um, a little bit unusual. I, I raced triathlons and, you know, so I jumped in the swimming pool today, got a pair of goggles, um, that have a built in heart rate sensor and have a display on the lens of the goggles.

RJ: So I can see my heart rate in real time and it counts my stroke. So it's very, uh, physical activity, exercise oriented, but to be able to sit there and swim laps for a half an hour. And it's showing me my heart rate, tracking my laps, tracking my strokes, you know, per, you know, 25 meters that I was swimming kind of thing.

RJ: Tracking my head angle, you know, so that I have better form was just, you know, as a triathlete was just amazing for me to see [00:35:00] that. Um, it definitely was distracting, something I'm gonna have to get used to, to seeing that information, but it's just, it demonstrates the proliferation of this technology and how it can be used in different areas to better understand what's going on.

RJ: CGM continuous glucose monitors have been around for, you know, a while now. Um, but what's interesting about those is various different manufacturers have now created versions. for people without diabetes. So normal people without diabetes can wear these devices and better understand what happens in terms of their blood glucose in their body as an educational component.

RJ: So, you know, I'm fortunate. I don't have diabetes, but I wore one of these a couple of weeks ago to see what the impact of food and different foods that I ate. Um, and, and [00:36:00] even, you know, the order of how you eat your foods can impact your, your blood glucose. So I think it's a very interesting educational tool, you know, for those people that are prediabetic, you know, particularly type two, that if you do eat better, if you move more, and I like saying move more as opposed to exercise, because you don't have to exercise, you move more walking, you know, so there, there's, if you eat, And you go for a walk after your eat, your blood glucose will not go up as high, so you are better off.

RJ: And I was able to run this simple experiment as I was wearing this device. You know, one night I ate the meal and didn't, you know, go for a walk afterwards. The next night I ate the same meal and went for a walk and was able to see the difference in my blood glucose. Um, so it's fascinating. Whereas I know that, you know, scientifically, like this is the impact of that walk, it was [00:37:00] fascinating to see it in real life, in my body, in that, in that, um, moment.

RJ: So that's an awesome capability that I think more and more people are going to have access to, to understand the impact of food. In terms of, you know, capturing the biometric data, you know, with the wearables, we can, you know, the heart rate and all sorts of things now are capturable. Nutrition is sort of like that last piece.

RJ: You know, there's dozens of different, if not hundreds of applications for people to like track what they eat and they're getting more advanced where you can take a picture and then that, you know, the, the technology and a lot of cases using AI can be like, Oh, that's a pizza. And this is, you know, what the nutritional profile is to help you out.

RJ: But tracking that information is cumbersome. It's not the greatest thing. So by using, you know, these CGM devices, you don't necessarily need to know all of the specifics of that [00:38:00] food, but you do know how it's impacting you, you know? So I ate yogurt one day and it spiked up the next day. I put some protein powder in that yogurt.

RJ: And it, you know, made a difference in, in how it impacted in my body. So again, looking forward to, you know, proliferation of CGM and, um, for non diabetic patients and what kind of impact it can make it on the world, all sorts of technologies in terms of, you know, training, um, you know, physical activity, you know, lactate thresholds and all sorts of things, which we won't get into.

RJ: Um, they're, they're really specific to, you know, athletes and things of that, You know, they're probably the top 1 percent of people in the world. And these technologies that are going to get them to be that, like that 0. 1 percent of the world, very useful if you're, you know, Olympic level, you know, athlete kind of thing, if you're the average Joe out there.

RJ: It's interesting, but it's not going to really add value, [00:39:00] um, to, to your training and experience, but yeah, the more and more it's the other, um, just so many thoughts are going through my head and in terms of like this new technology, um, you know, brainwave technology and understanding what's going on in your brave.

RJ: And when you talk about alpha and beta waves and different things like that, to just be able to relax you, you know, so. Morning routine. It's good to sit there and meditate or pray, whatever works for you. But a calming moment, you know, 10 minutes in the morning, it's a good practice while there are technologies that can look at what's going on in your brain to see how you are relaxing.

RJ: And then it sort of evolves to like, Hey, can we do this without? You were actually relaxing and just, you know, so fascinating what technology is going to be coming and it.

Mehmet: Absolutely. Now, coming back to, you know, what you do currently, and you've been doing it for a long time, of course, RJ at Estenda. [00:40:00] Um, how things change from the traditional, let's say, you know, Traditional healthcare systems, like, you know, the EMR, the EHRs and, and these things now, like, are, are, are you seeing also from customizations perspective things, moving directions as well?

Mehmet: And here I'm, I'm, you know what I'm interested to know, um, because when I was, you know, preparing, I've checked on the website, I've seen that. You know, like, like you partner with some of the known big names in that domain. So are you seeing these big guys, you know, usually following the trend, or are you seeing like more room for kind of, uh, new startups, you know, that they are coming up with like more creative, more innovative solution that fit, um, the digital health solutions.

RJ: Yeah, it's a [00:41:00] great question. And it is a trend I've seen over the years and it's probably made our lives a little more interesting. Um, from a running a business perspective, but hospitals, health systems, large companies have definitely, I think of it as a shifting the risk. So we're 20 years ago, you know, there was probably a lot more of, you know, this internal development, let's try this.

RJ: And it still definitely happens. You know, you know, we do plenty of business with plenty of different organizations. Um, and you know, there's a huge market for, for what we do, you know, globally kind of thing, but more and more, I do see this shift to let's work with a startup organization, you know, so that's, and I think of it as shifting the risk because that startup organization has now crafted the technology created, has done some testing kind of thing.

RJ: And then you got to get into, you know, run a pilot test [00:42:00] and, you know, a health system, um, in particular to see if it actually works. And so you have those partnerships and can run those pilot tests. Um, so yeah, there, there definitely hasn't been a shift in the last 20 years. I think shifting that risk more and more startups from being invited into, you know, healthcare systems, um, to advanced, you know, the science and capabilities of what people can do.

Mehmet: I think, um, you know, that, uh, Excites you any, have you seen any startup in this domain that is really exciting to you now?

RJ: There are so many startups out there. Um, it's it's interesting because healthcare is also particularly challenging Um, most of our experiences here in in the u. s. We've done a few things over in the eu, but It's here with our private payer system.

RJ: It's like always who's paying, um, and, and how are they, you know, so you have one entity that might be paying it, but they're not [00:43:00] actually using it. It's another group of people that's using it. So it makes healthcare a little. More challenging sales cycles are really long. Even, you know, if you're that startup trying to get into an organization.

RJ: So there's a lot of risk from, from that perspective. Um, just really excited to see what everybody's doing. Um, you talked about the wearables. One of the things that wearables are making possible is the idea of care at home, as populations around the world are getting older and older. You know, you know, if you and your parents are getting older, my parents are getting close to 80, you know, as they get older and they need a little more assistance.

RJ: You know, do they want to go to a nursing home or an assisted living facility, or do they want to stay at home where they're comfortable, where they're happy, where they're familiar with the environment, they'll have a much better quality of life there in that environment. So using the wearables in [00:44:00] what's, you know, the term care at home is, is really coming in into its own.

RJ: You know, how do we use the power of technology to let them stay at home? But understand. You know, what's going on with, you know, like passive technology, you know, put a camera, you know, in, in the room, that's a little invasive, you know, okay. It's like, Hey, we can watch you. We can look in on you and that gets a little invasive.

RJ: We'll now start using passive sensors and just understand, Hey, my mother got out of bed this morning. She opened up a cabinet, you know, I'm not sitting there watching her, but I am getting signals. And using the power of AI to understand patterns of behavior over time. It's like, okay, here's what my mother does every morning.

RJ: She wakes up at seven o'clock, gets out into the bed, brushes her teeth, starts the coffee machine, you know, turns on the TV. Well, all of a sudden those events don't happen signal, you know, Hey, call your, your care provider, [00:45:00] your loved one. It's like, Hey, check in on your mother. You know, she's not following her usual pattern of behavior today.

RJ: Hopefully there's a reason for that. If there's not, you can intervene in that. So yeah, I think in terms of areas like broadly care at home, I think is a big up and coming area using the power of wearables and technology and AI and like bringing all those things together.

Mehmet: Absolutely. Absolutely. Uh, RJ, like really, we, we, you know, we, we talked a lot about many cool things today, uh, as we are almost close to the end, Any advice you want to give to maybe, you know, younger generation that are now about to decide if they want to get into the healthcare, digital technology sector.

Mehmet: So, you know, a couple of words and then where people can find more about you and about Estenda.

RJ: Yeah, absolutely. I [00:46:00] think, and I started, you know, our discussion today talking about that understanding of. technology and people and process. And one of the things at Astendo we really emphasize is the idea of empathy, understanding the user.

RJ: So anybody that's, you know, coming into the field, whether it's on the health side, the technology side, the intersection of those two things, there's so much potential, so much opportunity, but you first really need to understand your user. Um, there's so much information available, like if you don't have diabetes, if you don't have congestive heart failure, you don't have multiple sclerosis, but you know, maybe a family member does and you want to help out in with that particular condition.

RJ: There's so much information available, one on the internet, you know, videos to, to understand that, but talk to people, understand diabetes. Their, their situation to be able to develop the solutions, um, sitting in [00:47:00] your garage is not going to get you very far developing an effective healthcare solution. Um, you really need to be out there and talking to the people.

RJ: Um, so yeah, and empathy and understanding the users hugely important. I'm in any, any industry, but definitely healthcare. Um, how to find me, um, LinkedIn is, is by far the best, um, search me on a LinkedIn or a standard website, a standard. com E S T E N D. Hey, um, also later this year, I'm at the, uh, I'm actually going out to a tech crunch, um, conference in California, I think it's like the end of October, depending on when this goes, goes out.

RJ: Um, but I'm also at the hit lab. convention in New York City in the first week of December. Um, great organization talking about all things digital health. So I look forward to seeing everybody out there.

Mehmet: Cool. Uh, again, RJ, thank you very much for, you know, this very [00:48:00] informative, uh, episode today. You know, you uncovered a lot of things related to healthcare, digital, uh, technology in general, especially when we discuss the AI, the wearables, the future also.

Mehmet: So really, these are like really helpful, uh, helpful, I would say insights to, to the audience and people who are interested in that domain. So thank you very much for sharing that with us. You will find the links to, uh, RJ is linking in and to the company in the show notes. If you're listening to us on, um, any podcasting app of your favorite, and if you are watching this on YouTube, you will be able also to see that in the description.

Mehmet: And this is the way I end my episodes. Usually, uh, if you just discovered this episode now today, and you discovered this podcast, Thank you for passing by. I hope you enjoyed it. If you [00:49:00] did so, please give us a thumb up, subscribe and share it with your friends and colleagues. And if you are one of the people who keep coming back, thank you for doing so.

Mehmet: Thank you for being loyal to the show. I really appreciate all that. And as I say always, thank you very much for tuning in. We'll be again very soon. Thank you. Bye bye.