 This is Dave Vellante with Paul Gillin. This is theCUBE. We're live from MIT, the Information Quality Symposium. Donald George is here. He's the Chief Architect of Prism Communication Systems, former CTO of the state of Georgia. Welcome to theCUBE, Donald. Thank you. So, talk about this conference. What do you think? What are you doing here? What are your takeaways? Well, the conference has been good. The aspects of data quality are core to what I'm presently developing out in the industry for intelligent remote care systems. So, when you look at the aspect of what drives patient care, patient outcomes, the analytics is all around data. Data is the core issue. And for many of us today, we connect in such a way using our mobile phones to connect to our physicians, connect in terms of the cloud computing to see our health, and thus more data is being added. And that data obviously brings about a challenge. Data management in terms of how you make that data actionable and provide the outcomes in terms of seeing patterns that could drive an understanding of the risks of patients. And then for the company, Prism, we look at how do we provide a total care delivery system in the home? That is monitors. Monitors now send data. And thus that data has to be analyzed. And it has to be looked at in terms of looking at the patient from a proactive viewpoint so that we deliver the best care possible. And a proactive care. And I love this whole concept because I think, the smartphone, this is one, another area where the smartphone really can be a game changer. The same way that municipalities try to build out these smart traffic systems to monitor traffic by embedding stuff in the roads. It turned out the easiest way to do it was by following the smartphones, right? So I wonder if we're gonna see the same thing happen in the home where the smartphone transformed becomes transformed into a device that may be a heart monitor, it may be a blood pressure monitor, it may be connected to a device for taking blood sugar. I mean, is that where you see, is that sort of what you see as the hub of this in-home network that you envision? And that is the direction. If you look at many of the news articles that have come out, Paul, you now be beginning to see another care delivery system. A care delivery system that doesn't require brick and mortar. You can have, as you stated, your smartphone, where you can now look at your blood pressure with a monitor that will transmit it to what we would provide in our company. As an intelligent platform, take that information, begin to see patterns, and send that back to you in what we call a visual graph of how your healthcare or your blood pressure is doing on a day-to-day basis or across many months. So it can help you manage your care better. Or the healthcare provider can take proactive action, and I might say, hey, your blood pressure has been elevated for five days, you should double your medication, right? Absolutely, so we see a new emerging future of globalization of healthcare. No matter where you are in the world, you will begin to say, can I access my doctor? That won't be even a question after a while. Whether you're using televideo, or whether you're being monitored by sensors as small as maybe this clip pin, what it does say that you can always get care no matter where you are. And that care can be analyzed in such a way to give you very straightforward advice of what is happening in terms of maybe lifestyle or things that you don't need to do, and thus that data is being stored over an extended amount of time to show you the trend then. So we were last month, the Cube was out in San Francisco and GE had an event around the industrial internet. They made a big announcement, of course GE in 2011 set up shop in I think San Mateo, California, big software shop to really do what some call the internet of things. Cisco calls it the internet of everything, Paul, and GE used the term the industrial internet, and they have the new commercials now with the bad guy from The Matrix saying, and it's really a big healthcare focus, obviously GE is very prominent there, but it was clear that they were laying out a long term vision, and there were some headwinds to that vision, not the least of which were, people are afraid of letting machines do all this stuff. So what has to happen, what has to evolve and what role can prism play in terms of closing that gap between the vision and where we are today? Well, of course we are evolving today in terms of individuals who have been monitored more in the high-risk aspect of cardiology, so that has already sort of been solidified. With a wearable device, for example, yeah. That's right, small wearable or what we call CEDs or cardiac electronic devices that are small, so that is already in place. What has not been more pervasive is some of the last risk-averse aspects of care or chronic illness, for instance, diabetes. We, of course, are looking across the span, the impacts of diabetes is in very much younger individuals than we have ever seen before. We're talking about as young as 15, and a lot of that has to do with the obesity. Jordan, of course, last exercise, and thus the onset of juvenile diabetes comes into place. That affects the cardiovascular system. That affects the systems in terms of your kidney, your eyes. So what we are looking at is ways where we can either automatically start getting a small amount of blood and having that device generate the outcome of what the blood sugar is, and then transmit it maybe every day or every two days so we can start to see the training. And also, here's the behavior, right? Many of the things that we see in healthcare sometimes cannot be solved with appeal. They just can't. What happens is we try to solve it with appeal, you're really not getting at the root problem. That's why Prism has looked at use cases and hypothesized about deterministic type things that affect care because it is both. One is the person is not losing weight. So you tell them to go and run and that will help their diabetes issue. What you will see is that if the diabetes stays at its current level, you now understand that most likely the individual is not reducing their weight or they're not eating the right regiments of food, less carbs, less sugar. So you begin to take care of the whole patient, not just from the illness, but also start to look at the behavior. You're modifying the behavior. That's right, because the two work hand in hand. And that's where you're gonna see the biggest new innovative developments come. Is that not only we look at the illnesses, but we start to look at what other things determines the outcome of this patient. And diabetes is one where if you have a set clinical guidelines for the patient and also they stay on task in terms of what they should be doing that you can monitor that and give them a graph and also help them to have better outcomes. So talk about the data behind this. You got data talking essentially visualizing data around an individual, but you got data on a lot of individuals across a lot of different diseases and so forth. What do you do with all that data? So what we basically do is stratify that data. Many times we have to look at age, race, sex, you know, things that would start. Geography. Yes, absolutely. That will help you scope the health risk of a patient. It gives you more of an understanding of what's evolving as you brought out. Maybe it's environment and it has nothing to do with I'm eating this or that. So to understand the disease and the effects of your behavior or your environment helps you to better bring a holistic way of care, especially for those who have multiple. You know, the statistic is that if you look at the aging population from 55 all the way to 80, it's almost two out of five that have, that have multiple diseases. And what does that mean? You no longer are tracking just the trend of a patient, let's say, having diabetes, okay? That patient could have a cardiovascular issue and yes, diabetes is having an impact on that, but now you have to deal with both of them to bring some care that will allow you to lower the risk level. So the data becomes the central point of triggering processes, automating clinical guidelines because one of the main things that is happening in healthcare and both of you probably are aware that even though a doctor or nurse will look at the analytics, there are things that they're gonna miss on the dashboard. So what we do at Prism is bring in automated guidelines that help look at certain data elements that tie multiple illnesses together to bring the broad perspective of the care that they may have not even looked at. And you surface those in a way. That's right. And what happens? It brings not only care, but it brings better intervention. You catch it before it happens. You can see it trending very clearly. Most of this data is in graphs so that the doctor or the nurse doesn't have to do the speak or language and looking at a dashboard and trying to figure out every little column. You wanna make it simplistic. In that respect, you begin to engage the patient as well as the physician and the care team. And that's what we wanna do. I think we would all agree that one of the most wasteful aspects of the healthcare system is the office visit now, the time required to set up, going, waiting in the office, waiting for the doctor, and very often the visit is not really even needed. Did you have any estimate of what could be saved by having effective home delivery of these services? Well, you asked a good question we have. If you take the follow-ups and to your point, and that's a real area that you could save money and time and it'd be better served to do a follow-up. An example is when we do telemonitoring of the patient and understand their trends, when that follow-up happens, let's say in telehealth through video, there's not this prolonged issue that the patient has to come into the facility. I mean, some patients commute from 30 minutes to an hour just to do a follow-up that's 15 to 20, less than 20 minutes. And then the charge and the insurance company has to pay for the office visit. And you still don't have quality at that point. What we see is make the center of care, or patient center care, at the point of care. That is, whether it's in the home or somewhere else, have the different devices or means to access the patient, to monitor, and provide that rather than the commuting between A facility and B facility. So we're looking at tremendous cost reduction and also time spent by the medical staff. If you look at that, when you come in for a follow-up, you got a nurse, you got a physician, you kind of time their time a lot when they can also spend some time to fit in another patient. So when we look at remote care and intelligence, you're actually getting to the core of treating that patient because you have the statistics, they're right there where the patient can see it. And also the nurse spends less time. And then the follow-up allows the patient to be in their normal care setting, which is significant to patient satisfaction. Yeah, so essentially you're empowering the patient to tap and leverage the system directly. Exactly. As opposed to going through all the red tape. Okay, so we're on the steam of data in our healthcare system, and we all know that that system is broken. So we talked to Farzad earlier, and he really set forth a pretty powerful and compelling vision as to where this country is going with regard to healthcare. Talk a little bit about the role of data in that vision. So again, data is the core. The vision that Fazad had mentioned, being a CTO of the state, it begins to see many different methods of care delivery, but data being the real viewpoint of how you treat and care for a patient. We have to have information that's shareable between providers and care teams and payers because we definitely look at a surging cost that's skyrocketing, why? Again, we spend a lot of money taking care of individuals, but the statistics show what we get as an outcome, we rank almost 25th, why is that? Because what is happening, the data is not being shared with the patient, the physician, and the care team. They don't have the same view. They don't see the holistic patient. And so when we look at the central focus of where we are is making that data actionable, we have to have data that is clean, that we can drive over a repetitive cycle with feedback to make sure that we are cleaning up those inaccuracies in the data. Because when you look at remote patient care, there is not this touchy-filly situation where the doctor is really touching you. And some doctors feel averse to that, but the point is the data will tell you with its trending, its capabilities, and as we use big data to help us to begin to look at use cases, in fact we're looking at one, transition of care. Many would not know that we spend $280 billion in this country in terms of having re-admissions to the hospital. And what does that mean? That means that you have a whole situation here in which the person who is being discharged, we don't have accurate information to retard the return to the hospital within 30 days. So when we look at the whole scale, the data has to be actionable. We have to have data that is focused on the patient's care, the outcome, and what we expect ongoing. So we will obviously get into predictive modeling that will help us better manage the patient care, live a more active life. Keeping them there a day longer might make more sense than pushing them outside. On a theme we've talked about with some other of our guests today is information sharing. And to make what you're talking about really happen, you need to have a robust infrastructure in place for every entity that's collecting this information to anonymize it and share it with everybody else in the furtherance of the common good. And your experience, how ready are these industries to enable that kind of sharing? Well, I think they are maturing to get to that level. We have a lot of issues in security. You've probably heard about breaches that obviously the public fears that somebody get a hold of their information. But as this nation transforms its healthcare system and brings about achieving interoperability with correct data, I think they will feel more relaxed. And thus, once we look at the security issues around access of patient information, I think we will begin to make an accelerated growth in these areas. Because at the heart of it, if an individual today fell out on the street and didn't have a doctor near him, the first thing that's gonna happen is when the EMTs come on seeing what is their medical history, right? And if they don't have access to that medical history, they either do nothing or they give them some level of medication for stability. With sharing of data and the access to that data, if the patient has given that authority, you can see care can be done right at the point of where that patient collapsed. And is that part of what you're working on? And that ability to have, to carry your medical record with you, your full medical record so that an EMT can instantly transmit that data, have that critical information in a matter of seconds. Is this something that you need to be aware of? And that's what we're looking at. It's either by, they have a bracelet with a code that the medical systems must be integrated into that where they have an identifier. And let's say the EMTs solve a number, they type it into their laptop, boom, they got it, they look at it, they can treat, or the patient has some kind of device that has the information on it where they can plug into the laptop and get it too. All of those are fraught, obviously, with someone getting access to it. I mean, you know, let's be somewhat clear. But those are solvable problems. That's right. We have the same issue in the banking industry. And we're surely gonna solve it in healthcare. So, Donald, my last question is as a former CTO, current chief architect, what texts excite you these days? What are you looking at? Well, you know, what's really become an interest is more so on the telemonitoring side. That is that when you look at the mobile devices and they're gonna get smarter and you have means to actually gather standard data that can be used to help the consumer as well as the patient to keep their healthcare stable. The new devices, the M2M, the machine-to-machine, you could have a gateway in your home and you have these monitoring devices, small, very small. And thus, that will allow, without you even knowing it, that you're being monitored, that if there was an anomaly in your heartbeat, that that would be picked up before you would know it and thus intervention could be done. So I think there's a great new world in terms of how we're gonna deliver care for the future that I think I'm very excited about. It gives more access to individuals, to care, and also it is more proactive than we have ever seen before. Yeah, and a lot less of a hassle. Data is behind this and potentially more effective and hopefully much more cost effective. Right, and key, you got it, more cost effective. The cost will go down and that's what we want to provide. Affordable healthcare, that's the key. All right, Donald George, thanks very much for coming on theCUBE, great vision, fantastic meeting you, appreciate it. All right, keep it right there, everybody. We'll be back to wrap up right after this. Actually, no, we got a surprise guest coming on. Keep right there, this is theCUBE, right back.