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Doug Teany, COO, Corindus, a Siemens Healthineers company – Interview Series

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Doug Teany is the Chief Operating Officer of Corindus, a Siemens Healthineers company, a global technology leader in robotic-assisted vascular interventions. The Company’s CorPath® platform is the first FDA-cleared medical device to bring robotic precision to percutaneous coronary and vascular procedures.

What is it that compelled you to dedicate your life to developing lifesaving medical products?

Almost all of us strive to work on something meaningful – something that makes a difference in our communities and broader society. I believe that everyone who works in the medical device industry is motivated by the fact that our work can make a difference in the lives of patients. And for most, it’s not an abstract concept. Those patients are often friends and family members. The possibility of improving or prolonging the life of people we care about is a powerful motivator.

You’ve worked in high-level positions with phenomenal companies such as Boston Scientific Corporation, and Abbott Laboratories. What is it that attracted you to work with Corindus Vascular Robotics?

I feel very fortunate to have worked for world-class companies like Boston Scientific. The scale and resources of large companies allows them to reach hundreds of thousands of patients with life-saving products. However, some of the most innovative products come from small and emerging companies – companies that are actively challenging the current treatment paradigm, and by doing so, moving patient care forward. For me, Corindus falls squarely into this model. It’s sort of a David vs. Goliath story – a small innovative company working to disrupt the current care model for emergent conditions like heart attack and stroke. It’s a bold goal, but sometimes the most difficult challenges are the best things to work on. They have the biggest returns – both for the people working on them and for the patients that will benefit from them.

Vascular Robotics enables robotic assisted vascular interventions. Can you discuss the benefits of robotic-assisted intervention versus manual human intervention?

There are two categories of benefits stemming from robotic-assisted intervention: benefits that we are realizing right now and benefits we have the potential to bring to fruition in the future. Right now, robotic assistance makes procedures such as PCI safer for both the patient and the physician by making them more precise and effective while shielding the physician from harmful radiation exposure.

Moving forward, our goal is to normalize remote robotic intervention, or telerobotics, to treat highly emergent conditions that require specialized care such as acute ischemic strokes and heart attacks. In the U.S. today, 80% of patients that suffer from a heart attack live close enough to a hospital to receive essential care in under an hour. However, we think that number should be closer to 100%. With remote robotics, if we can reach the 20% of patients who live more than an hour away from the hospital, we can do wonderful things for them while taking a lot of costs out of the health care system long term.

One of the benefits of robotic intervention is that the human operator can avoid long-term radiation exposure. How big of a problem is radiation exposure for medical staff, and how does the CorPath System minimize this level of radiation?

Interventional cardiologists experience the highest amount of radiation exposure of any medical professionals, which leads to a significantly increased risk of developing a malignant tumor. 85% of brain tumors reported by physicians occurred on the left side of the head, which is the side closest to the radiation source and a sign that performing these procedures manually contributed to the diagnosis.

To protect our physicians, as well as technicians and patients, the CorPath GRX System is designed to remove the physician from the radiation field, reducing exposure by upwards of 95%. The technologist and patient also receive a markedly lower dose of radiation with robotic-assisted procedures compared to manual procedures, which has tremendous benefits for their long-term health.

Can you discuss the level of precision that CorPath Systems are currently capable of, and how that compares to humans?

One of the primary advantages of robotic assistance in a procedure like PCI is that it brings a level of precision that you simply can't attain with human hands alone. The robot can move interventional devices one millimeter at a time. It provides physicians the tools to measure patient anatomy to the sub-millimeter. A human just cannot calculate consistent measurements that fine without technology. That precision provides benefit to the patient because the physician can complete cases more effectively with one procedure. Moving wires and catheters within the vasculature and placing stents exactly where they need to be – down to the millimeter – will ensure the patient receives the best possible outcome from the procedure and reduces the likelihood of needing a second stent because the first one was slightly misplaced.

Robotic-assisted intervention also provides the operating physician with a much clearer visualization of the case. They sit at a robotic control station directly in front of a large, high-definition monitor, which gives them a much better view of their work as opposed to the traditional method of standing hunched over the operating table. That visualization component also contributes to accuracy and precision in these delicate procedures.

A study demonstrated that accurate measurement of coronary anatomy, using CorPath, reduced the use of unnecessary additional stents in 8.3% of cases. Can you discuss why this is so important?

Today, physicians have tools to perform visual estimates of lesion length to select stent size. Robotics offers the ability for sub-millimeter lesion measurements and accurate stent positioning, levels of procedural control which are difficult to do manually. Stenting one lesion in the heart with a single stent is better long-term for the patient than requiring a second stent. With reduced devices, robotics can help decrease the likelihood that the patient may need additional interventions or have long-term complications. As our health system works to achieve value-based care initiatives, this technology also makes readmission for a second stent procedure an avoidable expense for the patient and payer.

How many hospitals are currently using CorPath Systems?

Corindus has seen a significant amount of growth over the last couple of years. There are approximately 70 facilities worldwide that have developed robotic programs for interventional procedures.

In November 2019, Corindus Completed the first transcontinental Simulated Telerobotic Percutaneous Coronary Intervention Procedures Over 5G, Fiber, and Public Internet Networks. Can you discuss why this is so important.

When telerobotic procedures become more widely adopted to treat patients remotely, the first and most common scenario will involve a physician at one hospital directly connected to a robotic system at a second hospital through a secure fiber optics network. We refer to this as a “hub-and-spoke” model, where a physician at a larger “hub” location can operate a robot at the smaller “spoke” location where the patient presented because it was closer to them. Long-term hub-and-spoke will evolve into something that looks more like a connected mesh, or a connected network. Any of those spokes could reach out to each other, or a spoke could reach back to the hub, creating a very dynamic model where a physician at any location could treat a patient at any location, and it's the best infrastructure to provide quick access to timely care.

The emergence of 5G offers an opportunity to broaden the hub-and-spoke model. 5G is the first generation of wireless connectivity with the speed and bandwidth to support a remote robotic procedure without any perceptible latency, as Dr. Madder demonstrated in the test procedures you referenced. Theoretically, we could install a robot at a treatment facility in a remote area and connect it via 5G to a capable healthcare system to treat patients. Instead of the hub-and-spoke including hospitals in a connected network, we can extend our reach to include treatment facilities in extremely remote areas. In this scenario, 5G could play a key role in bridging the gap of where the fiber network ends and where patients need specialty care.

How big of a market and how important do you believe long-distance, multi-location remote procedures will become?

For certain procedures, such as heart attack and stroke, time is of the essence. When treating stroke, time is brain. Any delay in treatment can have a negative impact on outcomes for patients. However, due to the lack of skilled specialists and facilities that can perform the gold standard of treatment, less than 10% of eligible patients receive this treatment and rates of death and disability are staggeringly high. If we can bring the physician to the patient through telerobotics, we believe there would be an increase in the number of patients treated in a shorter time window. Not only does this improve patient outcomes, it also may reduce long-term care costs to society.

Is there anything else that you would like to share about Corindus Vascular Robotics?

We're really excited about what we’re developing with procedural automation at Corindus. In the future, when we incorporate technology like artificial intelligence, the robotic system will be able to learn from experience and adjust to new inputs, allowing it to perform the same movements that some of the best physicians in the world perform to overcome challenges when treating patients. This will allow physicians to focus their attention on case strategy and respond to problems as they arise. Automation will standardize the way procedures are done to a very high level of quality, which gets to the overarching goal of robotic automation – making cases safer, faster and more effective while reducing trauma on the patient. In pursuing this goal, our objective is to achieve levels of “high automation.” While large portions of the case can be automated, we believe there should always be a physician present to monitor progression of the case and intervene at any time to ensure the highest levels of safety and patient care.

Thank you for the great interview. It's exciting to learn about the future of telerobotic procedures, and how Corindus is leading us towards that future.

A founding partner of unite.AI & a member of the Forbes Technology Council, Antoine is a futurist who is passionate about the future of AI & robotics.

He is also the Founder of Securities.io, a website that focuses on investing in disruptive technology.