Dr Dale Yoo

In Testimonials•24 May 2022

Month: May 2022

Electrophysiologist, Heart Rhythm Specialist at McKinney, Texas

I don’t think I have to state, or overstate, or even understate why remote support matters. With the Covid world we live in, I thought there would be an end to it but it’s just the new normal, we have been able to continue to do what we do day to day with the safety measures that we needed and the continuity of safety into healthcare; and still being productive and being everything that we want to do with new technologies is an important part of this.

We want to make sure that cases can be done, add-on cases occur, but your favorite mappers, clinicals, reps, they don’t always exist, they can’t be everywhere at the same time. So, it’s been fantastic to be able to utilize some of the support that we get (…) and then of course pulling in something new: that’s the Medinbox component. You can basically do this entire support remotely safely without taking longer. It’s basically the same time you normally do it with the best of the best anywhere in the world potentially supporting you. And I think that’s really great. Also, it enhances the education piece (…).

A lot of the new mappers, and a lot of the new support staff can kind of learn how to do what they need to do back home they can now do this live with us, like they’re part of the case, from where they are in the comfort of their own homes and labs, and I think that’s a really important part of that as well. So, of course we’ve kind of talked about a case support getting input from other sites, other leaders that have been a little bit more advanced in this field. Maybe they have experienced more cases than you and your team. I think that’s very important. We’ve talked about how this is going to really revolutionize our ability to do high-level mapping, high-level technology delivery to all parts of the globe, maybe to Mars if we get some help with Musk and other people! But at the end of the day, we’re able to help every nook and cranny of this planet because there is patients on every nook and cranny of this planet and they all deserve equal care, if you will.
Technical support has always been there, but this really highlights the opportunity to really use that 24/7 support from a team leader, somebody that you may know or somebody that you want to know, and they can help you again remotely. I think in terms of the world we live in; we’ve seen a lot of the movies that have already shown you what you can do but what’s great is, I think, this is the first time we’re actually bringing the future to today. We actually have the technology that allows us to meld all these things as of a couple of days ago, when we did our first live case with every integration as I know it, the first case in the world where we took the best of the best, we were able to do the support with the Medinbox that allowed the mapper, the support staff to actually control items in our lab live from a remote site, with minimal use of bandwidth; which has been a limitation for a lot of different companies and delivery technologies in the past.

"I don’t think I have to state, or overstate, or even understate why remote support matters."
Dr Dale Yoo

If you have a case that goes late, that goes early, a mapper is stuck in traffic, they’re in another site, they’re stuck in a plane; I mean I think a lot of us here, continue to see those problems where you’re basically at the whim of other people and you can’t really take care of your patient how you want to. But at the same time, theoretically you could be in a car you have a wi-fi connection you have some type of hotspot and you’re able to get on with enough bandwidth, you’re able to support it. In this case, we went early, and our mapper wasn’t there yet, and our senior mapper was available remotely, was able to chime in. (…) Our senior mapper and I have been able to work together really well over the last decade to revolutionize the zero-floor minimized fluoro techniques. But now enhancing that with remote support is amazing, so he’s able to help us.
And even if your staff is not experienced, you’re able to talk them through really how to do this, I mean we have this in almost every other arena with computer support. This computer support is on the other side of the planet usually. We hope that everyone speaks the same language but, in this case, we do, and if you don’t understand the technical parts, it’s okay because the remote staff is there to help you through that. And that’s exactly what happened so we can get the patches going so we have a case going early and we didn’t want to delay that case. This patient is on the table already under anesthesia and this shows you the utility of what you need to do to stay efficient and of course for safety for the patient as well. So, I kind of led into it, so the partnership with Medinbox is a very huge one. (…)

We did an Afib case. The Medinbox system allows you to get any inputs, up to eight, into the box, and allows that connectivity back to the remote staff. Previously, you had access as a remote staff to the mapping portion of it, but not necessarily to any other inputs from the lab. Now you have up to eight other inputs. You can access, change, manipulate, completely full operational effects from another site. We talk about this akin to drone usage, if you will you know, you have a master base that’s on the other side of earth and they’re controlling a very expensive modular aircraft on the other side of earth and able to do it. But in this case, it’s akin to that. The ability is there and it’s pretty amazing so we talked about also having audio capabilities too so we have direct communication with that remote staff wherever on earth they could be. I mean we do that already with Teams, Webex, we do that with Zoom as well. We’re just basically integrating that into the technical space and able to communicate both ways fairly seamlessly without any delay or any issues with lag.
We were able to do this live the other day, really no preparation, we just jumped in, both feet down and we see what we did. It went very successfully as a first global launch of this. I think it was the best it could be, and it was pretty amazing, and we’ll have a little footage of that as well. You can tell that they have access to the full map, starting to create it, start to do all the logistics with that; Medinbox again gives you the ability to have feedback with auditory. You don’t have to get on a phone. You don’t have to communicate via a separate way. This is all integrated and then also if you want to move a camera which there’s a camera part of this as well that can be either mounted or on wheels as we have it. It gives access to a camera that’s already there so if you have an advanced lab that has a bubble-cam as we do, they can actually integrate that to an input and move it around pan because it does matter: they can show you what the patient has in terms of their patches so you get feedback visually, you have feedback auditorily, you get feedback electrically.

So basically all aspects of it at the fingertips of the remote operator. And I think that’s very amazing, and I think this is showing you the capabilities of what we can do going forward. (We made) a little video. That was a camera on wheels that we had. This is a case literally from two days ago -the one that we did. (…) These are all the inputs that you had at the laptop station on the remote side. They could see a lot, we also used ultrasound to get access to the leg, then we switch over to the other module. Whatever’s coming out of that streaming out of that, they can see it at all times. They have the camera support, and you have the audio support on the backend. We obviously have our module there, but we had vacated it after we got it set up. We really had them do nothing but of course this is the first launch so in case there was something we had someone in support. But you can see that there really doesn’t need to be somebody. You train the staff. They don’t really need to do much except for turning on a computer if you will.

Everything is done remotely with the two strains, as you saw there, they have the ability to see all that you can see on here, including anesthesia if you want that as well, that’s another input that we had. And again, up to eight inputs of any kind. And even though we have more and more technology going into this, eight is fairly a lot that encompasses pretty much everything you need and then some. I think we had six going in, but if you wanted something additional, that gives you the extra capacity of that as well. In terms of mapping, there was no delay when I was asking them to rotate the map as my mappers hate and love me, for I love orthogonality; I like to have two separate views. I want them to follow me. I asked them to do it. They did it immediately, just like they’re in the lab. So, except I can’t throw things at them, so, I think they love the experience probably even more! So being there and being able to see it live and for our first case, we initially thought that maybe we’d do a simple Flutter, an Avian RT, let’s just, let’s tread lightly and figure out how we use this. It didn’t turn out that way, the real world doesn’t. This was an Afib ablation. We went in there, we identified, and we did everything like it was in the lab.

So again, the feasibility of this, it actually gave me no angst, I had no more stress than I normally would have, and the case finished on time – otherwise, I wouldn’t have made it here on time either, so everything really did come together just like it should be. And of course, there’s some things that we’re going to tweak going forward. Who knows, this is an intro to this remote world that we have, and Covid really helped us launch into that remote world anyhow. And this just utilizes what technology we had, some new ones thanks to Medinbox and being able to put that all together so we can go forward, forge this into potentially other spaces. (…)
I think the bounds are endless and so I’m very proud and very lucky and humbled to be a part of this experience. Hopefully more going forward and hopefully some of you out there will have this opportunity too going forward. (…) I think the utility is huge in developing and emerging markets. Of course, the education pieces need to be there more, but these are the types of technologies that allow us to do that in a safe manner, expand that knowledge to everyone around the world.

by Laetitia