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5G, the latest wireless communication technology, has started to change how agencies think about networks, both from a physical infrastructure standpoint and for how it can enhance service to employees and constituents. The Federal Drive with Tom Temin talked about this with a man at the forefront of this thinking at the Department of Veterans Affairs. He is Dr. Tom Osborne, Director of VA’s National Center for Collaborative Healthcare Innovation.

Interview transcript:

Tom Temin: Dr. Osborne, good to have you on.

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Thomas Osborne: Thanks, buddy. Good to be here.

Tom Temin: And not to be confused with Dr. Oz who’s a political figure that’s running for office somewhere across the country. Well, tell us what happens at the collaborative health care innovation center, just set the table for us.

Thomas Osborne: So our center is really focused on delivering the best, most advanced health care possible for our veterans. And to put VA in the driver’s seat, you know, in doing so, we also hope that these advances that we do for our veterans, the largest integrated health care system in the United States, we’ll also potentially help others around our entire country and perhaps around the world. So it’s a really exciting place to be.

Tom Temin: And as a doctor, you were a medical doctor, you didn’t get a PhD in 16th century Flemish art here, you actually practice medicine. So I guess that is important to have in running a collaborative healthcare innovation center, where you may not be touching patients personally these days.

Thomas Osborne: Well, I do still practice; I’m a very busy guy. I got a lot to juggle. So that really does help inform the things that we do. And we have a pretty diverse portfolio, but our why is really to advance healthcare and deliver the best care possible for our veterans. But, you know, sometimes we fill the gaps that we have with the technologies, and sometimes with collaborations with other partners around the VA, other government agencies and with industry. That’s sort of the what and the details of it. But the what is really about delivering the best care possible for our veterans.

Tom Temin: Well, how does 5G and network communications and all of that figure into this?

Thomas Osborne: Historically, one of the things that we’ve done in health care that’s quite valuable is we’ve collected a lot of data, and in particular, most places have gone to electronic health care systems. So we have tons of data, it’s an amazing resource. But converting that data into information, knowledge and wisdom, that’s something that will bring great value and something that we can do more of. So like other teams, we’ve been doing a lot of this in retrospective analytics, looking at historical data, to get insights on a population level. But the next frontier is bringing value by converting that into individualized personal care. And that’s what we’re really focused on. And that’s what this particular infrastructure, the 5G infrastructure will help us do more of.

Tom Temin: And how will it help just by being faster or allowing simpler or simplified network architectures? What does ir actually do for you? I mean, it’s a number on a telephone, but otherwise, I don’t think we’ve seen a lot from it.

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Thomas Osborne: That’s a great question. So 5G, it’s an infrastructure right. And in and of itself, infrastructures, you know, a resource is not going to do anything by itself. But it enables us to do things that we couldn’t do before. So it allows us to move more data, faster. Now, OK, think about diagnostic images, it’s a big study, like as far as megabytes, so you have a lot of images, and it can be up to a gigabyte. And then you want to bring in other data to process that; you want to bring in genomics or EHR data, or even sensor data. All of a sudden, that’s a ton of information, if you want to move that through a system to then process it and bringing that insight back to the point of care. If you don’t have big pipes to move all that stuff, it’s going to be a major challenge. And so having 5G, and in particular cloud computing adjacent or you know, a component of that allows us to do things that we maybe could only imagine before. And you know, that’s sort of the place that we’re seeing. We’re seeing this allow us to do things we could never have imagined before, in some ways and do things we’ve only hope to do in the past.

Tom Temin: And how are you noticing your IT people are actually making this happen? What are they doing differently?

Thomas Osborne: Most of the work that we’ve done in this space, well, it’s been collaborative with so many people across VA, many different teams, and services, but also with our industry partners. And so we have a large collaboration between Verizon, Microsoft and Metivis. It’s a collaboration that our team is leading. And a lot of the work we’re doing is to work with those partners and their expertise and really amazing engineers to bring this technology to our veterans that wouldn’t otherwise be possible. So it’s all about connecting the dots and bringing in people who know things and complement each other.

Tom Temin: We’re speaking with Dr. Tom Osborne. He’s Director of the National Center for Collaborative Health Care Innovation at the Veterans Affairs Department. And it sounds as if this kind of research into better health care is an analytic exercise, almost like baseball is: looking at large datasets and seeing, as you mentioned, how it comes down to the individual. What are the topics you’re looking at? Because medical research is often devoted to a single disease, you know, a single malady. And there’s tons of research that may go on at multiple places there. What types of research specifically does the center do, and how does it fit in between all of the individualized medicine research that’s going on?

Thomas Osborne: So a lot of the work that we do is in the category of translational work, and translational is just a fancy word that sort of says, you know, taking a lot of scientific work from the bench, or in a lab, to the bedside. And so bringing the scientific insights to the care of patients so it can improve outcomes. Now, data is a big part of this. And one of the things that we see is an underutilized resource that we can leverage to better care for patients. And what we’ve been doing quite a bit of, we have a pretty diverse portfolio, but what we’ve been doing quite a bit of, is understanding what the historical data has to tell us. And that kind of, if you know the past very well, and the trajectory of things, then that can tell you what might happen in the future. So you can be more proactive in things. So we’re talking in the category of predictive analytics, and clinical decision support. So if you have an idea of what might be going on with a patient, because you have like really great processing and analytics, then you can come to the diagnosis faster. And when you do that faster, more effectively and efficiently, then you can get to the treatment quicker, and you can provide better care. Some of the things that we’ve been doing in that category also involve looking at things in different ways than you would have been able to do otherwise. For example, being able to process really big data files, such as diagnostic images in a new way, turning the two dimensional images into a three dimensional hologram. That then you can manipulate and look at at any angle, can help you understand the complexity of human anatomy and physiology in ways that is difficult or not efficient otherwise. And so not only is it beneficial for teaching and training, but also for pre-surgical planning. And we’re working diligently to use this system for operative guidance, in other words, to be able to see what you’re doing with greater fidelity, and have safer, faster, more effective procedures and care.

Tom Temin: So what you’re innovating with, then, is things that exist as possible remedies for a given patient situation, to distinguish that from when you say, bench to bedside, often something works great in a lab, but then there’s 10 years of FDA testing, before you can use it. You’re not talking about those innovations, but rather innovating with what we already have in the toolkit. But it’s hard sometimes for providers to know everything that they could possibly do with the given patient in front of them.

Thomas Osborne: Yeah, you bring up a lot of great points, Tom. I mean, like we were talking about earlier on, there’s a ridiculous amount of data. And for current health care, there’s just not enough time and enough providers to take care of the patients who need the care. And so if we can help providers by processing some of that data, collecting it, making it easier to assess and analyze, then they’re going to be able to concentrate on other things instead of you know, searching through the record and trying to do the calculations on things. So that’s a big part of it. That’s iterative, like you were describing that sort of improving on the existing system. But there’s other things that we’re doing that are totally like cutting edge and pioneering, like being able to use this system, for example, augmented reality and taking someone’s images, to put those images on top of a patient, virtually, if you can do that, then you can have three dimensional X-ray vision, we’ve never done that before, three dimensional real time X-ray vision, which is profound in so many ways, not only to understand what’s going on, but also to guide procedures and diagnosis. So there’s other things that we’re doing, quite frankly, that’s also like science fiction. I’ll give you an example. You know, if you’re a Star Wars fan, you might remember a scene when Princess Leia was projected by R2-D2 and she’s like, Obi Wan, you’re the only one that can help. But I saw that, you know, like many people, and I thought, oh my gosh, that’s cool. But that’s science fiction. That’ll never happen. Well, we’ve been able to do that. We’ve been able to do that with the advanced technology that we have, and that has tremendous implications for health care. And in fact, we did a little bit better than Star Wars because in Star Wars it was, it was a recording and we’ve been able to do it real time so we can project a three dimensional hologram of someone who’s sitting in one room and put them into another room, which you know, if someone’s in isolation because of infectious disease protocols, such as in COVID. And you can virtually project someone at that room all of a sudden, you’ve made that care interaction more humanistic than it would have been before. So technology instead of distancing people brings people closer together.

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Tom Temin: In some ways, it’s almost like telemedicine is advanced to an astonishing degree, sounds like?

Thomas Osborne: Exactly, yes. And definitely it huge implications for telemedicine as well.

Tom Temin: Yeah. So if the person is in one room, and the person looking at the hologram, the provider is in another room, that other room could be on the other coast, or maybe even in another hemisphere?

Thomas Osborne: That’s exactly right. I love the fact that you said that because now we’re talking about democratizing care. Because there is a digital divide and there’s also a care divide, you know. People who live very close to an academic center, where there’s tons of really smart people focused on a particular topic, they can get a different level of care than someone who’s living in a remote community that maybe only has access to a generalist that is doing their best to pull it all together. With this type of technology, you can have a capacity that you can bring people efficiently, virtually into a different location and help other people out. I mean, imagine, imagine you’re in a surgery, right? You’re the only surgeon in town, and you’re focused as a generalist, but all of a sudden, something some emergency comes in, that’s only a specialist can handle, you’re in over your head, you would love to have someone help you there, but you’re going to do your best. All of a sudden, you can use this technology. And you can have the world renowned experts in that niche little field, from anywhere around the world come in real time be with you see what you’re seeing. And point with holograms exactly what you need to cut what you not need to cut, all of a sudden, you’re providing care everywhere, at a more equal level than it ever was before. So that’s super exciting for us.

Tom Temin: So that veteran in deep Appalachia can have access to the same care as the one who might be in the Upper West Side of Manhattan?

Thomas Osborne: Exactly right. And that’s really important for us at VA because the majority of our patients live in rural communities. But quite frankly, geez, a lot of people now are living in rural communities because they can you know, oh my gosh, the pandemic has told us that we don’t necessarily have to be tethered to a big corporate headquarters. And so this is relevant not only for veterans, not only for the U.S., but quite frankly, the world because there’s lots of people all over the place who need this type of care and just don’t have access to it because of the place that they happen to be born in.

Tom Temin: Dr. Tom Osborne is Director of the National Center for Collaborative Health Care Innovation at the Veterans Health Administration. Hey, thanks so much.

Thomas Osborne: Thank you very much, Tom.

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