CurveBeam Connect Cast: Recent Episodes
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Welcome to CurveBeam Connect. Listen in monthly as we talk with doctors and experts in the field discussing innovations and insights into orthopedic imaging.
KEY POINTS:
- The mentor/mentee relationship is critical in advancing medicine and technology.
- Significant technological developments in bone health imaging help predict fractures.
- As the density of bone goes down, the risk of fracture increases.
CurveBeam AI Medical Director - Endocrinology Prof. Ego Seeman recently sat down with Vinti Singh, CurveBeam AI’s Marketing Director, to discuss the future of bone health imaging.
Prof. Seeman is a Professor and Endocrinologist in the Departments of Medicine and Endocrinology, Austin Health, University of Melbourne.
He was recently awarded the Gideon A. Rodan Excellence in Mentorship Award at The American Society for Bone and Mineral Research (ASBMR) 2022 Annual Meeting in Austin, Texas.
Dr. Seeman said his own mentors have played an integral role in shaping his career. He first became interested in bone and mineral metabolism during his post-doctoral fellowship at the Mayo Clinic in Rochester under Professor B Larry Riggs.
“I learned so much," Prof. Seeman said of his experience at Mayo. "I made wonderful friends that I still have today, and I recommend to every young person to move out of their local town and get into the world.”
Prof. Seeman also discussed the current paradigm of bone health imaging, and where analysis based on high resolution peripheral quantitative CT imaging holds promise for better detection of those patients at risk for a fragility fracture.
"The technology is such that the radiation exposure has been minimized and allows us to measure the very fine architecture...of the bone," Prof. Seeman said.
In this final episode featuring Dr. Cuellar, Co-founder and Chief Biomedical Engineer for Efferent Health who is also an orthopaedic surgeon specializing in hip and knee replacement surgery spoke to Vinti Singh, Director of Marketing at Curvebeam about cybersecurity requirements and much more.
The conversation opened with a look into how Efferent Health builds layers of security with its partners to protect its clients. However, Dr. Cuellar first acknowledges associated with effective cybersecurity measures.
“I think it would be irresponsible to say, you know, nobody can break into our system because there is now a population of billions of people. There's a lot of smart ones and we can see by what's happened here in the US and elsewhere that hackers can hack into anything,” said Dr. Cuellar.
To combat this, Efferent Health works with 3rd party middleware developers such as Citrix to establish secure VPNs (Virtual Private Networks). Then they start layering middleware technologies to address the multiple vulnerabilities that give hackers the opportunity to compromise systems and gain access to valuable data. The challenges associated with creating these robust security protocols make it very difficult for an average institution to manage and afford.
Dr. Cuellar went on to speak to the importance of effective security measures noting that technology issues take up a significant portion of his time. He spoke to the rarity of going through a day without challenges such as log-on issues.
“I consider current systems to be so obstructive and that's really the massive pain point. It's every single day I spend less time, much less time with my patients and more time trying to make a document correct” for example said, Dr. Cuellar.
Dr. Cuellar and his colleagues at Efferent Health work with multiple partners to address these concerns and develop IT solutions to increase productivity while reducing costs within the healthcare system.
One of healthcare’s biggest expenses is in the processes utilized to run systems and provide patient care. Dr. Cuellar, Co-founder and Chief Biomedical Engineer for Efferent Health who is also an orthopaedic surgeon specializing in hip and knee replacement surgery spoke to Vinti Singh, Director of Marketing at Curvebeam about the antiquated processes driving up the cost of healthcare throughout the US.
In the 2nd episode of this 3-part series, Dr. Cuellar noted that current processes are a lot more cumbersome than they need to be. Additionally, “it seems that today's healthcare applications counterintuitively automate the already distorted systems. Although harsh, I came to this grim conclusion after compiling and analyzing the financial healthcare data in relation to the financial information technology data,” said Dr. Cuellar.
The conversation continues to recognize that a lot of IT companies are creating applications that automate “existing processes without even examining whether the existing process is the right way to do it in the first place right.” He continued to point out that “everything in healthcare except the act of actually providing medical service is riddled with distorted processes communication barriers as well as inadequate and cumbersome data management.”
These processes helped to create “an expensive and massive dysfunctional industry. The monetary incentives to protest the pay into healthcare system are such that the industry is destined to fail.” This led Dr. Cuellar to begin investigating the idea of “building an organization that provides infrastructure and digital services to enhance the delivery of medical goods and services that are better, more efficient, and less costly than the current system.”
And Efferent Health was born. A company that is dedicated to improving healthcare systems for both providers and patients. “Efferent’s proprietary SmartLink (Patent Pending) solution facilitates PHI transfers, including images between healthcare facilities, device manufacturers, and other stakeholders without massive servers and resource allocation. SmartLink uses the latest encryption and HIPAA high-tech transfer technology to move data up to Efferent’s platform in Microsoft Azure.”
When it comes to healthcare in the US, there is little doubt that the economics behind the system is somewhat of a mystery. With the rise in AI, IoT, and machine learning technologies, one would think the cost of healthcare would be on a downward trajectory. However, the reality is completely opposite.
Vinti Singh, Director of Marketing at CurveBeam, sat down with Dr. Alberto Cuellar, Co-founder and Chief Biomedical Engineer for Efferent Health who is also an orthopaedic surgeon specializing in hip and knee replacement surgery to discuss the fiscal well-being of the healthcare system. The conversation was so engaging that it turned into a three-part series.
Dr. Cuellar, once in private practice, decided to join Baylor Saint Luke’s Medical Group to continue serving patients due to the financial challenges associated with working in the private sector. He shared his knowledge in a 14-year economic study on private-practice orthopaedics at the 2013 American Academy of Orthopaedic Surgery Annual Meeting, which won best poster presentation.
“In the early 2000s anecdotally, I noticed the dropped an income from our professional services in our orthopedic group. In addition, we became more reliant on ancillary services such as partial ownership of a surgical facility, X-rays, MRIs, physical therapy, braces, and other medical equipment,” said Dr. Cuellar.
Initially, the study was meant to understand the financial dynamics of his group practice, but it evolved into finding ways to make prudent financial and operational decisions utilizing data. His work illustrated inefficiencies within private practices that were simply not sustainable. Singh noted that the “cost of technology and the efficiency that technology has afforded us has increased over time.” And one would think that if “healthcare was properly leveraging technology would have also in the inverse decreased but that is in fact not the case health care costs are rising.”
Dr. Cuellar’s work illustrated that healthcare costs actually rose 3000% between 1970 and 2018. With all these factors in mind, it’s no wonder Dr. Cuellar decided to use his expertise to found Efferent Health where technology automates healthcare systems to reduce costs and increase efficiency.
Those in the medical field who have heard of or used weight bearing computed tomography (WBCT) should prepare themselves. From October 17 through 19, the first in-person user conference, Weight Bearing CT: New Directions, will be held at the Inn at the Chesapeake Bay in Kent Island, Maryland. WBCT is relatively new modality, but has been validated in multiple peer-reviewed publications and is now moving more mainstream. Vinti Sigh, Director of Marketing at CurveBeam, joined Host Daniel Litwin to provide insight into what the conference will entail.
“As is becomes more of an established technology, now we’re asking questions that are deeper than, ‘Does it work? What can I use it for?’” Singh stated. Now, gray areas include topics such as billing, authorization, utilization, proper referral education, and issues with state and federal requirements, to name a few. “What a lot of our customers maybe don’t get from the podium at scientific conferences is how to translate that into real clinical practice,” Singh stated. The conference will also examine how WBCT is revolutionizing several specialty areas, including sports medicine and pediatric applications.
A networking cocktail reception will occur the first evening of the conference, followed by a full day of sessions. The conference will be split into three categories: Inspirational, which will provide insight into future applications such as custom insole design. The Clinical component will include an in-depth look at billable indications, and the last component, Operational, will address practical subjects for implementation and utilization.
“With WBCT, you’ve made a major capital investment and you want to make sure that you’re getting the most out of your system, so this will give you that, while also hopefully creating opportunities to make friends from around the country and maybe even around the globe with the same mission,” Singh summarized.
Singh said CurveBeam is currently finalizing the agenda and is looking for speakers. Potential attendees may fill out an online form to express interest in conference participation and receive registration information; that form is located here. Those interested can also email vinti.singh@curvebeam.com for more information.
The orthopedic specialty has progressed since the first robotic applications were first introduced 30 years ago. Dr. Stefano Bini, Chief Technology Officer for the University of California San Francisco (UCSF) Department of Orthopaedic Surgery, discussed these advancements with Host Vinti Singh.
Dr. Bini commented how some of the biggest impacts tech has had at UCSF has been on the administrative side, with improved tools for intake, referral management, surgical scheduling and patient engagement.
In the Operating Room, robotic surgery is a fast growing area, but challenges include the increasing costs for deployment.
In addition, UCSF doctors are using 3D printing to better prepare for complex pediatric deformities and spinal deformities. Dr. Bini himself uses 3D printing prior to hip surgeries to better understand bone loss in the pelvis, especially around the implants.
"The next generation of that, however, is you don't need to print a 3D model - you can create a 3D hologram," Dr. Bini said. "And visualize it using a VR or AR headset, but even a phone or iPad. And then you can literally manipulate it as if you had a 3D model in your hand."
These models, whether printed or virtual, or built from segmented medical images. Machine learning algorithms that automate that segmentation process are becoming stronger with each dataset they are fed.
These algorithms are developing so quickly that, "I’d say you will see clinical applications over the next two to three years,” Dr. Bini said.
Adoption of synthetic data, or manmade medical images statistically equal to but different from the original set, could drive AI modelling accuracy even more quickly, he said.
However, not all physicians are running to adopt these trends. Dr. Bini explained that resistance will eventually ease.
“When the technology is presented in such a way that it clearly solves a pain point, and it does so at a price point and at an adoption point that is manageable for that particular person in the environment, then it tends to be adopted rather quickly,” he stated.
Finally, Dr. Bini discussed the upcoming Digital Orthopaedics Conference in San Francisco, which he organizes. Visit docsf.health for more information.
For more information on these trends, subscribe to the podcast on Apple iTunes or Spotify and visit the curvebeam.com website for imaging solutions and AI insight.
Dive into the research and technology that can provide better alignment treatment.
To watch the video version of this conversation, please CLICK HERE.
Weight bearing CT imaging could change how surgeons approach hindfoot alignment (HA) & deformity. Multiple scientific papers delve into the difficulties of measuring HA on traditional radiographs. Challenges posed by 2D imaging include superimposition by the midfoot and dependency on patient position.
CurveBeam Connect host Vinti Singh spoke with Dr. Arne Burssens, Foot and Ankle Surgeon in Belgium, and Sorin Siegler, Mechanical Engineering and Mechanic Professor, Drexel University about different methodologies to measure HA via WBCT.
Dr. Siegler has devised a proposed method that takes the tibia, talus and calcaneus into account and is inspired by clinical measures that are done in a qualitative manner by surgeons in a surgical procedure. Siegler described his methodology in detail.
Meanwhile, Dr. Burssens et al have taken the approach of utilizing methods previously described in scientific literature for radiographic evaluation of the hindfoot. However, these methods account for internal rotation, which radiographs do not. These differ from Dr. Siegler’s in that they use the anatomical structure of the tibia rather than a centroid calculated from anatomical landmarks.
"Standards committees are being established to determine which measurements should be adapted as the standard." Burssens said.
Weight bearing CT imaging could change how surgeons approach hindfoot alignment (HA) & deformity. Multiple scientific papers delve into the difficulties of measuring HA on traditional radiographs. Challenges posed by 2D imaging include superimposition by the midfoot and dependency on patient position.
CurveBeam Connect host Vinti Singh spoke with Dr. Arne Burssens, Foot and Ankle Surgeon in Belgium, and Sorin Siegler, Mechanical Engineering and Mechanic Professor, Drexel University about different methodologies to measure HA via WBCT.
Dr. Siegler has devised a proposed method that takes the tibia, talus and calcaneus into account and is inspired by clinical measures that are done in a qualitative manner by surgeons in a surgical procedure. Siegler described his methodology in detail.
Meanwhile, Dr. Burssens et al have taken the approach of utilizing methods previously described in scientific literature for radiographic evaluation of the hindfoot. However, these methods account for internal rotation, which radiographs do not. These differ from Dr. Siegler’s in that they use the anatomical structure of the tibia rather than a centroid calculated from anatomical landmarks.
Standards committees are being established to determine which measurements should be adapted as the standard. Burssens said.
A Conversation With WBCT Society President-Elect Francois Lintz
When it comes to diagnostic imaging, 3D imaging provides an all-encompassing view of the body. For weight-bearing body parts, a 3D look can allow doctors to get an image, make a more accurate assessment and determine the best medical care.
When it comes to diagnostic imaging, 3D imaging provides an all-encompassing view of the body. For weight-bearing body parts, a 3D look can allow doctors to get an image, make a more accurate assessment and determine the best medical care.
Dr. Francois Lintz, a foot and ankle specialist and pioneer of 3D imaging, has used the methodology as a central tenant of his care. During his time as a doctoral fellow, he stumbled upon hindfoot alignment in 3D, which led to his partnership with CurveBeam.
On this episode of CurveBeam Connect, Host Vinti Singh, Marketing Director for Curvebeam, talked with Lintz about his career and his work with 3D imaging. The duo also dug into the history of the WBCT and Lintz’s current role as president-elect.
Francois, a foot and ankle surgeon, fell in love with this practice in 2006. The doctor he studied under during his fellowship had the intuition that the industry would switch to 3D sooner rather than later. He then asked Lintz to work on hindfoot alignment in 3D. Lintz, confused, asked the doctor what he should do. The answer? Just find something.
“We had this idea to measure hindfoot alignment in 3D and to define what this meant,” Lintz said. “This was the seminal work that led us to work with CurveBeam.”
Listen to learn more about Lintz’s career, history with 3D imaging and work with CurveBeam.
Turner Dean and Stuti Singh meet with podcast host Vinti Singh to explain what customers can expect from the new CurveBeam Cloud platform currently in development.
Despite all of the challenges that the COVID-19 pandemic has brought us over the past year, it's also shown us a silver lining: When it comes to the systems in our society, there's so much that we can still improve on.
Dr. Alireza Khosroabadi discusses his AMI (advanced minimally invasive) bunion procedure.
Dr. Alireza Khosroabadi, DPM, opened the Khosroabadi Institute in Los Angeles, CA to shift his practice from general podiatry to surgical procedures.
His minimally invasive bunion procedure has been featured on “The Doctors” television show. Dr. Khosroabadi spoke to CuveBeam’s Vinti Singh about his approach to bunion correction.
Dr. Selene Parekh discusses the latest trends in orthopedics.
Dr. Selene Parekh, MD, MBA, wears several different hats in the orthopedic world. He’s a Foot & Ankle Specialist at Duke Health. He is known as “The Fantasy Doctor” in media circles, and he uses his data-driven insights and medical expertise to guide sports enthusiasts through the precarious world of sports injuries to make accurate predictions on how an athlete’s injury might impact their fantasy team. And, to top it off, Parekh brings his knowledge and insights of foot and ankle injuries to India, where his mission is to provide the latest techniques and best practices to the surgeons there. One area of orthopedic medicine that’s making a lot of progress these days, Parekh said, is 3D printing.
Dr. David Soomekh discusses the benefits of having an onsite Cone Beam CT imager.
Dr. David Soomekh is a board-certified foot and ankle specialist and surgeon and founder of the Foot & Ankle Specialty Group in Beverly Hills, CA. Soomekh specializes in sports medicine and reconstructive foot and ankle surgery.
He’s practiced foot and ankle medicine and surgery for the past 20 years, and his goal is to provide a one-stop-shop for patients from examination to diagnosis to treatment.
To do that, Soomekh relies on on-site imaging and diagnostic equipment.
“Everything is all here at the facility, so I can treat patients from A-Z,” Soomekh said.
That includes a Cone Beam CT imaging system.
“What’s the most important thing for a physician to decide is how a technology is going to change my practice in terms of how this will help the patient and help me guide them into a better diagnosis, which then leads to better treatment,” Soomekh said.
The onset of COVID-19 provided an added benefit to having imaging equipment on-site by allowing for fewer patient appointments.
“Patients are fearful of having to go to multiple places to have the various steps of the diagnosis process performed,” Sommekh said. “In my office, a patient is only coming for a foot and ankle issue. You’re not going to have a sick patient here waiting to get an MRI or a CT.”
Dr. Chris O’Grady, an Orthopedic Surgeon who specializes in shoulder reconstruction and replacement, joins CurveBeam’s Jenna Roller for a conversation about innovations in robotic surgery and 3-D CT scans.
Dr. Chris O’Grady wants to see joints.
The Florida-based Orthopedic Surgeon who specializes in shoulder reconstruction and replacement has experienced first-hand how helpful it is to have 3-D images when he prepares to perform a procedure.
While O’Grady is much more familiar with shoulders than knees, he’s still excited to see CurveBeam’s upcoming entire lower extremity scanner, having seen how getting in-depth images before beginning a procedure can change the game.
“I really learned the importance of [understanding] the three-dimensional glenoid or socket of the shoulder. Where things have advanced to now is that, for every single shoulder replacement that I do, the patient gets a CAT scan, the 3-D images are then put into this proprietary software that really quite literally allows me to do the surgery long before the patient ever gets to the operating room.”
O’Grady has become an innovator in the robotic surgery space but said he still considers it more of a personal interest than something he frequently puts into practical application.
Robotic surgeons coming close to the same level of their human counterparts are still a ways off, but there is still reason to be excited about innovations in technology, O’Grady said, especially as information is being shared more widely than ever.
“What the future is going to allow are the surgeons that are kind of the onesy-twosy private practicing people in the middle of nowhere who don’t have the intricate systems that would allow them research assistance and all that sort of stuff, you might still have somebody there who does 1,000 knee replacements a year,” he said. “Well, now that person’s data will be able to get pooled into the ivory tower people running these massive studies that instead of having a few hundred patients can have tens of thousands of patients, involve many more surgeons and analyzing that data is very quickly going to solve some questions that I think people are still arguing on these podiums about.
Vinti Singh, Director of Global Marketing for Curvebeam, is joined by Dr. Frederik Vanrietvelde of AZ Groeninge Kortrijk, for a conversation about how cone beam CT is being legislated and utilized in Belgium.
Click here to view an article Dr. Vanrietvelde authored for his hospital newsletter to to educate orthopedic surgeons about weight bearing CT imaging.
Belgian surgeons were beginning to utilize cone beam CT several years ago.
Then, doctors like AZ Groeninge Kortrijk’s Dr. Frederik Vanrietvelde suddenly had to slow their use of the modality because of price concerns, with cone beam CT suddenly left off a crucial list made by legislators.
Vanrietvelde and some colleagues lobbied to make sure it was included, noting that it met the definition of a CT scan approved for reimbursement by the government and that its absence was simply a mistake.
“If you look very closely, you could tell cone beam CT also corresponds to these particular parameters they use, so it should have been on this list, anyway,” he said. “So, there was really no reason why it shouldn’t be on the list, and they really never argued that what we were asking was not correct. They simply said, ‘Sorry, we forgot it. We have to correct it.’”
Even still, the process took two years for hospitals to once again be able to bill cone beam CT in the same way they were billing a more traditional CT scan. With that being the case, the numbers of Belgian doctors utilizing the technology remain relatively small.
Still, Vanrietvelde is confident their numbers will grow now that the scans are more accessible, and he said the most important thing was to put himself into others’ shoes.
“It’s always a difficult balance you have to do as a legislator. I’m thinking as a radiologist, and the patient is thinking as a patient. A legislator has to think as a legislator and think about budget balance, so my main advice would be come together,” he said. “Let’s get all those people together with different mindsets and different perspectives before you decide how to reimburse something.”
Curvebeam’s Vinti Singh chats with Dr. Jarrett Cain of PennState Health’s Milton S. Hershey Medical Center, about his research on various diseases’ and disorders’ effects on the foot.
Dr. Jarrett Cain knows he’s in a unique position.
Doing research with an academic institution, he has access to a number of tools helping with imaging, so he can truly see what is happening with a patient’s foot.
That has helped him perform studies like the one he completed looking into diabetic foot, the hallux valgus deformity and why examining the contralateral side of the foot is important when developing patient-specific instrumentation.
“I’ve been fortunate to be in a university hospital setting, which allows me other different modalities from a research standpoint, so I can evaluate and further examine how the biomechanics are affecting the development of an ulceration and even Charcot disease, which is common in diabetics, (and how it is) affecting their biomechanics, as well,” he said. “(I’ve been able to) come up with different modalities to help preserve the limb and prevent any ulceration from leading to an amputation.”
While pedobarographic graphic data contributes, Cain also uses weight-bearing CT, utilizing those techniques in tandem to get a complete picture of a patient’s foot and the changes that will happen over time.
This may be a relatively new method, but Cain expects to see weight-bearing CT imaging become much more common in the near future.
“I believe that in the next few years it will be the standard of care,” he said. “There are a lot of different technologies that come out. However, this modality has been shown to be effective, and the published reports are supporting that claim.”
Some of that research is being produced by Cain himself and his colleagues, but it’s clear that many of the advances in technology that are helping salvage limbs have been aided by the images produced utilizing weight-bearing CT.
Vinti Singh is joined by Dr. Matthew Solan, an orthopedic surgeon who specializes in foot and ankle disorders, to chat about how a mobile CBCT scanner
Doctors all over the world have been pressed into duty taking care of patients with respiratory issues during the COVID-19 crisis. But a deadly pandemic doesn’t mean they also get to press pause on other types of care.
While fractures and similar injuries have gone down with far fewer people playing sports and less drivers on the road causing traffic incidents, there’s still work to be done. For Dr. Matthew Solan, an orthopedic surgeon in the UK, that has meant adapting on the fly to make sure foot and ankle patients don’t get lost in the shuffle.
Solan and other doctors have utilized a mobile cone beam CT scanner to keep patients out of the main hospital but still get imaging that can help them determine next steps for those who have undergone operations or determine if someone has suffered a fracture. While it’s something they’ve used during a crisis, Dr. Solan said he’d love to see CBCT become common in emergency rooms.
“It’s certainly something I’ll carry forward in my practice after the emergency, and I hope the same will be true of weight-bearing CT, because it makes a big difference to how efficiently we can manage our patients,” Solan said. “There are lots of things we can learn from this experience, so, yes, I’m hopeful we can continue to use the service after COVID.
“I think in an absolutely ideal world, hospital emergency rooms would have cone beam CT as their first investigation. I’m sure the hospital I work in isn’t alone in having a steady stream of missed fractures that pass through the emergency room and are picked up subsequently.”
While weight-bearing CT is perfect for foot and ankle specialists, doctors also are finding wider uses for CBCT scanners beyond the lower extremities.
“The indications for cone beam CT are multiplying. Some of the latest machines scan knees, hips, and the spine, and there are upper-limb scanners as well,” Solan said. said. “We’re going to see cone beam CT really revolutionize orthopedic care. I think all orthopedic surgeons need to think about this and move toward using it as a way of improving care for their patients.”
Caroline van Heijkamp talks about T-Soles’ revolutionary approach to customized personal therapeutic insoles.
The Dutch may be famous for their wooden shoes, but with an estimated four million people in the Netherlands suffering from foot problems, there is a growing need for therapeutic insoles.
Caroline van Heijkamp, the CEO of T-Soles Insole Systems, created a solution for this problem. The T-Soles system is a personalized corrective insole designed through a 3D scan-and-print process.
Heijkamp’s goal is to provide a better insole product that is also less expensive, so the adoption and use rate will be higher.
“You can compare it to the number of people who wear glasses or contact lenses,” Heijkamp said. “Years ago, when glasses were costly, only the people who really needed them were willing to spend the money on glasses, but nowadays you can find glasses for a few Euros, and you see many more people wearing them. And you will see the same thing happen with insoles.”
The 3D CT scan process of the T-Soles system allows for an accurate picture of the foot for precise calculations to ensure the resulting insole will do its job correctly. And, with current systems, Heijkamp pointed out they don’t fully take into account the shoe worn with the insoles. With the T-Soles system, the foot scan takes place with the client wearing the shoe.
The T-Soles system is currently available in several regions, including Europe, the U.S., Canada, the Middle East and Asia. The software allowing the creation of therapeutic insoles for podiatrists should be available later this year.
Dr. Francois Lintz, an orthopedic foot and ankle senior consultant at UCP Toulouse in France, joined Voice of B2B Daniel Litwin to dive into the impact of the COVID-19 pandemic on the French medical community and the world of orthopedics.
In France, the impact of the disease has been felt most in the Paris region, with measures including additional participation of doctors outside infectious disease specialties, the transfer of patients to other areas of the country, and more taking place.
Like many areas of healthcare, orthopedic treatment and surgery have taken a backseat to frontline efforts to fight back against the spread of the novel coronavirus.
However, this hasn’t coincided with a shortage of care – in fact, Lintz said, there’s less need for orthopedic procedures during this time.
“As for orthopedic surgeons like myself, most of us were prepared to go to war with the virus if it came to that,” he said. “But, in fact, because of confinement, people actually injure themselves less. They drive less, they do less sports – so we have fewer injuries, and hospitals have been able to cope with the level of trauma and injuries.”
Moving forward, the country, like the rest of the world, is looking for ways to get back to a new normal that will include a return to regular office visits, elective procedures and more.
Vinti Singh, CurveBeam’s director of marketing, hears from Stuti Singh, the company’s Director of R&D Strategy, about advancements being made in AI and how they could change the way some medical procedures are done forever.
Mention AI in a clinic, and many people’s minds go to the idea of robotic surgeons whirring along and making perfect cuts and calculations.
While that isn’t the reality of medical AI technology today, there are enormous advances being made in the field, with many of the world’s power players like Google and Amazon among those getting involved.
Yet, even with more and more products earning FDA approval, few of them are focusing on orthopedics, especially when looking at extremities.
CurveBeam stands out.
Stuti Singh, CurveBeam’s Director of R&D Strategy, said the company is utilizing machine learning and deep learning to revolutionize procedures performed on the foot and ankle.
“We're going from the surgeon having to read a series of slices where with pixels that represent a foot to having the computer know what it’s looking at before you even look at it,” she said. “That’s where I see AI transforming what we do here in orthopedics.”
With so many variations in the foot, it’s difficult to design automatic methods that will work in a diverse range of patients.
“Since there’s no simple formula that’s going to work well on all feet, we decided to use machine learning,” she said. “It’s really the perfect solution to this type of application because machine learning - and deep learning, specifically - functions like the human brain.”
Like a brain, the input signal goes through several layers, with processing occurring at each layer. Later, the output results as a function of all the information received from the input. Without understanding the foot thanks to a level of prior knowledge, the segmentation process being carried out wouldn’t function.
Singh and her team reviewed research and created a proprietary algorithm that could have wide-ranging applications.
“The possibilities are really endless,” she said. “Some of the immediate ones we’re interested in are applications we’ve already been working on before this project. For example, the TALAS measurement that measures the overall alignment of the foot in 3D. This is really revolutionary, because, before our weight-bearing CT scanners, this wasn’t possible to do in 3D. Having that done automatically, (you can) scan a patient and can immediately see, ‘This is your foot alignment.’”
With other measurements and a SyndesMetrics component, it’s clear the platform will have a wide variety of potential uses.
It’s not robots doing perfect surgery, but, with progressions like CurveBeam is making, orthopedics are certainly moving into the next era.
Garry Carneal discusses the benefits of accreditation in diagnostic imaging.
Garry Carneal, JD MA, is the President and CEO of RadSite, a CMS accrediting body for diagnostic imaging accreditation, medical management, and a healthcare policy expert.
Carneal helped develop more than 20 different accreditation programs for various healthcare specialties.
“There are different shapes and forms for accreditation. Part of my mission statement and value is to make sure Rad Site is efficiently and effectively doing an intervention to help an organization we’re accrediting get to the next level,” Carneal said.
Part of what Carneal calls "accreditation reimagined" consists of real-time measurement of imagining quality performance, leveraging AI and evaluating purchasing coalitions.
“The ultimate goal is to create a shared educational experience that is as effective as possible, but make sure imaging providers have the opportunity to get reimbursed for the services they provide and allow them to get back to their focus on population health," he said.
Carneal said he works in conjunction with a community of experts in the field to develop, maintain and update Cone Beam CT imaging standards. Once the standards for Cone Beam CT imaging roll out, Carneal said some refinements may occur.
AmpRecover CEO Dave Nichols and AmpRecover user Dr. Trevor Turner discuss how new digital health software can provide the best, most effective possible care.
Technology is changing the face of healthcare, especially in the sector of orthopedic rehabilitation. Amp Recover, a new software designed to connect patients, providers and healthcare organizations, has flipped the recovery process on its head.
Rehabilitation from orthopedic surgeries and injuries is normally a largely hands-off process where patients do most of the work independently from a practitioner. But Amp Recover aims to bridge that divide. Joining Curve Beam Connect is Dave Nichols, CEO of Amp Recover and Amp Recover user Dr. Trevor Turner, an orthopedic doctor with Georgia Bone & Joint. The two healthcare professionals discussed how the software may provide the patient with the best care possible.
Gone are the days of sending patients home with three-ring binders, Nichols said. Amp Recover fills the gap when patients leave the clinic to heal by engaging the patient with a gamified experience that invites the user on a journey to continued recovery.
Amp Recover adds additional value in the data it collects from the user, practitioners and healthcare institutions, be they part of a shared network or not. By culling recovery data, institutions can streamline their process, becoming more efficient over time and monitoring the efficacy of orthobiologic data.
The short-term value of Amp Recover is better patient-provider communication. The long-term value will be the data, a tool ultimately leading to providing the best possible care.
Dr. Glenn Gaston explains how data, research, & analysis are changing the way hand, wrist & elbow injury methods are treated in pro sports.
How do professional athletes recover from sports injuries and what are the advancements in sports medicine that are making these recoveries faster, and better? On this episode of the Curvebeam Connect podcast, host Vinti Singh, Director of Marketing at Curvebeam, spoke with Dr. Glenn Gaston, hand surgeon with OrthoCarolina, and hand consultant for the Carolina Panthers and the Charlotte Hornets, about these issues, with a focus on hand and wrist injuries.
As a member of the NFL physician’s society, Dr. Gaston was able to share with Singh, how the NFL’s muscular skeletal committee operates, what it does, how it reviews player injury data, and how it works to find solutions for better player care, and faster injury recovery times.
The focus of the subcommittee’s work is broken into two parts; they look at common metacarpal fractures, hand injuries they see frequently in players, and then they look at injuries such as Scaphoid bone fractures, which are harder to detect, and if left untreated can cause permanent, long-term damage.
“Every single practice, every single game, every single injury to every single player is recorded,” Dr. Gaston said.
The committee looks at whether the injury took place on a Thursday or Sunday game, what type of turf the injury happened on, and weather conditions. A lot of considerations go into recognizing patterns and developing the right solutions and methods.
With this research, and the methods used to treat these professional sports athletes, often what gets developed for player injury recovery later becomes the standard used to treat regular injuries.
CurveBeam's Ryan Conlon is looking for critical thinkers & self-motivated candidates for their Regulatory Affairs Associate position near Philadelphia.
On this Jobcast episode CurveBeam Connect, we sat down with Pennsylvania-based Ryan Conlon who is looking for a self-motivated, detail-oriented candidate for the position of Regulatory Affairs Associate.
"The most important trait is someone with a little bit of creativity," Conlon said. "This role is going to require the associate to read and interpret the regulations or standards, and then use your critical thinking to determine how we're going to be in compliance with these regulations in a fashion that is minimally impactful to our product performance, company goals, and our timelines without ever compromising product or patient safety."
CurveBeam was founded in 2009 by a group of individuals with a proven track record in the advanced and compact 3D imaging device domain. They’re an energetic company that is innovating and leading the way in orthopedic 3D imaging on a worldwide scale.
Conlon shared insight into the company's culture, and answered our signature question -- If CurveBeam was a band, what band would it be -- with a timely reference to one of many hip-hop kings, Travis Scott.
Job basics:
Location: Hatfield, PennsylvaniaDays of the week: Monday - FridayTravel involved: Minimal, if anyEducational requirement: Bachelor's of Science in Engineering, Science, Regulatory, or a related discipline
If you’re looking for a place where you can work hard and better yourself in an energetic environment, check out Curvebeam job openings, podcasts, and education at CurveBeam.com.
CurveBeam's Dave Rovner has an exciting opportunity for creative software engineers to break into the healthcare field.
If CurveBeam was a band, it’d be the Foo Fighters. How’s that for a hook? On this CurveBeam Jobcast, host Tyler Kern got the details on an open software engineer position for Pennsylvania-based CurveBeam, the first company to offer a weight-bearing CT for extremities which has transformed the field of podiatry and orthopedics.
CurveBeam Software Development Manager Dave Rovner explained: “The main guy in that band Dave Grohl was in another band, Nirvana, a pioneer in the music scene. So, how does that relate? Our CEO Arun Singh as well as others at CurveBeam come from another pioneering company in the dental imaging world and CurveBeam really extended that technology to the medical field.”
CurveBeam, a 3D orthopedic imaging leader in the United States, Europe, Australia, and China, is looking for a software development engineer to join its reputed team five days a week in Hatfield, PA. Rovner said the ideal candidate will have a Bachelor of Science in Engineering, Computer Science, or Biomedical Engineering with a software emphasis, as well as two years of experience in programming Python.
Rovner said adaptability within this agile company is essential, as well as good communication skills within small engineering teams.
“Also, we want someone who has the confidence to present new ideas and challenge old ones,” Rovner said. “This is an environment that encourages that.”
Dr. Mark Myerson breaks down the mission of Steps2Walk and bringing quality foot & ankle treatment to the whole world.
When we sprain our ankle or break a toe, it's assumed that proper care is rarely far from reach. This isn’t the case for everyone, especially those who live in rural corners of the world. But there is significant hope for these patients with debilitating foot and ankle issues.
The philanthropic organization, Steps2Walk], offers life-changing treatments to patients all over the world. In many cases, the program’s surgeon’s have given permanently disabled patients the ability to walk again. We explored this forward-thinking organization on CurveBeam Connect.
Our guest was the esteemed doctor himself, founder and executive director of Steps2Walk, Dr. Mark Myerson. Regarded as one of the premier foot and ankle surgeons in the world, Dr. Myerson explored the operation of his organization, and how its reach is only expected to grow in the coming years.
“We are ‘Doctors Without Borders’ for the foot and ankle,” Dr. Myerson said when explaining the organization in brief; and if Dr. Myerson had his way, in coming years Steps2Walk would be just as much of a household name. With over 200 surgeons volunteering to participate in Steps2Walk, the organization is a force to be reckoned with. But the humanitarian program doesn’t accept just any surgeon.
Participants must be excellent educators, as well as highly skilled surgeons accustomed to deformities not often found in the Western world, like Cleft Foot. Steps2Walk aims to not only treat patients in need but to educate them on their foot and ankle health.
“Probably 80% of work that we’re doing is teaching.” Dr. Myerson said.
Steps2Walk is continuing to change patient lives and the way care is administered in a variety of countries with different health care systems. For doctors interested in participating in the program, or interested listeners wanting to know more, visit www.Steps2Walk.org.
Dr. Cristian Ortiz discusses weight bearing CT scans and gives insight to what's happening in foot and ankle surgery.
Orthopedics in South America are burgeoning as the number of foot and ankle surgeons begins to increase, said Dr. Cristian Ortiz [contributor page] of the Clinica Universidad de los Andes in Santiago, Chile.
“We are growing up in sports, but we’re also growing up in the practice of all the different areas of medicine and medical care, and especially in orthopedic,” Dr. Ortiz said.
For this month’s episode of CurveBeam Connect, director of marketing Vinti Singh sat down with Dr. Ortiz, a noted foot and ankle orthopedic surgeon and vice president of the International Federation of Foot and Ankle Societies (IFFAS). Every month, Singh interviews doctors, patients, and thought leaders in healthcare technology to discuss how weight bearing CT solutions are changing medicine.
In the last five years, Ortiz said he has seen a growing number of foot and ankle surgeons, especially in Argentina, Brazil, Chile, and Colombia.
“Right now in Chile, we have 60 foot and ankle surgeons who are well-trained or formally trained in the States or Europe,” Dr. Ortiz said. “So it’s a pretty good number for an 18-million-people country.”
More orthopedic surgeons mean an improved level of care and skill for the specialty, he said.
“Medicine is practiced in different ways depending on where you are, which depends on your financial support, level of expertise, and sometimes even if you have the same training, people do things differently," Dr. Ortiz said.
Dr. Ortiz is preparing for the next meeting of the IFFAS 2020 in Vina del Mar, Chile, where 1,400 surgeons will meet to discuss weight-bearing CT, sports injuries, total ankle replacements, and other hot topics right now in the foot and ankle surgery.
“So it’s very interesting because when you bring speakers talking about the same subjects, you get different ideas because they come from different parts of the world,” Dr. Ortiz said.
Dr. Martinus Ritcher breaks down his recent study on the correlation between cost and expose time for CT scans.
In this episode of the CurveBeam podcast, host Vinti Singh sat down with Dr. Martinus Richter, MD, Ph.D.to discuss the results of his latest published study: “Results of more than 11,000 scans with weight-bearing CT – Impact on costs, radiation exposure and procedure time." This first-of-its-kind study examined the economic implications of CT scans versus radiographs for patients.
Dr. Richter is department head of the foot and ankle orthopedic surgery section at Hospital Rummelsberg in Rummelsberg, Germany and has published numerous studies in orthopedic journals.
While previous studies have sought to measure a CT scan’s accuracy and benefit in visualization, Dr. Richter's was among the first studies of radiation exposure, procedure time, and CT scan costs, both for the patient and for the institution.
As a result of studying 11,000 scans of 5,000 patients, Dr. Richter found a profit of 51 euros per patient by implementing weight-bearing CT scans. The study compared weight-bearing CT imaging to the combination of radiographs and traditional CT imaging.
In calculating the cost, Dr. Richter factored in the working-time cost of radiology technicians and insurance reimbursement for weight-bearing CT to payments for a combination of radiograph and CT.
In this episode, Dr. Richter also offered insight into his research and shared how he studied the radiation doses, his results, and what this means for institutions weighing all these options.
“The main cost of a weight-bearing CT is not the scan, the main cost of a weight-bearing CT scan for the patient is a bad outcome,” Dr. Richter said. “When we can finally decrease the percentage of bad outcomes with trust in three-dimensional imaging, this would be a lot of cost savings.”
Dr. Cesar de Cesar Netto joins Curvebeam's newest podcast to introduce who he is and discuss advancements in extremity CT scans.
For a premier orthopedic surgeon, you might be surprised to learn Dr. Cesar de Cesar Netto [contributor page] has never broken a bone. Even as an athlete playing soccer, the founding member of the Weight Bearing CT Society never sustained an injury like the ones he sees from his patients in his orthopedic work. “I was a goalkeeper,” he says chuckling.
On today’s episode of Curvebeam Connect, host Vinti Singh, Curvebeam Director of Marketing, sits down with Dr. Cesar de Cesar Netto, M.D., Ph.D. of the Hospital for Special Surgery to learn more about the Brazilian surgeon and researcher and discuss advancements in extremity CT scans.
Since the society held its first meeting in Berlin in 2016, the society has presented at several conferences and made significant strides towards its mission, Cesar Netto says.
Specifically, a recent imaging study of patients with adult-acquired flat foot, or flat foot deformity, found that 70 percent of those patients had some degree of subtalar joint subluxation and sinus tarsi impingement. Cesar Netto was a co-author of the study that used weight bearing CT imaging and MRI, as opposed to two-dimension x-ray imaging.
“The foot is such a beautiful biomechanical machine with so many joints that I always thought x-rays couldn’t really demonstrate to you what the deformity consisted of,” he says.
With hospitals' tight funding for new equipment, Dr. James Kraft is going mobile, bringing CT scanning to them.
Weight-bearing CT scans have many benefits when compared to a weight-bearing X-ray. The problem is that many hospitals don’t have access to these CT scanners. This creates a need across the industry for for better methods of imaging. On today’s episode of Curvebeam Connect, host Vinti Singh, Director of Marketing at CurveBeam talks to James Kraft, founder and CEO of The Standing CT Company, a provider of weight-bearing CT services to hospitals throughout the UK and Europe via mobile imaging vans.
“In the UK, there is very little money for capital investment and new technology. It was clear that the weight-bearing CT scan was superior to the x-ray. The question was how to get more of these into hospital in a way that was financially feasible," Dr. Kraft said. "So, we came up with a mobile solution that could go from hospital to hospital."
The mobile scanning unit has so far taken off with flying colors, and hospitals are beginning to adopt this structure. “Right now, we are doing a lot of one-off scanning days with our first unit. And the surgeons are very motivated to get it into their hospitals. They know the advantages," Dr. Kraft said. "We plan to have our second mobile unit by end of the year and two to three more by 2020."
The company is very focused on educating surgeons, radiologists, and clinicians about the units, the workflow of getting scans back to hospitals, and why mobile units are more cost-effective. To bring together all stakeholders, The Standing CT Company is hosting a full day conference in London on July 12.
“The event came from the idea of looking at what the industry needed to know, and our advisory board was very influential. The conference will have lots of sessions from experts about CT scanning, orthopedics, and more," Dr. Kraft said.
You can learn more about the event by visiting their website or Curvebeam's. Listen to the entire podcast to learn more from James on weight-bearing CT scans and what their mobile units will look like in the future.
Dr. Babak Baravarian tells his history with technology in the healthcare industry and what impact it has on the way he treats patients.
The medical field is always on the cutting edge of technology. New ways to examine the human body and ward off the diseases that harm it have come a long way and continue to evolve.
In 2003, Dr. Babak ‘Bob’ Baravarian, DPM, FACFAS, made a bold move by going completely paperless at the University Foot and Ankle Institute in Los Angeles, where he serves as the practice’s director and co-owner.
Baravarian also implemented a digital X-ray system, which at the time was very uncommon in the United States. This forward-thinking, coupled with a focus on client care, has allowed the practice to succeed and become a leader in foot and ankle procedures in Southern California over the last 16 years.
On this episode of CurveBeam Connect, host Vinti Singh chatted with Baravarian about his history with technology in the health care industry and what impact it has on the way he treats patients.
Food and Ankle Institute uses weight-bearing CT Scans instead of X-rays, and Baravarian said the former is becoming increasingly obsolete as new and more effective equipment arises.
Still, the doctor sees a few major issues with the state of health care today.
“What is wrong with our health care system is that the dollar is going into the wrong pocket. If you look at the quality of care, the biggest issue is you have a health system where the right hand and the left hand aren’t talking to each other,” he said.
On that point, Baravarian elaborated that the ratio of administrators to doctors has increased rapidly, which has raised prices while lowering efficiency and reducing the level of care.
Baravarian is excited to see how health care might change in the near future, and surely there will be new treatments and technologies leading the way.
Dr. Alexej Barg breaks down his recent research on evaluating syndesmosis and whether his findings could translate to a clinical setting.
On this month’s edition of CurveBeam Connect, Vinti Singh, Director of Marketing at CurveBeam interviews Alexej Barg, M.D. [embed contributor page], an orthopedic surgeon at the University of Utah.
Dr. Barg specializes in the care of the foot and ankle, as well as reconstruction of traumatic injuries to the foot, ankle replacement, and joint preserving procedures.
Prior to coming to the University of Utah where Dr. Barg has set up a very impressive biomedical research lab, both in terms of size and the breadth of projects, he was the head of the Orthopedic Department at the University of Basel in Switzerland.
Dr. Barg currently serves as a reviewer for numerous medical journals including Foot & Ankle International, Journal of Biomechanics, Clinical Anatomy, and BMC Musculoskeletal Disorders, and is well published in foot and ankle replacement.
Currently, Dr. Barg is working with a variety of other researchers on a series of weight-bearing CT projects, including two cadaver research studies. On working with Dr. Arne Burssens on a templating method, Dr. Barg said: “we’re able to compare the healthy side versus the injury side and can detect very small differences in imaging using weight-bearing, which we’re not able to do using conventional radiographs and MRI.”
Give this podcast a listen to hear Singh and Dr. Barg break down his recent presentation on evaluating syndesmosis, his discoveries on the effect that torque plays in syndesmosis measurement, and whether this findings could translate to imaging in the clinical setting.
Vinti Singh, Director of Marketing at CurveBeam, and guest Dr. Francois Lintz, M.D., Orthopedic Surgeon, explain why X-rays are no longer the gold standard for orthopedic imaging.
CurveBeam, the internationally recognized leader in Extremity CT imaging, is excited to share their new podcast CurveBeam Connect, a show where anyone interested in healthcare and technology can learn about the amazing new innovations that are affecting medicine.
Our host is Vinti Singh, Director of Marketing at CurveBeam, and today’s guest is Dr. Francois Lintz, M.D., Orthopedic Surgeon at Clinique de L’Union in Toulouse, France. Dr. Lintz is a renowned foot & ankle surgeon, as well as: Scientific Committee Chair for the French Foot and Ankle Society, the Fellowship Committee Chair for the European Foot Society, and a Founder and Member of the International Weight-Bearing CT Society.
Dr. Lintz has been using a CurveBeam Weight-Bearing CT System since 2016 in both his daily practice and his research, and has found they're more accurate than the X-ray, which project images and represent a 3D structure in a 2-dimensional format.
“It’s not reality itself,” said Dr. Lintz. “When we plan surgeries-- we’d like to know exactly what we’re looking at. In film, it’s distorted by a number of effects and makes it more difficult for us in terms of angles, distances, and things we require to plan for a good surgery.”
Conventional methods, like X-rays, are thought of as the “gold standard,” but there has been a huge emergence of three-dimensional imaging in other fields and industries. The weight-bearing tool is a game changer, giving the ability to see the foot and ankle in 3D, in a standing position. We can see actual damage with a model that very accurately represents reality.
In this podcast, the two will talk about CurveBeam systems, the InstaX plugins, all the different views that are available, and how these views are available at the click of a button, without an X-Ray tech moving the patient and tube around.