Welcome, everyone, to another episode of
The Sync Podcast, where we explore the
value of an inclusive approach in the way
we think, work, and engage with our
communities and workplaces.
Here, we challenge the idea that inclusion
is exclusive.
Instead, it's about ensuring that no one
is left behind.
Each episode brings you candid
conversations with thought leaders and
changemakers who are driving inclusive
innovation across various sectors.
I'm your host, Nicole Piggott, and today
we're joined by an incredible guest, Dr.
Keith Thompson.
Dr.
Keith is a family physician based in
London, Ontario, and the chief medical
officer at Nuralogix, a Canadian health
tech company.
With a career rooted in clinical care and
innovation, he's also a board-certified
medical affairs specialist and teaches at
Western University.
Dr.
Thompson has been a pioneer in virtual
care and telemedicine, contributing to
national and global efforts to advance
digital health through organizations like
the World Organization of Family Doctors
and the C.D.
Howe Institute.
I'm excited to talk with him today about
the future of healthcare technology and
patient-centered innovation.
Welcome, Dr. Keith.
So, Dr. Keith, welcome to The Sync Podcast.
It's great to have you with us here today.
Yeah, thank you, Nicole.
I've been looking forward to this for many
weeks since we first met, so yeah, thank
you.
It's going to be fun.
So, let's start at the beginning.
Like, you've had a really rich, incredible
journey, but I don't think most people
normally think of technology, digital
technology and healthcare.
And so, talk to me what led you to blend
the two and see the value of technology
and how it could play a role in improved
outcomes for healthcare.
Yeah, it's an interesting perspective as a
family doc, right?
I've been doing this for, well, 34 years
now.
And, you know, to be honest, I was a late
bloomer to technology.
In fact, I was converting from paper to
EMR the day that we announced COVID, which
was just insane.
We weren't sure we were going to be able
to complete our training session.
But, you know, that was kind of my first
foray into the applications of technology
and how it might help us in encounters
with our patients.
But literally, I would say through the
pandemic, kind of my aha moment was
emoting to one of my former staff men here
at Western, a faculty with the
department.
And, you know, kind of frustrated.
We're seeing our patients by video.
We're in lockdown.
I mean, it was an incredibly stressful
time.
Not to mention the cutbacks in services.
We didn't have fee codes for virtual care
at that point.
So, if you can envision, I think it was
three months without any income.
We weren't sure how this was going to
work.
And, you know, I found myself kind of
going back to my roots.
All of the early training under Dr.
Ian McWhinney, I would say he's the
forefather of family medicine, really
globally known, but really, you know, the
first to see and evolve family medicine
into a specialty unto itself.
And I started reading through some of his
principles, and, you know, it just brought
me back to what this role really is about.
And that's a caring and it's a healing
profession.
But at its core, it's artisan or holistic.
If you look at the work by Ursula
Franklin, you know, great thought leader
here in Canada, you know, she speaks a lot
about this.
There's certain technologies which are
prescriptive and are EMR and some of the
digital health, right?
It's prescriptive, certain way of doing
things.
But how we interview and encounter with
our patients and understanding their
illness and the context of their world,
man, there's no algorithm for that.
And that's what really, I think, kind of
got me charged.
And, you know, I'd been doing some early
work with telemedicine and trying to
figure out platforms within OTN and what
that would look like.
And serial fail, by the way, in trying to
get some startups going.
But it taught me a lot, right, in really
the limitations and integrations of these
technologies into clinical workflows.
But it got me excited about some of the
thematic, you know, data behind what it is
that we do.
And still, that's an ongoing process for
me, right?
Learning from others.
Yeah.
So it sort of came at you.
It's so funny because, you know, everyone
we speak to, we have, we all know the
negatives that we experienced during
COVID.
But it had forced us to look at the world
differently and look at how we interact
with the world differently.
And it forced us, it was a forced pause to
kind of say, you know, do I, the world has
literally gone off its axis.
Do I continue to act like it's the same
old, same old?
Or what do, what can I do differently?
And I love that it's been the source of
innovation.
It's been the source of re, going back to
your roots.
That's what I'm hearing you.
Like you went back to the beginnings and
said, you know, what is behind my passion
for family medicine?
So, you know, I actually met your
organization through, you know, speaking
at a conference and I was fascinated by
this notion of Nuralogix.
And the notion of AI and the role that AI
can play in improving health experiences
and outcomes and, and the role that, you
know, technology beyond robotics and other
things that we've sort of thought about in
the healthcare space.
But I've never, ever thought about AI
playing a role in healthcare.
And so I really love my audience to hear
more about that notion of what Nuralogix
is, what that technology means, and that
whole notion of early detection, et
cetera.
Yeah, yeah, no.
So, you know, again, early in my journey,
as I mentioned, working with OTN, one of
the projects we had started was to create
this kit that we were going to take to
patients that lived within participation
house.
High needs clients, bringing them to the
office, I mean, with a van plus an
attendant.
And we realized that once Ontario Health
opened us up and said we can do virtual
visits, this is pre-COVID, mind you.
We thought, hey, you know what, we can use
a stethoscope and an otoscope and all of
those tools and use the internet to
examine the patients at home where they
are.
Saves the participation house over $200,
$300 in transportation costs.
Huge relief for the clients, not the
stress of being transferred to the office.
Easy for me, I can do an encounter on my
laptop, right?
So that initial kind of dive into how can
I encounter my patients in a deeper manner
than just video, not just talking heads.
How might I examine them?
And that's how I discovered, you know, and
was introduced to Nuralogix as blown away
by, you know, the first day, the
technology.
I'm like, are you kidding me?
Like doing video and getting vital signs?
Like, how does that work?
I mean, Arthur Clarke says, if technology
is truly evolved, it'll seem like magic.
And we still get that wow effect, right?
When we demonstrate the technology, people
are like, whoa, now it's good and it's bad
because then we have the clinicians and
the scientists that are skeptics and maybe
go, okay, explain this to me.
And that's where I love my role now,
right?
Being able to tell folks, how does this
work?
Well, it's a novel form of remote
photoplasmography.
So that little device that we put on our
fingers, be it at the dentist or we go to
a merge or a doctor's visit, captures our
oxygen level.
There's a red light source going into our
fingertip and it can see the pulse wave
every time the heart beats.
And you'll see that little blip across the
screen, okay?
That's a form of photoplasmography.
We're doing the same thing.
Any camera, red, blue, green capabilities,
30 frames per second.
We can see that pulse wave as reflected
light changing.
The light comes into our face, reflected
back.
The amount reflected back changes because
of the pulse through the face as the
vasculature opens up during the cardiac
cycle.
And we can actually see that pulse wave,
not just in one region, the tip of the
finger, multiple regions.
So if you looked at our DEPA data, you
would see these pixelated images of blood
flow.
We don't store the image of the person's
face.
There's no personal identifiers, right?
This is anonymized data.
We don't even know who we're analyzing,
but we're capturing those images.
What we've done is taken over 55, I think
we might be close to 60,000 individuals,
and brought them into the lab under their
consent.
We've captured their pulse wave, right?
Their transdermal optical imaging.
You'll hear me talk about TOY from now on.
That's our, you know, trademark
terminology.
Right.
We can see that data pattern in the face,
but now over 55, 60,000 individuals, we
have their cholesterol.
We have their blood sugar levels.
We have their blood pressure measured by
auscultation, right?
Ground truth.
We know exactly what that reading is at
the time we do that scan.
Imagine that over tens of thousands of
patients, we can use the AI machine
learning to start to recognize, oh, well,
I know what blood pressure is if I squeeze
your arm and listen, but what is that same
reading in that data pattern in the face?
And it's then, I mean, I'm simplifying it,
but it's a data match.
It's a different set of parameters that
we're seeing match to a known ground truth
based on, you know, medically approved
measurements.
We're still investigational, you know, got
to clarify that.
We're working towards getting these
parameters cleared through the various
regulatory bodies, and we're excited about
that.
But that's really how the technology
works.
It's not as mysterious, right?
And the neat thing is blood flow is blood
flow.
So we're using large data, but based on
ground truth, so that some of the
algorithms out there that might be
difficult because of social determinants
of health, and we're going to talk about
that today, right?
Well, social determinants, yes, may affect
your health outcome and may affect your
atherosclerotic or diabetic risk, etc.,
but at the end point of what is going on
within the vasculature, that's the same
across all the populations.
And so we have a very heterogeneous
population set that we've tested and
trained this on, and now we just have to
prove to those regulatory bodies that,
yep, we can use this across wide
population sets.
So it's going to change.
I think as a clinician, I get excited
because I go, wow, you know, like how many
people have one of these in their pocket,
right?
And I don't need to buy another device or
a wearable.
It's something I already have, so that I
can reach in into those populations and
see what's going on.
So that's really cool.
Listen, for my audience, I want you to
understand, this thing blew my mind.
So I went to the kiosk at this conference
and had the scan done.
It takes no time whatsoever.
30 seconds.
30 seconds, is it?
Okay.
Yeah.
It was wild.
Like I literally, and I have to say, I was
one of those skeptics.
I thought, okay, I've got this, you know,
fairly rare condition.
And I thought, oh, it's never going to
pick this thing up.
And so the real clincher for me was,
was front and center in my report was this
di-
Well, this, it highlighted that I likely
had this and I do.
Yeah.
And so I, I was blown away.
And at that point I said, this could be
huge.
And so, and really, you know, Dr.
Keith, you and I have talked about the
fact that I spent a huge portion of my
career working in remote communities.
I've worked in Northern Canada.
I've worked in Northern Canada.
I've worked.
I've also, I'm the chair of a, of an
organization that works in conflict zones
in the Southern Hemisphere, largely in
Africa and the Congo.
And so the Cape, the, the possibilities of
something like this for remote communities
is huge.
So talk a little bit about the role that
this, that Nuralogix, and frankly, this
AI technology can play in bringing
healthcare to people who are underserved.
Yeah, no, no, absolutely.
You know, we, we have a whole suite of
different measures or parameters that we
do, and some of them are direct measures.
I mean, blood pressure by this analysis of
facial blood flow is a measurement, but
then other analysis we do would be
classifier models.
And it reports back, what is the
likelihood that you may have a certain
condition, elevated cholesterol, diabetes,
for example, or fatty liver.
If you think of the traditional way of
assessing risk for that, it would mean
going to your doctor or healthcare
provider, maybe an initial history,
getting a lab rec, getting a blood test.
Maybe if you're lucky, it's point of care,
but usually it means going to a lab or
someplace else.
Those services, heaven forbid, if they're
even available in some regions of the
world.
Let alone the time and the workflow needed
to get that.
We can do that analysis within that 30
second scan and determine who may be at
risk.
What's interesting about that is, and
we've had some example workflows.
We've been approached by some public
health organizations and saying, look, we
want to do an analysis across a region and
there's, you know, half a million people.
We want to know what is the risk of
diabetes or hypertension or what's going
on in that community.
It would take an army of nurses and
physicians in the lab that we could do
that with a scan and determine a heat map,
if you would, with a really high negative
predictive value.
And that's the other key.
So we'd say, if you screen negative,
likely you don't have that condition.
We can say to that person, you're good.
For those that screen positive.
Now, this is where it gets tricky because
as wonderful as the technology is, okay,
we've done the test.
We've done the screen.
Now what?
Because now we need that intervention.
And, you know, I think, you know, probably
we'll talk about this more, but as you're
aware, and certainly certain populations
in Indigenous communities, I can't just
come in with my device and say, let me
show you how to use this.
We need them at the table to partner and
say, maybe the concern isn't hypertension
or diabetes.
There may be mental health.
There may be other issues, which we can,
by the way, determine stress, mental
stress by doing these analyses and scans.
But in working with these communities and
helping them design or co-design, what
would this look like, I think really is a
game changer.
And, you know, we need that connectivity
for sure.
We've got to have internet access.
And, you know, some amazing work being
done right here in Canada.
To check out Scott Brass, by the way,
Eagle Flight Network, and no conflict of
interest.
I just, Scott's doing some incredible work
in getting a line into these communities.
And Scott gets it because he said, Keith,
it's not just about healthcare now and the
connectivity.
It's social determinants of health.
And that line into the community can
create micro economies that they
themselves can participate and develop
wealth, right?
And I think, wow, that's cool.
And, you know, we're not yet into that
work here in Canada.
We've done some overseas and elsewhere,
but certainly open to those possibilities.
I think that's fantastic because one of
the things for, you know, working in this
space that we work in and having a keen
understanding of the histories of some of
these underrepresented groups,
there's going to be a huge level of
skepticism around, A, is this technology
designed for me and my community?
Because we've had experiences such as the
Blood Ox meter during COVID that really
underserved people from the Black
community.
We saw, you know, poor readings for people
from the Black community and often acute
outcomes for a lot of those people.
You know, we had deaths associated with,
and there's a huge lawsuit associated with
that very issue.
And so there is going to be, due to those
historical experiences with the medical
world and particularly the settler world
on those communities,
is this another way to test your stuff on
us and that it's not going to work?
So how do you get over that?
How are you, like, you talked about
working with leaders in the communities.
Talk to me a little bit about how you've
managed to get through.
So, you know, in some of my other work,
certainly at Western within the Space
Institute, I'm involved in the C2M2, some
of their projects.
And that's how I met Scott Brass, for
example.
And quite frankly, just honest discussions
and trust.
I mean, this is not a situation where we
can come in and pop up a kiosk and expect
to start to serve, right?
We have to have ongoing and relationships.
And so trust is of paramount importance.
In fact, one member of the community up
north, the First Nations, told me that,
you know,
bringing these medical modules into remote
communities and trying to serve,
fascinating, Keith.
But keep in mind that during the
residential school program, the first
thing that happened was a medical van
would arrive
and the kids would come and get their
examination and disappear and never be
seen again.
So how traumatic, we can't reproduce that,
right?
We just can't go back there.
And we have a lot of making up to do.
I think we talk about reconciliation, but
my gosh, I mean, 44 kilometres from where
I sit here in London, Ontario,
you know, we have a community that's on
boil water advisory.
Yeah.
Like several times.
And that to me is insane.
So I think the first step really is just
developing that trust and then asking,
with permission, what do you need, right?
How can we help?
And what might that look like?
To me, what you're hitting on, I want my
audience to hear this as a learning.
We cannot apply our typical approaches and
our typical sort of westernized approaches
to inroads into these communities.
And sometimes we can get frustrated by how
slow the process is to get a foothold, to
even start to get to the solutions.
But that investment of time and effort in
building trust, listening, developing
relationships with people within these
communities that have been injured by
settlers historically
and therefore have a rightful skepticism
around any sort of overtures is an
investment in absolutely achieving success
with the implementation of some of these
solutions for those communities.
So hearing you say that is so crucial.
Yeah, I think that's true, Nicole.
And I think it, you know, behoves each of
us within this realm to ask ourselves, are
we, you know, creating or designing a
solution?
Are we approaching these communities
because they are a potential market?
Or are we approaching because we want them
to be self-serving and develop their own
solutions and innovate?
And I think that's, you know, back to the
idea of the connectivity and letting them
design what would work for them.
And, you know, there are a few examples of
that within some EMR programs, right, that
are catering to First Nations languages,
et cetera.
And I think that that's a start.
We have, yeah, we have a long ways to go
for sure.
And it's shocking, right, that Joyce
Echaquan, if I'm saying her name correctly,
and put back to that horrible story,
right?
Absolutely.
And that's not more than how many years
ago.
I say, really?
I had one lady explain to me she would not
let her father go to the EMERGE alone.
He had cerebral palsy, but would instantly
kind of be seen as, you know, on substance
or alcohol abuse because of his
impairments, right?
Which were physical, not neurologic.
But, yeah, so learning.
And I think if you're working in that
area, imperative that you take a cultural
safety training.
And San'yas, I think, is one.
There's some good programs out there.
And then just explore locally, right?
We have opportunities to learn and visit.
And don't be afraid, right, to approach
and just be willing to listen.
Learn, and I love that.
You know, you're telling your story.
So for my audience, those of you who don't
know, we had a situation here.
It was around COVID.
It was during the COVID period that we had
a young Indigenous woman who was calling
for help within.
She was at the hospital calling for help
and was ignored and chastised.
And then she finally passed away without
help and without aid.
And she was actually ridiculed and
denigrated during her stay with the
typical tropes that we see towards
Indigenous communities here and, frankly,
elsewhere in the world.
And so it's just from a personal
experience, I was in the hospital with a
friend two years ago.
She was in the emergency and there was an
Indigenous woman beside her who was under
the influence, but the level of contempt
and disdain and dismissiveness that was
visited upon this woman instead of empathy
and kindness and understanding.
And I understand people were frustrated
because, you know, people who are under
the influence can be frustrating to you
because, you know, it's hard to get
through.
But there was no, I just sensed that the
frustration was eclipsing the ability to
help this person.
And I finally couldn't help myself.
I wasn't there for her.
I was there for a friend.
But I went over and I said, listen, I know
you're frustrated.
And I can completely appreciate, I've
listened, I can appreciate that, you know,
she's frustrating.
But ask yourself, what brought her here?
And that could be your sister, your aunt,
your cousin, your, you know, that could be
someone in your family.
And you would hope that if they were in
the emergency, that a colleague of yours
would be treating them with kindness and
care.
And so just try to try to keep that in
your mind when she's driving, like when
she's driving you crazy, because she needs
your she needs your understanding and
help.
And part of her reaction is reacting to
the hostility that she's getting from you.
And I can see it.
And I'm in two beds over.
Yeah, no, listen, Nicole, I'll tell you,
I've had an experience, I would say, has
blessed me in many ways in being able to
meet an Indigenous artist.
Melanie Montour first encountered her in a
conference up north in Timmins in
Cochrane, Ontario.
And attending the second year, drove
Melanie up to the conference.
So we're in the car together for eight
hours, right?
And hearing her story as a Sixties Scoop
survivor.
But I tell you, doing a course is one
thing and learning and doing the modules,
but hearing it firsthand from someone just
totally changed my experience.
And I would say, listen, I'm not I'm not a
leader in this space, I'll be honest,
right?
There's a lot of things I'd like to do and
still endeavouring to do and would like to
see these technologies be able to serve.
But the first step at understanding really
what true reconciliation is about and just
hearing Melanie describe what she went
through as a young person, right?
And, you know, to be able to tell her,
actually, I'm sorry, was a pretty powerful
moment.
Yes.
And I won't forget that, that, you know,
as I said, kind of put a signature on my
heart.
Really, what are we doing within health
care?
And as a family doc, what's my role,
right?
Yes, exactly.
So it kind of brings you back as
frustrating, as chaotic as everything is.
And, you know, that the technology is not
just the full solution.
It can do wonderful, incredible things,
but it needs to be partnered, right?
We kind of need that, that, that hybrid of
compassion.
And yeah.
Talk to me about that, because to me,
Nuralogix and the notion of AI and the
ability to sort of give you an initial
assessment, because I see it sort of like
an assessment tool.
It gives you an initial assessment.
Now, where do you go from here?
And you talked about working with
communities to help them to take it, to
take the next step, because, you know, you
get a diagnosis or you get an assessment,
where do we go from here?
And you and I both know, and I've worked
in the, like I said, in remote
communities, where, okay, I've got an
assessment, but the next specialist is an
eight-hour car drive away or a four-hour
plane ride away.
That comes once a day and costs $1,000 for
me to get to the nearest physician.
And, you know, so how, like, where do we
go from here?
Yeah.
You know, again, not that we're directly
involved in these projects, but I
certainly can give you some really amazing
examples.
Ivar Mendez, right, in Saskatchewan, and
has worked with the First Nations there.
They have this incredible virtual hub that
was designed by and for Indigenous
communities, and it looks like something
you'd expect at NASA.
They have all these video terminals and
their remote connections into these
communities, like, literally, you know,
hundreds of kilometres away.
70% of the medical services are now
providing in community, on-site, not
having to bring people to the south.
He was explaining to me one tool, for
example, they use is an infrared scanner
to check for subdural hepatomas.
So I have a fall or I have a potential
bleed in my brain.
Normally, it would have meant we've got to
fly you out for a CT to determine that.
Now, with this tool, right, they're able
to do a screening exam and determine with
a high negative predictive value, again,
back to if it screens negative, we're
good.
We can watch you here, right?
Dramatically reduce transportation costs,
But they can do remote ultrasound, right?
Remote robotic surgery, in community or
in-house.
And I think that's where the ancillary
services that we build, and I like that
project.
I speak about it often because I think he
really is a hero of being able to work
with a community and design not just the
technology for the screening and the
assessment, but those interventions that
follow up.
Right.
Globally, Aaron Jose, a group out of the
Center for Chronic Disease Control in
India, have a telemedicine platform where
they take community paramedics or
community health workers empowered by
these AI tools.
So, again, envision a tool like ours being
able to screen at the local pharmacy,
right?
Those that test positive, okay, we can do
further testing or point to care, but the
person driving it or in control is part of
that community.
So they have that trusted, you know,
relationship.
They're the social Sherpa, if you would,
to bring this technology in, and I think
that's a fascinating model because they're
serving areas that are very
remote or high-density urban, you know,
40,000 people within a region, and there
is no physician available, right?
I've been to India, and I could see how
that would be hugely beneficial to a huge
population that often, to your point, it's
like by foot, cow, you know, to get to an
urban centre.
You know, I've been outside of New Delhi,
and it's, you know, it's hard to get
anywhere.
We're sometimes in a bubble here in the
developed world, right?
We forget what's going on elsewhere, but
that concept that a pharmacy might be your
point of care or point of need, you know,
is really fascinating to me.
So this technology, I think, is definitely
a game changer.
The intervention supporting it, I think,
is where we still obviously will have
work, and that's what COVID revealed, that
digital divide, you know, people that just
didn't have access.
I mean, I still use a telephone a lot for
some of my virtual stuff because it's easy
access, but I need to match the modality
to the patient needs as well.
And so, you know, we won't say that this,
you know, technology works well for some.
In some circumstances, it's back to the
hands-on and the face-to-face.
Right.
I remember a lady with a serious cancer.
She was end stage, and I thought that a
video visit was going to be perfect.
The daughter didn't have to come from
Toronto to bring her to the office, and
she was terminal.
We knew that the end point was, you know,
what that entailed.
And so I initially spoke to her and said,
hey, let's set up some video chats, and it
was more mental health and stress and
anxiety.
And she, at the end of the interview, she
says, oh, Dr.
Keith, I really want to come and see you.
I'm not much for this video thing or
computers.
And so then ensued, you know, the regular
visits, and I would feel for lymph nodes
and listen to her lungs, and I thought,
this is a futile maneuver.
I mean, I'm really – but it reassured her.
Exactly.
Right.
And she needed that, and that was so
therapeutic.
So we can't lose or replace always those
kinds of relationships.
So I think even in these communities that
are marginalized, we need that hybrid
model.
There's got to be somebody there beside
you when it's needed, right, and when
appropriate.
But what I'm hearing from you is it allows
us to be really targeted, and those people
who you could – they can easily be served
by this up to a certain point, you at
least don't spend the resources, the
limited resources, the limited both
financial and actual healthcare
professionals.
We have a shortage of family doctors – I
don't know what it's like in Ontario, but
Quebec, we've got a six-year, four- to
five-year backlog to get yourself a family
physician.
So if you had something like this to sort
of take away – to build capacity in the
system so that that kind of intervention
is for those who need it, that – I think
that's a win-win.
I agree, and I think it will challenge us
to rethink how we deliver primary care in
Canada.
And I think we'll go through some birthing
pains, truthfully.
I think even within my colleagues, the
idea of task-shifting or decanting what I
might normally do to someone else, be it a
community health worker or RPN or whoever,
empowered with this technology that allows
them to do what I once did.
But by increasing capacity, some of us may
grit our teeth and think, right – again,
back to Ursula Franklin, she talked about
that wanting to control technology.
It becomes the power of the elite in some
ways, right?
We don't want to let go of it.
But we're seeing now – we're past that.
I mean, the genie is out of the bottle.
You can go into chat GPT, and it's
amazing.
I had a patient that was going to be 18
months, if you can believe, to get to a
dermatologist.
And I tried other avenues, and they're
like, no, I just couldn't get this person.
I said, you know what?
Do you mind if I take a picture of your
rash?
Let's load it up to this system and see.
And not endorsing this as a medical
software, right?
But, oh, my gosh.
Like, it described the annular margins,
desquamating, central pallor.
The whole thing.
The whole thing.
Have you suggested it gave me a list of
differentials, what I should do?
I'm like, wow.
That's basically an e-consult, right?
Did it save me time and frustration?
I was ping-ponging referrals.
No, sorry, Keith.
We can't see that problem.
No, it was 18 months.
No, you're outside of our area.
We can't accept this referral.
I mean, 18 months without relief.
That's the difference between 18 months
without relief and at least some relief
between that point and getting a consult
with a dermatologist.
This is what I'm, to me, it's super
exciting.
And, you know, you mentioned something,
the case in India, that really resonated
with me.
Because, you know, I go into the pharmacy
over here and I'll put my arm in the cuff
of the blood pressure reader.
Blood pressure's good.
Yeah, it's good.
But I, just for fun, like, I mean, I'll
just test it.
And I think that, like, what, just for the
folks' benefit, and you'll, at the end of
the podcast will be the links to
Nuralogix, so you'll be able to check it
out yourself.
But if I could see something like that, a
kiosk in pharmacies.
Yeah, yeah.
And then linked to here in Quebec, we have
something called the CLSC, there are
public health clinics, so to speak, that
do a lot of care between your physician
and the emergency care in the hospitals.
And so I could see that being some sort of
system that's related, connected to that.
Yeah, yeah.
No, that's exactly the discussions we're
having with the magic mirror, right, which
was our latest version of it.
So, yeah, sometimes everyone's camera is
different, the lighting is different, so
we've, you know, been able to control for
those circumstances.
We control the camera, control it.
It is now a one-stop shop in terms of
device and configuration to get those
measurements.
And absolutely, yeah, that's what we're
envisioning as well, is, you know, have
this in the pharmacy, or, gosh, maybe it's
in a mall, maybe it's in a fitness studio,
maybe it's in a nursing station in a
remote community.
And we had some early experience with that
in regions of South America, where folks
were coming down from the upstream and
really remote rural areas and coming to
these, you know, pop-up nursing stations
to try and determine, you know, risk of
various diseases.
You know, we have a billion people with
hypertension in the world, and half of
them don't know that they have it, which
is a crazy statistic when you think about
it.
If we could simplify just the process for
screening, just determine, yeah, you might
have this, okay, let's examine more and
clarify or validate what we're seeing with
the screening tool.
Yeah, like, man, what we could do with
that.
Wow.
So, I think that's where this is going to
go.
You know, our other platform being the
telemedicine, and we can capture these
signals and measurements during it.
So, if I had this plugged in, I could say
to you, Nicole, hold still for a sec,
right?
And during the telemedicine, right, get a
capture of your measures.
So, that's another workflow that we
envision with these kiosks being set up.
Well, then, might there also be a
potential for a telemedicine feed to a
physician as needed?
But, yeah, it's just, it's crazy where
this technology might take us, yeah.
Incredible potential.
So, Dr.
Keith, you know, at this end of this
segment, we always ask people to share
with us, how do you make sure in the work
that you're doing, because you do family
medicine.
So, folks, Dr.
Keith still sees patients in the
traditional way as a family medicine, as a
family doctor.
He also is a professor at Western
University and in London, Ontario, but
also is working with Nuralogix.
So, how do you make sure that your values
are always reflected in the things that
you do?
Because you're a real ally and advocate
for underrepresented groups and
underserved communities, and I hear that
in what you say, in the humility and
humbleness that you bring to the work that
you do.
How do you make sure that it's always a
guiding principle?
Yeah, you know, I think just looking for
opportunities that I might bring others to
the table and whatever that may entail.
And maybe we're planning a workshop or a
conference and suggesting the idea, how
might we look at this from an Indigenous
perspective or, you know, how might we
look at this from a patient-centered care?
So, my core value, if I would say, in
reconnecting with my former staff people,
right, is kind of 62 years of age, and I
feel like a student again.
That's a little weird, but, you know, it's
been incredibly rewarding.
But those core values being what's
important for the patient.
And I know we have to balance it, because
it is frustrating, right?
And I have to go through certain workflows
and the meso, the micro, the macro,
barriers and facilitations to all that we
do.
But I think it starts with really just
having those conversations and being, you
know, brave enough to introduce the topic,
right?
And listen, I don't consider myself at the
forefront in terms of the work within
marginalized populations.
And there's certainly people have done way
more than I am a technological guru and
excited about that.
And I want to see this grow.
But, man, you know, Dr.
Boozary, I believe, in Toronto, right,
has done some work with the homeless and I
think recently got a Governor General's
Award for that.
Some really outstanding people, right,
that would know more about this space than
me.
But I think being willing to learn and
say, OK, how can I change what I do or how
can I influence those around me with the
conversations is a start.
You know, I had a great role model growing
up.
I'll tell you, my dad worked as a factory
worker.
And I'll never forget that early in the
80s, there was a diaspora of people from
Vietnam coming to Canada.
And they set up in the factory where my
dad worked.
They couldn't speak the language.
And the fellows would sit in the cafeteria
by themselves.
And, you know, there was a usual sort of
comments about, you know, not speaking
English and what's, you know, why.
And my dad went over one day and sat with
them.
And he started sharing food and explaining
in different language what an apple is,
what, right.
And it changed the atmosphere within the
shop.
And, you know, suddenly it was like, you
know, people were kind of learning to say
hello and goodbye in Vietnamese.
And probably after several years, we were
invited, you know, to a dim sum with the
family.
But the impact on me as a teenager to see
how my dad responded to that, right, in
being able to include rather than just
look and not make that effort, willing to
walk across the room and make those
friendships or reach out.
I think that's where it starts.
Everybody has a story.
Everybody has a story.
We just have to take the time to listen,
right.
I love that what you're talking about is
role models.
People are watching folks.
People, young people are watching you.
People who admire you are watching you.
And the way you behave either endorses
exclusion or endorses including people.
And I call it building a bridge.
What your father did was building a bridge
for people who have gone through a
horrific experience.
You know, I went to school with kids who
came over during the crisis in Cambodia
and in Vietnam.
And I remember, I mean, as a child, I
didn't appreciate the trauma these kids
had gone through.
But what your father did was reach out to
people who have a, to your point, a story.
And that story, you and I had the
privilege that we didn't have to live a
story like that.
And so what that, you know, a little
gesture like that, which probably was
nothing for your father, what that meant
to a person who is traumatized, feels
hugely isolated, and is isolated even
linguistically, is a terrific example.
And so what I, I was going to let you go,
but I have one other thing that what you
just said triggered for me.
Because I used to be on the board of the
McGill University Hospital Centre here in
Montreal years ago when we were building
our big facility at the Glenn site here.
And I remember at one point, I was walking
around the children's hospital and a child
was being difficult and fighting the nurse
who was trying to administer care.
And I stopped and I was a young mother at
that time.
So this is 30, over 30 years ago.
And I went over and I said, you know, can
I help?
And I talked to the little, the little
boy.
And he, what he revealed to me was he was
not understanding what they were doing.
They were just doing what they had to do,
but they weren't explaining to him what
was happening.
And the last time he had not asked
questions and not gotten information about
what was going to happen to him, he was
put under for surgery.
And he thought he, he thought he was never
going to see the way he put it was, I'm
never going to see my mommy and daddy
again.
And that was what was running through his
head when he was like, if I submit to this
woman, am I, you know, what does this
mean?
And we implemented at the university, a
patient education program where patients
came in and spoke to young med students
about what they were hearing when you were
saying, when you were talking to them.
And, you know, that's what I'm hearing
from you.
It's like connecting with people, talking
to them.
What you, like, as a professor, how are
you making sure that the next generation
of students have this notion of empathy?
I'm adjunct faculty, let me make it clear
I'm a pseudoprof, right?
But, yeah, no, no, you know, it's
honestly, one thing I've learned over the
years is I thrive on visiting with people.
And I just, I enjoy it.
You don't want to be the last patient in
my clinic in the afternoon because I'm
going to talk your ear off, right?
And my wife used to work in the front when
she was, before children, a social worker.
And she's like, Keith, you got to let them
go.
My gosh, you're going to talk.
Like, they want to leave, right?
But, you know, that is a reward, honestly.
And as I said, in discovering what people
are about, what's their journey, and how
that relates to their illness can give you
some incredible insight.
You know, we're so caught up with
efficiency in the system and throughput,
and we're losing sight of efficacy.
The tools, the AI scribe, it gives me
extra time with the patient because it
saves me from doing notes.
Wonderful.
It gives me back that currency.
But how do I want to spend that currency?
I want to spend having a little visit with
people if I can.
And, you know, and the Ministry of Health
is going to shoot me for this because,
yeah, you're supposed to be seeing 88
patients, you know, a week or whatever.
Like, you know, and I'm like, no, but
that's the thing we lose sight of, that
efficacy.
That's what makes us thrive as family
physicians.
I mean, when he said that, you know,
efficacy has a higher value for us as
primary care.
And, you know, if we lose that, God
forbid,
we lose a lot of what healthcare is meant
to be.
One last shout out, AMS Healthcare, right?
Compassion and Technology, check them out.
We've been to a few of their conferences
and this is
their burden as well.
So, you know, there's a community of
interest out there.
And thank you,
thank you, Nicole, for this chance, right,
to speak to you.
It's exciting, right, to meet others
that are passionate and say, oh, wow, you
know, I'm in warm water here, right?
So this is good,
really good.
Well, it's been great having you.
I so appreciate your joining our inaugural
year of
our podcast.
I could not have thought of a better
ambassador for what I experienced when I
experienced
the Nuralogix technology.
And I love the humanity that you bring to
this.
I love the curiosity that
you bring to this.
And so I want to thank you, Dr.
Keith.
And I hope we get to have you back.
All of
your information will be in the
information section of the podcast.
Please check us out on YouTube and
all of your podcast providers.
And you will learn more about Nuralogix.
You'll learn more about Dr.
Keith and check out the rest of our other
podcasts in our series.
So thanks again, Dr.
Keith, for joining us.
Thanks so much, Nicole.
Appreciate it.
Thank you.
Thanks for tuning in to the Sync Podcast.
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