Jan 13, 2025

109 – How AI is Saving Lives Every Day | A Deep Dive into the Future of Heart Care w/ Joel Portice

Featuring: Vic Gatto & Joel Portice

Episode Notes

Vic hosts an insightful discussion with Joel Portice, CEO of egnite, delving into the transformative role of data and AI in revolutionizing cardiovascular care. Joel shares his journey of leading five successful healthcare data companies, including the genesis and rapid growth of egnite, spun out from Edwards Life Sciences. They explore how egnite's flagship platform, Cardio Care, uses advanced analytics, machine learning, and AI to identify and manage cardiovascular patients, saving lives daily. The conversation also covers challenges in healthcare innovation, the impact of early detection, and how their subscription model bridges hospitals and industry partners to improve patient outcomes and accelerate clinical trials.

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Episode Transcript

[00:00:00] Marcus: If you enjoy this content, please take a moment to rate and review it. Your feedback will greatly impact our ability to reach more people. Thank you. All right. Uh, last show of the year. This is a prerecorded guest show. Vic, uh, tell us a little bit about who you have on the show today. Yeah. 

[00:00:14] Vic: So we have Joel Portis.

[00:00:16] Vic: He is, I think he's done five or six successful startups. Wow. So he's like a, Success, success, success, success. Always around data in healthcare. And his current, uh, project spun out of Edwards Life Sciences. It's, it's on the series, it's my heart health series. Oh, okay. Cause he has a, kind of a really large database of heart data from, um, Uh, maybe a hundred hospitals.

[00:00:43] Vic: And so we go through how the company spun out of Edwards and what he's building. It's really impressive. He's saving lives and saving money. It's really good. So Joel Portis company is called Ignite and the product is cardio care. 

[00:00:56] Marcus: Awesome. Um, let's, uh, let's listen to the show with you and [00:01:00] Joel.

[00:01:10] Vic: Okay. Welcome everyone to health further. We're continuing the discussion of. Heart health innovations today. I'm excited to have Joel Portis. Joel is the president CEO of Ignite. Joel, thanks for doing this with me. Excited about it. Vic, it's great to be here. Thank you for having me. So we have spent a few months getting to know each other, but the audience may not know your background that well.

[00:01:30] Vic: So maybe you've had quite a bit of experience in health care. Broadly and specifically data and analytics. Maybe let me talk about your background broadly just to introduce the audience to you. You 

[00:01:41] Joel Portice: bet you bet. Well, thank you for that opportunity. So I will tell you, I have been in the healthcare data and technology space for over 25 years pretty much by accident.

[00:01:55] Joel Portice: But I got into this after graduate school [00:02:00] when I saw an opportunity to use data and software to solve what I saw as, as a problem, uh, on the payer side and the healthcare payer side launched a company. Um, basically using that information and those capabilities to try to solve some problems. And, um, that company was acquired by United Health Group about 6 years later and we're talking in the 90s or early 2000, what's the rough timeframe we're talking the late 90s.

[00:02:32] Joel Portice: So, so the company was acquired in 1998. Okay. Yeah. Um, and so I, from there, then, you know, at United, um, we were Um, it was, so I would look at the, the United experience as really transformational for me because, um, I had not been part of a big company before, and I had a three year earn out as part of my deal.

[00:02:59] Joel Portice: It was my [00:03:00] first earn out. It was my last earn out. And I'm really glad I did it, but I'll never do another one. Yeah. And I'm glad I did it because again, as I said, I was kind of I kind of accidentally got into this, but what I discovered there was one, I, I met some amazingly smart people who I'm still friends with today.

[00:03:20] Joel Portice: And 

[00:03:21] Vic: at the UHG headquarters. That 

[00:03:22] Joel Portice: was at the UHG headquarters, um, before Optum, there was Ingenix. And before Ingenix, there was this little area called Applied Healthcare Informatics. And they were just transitioning from Applied Healthcare Informatics into Ingenix. So I was, I was one of the original guys, one of the original people, um, during that, that transition to Ingenix.

[00:03:46] Joel Portice: Yeah. And 

[00:03:46] Vic: is it, is it fair to say that UnitedHealth Group and that team were really, Rethinking how data could be used, should be used, might be used to, to, to help patients and manage their cost of care better. 

[00:03:59] Joel Portice: [00:04:00] 100%, 100%. So they had at the time again, this is in the late 90s, they had divested from their PBM.

[00:04:06] Joel Portice: The CEO at the time, Bill McGuire was looking to roll up some different informatics companies to create this informatics piece that eventually became, you know, this, this large entity of Optum and they 100 percent we're looking at how do we use data? How do we use? Advanced analytics, high math in order to try to, uh, solve problems.

[00:04:29] Joel Portice: And when I say it was my first turnout, my last turnout, and I'll never do another one, but I'm glad I did that one was because while I was there, I got to meet great people, smart people, had access to more data than anything else I had seen. And it was also along those. Lines and in that area where I saw what I thought were more problems and in this particular case, it was the inconsistency, the unavailability.

[00:04:57] Joel Portice: Of provider information, and [00:05:00] so we then, uh, after a period of time, and after we left, launched a second company called InClarity, in which we became the single source of truth of provider information, and the whole idea was to be able to create this repository using analytics and software from the marketing side.

[00:05:23] Joel Portice: Where they could predict people's buying patterns and things like that in order to predict the accuracy of provider information so that we could use that to populate into, uh, integrate into workflow systems and operating systems to make sure that, you know, claims were played, paid properly, that provider information was accurate that web directories back in that day, um, were, you know, They contained accurate information for patients.

[00:05:53] Joel Portice: And so, 

[00:05:54] Vic: yeah, I mean, sorry, but one of the assets that a payer has. Is there their network of [00:06:00] physicians and the contract pricing that's one of the core things and if they don't keep up with I mean, there's a lot of changes in the physician Uh network, that's right keep up with those changes day to day month to month And and that's what that's what in clarity was really good at is that 

[00:06:16] Joel Portice: it was extremely good at it.

[00:06:18] Joel Portice: The data was was Real time updated it was verified phone verified when needed Um, but we tried to rely mostly on technology and data and probability scoring and ranking that we had. Um, eventually we, eight years later, we sold that company to LexisNexis. Um, but what those two experiences really taught me was that using data and software to solve big problems in healthcare.

[00:06:49] Joel Portice: It was something that I wanted to continue to do, and so it really has, as I said, it built my career over the last 25 years of using software, using data, [00:07:00] surrounding the organization with really smart people, committed people, in order to solve some of these big problems in healthcare, because our system is very dysfunctional, and you see it, you hear it, Um, we've all experienced it, the fragmentation, uh, the ability for sick patients to fall through the cracks and kind of get lost in the system.

[00:07:26] Joel Portice: And so, you know, really from that, that 1st, start with integrity plus to, uh, the 2nd company within clarity. And then on through some of my other ventures, it's really all been about how do we, how do we solve some of these problems by using data and the technology to support the clinicians. Let the clinical experts be the experts.

[00:07:49] Joel Portice: What we want to provide them are with tools and data that will help them make the best decisions to provide the best outcomes for those patients. 

[00:07:59] Vic: Yeah, excellent. So, [00:08:00] um, Joel, you know, I have this saying, I stole it from a woman that I used to work with. If you have one success in health care, you're, you could be lucky.

[00:08:11] Vic: Two in a row, and you're, you're clearly good. Three, and you're a legend. You've had five successful data companies, one you were on the board of before you were in the leadership team or the co founder, what lessons or success factors or is there a, a rough formula? How do you think about approaching a data company, um, to have this, are there anything to take away that others could benefit from around this?

[00:08:41] Joel Portice: Yeah, I think, I think my themes. And, and they're all related to, to those, those five examples that, that you just mentioned. The theme is one, we've always stayed very focused, right? We don't try to be all things to all [00:09:00] people. And I stepped over as we all have the carcasses of, of companies that really tried, they had grand strategies.

[00:09:09] Joel Portice: But we're not very good at executing and perhaps they were too broad. Perhaps their strategy was too wide. Um, not grounded in data. And what we have always done is stayed very focused on three to five. Problems three to five things that we're going to be better at than anybody else. And the smaller, the company is smaller, that number, um, you know, at various health, for example, we provided a broad set of solutions, but that was because we actually rolled up nine different healthcare assets and we inherited these things, these were nine different companies that were competing against each other in certain areas.

[00:09:51] Joel Portice: And. The leadership at various analytics, the public company said, we need to bring these things together. And and we did that and [00:10:00] had significant, really tremendous organic growth over a 5 year period, but we, we stayed very focused on what we were great at. And we quickly made ruthless decisions on those things that we were not good at.

[00:10:16] Joel Portice: And, and we, we killed those. And then I think the other theme, Vic, is that it's really all about the people. And so in my case, I have been very fortunate to have certain individuals work with me through three, four different companies. Um, And to be able to be surrounded by a team, both at the leadership level, at the technology level, at the operational level, at the marketing level, that's very strong.

[00:10:48] Joel Portice: And, and I believe, I believe culture is a very important piece. And I believe, you know, part of my job as the CEO of these organizations, as the founder of these organizations, is to [00:11:00] really create a cohesive strategy, a cohesive leadership team. And drive that, that type of, uh, cohesion across the entire organization with clarity and to what it is we're about and how we're going to go about executing our plans.

[00:11:16] Joel Portice: Yeah, that's a huge 

[00:11:17] Vic: advantage to like get the band back together where you know how these people, you know, their strengths, you know, where they maybe need help. And you can, uh, save a ton of time as you, as you do another adventure. 

[00:11:28] Joel Portice: Well, everybody in those situations, particularly the very good people, they understand the, the nuances.

[00:11:37] Joel Portice: They understand the idiosyncrasies of individuals that they've been working with. Um, we're not all best friends, but we're very close and you, you get close when you go through. The trenches that that some of us have gone through together. Um, and it really does help because the learning curve is, is pretty much eliminated on day one.

[00:11:56] Joel Portice: We all get it. We know who's strong at what? [00:12:00] Um, and then my job is to really kind of be the conductor and make sure that we're, we're moving and, and Advancing the things that we need to advance. 

[00:12:10] Vic: Yeah. Yeah. And so your most recent company company you're involved right now. Ignite is really focused on cardiac disease.

[00:12:19] Vic: You have a pretty audacious vision for the company, but I want you to describe the vision for ignite and what you're trying to accomplish. 

[00:12:26] Joel Portice: Yeah, yeah. So, um, So Ignite was a operating business unit within side of Edwards Life Sciences. And the leadership team at Edwards, uh, approached me during COVID. And said, we've got this asset.

[00:12:44] Joel Portice: We think maybe we should spin it out and set it up as a separate company. Would you take a look at it? And I did. And my view of it was, this is a digital health company. And you can [00:13:00] imagine, you know, you're part of this 50 billion, massive, innovative, uh, device company that not only is involved in the, the development of, of certain devices, but also in the innovation and the science around those things.

[00:13:19] Joel Portice: And so it's a, it's a very 

[00:13:21] Vic: Manufacturing to hugely, uh, Specific specifications. I mean, it's exactly complex. Uh, and 

[00:13:28] Joel Portice: it's a very sophisticated, savvy company. And I've been extremely impressed with the folks that I've worked with there. And so during covid, we looked at it and I said, look, I think I think this is a digital health company because because imagine this, this business unit.

[00:13:45] Joel Portice: Is fighting for operating expenditures and, and innovation expenditures and everything else among everything, every other business unit. And so their theory was, if we spun it out, [00:14:00] I bet it could be very successful by itself. And so I looked at it and I said, there's 3 things that have to happen. I mean, they were looking at 1 specific valve.

[00:14:08] Joel Portice: And it made sense because they were the leader in that particular valve. And I said, my, my view was, you need to move to all pathologies of structural heart, but you also have to expand to the electrophysiology side. So really think about a patient detection, patient management capability that is looking across the full continuum of cardiovascular.

[00:14:34] Joel Portice: And that means. That you're going to identify patients that you're going to elevate for some form of therapy that might benefit your competitor. Right. Got it. Edwards 

[00:14:46] Vic: may not have the leading solution in that space and to their credit patient, it may not affect the Edwards stock price. 

[00:14:54] Joel Portice: That's right. And to their credit, they were, yes, that's okay.

[00:14:57] Joel Portice: It's good for the patient. And I said, the second thing we need to do [00:15:00] is they were using the A proprietary NLP natural language, processing technology to read echocardiograms. And my view was, we needed to collect all types of data. You know, we need, we need to gather much more data than just that. And so we came up with a whole data governance, data collection, data management strategy.

[00:15:21] Joel Portice: becoming a data centric digital health company. And they said, we agree with that part. And then I said, the third piece was, um, we're gonna create a two sided network in which we're going to work with industry and by industry. We define that as, as, uh, device companies and pharma companies. And you gotta be okay in this case, because now we're actually creating commercial relationships with your competitors and to their credit, they Yes, we understand that, that strategy.

[00:15:50] Joel Portice: And that vision. And again, it's about the patient. And, and so they, they were a great partner. And then of course the final piece was we got to be autonomous. [00:16:00] We need to be able to set this up as an autonomous separate entity. And they were very supportive. Um, they're represented on our board of directors, and I remind them we've grown probably 10X since we spun out in Q1 of 2021, and I remind them that your thesis, their thesis was right, um, that by spinning this thing out, letting us become entrepreneurial, opportunistic, and really execute on the 3 to 5 things that we believe will impact cardiovascular patient identification, patient management, is going to be good, okay?

[00:16:35] Joel Portice: Not only for, uh, ignite as a business, but also for the patients that that we impact and they've been extremely supportive. So we, we did create this very audacious goal of identifying. all cardiovascular patients in America. And, and that's very specific for a reason, is that we're not [00:17:00] international. Could we be?

[00:17:01] Joel Portice: Yes. Um, but right now my focus is really on the U. S. population because I think there's such a huge opportunity. I have become converted in that I believe cardiovascular disease in general is a preventable death. And if we can get these folks who have this disease who are walking around, Vic, and you'd be shocked at the amount of people.

[00:17:28] Joel Portice: that have severe or moderate cardiovascular disease, structural heart disease specifically, and don't even know it. They're walking around with a death sentence. And what we believe we can do is identify them, elevate them. We have nothing to do with the therapy selection. That is all up to the clinicians.

[00:17:45] Joel Portice: Our job. We stop at the last mile. We have purposely become Switzerland. We stop at the last mile to elevate the patient. And engage with them to try to activate their, their therapy, um, but we have nothing to do with [00:18:00] whatever therapy that physician chooses. 

[00:18:02] Vic: Let me, let me rephrase, make sure I'm following.

[00:18:05] Vic: And then I have a question. So is it, is it fair to say that the origin story of cardio care, which, which is the product name in inside ignite? That's right. It started life really as a way for. Edwards Life Sciences to, um, highlight patients that could benefit from their specific valve replacement, uh, device or treatment therapy.

[00:18:30] Vic: Um, and they saw an opportunity to expand it, you did as well, and so it spun out and now it has this, uh, mandate to work with all types of structural heart disease and the electrical physical side of heart disease and work with I think to the 2 sides, this is where I have a confusion. The 2 sides are the health systems providers and the other side pharma and devices, or that's right.

[00:18:58] Joel Portice: That's it. So, 1 side, it's [00:19:00] the hospitals. So today, um, they're on a nightly basis. About 400 hospitals are contributing data into our data contribution model that we can use for, um. Are strengthening our models. Um, research for publications, we've had a number of, of publications and our thought leaders on our medical advisory board and other, uh, physicians that we've worked with, um, who have been the authors of these publications, uh, because of the research capabilities that we have with that data.

[00:19:35] Joel Portice: Um, and, and so that's, that's what the hospitals and then the other side, it's the industry and we define industry in our case as. The medical device companies and the pharmaceutical companies. 

[00:19:48] Vic: Yeah. Okay. So every night, um, 50, 70, a hundred hospitals. Uh, contribute data to your ongoing, uh, 400, [00:20:00] 400, 400, 400.

[00:20:02] Vic: Okay. So every night, any, uh, echoes they have done, all the, all the patients that have, uh, any heart disease get pulled in. How, what's the, how does the data get pulled in? 

[00:20:13] Joel Portice: Yeah. The data gets pulled in. It doesn't have to be heart disease. And so this was the other piece, right? You talked about 

[00:20:18] Vic: focus. Yeah.

[00:20:19] Vic: Cause that was a surprising thing out of one of the, we'll get to your papers in a minute, but a lot of people are not. Aware that they're poor set perceivers that they have heart disease, so they're not necessarily reporting in as heart patients, 

[00:20:33] Joel Portice: right? That's right. They might not. They might not know it.

[00:20:36] Joel Portice: And that's the other. So we talked about the audacious goal and how I was specific that it's, you know, it's, it's all cardiovascular patients in the US, right? We're focused domestically for now. Um, we certainly talk about what the international expansion would look like, and and we've been approached by.

[00:20:56] Joel Portice: Um, organizations that have [00:21:00] international, uh, footprints in order to, to do that right now. It's, it's, it's not on my radar. It's, it's on our plan. We're focused on the domestic side. Then the other piece is it's cardiovascular. So we get 2 billion records a night to, you know, the, the amount of data we get is, is, is phenomenal.

[00:21:20] Joel Portice: Incredible. And what, what we're doing though, is we're still focusing on cardiovascular. For us to adjacently expand into other areas and other disease states is absolutely something we think about. We talk about, but it's not where we are. Now, right now it's let's solve this problem in cardiovascular.

[00:21:40] Joel Portice: Let's, let's help identify, uh, Those patients that have moderate to severe structural heart disease and get them engaged so that we can get them care. 

[00:21:53] Vic: Well, the really interesting thing, well, one, it's, it's a plenty big enough market, right? The U. S. cardiovascular patient [00:22:00] market is huge in itself. Yep. Two, It's pretty exciting because if you, if you find a patient, we have treatment options for them as an industry.

[00:22:11] Vic: And so we can bring them, um, improvement. We might bring them cure, they might die of something else besides heart disease. The faster we catch them, the earlier we catch them, the better. 

[00:22:23] Joel Portice: To that point, Vic, Every day, every day, I could find patients, multiple patients, that we have, we have been a part of them having a life saving therapy because they were identified by our software.

[00:22:39] Joel Portice: It happens every day across this country. 

[00:22:42] Vic: Yeah, every day you are pulling in a patient who, Who would have been not seen otherwise and their life is saved and, and we need to get it out to more hospitals and more patients because every day there's, there are people that are still not seen today that are [00:23:00] not in the Ignite system and need to be.

[00:23:02] Joel Portice: That's right. And what we know, Vic, is that because of the fragmented system we have, that if somebody isn't, if there's not a follow up on somebody within 90 days, there is a very high likelihood that that individual is just going to kind of fall through the cracks, be forgotten about. And then they'll be dead within two to three years.

[00:23:24] Joel Portice: So it's serious. It's real. And our team gets pretty excited about the fact that we know, and we can identify, we can point to an individual whose life was saved because our software identified them. 

[00:23:38] Vic: Well, let's get into the business model just for a minute because I have, there are a lot of health system leaders that are listening.

[00:23:44] Vic: Um, do the health systems have to pay for this? Who pays? I mean, certainly they'll benefit from more and higher acuity patients coming in. Um, I think I know the answer to this, but I want you to talk through it so that people listening can understand how does it [00:24:00] work financially. 

[00:24:00] Joel Portice: Yeah, so our hospitals pay us a subscription model, or it's a subscription model.

[00:24:05] Joel Portice: Hospitals pay us an annual subscription, 

[00:24:07] Vic: and 

[00:24:09] Joel Portice: in exchange for that subscription, we provide them this very, uh, elegant dashboard that is updated on a nightly basis that helps them identify in a very efficient and effective way. Those individuals that are in their system that have moderate or severe structural heart disease or some form of heart failure, atrial fibrillation.

[00:24:37] Joel Portice: We identify that very quickly. The industry pays us a subscription and that is for, uh, us curating a relationship with the hospital to help. Accelerate the population. Uh, I'm sorry. Accelerate the enrollment of clinical trials. So if a industry partner [00:25:00] is looking to do a trial, 

[00:25:04] Vic: you have a new device or a new, a new 

[00:25:07] Joel Portice: medication, whatever, and we have a relationship with that hospital, we can help bring that two together.

[00:25:13] Joel Portice: They pay us a subscription and what we do is we use our technology. We use our software. We codify what the inclusion exclusion criteria would look like for a certain patient. And we create a subset of that. And then there is, of course, the process of qualifying those patients, uh, consenting those patients, and then ultimately enrolling those patients.

[00:25:37] Joel Portice: And so, the industry pays us for that. And the industry also pays us if they have a device that has come to market, we can help them accelerate commercial adoption, uh, with the relationships, uh, that we have with our, uh, provider customers. 

[00:25:54] Vic: Yeah, and then, uh, this weekend I was listening to another podcast you did, and I think it was around valve replacement, [00:26:00] but in one specific, uh, intervention, kind of the macro level growth rate was 6%, but your clients were seeing a much higher growth rate because they were seeing the, the patients that were most interested.

[00:26:14] Vic: Most in need of some kind of intervention, but but untangle my, my incorrect facts, but they pay the pay a small amount, but then they get higher acuity and more procedures. 

[00:26:28] Joel Portice: It's a more efficient use and a more effective use of their, their lab time. So, you know, Our clinician, uh, customers will tell us that, you know, they, they used to look at 15 patients and maybe provide a therapy to three of them with the precision of our identification and our, our management tools, they'll look at 15 and they can provide a therapy on 12, 13 of those.

[00:26:52] Vic: Yeah. 

[00:26:52] Joel Portice: Um, so it's a better use of time. It's better for the patient. It's better for the hospital. It's better for the, uh, [00:27:00] industry partners. 

[00:27:01] Vic: Yeah. 

[00:27:01] Joel Portice: And. Just generally, it, it, I think it improves overall health care in this category. So you're, you're right in that if the market was growing 6%, which was a stat, I don't remember what year that was, but I know what you're talking about, our, our customers were generally seeing anywhere between 12 to 18 percent growth.

[00:27:23] Vic: Yeah, and that utilization of all the fixed costs, the physician's time, the OR suites, the lab time, the patient rooms, all of that, a lot of, a lot of fixed assets in health care, utilizing it more effectively. Uh, can give a pretty quick ROI on the subscription fee, uh, very, very, so they get better health care.

[00:27:46] Vic: Their patients are happier, treated better. The docs are doing more acute and better reimbursed procedures. Yep. Yep. 

[00:27:54] Joel Portice: Yep. Yeah. It really does benefit everybody. And so I've been, I've been doing this, as I said earlier, [00:28:00] about 25 years and I've been very fortunate to be part of companies that have made.

[00:28:06] Joel Portice: Really important impacts on the administrative side of health care to try to improve administration. This is really the first time where My company is is impacting patients directly and I gotta tell you I love it. I love it I love the fact that that we know that patients are receiving life Saving care because of something our software did.

[00:28:30] Vic: Yeah. Yeah, it's incredibly fulfilling I'm sure it's a thing about we were saving lives every day that you come to work your Positions get connected to patients where they can make a difference every day. Yep You just had your company just had some Uh In partnership with some researchers of publication in, uh, structural heart, I think was the publication, and it was a little bit over my head, but it was talking about the benefits of [00:29:00] diagnosing, uh, structural heart disease early to patient outcomes.

[00:29:04] Vic: And my takeaway was, it's really important and beneficial to catch it early, but you proved that and published it. Um, maybe talk about that paper and, uh. Well, how did that come about? And then maybe, uh, describe for the listener better what what the results were. And I just, 

[00:29:22] Joel Portice: yeah, yeah, we, we did. We did that paper with some of our, um, 

[00:29:27] Vic: so the actual paper in the show notes.

[00:29:30] Vic: Okay. 

[00:29:31] Joel Portice: Yeah. And basically what it identified was, well, first of all, there was a big trial that occurred. Um, and I believe Edwards may have sponsored the trial or 1 of the large device company sponsored the trial. Uh, Dr general, I think was the, uh, primary investigator on that and that was a very lengthy trial.

[00:29:54] Joel Portice: Ours. Really complimented that and not that it needed validation, [00:30:00] but it was a validating point in which our data proved and showed to that earlier intervention is key, meaning that, um, if something is symptomatic or asymptomatic, you know, in, in the past, I think people have typically looked for symptomatic, severe structural heart disease and, and what these papers and what this research.

[00:30:26] Joel Portice: Is showing is that asymptomatic even asymptomatic moderate, um, is really important to identify and to get care earlier. Right? So 1 of the things, uh, our, our platform does. And you're right. The company is ignite. The platform that we use for this solution is called cardio care. Cardio care has predictive analytics, predictive models in it that can.

[00:30:54] Joel Portice: predict the likelihood that if somebody was diagnosed as moderate, they're [00:31:00] actually severe. But I think what's more important is we can predict that if someone is severe, the progression of that disease. And that's been very important. But what this new research shows is that early intervention is key because if somebody has moderate, uh, some form of structural heart.

[00:31:23] Joel Portice: That person is just as susceptible to illness and death as somebody who has the severe. So, it really has, I think, opened up. The, the eyes and, and the opportunities to say, we need to get care earlier than later. 

[00:31:42] Vic: Yeah. And the, the opportunity and the challenge is that catching structural heart disease when it is still asymptomatic.

[00:31:51] Vic: Yep, obviously is difficult because the patient is not experiencing symptoms and so there needs to be data [00:32:00] markers or things that your software can see in their, in their physiological data or the echo data, just the data that comes out. Before it manifests to symptoms, the patient feels 

[00:32:12] Joel Portice: that's right.

[00:32:13] Joel Portice: That's right. And this is where data and technology come in. Right? And so, and this is where the clinicians like our biggest evangelists, our biggest advocates are the clinicians because they understand how this can help their practice and how this can can help them deliver care. Because these, these folks, these men and women, are doing this because they want to help patients.

[00:32:32] Vic: And when they get called in and the patient already has all of these symptoms, they're just more limited choices to what they can do. That's 

[00:32:40] Joel Portice: right. And so the reason I think this evangelism from our clinician population occurs, Vic, is because they understand that using this advanced technology, analytic, advanced technology, algorithms, this high math is able to find [00:33:00] these patients and these indicators more precisely than if they're just reading an echo, for example, by themselves.

[00:33:07] Joel Portice: Or if somebody's reading an echo, what if there's a, what if there's a misread of the echo, right? It's, it may not be the 

[00:33:14] Vic: heart surgery, it could be a primary care doctor. That's exactly, that's 

[00:33:17] Joel Portice: right. That's right. And so we're, we're taking We're taking that human intervention out and applying artificial intelligence, not generative, but we're applying our, our AI to it in order to make a prediction of what that disease is and the state of that disease.

[00:33:40] Vic: Yeah. Yeah, and so let's talk about your use of AI and NLP and machine learning. There's all this buzz around generative AI. And it is exciting, but it's, it's a non deterministic. So, so it is, brought with [00:34:00] randomness, which is okay if you're generating a, you know, a blog posting, but maybe not good in heart disease treatment.

[00:34:08] Vic: How does Ignite use NLP, machine learning, AI? Do you have the ability to sort of, um, see where these patient goes in the electronic medical record and then be able to sort of have the, You know, the end of the story as, you know, so to feed the database, how do you think about using technology and machine learning AI to benefit igniting patients?

[00:34:33] Joel Portice: Yeah, so we use all of that. We use NLP. We use machine learning. We use artificial intelligence, um, because of some of the things you've just said about the, uh, just the use of that in the market and the literature in, in, in the media. Um, people can get a. I don't know, maybe an uninformed view of what AI really is.

[00:34:57] Joel Portice: And so we're very careful about how we describe it. [00:35:00] We don't do, this is not chat GPT, right? It's not generative. I mean, it's not like, it's not generative. That's exactly right. And so, and I think what makes our ability to identify these These patients with the level of precision that we can that is better than human detection is because we have access to so much data, right?

[00:35:25] Joel Portice: We've got this 360 view of the data. And because we're just focused on cardiovascular, our data is extremely deep. So some of these data companies that are out there are an inch deep and a mile wide, right? We, we are very, very deep and we, choose not to go too wide. Right. And it is the ability to use that, that breadth of data, that 360 view of a patient and apply our technology to it, whether it's the natural language processing [00:36:00] to review echocardiograms, whether it's the AI to, uh, to create algorithms and to look at the entire patient situation.

[00:36:09] Joel Portice: Whether it's the machine learning to understand and train on what these models can do based on people that look like this, that have these. Uh, these clinical medical characteristics and to start making predictions and be able to pull that out and to do that very, very fast. Um, that is a very different situation.

[00:36:33] Joel Portice: Then again, relying on on a physician to read a chart or to read, you know, an echo. 

[00:36:41] Vic: Yeah. And just to be clear, you said this earlier, but your, uh, technology stack, your solution is highlighting or maybe triaging patients that should be seen by the heart care team as soon as possible. You're not doing a [00:37:00] diagnostic service.

[00:37:00] Joel Portice: 100%. We are not doing diagnostics. Highlighting them 

[00:37:02] Vic: and raising up the most important patients at the top. And that's a very different service than, uh, trying to be predictive. 

[00:37:09] Joel Portice: And that is. You're exactly right. And that is by design and it is intentional by Ignite and by our team because candidly, I don't want to go through the FDA process every time.

[00:37:20] Joel Portice: You know, we're a software company. We're a technology company. 

[00:37:23] Vic: Yeah. 

[00:37:23] Joel Portice: And let the doctors do what they're trained to 

[00:37:27] Vic: do. Yeah. 

[00:37:27] Joel Portice: We're there to support the physicians, um, in the decisions that they need to make. And we're able to do that by providing clinical information for them. To present that in a very efficient, immediate way, so that they can determine the best course of action on that patient.

[00:37:47] Vic: Can you give me a little understanding of the typical patient journey? I mean, how are these patients missed today? They're just not referred over to the cardiac care team, or [00:38:00] maybe they are, but they don't follow up. How do they get lost? And then, Is there a common area that you're trying to close? They always, they never come in from this, this area.

[00:38:12] Joel Portice: Yeah, yeah, so, so, I mean, it can happen in a couple of ways. You know, we talked earlier about somebody might misread an echocardiogram, for example. 

[00:38:21] Vic: Yes. 

[00:38:22] Joel Portice: A mistake. Um, somebody may identify somebody as, moderate when in fact they're severe. And as we talked earlier, even if they're moderate, we still want to be able to see them.

[00:38:33] Joel Portice: Yeah. Um, because if they're moderate, they could actually be severe. And so maybe they're, they're diagnosed as moderate. They should be severe and the physician says come back in two years. Well, unfortunately, in two years, that person will probably be dead. So that doesn't work. People, 

[00:38:53] Vic: it's hard to follow up in two years 

[00:38:55] Joel Portice: or so.

[00:38:56] Joel Portice: Yeah, exactly. Or somebody, um, they, they [00:39:00] may be identified. They may be diagnosed and the next step is okay. We need you to schedule some time to come back and that person doesn't do it. Whatever they, they move on. And maybe they don't understand what the mortality rates are. of somebody who has some form of severe structural heart disease, and they just, they may not understand and appreciate that, and they go about their business thinking, I'll take care of, I'll, I'll go back in, you know, six months or something like that.

[00:39:25] Joel Portice: Um, and that's what I talked earlier about. If somebody isn't seen, if there's not a follow up to the HEART program or to the HEART team within 90 days, you We know, we have research that shows that person falls through the cracks. 

[00:39:39] Vic: Yeah. 

[00:39:40] Joel Portice: And that's a problem. And we're trying to prevent that. Just to 

[00:39:42] Vic: be clear, I think the mortality rate, meaning the percent of people that pass away within two years is like 50 percent if you have structural heart disease and are not seen.

[00:39:53] Joel Portice: It's 50 percent in two years, it's 80 percent in five years. 

[00:39:57] Vic: Yeah, wow, scary. 

[00:39:58] Joel Portice: And that's what I say, when I said [00:40:00] earlier, I've come to believe that cardiovascular death, as a general statement, is a preventable one. 

[00:40:10] Vic: Right, I mean, I'm really, Part of the reason I wanted to do this spin off podcast series around heart disease is, one, I have heart disease, two, it's the largest killer of people in the U.

[00:40:23] Vic: S. and globally, and three, as you're saying, I think it is largely preventable. If we catch it early, which is a, which is the main problem now. Um, but there's an opportunity to really make a huge impact on people's life, like, like, 

[00:40:40] Joel Portice: it's really 

[00:40:42] Vic: hard to see. 

[00:40:42] Joel Portice: I think, Vic, it's if we catch it early and we intervene early.

[00:40:46] Joel Portice: If we get them in, we can activate those patients so that physician can start to put together a plan for that patient. And that's where this whole early, uh, what you were talking about [00:41:00] was early Taver, where that. Really comes in is that whole idea. 

[00:41:04] Vic: Yeah, let's 

[00:41:04] Joel Portice: find them. Let's get them in and let's start to prepare the right type of plan and program for that.

[00:41:10] Vic: Yeah, because even though the mortality rates are quite scary, the treat, we have more treat more and more varied treatments for heart disease than almost any other disease. We have a lot of resources to treat patients if we can get them in and get them seen and treated. 

[00:41:28] Joel Portice: We think about the, you know, it's number one killer in America.

[00:41:31] Joel Portice: Um, and I think people in the heart industry would be happy to concede that to cancer, um, if they could. Um, and but it's the number one killer in America. The cost. Uh, not only to patients and their families and things like that, but the cost to our system, the cost to our society is huge. And if we can create, and I know the American Heart Association does certain things where they're really trying, you know, [00:42:00] obviously the whole genesis of that is to create awareness and education.

[00:42:04] Joel Portice: Um, but I think what we're talking about here is really about the, it's about. It's about identifying and engaging and activating, right? And it's that clinical component. And we, we have enough information to know that this is, Preventable, we can fix this and we have stories. It's not the 85 year old person that that we're talking about here.

[00:42:30] Joel Portice: We have stories of 26 year olds going into the into the emergency room who, you know, for the last couple of years, we're having some kind of loss of breath. I thought it was asthma. 

[00:42:41] Vic: Yeah. 

[00:42:42] Joel Portice: Our system said, no, this individual has heart failure and he needs to be treated now and actually was able to have, uh, procedure done.

[00:42:53] Joel Portice: Um, we have, you know, 50 year old people. It's not just the elderly that are [00:43:00] falling prey to this. 

[00:43:01] Vic: Yeah, definitely. So, so that maybe it's a good point to talk about where ignites headed. So over, you know, we're here in December, this will, this will air probably right around the holidays. So we're about to start 2025.

[00:43:15] Vic: Where's Ignite headed? And what do you see for the future? 

[00:43:18] Joel Portice: Yeah. Um, you know, I tell my team that we're really in the unsexy stage of our business. And that is execute, execute, execute. We, when we spun this business out, we knew that we needed to expand our technology, our data, uh, strategy. And we did that, right?

[00:43:36] Joel Portice: So we spent several months right off the bat, just building out the technology, validating in the market, validating with publications research. So we've been published in, in all the major medical publications. And we have a situation where the business is growing very nicely. [00:44:00] And as I tell the team, we're just going to stay focused.

[00:44:03] Joel Portice: We're not going to chase shiny objects. We, we know that what we're doing is working. It's having an impact. Um, I believe this is, um, I believe that we, we have a lot we can do yet in terms of, of helping patients in this area. And that's what we're going to continue to do. So, as I said, Execute, execute, execute.

[00:44:25] Joel Portice: We've got a plan. We've got a strategy. And we're just going to continue to advance that. 

[00:44:30] Vic: Yeah. Well, exciting stuff. If people want to learn more, what's the best way for them to connect with you or Ignite, or if they're represented health system, get involved, how do they approach it? Where should they? Yeah, I 

[00:44:42] Joel Portice: would love to have them send me an email.

[00:44:45] Joel Portice: Joel, J O E L dot Portis, P O R T I C E. Great, I'll 

[00:44:51] Vic: put this in the show notes. So, uh, send you an email directly. Yep. And, uh, is there, I know there's a website. Is there places they can go on there and also learn a little bit? [00:45:00] There is. Maybe go to their team or, you know, their, uh. 

[00:45:03] Joel Portice: Yeah. I, there's a demo on there.

[00:45:04] Joel Portice: I think it might be a little outdated, but there is a demo out there. 

[00:45:07] Vic: Okay. Yeah, um, 

[00:45:09] Joel Portice: there's a contact us, right? So, so there's inquiries, uh, that we get every day. We get all the time. Um, so, so do that. But if again, I'll put 

[00:45:19] Vic: your email in and I'll also put the website so they can do some research and check out the demo, even if it's a little outdated, I can see the dashboard and see some stuff.

[00:45:28] Joel Portice: Yeah, exactly. That's right. 

[00:45:30] Vic: Okay, anything we didn't cover that we should have? 

[00:45:33] Joel Portice: No, I, I think again, you know, for all those folks that are, they're listening to this, that are interested in cardiovascular, uh, that are in the industry side or working on the hospital side, would love to, uh, figure out a way to, to connect with you.

[00:45:46] Joel Portice: Um, and for all those folks who are trying to solve problems using data and software, um, I think, you Keep at it, keep at it, man. There's a, there's a lot we can do. You know, you talked about some of the, I was on the board, for example, of Apexio, which [00:46:00] used AI back in the early days, uh, in order to help with MCC coding and HCC coding.

[00:46:07] Joel Portice: Um, and you know, that was a company that was based in Silicon Valley. And I joined, um, uh, a friend of mine who's an investor, a person that I'd worked with in the past, put me on the board as an independent. The thing was doing. 700, 000, 750, 000 in revenue. When I joined five years later, is it 65 million and growing?

[00:46:28] Joel Portice: Um, just a great company with great people, um, solving really important problems, but again, they stayed focused, right? They had a good team, stayed focused. And 

[00:46:38] Vic: I don't know, but Sean, I can't say his name. He I've pulled him into Gracia health. One of my portfolio companies. That's fantastic. 

[00:46:47] Joel Portice: That's fantastic.

[00:46:48] Joel Portice: That's fantastic. So, um, yeah, there's, you 

[00:46:52] Vic: said it well, like to do any startup, but data, certainly it's really focusing on that one really critical [00:47:00] idea that you're going to get right better than anyone else. And then build a team of people smarter than you around you to do it with you. Those things are hard to accomplish, but, but really important in having, well, 

[00:47:11] Joel Portice: I think And you got to keep your, your eye above the, the grass too, to make sure you're not going off the cliff.

[00:47:17] Joel Portice: Right. So, you know, it's, it's having the plan. It's having the visions, having the strategy, but it's also paying very, very close attention to it to make sure that if you need to pivot just a bit, it's okay to pivot, right? You know, you don't, you don't do a complete 180. You know, on one day, but you know, pivoting happens and it's a good thing.

[00:47:37] Joel Portice: Right. 

[00:47:38] Vic: Yeah. I mean, Edwards life sciences, um, pivoted in one sense by spinning this out and took a risk and it's going to be great for them and great for the whole industry. 

[00:47:48] Joel Portice: That's right. And Edwards life sciences was a spin out. I believe spin out might not be the right word, but it spun out of Baxter.

[00:47:56] Joel Portice: And, uh, I hope that Ignite has the same success they [00:48:00] did when they spun. Yeah. 

[00:48:01] Vic: Yeah. Excellent. Good. Well, thanks for doing this, Joel. We'll have to do, we'll come back to you once you're having that kind of success and taking that can be another show. 

[00:48:11] Joel Portice: I like that. I like that. Thank you, Vic. I really appreciate 

[00:48:14] Vic: it.

[00:48:14] Vic: Have a good holidays. 

[00:48:15] Joel Portice: Good to talk to you.

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