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Zone 3 is a podcast that discusses everything MRI. Tune in to hear about the latest advances, optimization techniques, and more! Hosted by Robert and Reggie who are both MRI Technologists. They have an entertaining rapport as they tackle topics like MR safety, imaging protocols, upcoming technology, and so much more.
You can tune into Zone 3 Podcast on YouTube or listen to it on your Podcast RSS Feed! Thanks for Stopping by Zone 3.
https://youtu.be/NV9u6O-Xr4I?si=lo6Lpxko_3coXg56
[00:00:24] Zone 3 podcast. I am Robert.
[00:00:25] And we are here today with Pete Jablonka. Nice to meet you. We've done the zoo. We've also got with Brian Huber, with Huber and Dr. Stenger. Nice to meet you guys as well. Thanks for joining us. Hey, goddess. Welcome. So we're here to discuss what? Remote scanning in general. But you guys are affiliated with what company? Alpha. And you guys are all business partners. Take. Correct. So we try to just go around the room. Which roles do you guys play? So am co-founder and in charge of the technologists, of hiring technologists that make sure that there that are meeting the requirements, they ensure that they're doing quality work and just assessing new hires. Okay, then I guess we'll go with Neil first. Hey guys. Thanks for coming. So Neil Huber, vice president of partnerships for Alpha. I also oversee education. So what does that actually mean right. So building out the tech program curriculum, working with the clinical sites, our political partners and developing relationships for Alpha. So happy to be here and look forward to working with you guys today. You got kind of a background in educator. I believe you're in charge of Pulse Radiology. I do, yeah, yeah. So I founded pulse back in 2016. We exited this past year, actually a year ago today, and also founder and CEO of Pulse Radiology Institute. So got a lot a lot of irons in the fire. And it's a family business.
[00:01:53] So we've got your brother Ryan Neil. Right. Hilbert. Nice to meet you as well. Ryan. Yeah, nice to meet you as well. Thanks for stopping by and giving us some time to talk about a hot topic here, a remote scaling. My role here in the company is to handle the nuts and bolts, the day to day operations. So the financial side, the legality side, working with our partners to get them onboarded, as well as some of our technological initiatives that we're working on at the moment, which we could touch on later and the capitalization side of the business. Now, the last but not least, Dr.. Senator, nice to meet you. Yeah, nice to meet you. But to rejoin you late. Yeah. Thank you for having us. So, so tender. I'm a practicing radiologist with a specialty in musculoskeletal radiology. So, you know, my my big role on the team is quality and making sure, you know, our output is both exceptional but also safe. So quality and regulation is where I kind of have a hat. I also assist with it in some kind of the technical outside of the actual scanning kind of issues. I also help with business strategy, like moving forward kind of our game plan as we expand and increase our operations. And I like to touch on your your intentions of expanding because imagine you guys see yourself in 5 to 10 years is growing, progressing in industry, probably diversified in ways.
[00:03:17] What's your intentions there? Yeah, sure. So, you know, we want to expand. We want to expand at a cautious and leveled pace, meaning that what we're doing is we find it is, you know, very important and very kind of innovative. But at the same point, it a lot of people are interested in and want to grow with us and move fast. But our whole goal is we want to expand, but we want to do it at a level pace, meaning that we want to provide the best quality of service and safety, but also making sure that we can help people who really have a high need. As you know, there's a huge dearth of technologists. And, you know, every day people are telling us, you know, either the technologists are calling out for people we're covering or people can't hire other technologists. So I think in our sense, the business is there. We see ourselves growing, you know, very fast in right now, our focus is only in MRI for now, with the future, we're looking at expanding to, you know, CT and other aspects. But I think we're just at this point kind of balancing that, that high demand with us wanting to make sure we're able to deliver exceptional service, quality and safety. Well, I would say that, you know, the backbone of any successful business is you're coming up with solutions to fix problems.
[00:04:34] Right. And so remote scanning, what problems do you see there? What solutions have you come up with.
[00:04:41] So we started this company in 2019. We did not start taking a single picture until last year. Um, we basically sat together, brainstormed every possible scenario that could go wrong, that would go wrong. We were Manuel Ford, William. We decided on a people that that that that weren't jiving with what we're doing or coordinated what we do. We we thought we're not signing contracts with them. You could speak to this to safeties are most concerned that as everybody else. That's why we created an MTA program that can test too.
[00:05:20] So that's Giriama Tech Assist and our tech aid. Right? Correct. Okay. And so what is that program? How long is it? What's the trailer like?
[00:05:30] Yeah, thanks. So the MRI tech program, and like Pete was saying, the foundation of this entire operation is safety. Right. So when we think about, you know, removing a technologist that's traditionally on site and pulling them to a remote scanning hub, you know, we have to be able to provide a strong foundation of responsible, confident and highly skilled, trained and tech aids. Right. So this on site practitioner role has to be, you know, thought through and is the pivotal piece to this entire entire, you know, wave of where we're going. And so, like Pete was saying back in 2019, we did not touch a patient. You know, we did not scan a patient. We brainstormed and figured out that is where we need to build a alpha. Is that remote that, that on site practitioner. So when we kind of peel back the onion and really get to the core, it's MRI safety, right? So what we're doing is we put together several, guess you could say backgrounds that were to become eligible for either the MRI tech role, one being EMTs, paramedics, those that are traditionally found, you know, within that crucial health care sector. In addition to that, we can sort of open that that scope up a little bit to essentially the folks that are already on site, those front desk workers that are looking for a growth opportunity within their current with their current employer.
[00:07:03] So that's another way. And then also another one, if you kind of go out a little bit further, is the service industry. So the folks that work in hotels, the folks that are surveying, you know, the current, you know, you know, economy, right. So if we kind of take all of those and we sort of create this guess eligibility pathway, we could say to ourselves, yes, they can make it. And essentially when we look at that curriculum, obviously the most important part is this MRI safety. So we start there. It's a nine week program okay. And it's bifurcated right. We're going to kind of hear that word bifurcated quite a bit in this conversation. But there's education. And then then there is the practical training piece. So the education will just sort of focus on that for a moment. It's a nine week program okay. We start off with a pretty much an overview of what the day in the life of an MRI tech would be like. Okay, so what are the common situations? What's the processes and policies and procedures of that MRI tech aid. Right. As we continue on week two, it's a level two personnel safety training. So we start there okay. And we sort of build every certain scenario that could happen on site as an MRI practitioner. Right. So as we kind of continue on, peep myself, Doctor Reagan and Ryan kind of figured out what else needs to happen here to become a certified tech aid.
[00:08:29] And when we look at it, we say it needs to almost be an MRI tech itself without the technical piece. So we're pulling out all the parameters, we're pulling out all of the understanding, all that tough stuff that we've all been through together. Right. So when we peel that out, you're actually left with an MRI tech aid because at the scene in that scene concept, we are all MRI tech aids, right. But an MRI tech takes that next step, which is which is that technical piece. So week three focuses on medical terminology okay. So we need to be able to understand how to read a script. What does a certain rule out look sound like. Yet what is it really looking for. And then how does that rule out you know determine you know where to position on a knee. Perfect example quad tear right MRI knee rule out quad tear. What are we going to do? Are we going to position like a normal knee. No we're going to we're going to position a little bit superior because you want to ensure you're capturing the quad tear. These are the things that we're teaching okay. So that's the week three is the medical terms. As we continue on we talk about equipment within the MRI machine. We take the shell of the MRI unit.
[00:09:40] We take it off. We see what's inside. We want them to actually learn. Why are we patting patients? Why are we not crossing legs? Why are we not, you know, decoupling the the the coil plug, right. All of these things matter. We talk about our frequency pulses, gradient pulses, everything within the actual equipment component as we move on. Very robust training in anatomy. So we're learning, you know, a pretty substantial amount of anatomy and specifically learning the landmarks. Right. And the positioning. So each we have, you know, training videos for each body part from head to toe, talking about landmarks, talking about how to position. What are some common troubleshooting for positioning. Right. You might have a heavyset patient for a shoulder. How do we get that? To work, right? So there are a whole bunch of troubleshooting techniques there. And as we sort of continue throughout the program, we talk about clothes, right? We talked about, you know, punching, you know, if we're in a hospital setting or a regular imaging network, these are all things that need to be acknowledged and learned. So that's the the didactic portion. From there, you end it at after the content and you move on to your clinical training. Okay. So clinical training is composed of being on site at an actual center, zone three, zone four under the supervision of an art or a technologist.
[00:11:05] And what that MRI Typekit trainee must do is three components for each body part they must conduct. Um, I believe it's 50 MRI screenings independently signed off by an Or technologists. They have to have position two of each body part an independently signed up by an art technologist. And then they must position a two by two times for every single body part independently signed up by an art technologist. So once those two part A and part B are complete, they come together. They're eligible for their certificate exam. They complete that certificate exam 75% or above. You pass, you get three attempts to take it very similar to what we do with the art technologists. So hopefully that, you know, allows a deeper look into the MRI tech program and kind of where it's started with the inception of it. I want to touch on one thing that Neil, just Neil's articulation of the Mr.. And the role that it plays in the whole operation, I think, is just one example of the depth of thought that we've provided to each of the components of the business and to touch on what Pete laid out at the beginning. And that Neil piggybacked on, was that we started so long ago and deliberately spent. A fair amount of time. And the analogy that we use is that before we began the road trip, we looked down the road and found every pothole that we could imagine and figured out how to fill them.
[00:12:42] The ticket is probably the largest pothole and think it's. It's pretty clear that we've given the correct amount of thought to it and solving that problem. But we find ourselves in this unique position where, you know, no one, none of our imaging partners has come to us and said, hey, we'd like you to help us make for a safer operation. They're coming to us to solve a different problem, an economic problem, one that is focused on staffing shortage. And so we find ourselves in this position of being, you know, the innovative startup that has to pump the brakes a little bit and say, no, no, no, no. This is new, of course, but safety comes first. And here are the parameters that we need to put in place before we scan a single patient. And so that's I think just indicative of our approach as a company and our philosophy as individuals. But Neil, your articulation of the Typekit think is one of the best examples of that. And the certificate is at the end of their training. That's just the beginning. That would they when they're interacting with the with the technologist of the VR, as we call them, virtual radiology technologists, and they interact and they learn every day from the technologists that they work with. So that that's.
[00:14:02] Why as a technologist, I can tell you it sounds very reassuring. You giving it this much thought can see now why this this first, this thought first came up in 2019. Are 2023 almost into two 2023. So a long time. Yeah, yeah. Um, due diligence is the first word that comes with the first term that comes up to mind. And kudos to you, because I think that there's a lot of concern. Well, I know there is. In fact, I put out a poll online asking people what were the pros and cons that remote scanning. And I'll tell you, man, the overall the overwhelming response was a lot of concern, a lot of skepticism. And I'd like to address that today. But it sounds like were you giving just something, a component such as a tech aid? So much thought. Well, it tells me you're giving everything else thought to because like you said, at the end of the day, they're just a tech minus the image acquisition, but they're still learning about what does the consequences to that, because a lot of people, they know metal is not safe, but they probably haven't thought about RF and the consequences of that as well.
[00:15:03] So they don't know the Lorenz effect, but they know what a loop recorder and I'll tell you that. Yeah. Yeah. And this could be a pathway for a lot of them if they're looking to accelerate or get into health care. So you know, we always think of you know the field's going to grow. How do we grow train people. And you have to start somewhere. So like Neil was saying getting people from outside the densely healthcare, this is a nice introduction. Instead of having to do, you know, slow 18 month training to get your, you know, full or kind of certificate. So this kind of lets people kind of get in early, get on the ground floor. We're really trained with high level, you know, technologists and really understand what the field is and what it could be that, you know, the next be an MRI tech or something. Believers took. Two of them that I've spoken to that are going to go to Emmaus. Paul, just because they start off as a ticket.
[00:15:56] I'm not a few techs who started off as tech aides, but this is in a more formal setting. And so it's official. Mean it comes with a certification, correct? Yes. And and so that itself can be put on a resume and it along with the experience. But I know at my facility where I work, Reggie and I both work. You know, if you can come to us with some sort of like credentials, it definitely helps you drop a line in front of other candidates that are applying for the same position.
[00:16:23] Yes. And you're.
[00:16:24] Right. I think that as far as like pathway goes, immediately what my mind went to was a lot of times you'll start by personally my path was is I started off as a transporter while I was in school for x ray, you know, then you get I would then I became a practical tech as soon as I got the comps, and then as soon as I graduated and then became a naughty. But this is just one step sooner you can get into health care, specifically imaging.
[00:16:50] You know Rob. Plus we've been you know, we've been hearing MRI tech needs for how many years now? You know, I've been working with MRI is my whole entire career. And it just never had the I guess, the clean and encapsulating certification around it. Right. So it's it's a little bit well overdue. So essentially we're kind of, you know, hashing that out but also fortifying it for, you know, what's what's what's coming down the pike here with remote scanning.
[00:17:18] So here we are, 2023. You guys said you started in 2019. You had to kind of pump the brakes and think, that's a good way of saying, I like your analogy with the potholes and all that, but and now you guys are on the road, you're driving down that road trip. What are some of the obstacles that you've come across that maybe you didn't see initially?
[00:17:35] Sure. So at the beginning, you know, we're we're excited to start. We were speaking with Will named the place because they still want to talk bad about anybody. Um, they wanted to take some shortcuts in, in in the way that we do this. They wanted Beskidian gone using one tech aid for multiple trailers or multiple sites at different levels, floors. And we just did not like the way they were seeing the future with remote scanning. So we backed out. We lost money. We lost money because we we did not sign the contract so respected. It's called integrity. Yeah, you.
[00:18:16] Have.
[00:18:16] It. To this day, as we.
[00:18:18] Sit here in of 23, how many patients have you scan?
[00:18:23] Well, you can see it live on our website, but right view of that number. Yeah, yeah. At last count, we were at around 8500 as of yesterday. Yeah. And the big fat. Yeah. And that and that that number is increasing at an exponential rate. That's a term that gets overused and used incorrectly, but it truly is sort of accelerating in its growth, which is really wonderful to see because, um, it's it's a testament to our partners trust in us and the results that we have provided. But also I think it's, it's. But of a vote in favor of how we're approaching this technology and this paradigm shift. Um, so we're humbled by that. Um, but we're also sort of laser focused on the road ahead and making sure that, you know, think we're staying in our lane at the moment. Make sure that we're not driving into any panels, but also aware of any cars in the lanes next to us that might be swerving in our direction and trying to stay the course. We think that our strategy and our philosophy is the right one that will carry us forward. Abby 10-K by Orsini and truly thought about the numbers either. It's just relate it to weightlifting. I'm a weightlifter and always get the question how much can you bench? It's I'm here every day. I'm telling I'm here five times a week. The strength comes because I'm here five times a week.
[00:20:00] So that's where the numbers are coming from. Another thing you know is what we're kind of doing as we're moving forward is we kind of sit back and like, yes, like we have we have customers, right? We're scanning patients. Things are going well. But we also sit back and say, all right, guys, how are we doing here? Right. Are we doing, you know, are we doing, you know, a great thing here. Are we pushing this forward correctly actually just, you know, lectured at the armored conference in Las Vegas a couple of weeks ago. And the message there was, I want to hear from all the other techs out there, right. I want to hear from, you know, the other really good minds that are that are kind of out there, you know, where where should we focus? Like, are we missing something essentially. So it was a great opportunity to sort of air it out there in Vegas and, you know, kind of meet a lot of people and kind of hear their feedback on, on the remote scanning. So. And just on that point, I just want to tie in Rob's question to the last topic you addressed as relates to tech aid. And also, you know, one of the potholes. So think and Pete, this is going to be in your wheelhouse. But I think one of the primary distinctions here and how we sort of layer on belt and suspenders in our operations is the timeout.
[00:21:22] And so that's critical to our operations. Pete, I think, you know, you're most intimately connected to it. Do you want to just sort of walk everyone through what the concept is and what the the intent is for it and what we mean to accomplish with the timeout? Sure. So I'll basically start from like day one to the first patient of the morning. Right. The the technologists, the VR team will review the script and we'll review all the paperwork on online. At first the the Mr. will interview the patient and get them ready. And then we do something called a timeout where we talk the VR and the Mr. talk to each other and we go down the list. Peach's name, date of birth, body part that we're doing, the laterality. If there's if it's right or left, is there anything in their body that they were not born with? Is a is a great question. Bill Faulkner for this that one. Um, any kind of implants and if there's an implant we discuss it. If it was if it was vetted, we we also vet them as well. We've even caught a few that the, the site said that it was okay to do. And then we double checked and it was and respectfully, we just went back to them and told them if we are not in alignment, we do not do the patient, you know, but we'll get we'll get a third party involved or we'll just reschedule the patient.
[00:22:48] So that's how that lymphs. Yeah. And this is on top of the screening form that's already done. So this is an added layer. When you pick up like a process. These patients have already been screened. We've reviewed those screening sheets. But we implemented you know kind of catch all the Swiss cheese model kind of aspect where you know, every once in a while these old lineups, we're what are called processes here is adding layers of redundancy even that will make certain that anything gets caught, like saying 2 or 3 implants were caught with that. Just not only we already reviewed the screening form with script everything else before the patient even gets on the table with our vets themselves because we have access to our client's risk. But also, you know, the Mr. over time is also learning about that to alert us about any issues or anything else. So that happens. And then on top of that, right before any buttons are pressed or any, you know, any fields are put on is is secondary form that we document every this that it was it's not just, you know because they brought it just happens over time and you and you forget. But we have an actual toggle on on a form that our vets have to fill out.
[00:23:56] Make sure that they did this every time and sign off that it was done with issues. And, you know, going back to the numbers along those lines, we've had zero callbacks. So those 8500 people that were related to any of our scanning, there was, you know, think maybe one a radiologist wanted to expand the field of view, which is something, you know, we checked with protocols, but but, you know, working to practice myself and knowing how many patients call back, I think the industry status, 4 or 5% of patients that do get called back for some reason. So, you know, I think we really value that, that we've been not only been able to maintain that safety and stamp patients without issues, but also, you know, none of them have to come back and obviously their satisfaction. That's been great. And, you know, I'm in touch with the radiologist said, you know, I've only heard great things about, you know, our scanning and our techs. And we could talk more about, you know, the, the training of our specific texts. But overall, you know, we we really try to kind of make sure that we're doing everything on safety side, efficiency side and, you know, image quality side to to give the best possible service. You guys are going to make fun of me because I'm always speaking in metaphors. Um, but the the timeout is sort of akin to a pre-flight checklist between a pilot and copilot.
[00:25:14] So they they run through the same list every time, and you'd think that they'd get bored of saying the same thing, but they go through it every single time, and they do it before the wheel moves an inch, not right before they're about to take off. It's before they leave the gate. They run through every single point. And so that's how we approach every scan. It's the level of importance of a plane full of 150 people. It's the same level of detail and rigor and due diligence that we take every time. And, you know, in that checklist, sometimes we mix up the order of the questions so that people don't, you know, out of muscle memory, sort of go down the list. So that's just another example of the. How in the weeds we get as it relates to operations and making sure that everything is done to the. This one time a place wanted to start doing a TV. All right. So they had been going to they're going to do it and said I know how to do it. So we got it really all just sat at the console and I built the program for them. He was so elated with it that he wanted to start a program there in this facility for it. So we'll do it that way as well.
[00:26:32] You're expanding everybody's load cells. Try to. Yours was.
[00:26:35] As well.
[00:26:35] Mean we need to team effort.
[00:26:37] Person that says they know everything. Quitting discipline.
[00:26:40] Reggie.
[00:26:41] Release the retrofitted.
[00:26:43] Uh, but as far as, like. So as far as team effort goes, it sounds like declared implant. It certainly is a team effort, but ultimately default to what the VR says and not the site itself. So it was like.
[00:26:58] This. Well, it's we we ultimately make sure that it's been vetted by the site. And if and then we revisit it and if we disagree, then we discuss it again. We we that's that's it. We don't don't say exactly. No. We put it on delay until somebody will hire the radiologist or somebody that says, yes, I approve it. And then we do it to site says. And that's another contract too, that we have the right to refuse a patient or due diligence. And at each site we have an Or, we have somebody tagged either at site or associate sites who's kind of, you know, the final say in, you know, what they're, you know, whether it's an implant patient or parameters that we ask to change, you know, they're the ones who kind of decide and kind of. I would say it's the end all, but our votes always have the opinion or the right to to refuse. If they if they believe it's not, then we work it up. Up the chain to, you know, Pete or whoever's necessary. And we kind of try to figure out what the problem is, but we haven't run into that yet. Everybody here, nobody wants to take a risk, as you guys know, with them are it's more the opposite is that, you know, if there's question, we're going to say no, let's hold off until either we get a card if it's an implant or we get some more information. So I think we've just been lucky. We've had great collaborators. We have as. I think right now our at our site and the man and the the head techs make our decisions. And then on the imaging center side, we kind of either it's or whoever is kind of labeled as the the head on there. So we work together with.
[00:28:35] So it seems to be a pretty reoccurring theme here, which is just thoroughness. A lot of foresight and stuff like that. And so I guess that also comes down to your accrediting bodies. And so how have you guys addressed that?
[00:28:50] Subtended. Yeah, sure. So that's part of the process of this. You know, one and a half to two years of work beforehand is is kind of realizing that, you know, accrediting bodies were a little bit behind the ball with this. They didn't you know, they didn't really have much on remote scanning other than one sentence. So there'd be any of their manual. Um, so we really worked to kind of have the foresight to know that these, these, these bodies, although not yet approaching it, they're going to have to do it so that that kind of was in the the realm that we built, this, this atmosphere and ecosystem with the bifurcated system and spent so much time. But, you know, we honestly believe as others out there do that, that, that this role is, is, is the most safe and efficacious way to divide the remote scanning ability without adding too many third party hands. So luckily, you know, I'd say maybe two and a half years ago, we, we were put in touch with Gary Carniel from Rad Sight, and they've been extremely forward thinking and actually have their own remote standards, which they're the first think only accrediting body to have individual remote MRI standards that lay out how remote scanning should be done, what should the requirements be of the on site person, what's the requirements be of the remote technologist? And actually, we were able to get the MRI tech program approved by.
[00:30:18] It took almost a year and a half of them working with us to build the probe to build and understand the program. So it's approved as a as a certified, I think, the only certified program for Rad sites. So for Rad site accredited facilities, which is, you know, Rad net and the sign met a bunch of large facilities are saying people are moving over as far as they're coming out with a new standards. They came out with a draft, which was kind of kind of had a lot of kind of all over the place, to be honest. It was just a lot of different hands at play. And, you know, we we're in touch with many thought leaders in safety, and a few of them are actually going to be on the board that we're putting together very shortly. And, you know, think all of us are kind of on the same line that it was a fragmented approach, and it was a good early kind of approach. So right now they've taken kind of community comments and they're going to come back.
[00:31:11] So we're we're awaiting the ACR to see what they're going to come back with as, as, as the way they they envision remote scanning to be to be operated. Again, they're not a, you know, they're not a legal entity. It's just a it's a recommendation. And, you know, we're definitely we would like to be on the same page. And, you know, we're open to speaking to anyone, you know, on the committee. And we've been in touch with some people, um, you know, here and there. So I would say right now we work really closely to make sure that we either are partnering with or not. What's what's going on with those, with those different segments. So always, you know, it's it's in the end we're not running MRI facilities. Right. So we're not ever being the ones accredited through these facilities. So we always it's always the responsibility of the end person to our customer to kind of make sure that they're, you know, following all the recommendations, you know, the phantoms, the other things that, you know, we we don't necessarily keep on top of for them, but we, we we would, you know, ensure that they are accredited. They're meeting their accreditations and we're there to help however necessary.
[00:32:15] Well, doctor sedentary you did mention a safety board. How there are some names. Are we able to name those people yet or.
[00:32:24] Um, yeah. Neil's the one who's in. I think we're just, you know, um, you know, not coming from a business background at all, you know, just being a radiologist. I would have said yesterday that I looked at Neil and Ryan, who are the two biggest. Uh, there are some documents that have to be signed, but they're going to be people everybody mean, knows and potentially mean. Maybe a bit on your podcast, but they'll be they'll be people, you know who are were preeminent. People would have to say. And, you know, maybe by the time this comes out, we will have something. We can give you a little blurb to say, but we're very we're very close. You know, the thing is, is like. You know, we appreciate them helping us, but we also expect a lot from them. So we've written out kind of what what we want to have from a safety board, which is quarterly meetings, which is potential drop in site visits, which is a lot of things that people have to be they have to be on board with, you know, so we're we're hoping it's about, you know, anywhere from 4 to 5 people.
[00:33:21] So we've had about three secured 100%. And then we're just getting the other two. But maybe, you know, by Sunday we should have the full board out. But definitely people, you know and and then have the board again. Yeah. And we're and we're treating that as kind of an independent body because you know we created this like you said years ago with safety in mind and, you know, with our own kind of backgrounds in safety and knowledge. But now we want to give that off to an anybody basically, in the sense that we want it to we want there to be no bias, you know, no, the oversight to be, you know, not judgmental. No, you know, kind of incentive necessarily from the company. That's that's just the way to go. As we as you can see where safety is like the only thing that's at the top of our list. So we think making an independent board is where it's go, where where that will go. And we have to abide by, you know, their kind of rules and regulations and oversight. You know, as I'm looking at.
[00:34:17] The clock here, I see we're about to lose Neil. Thank you for your time, Neil. But before you have to leave, I do want to get like, what is your mission statement?
[00:34:25] Yep. So, you know, think it's been pretty pressed the last couple of minutes here. But safety right. So when we look at you know scaling you know our current operation it's safety focused you know and you know backed by experienced technologists as the core. Right. So just looking at the processes and procedures, seeing how the process works, being able to have this checks and balances with our with our safety committee and being able to really dive deep and see, you know, where the problems may lie. There might be problems not here today, but that might come down the pike. So it's very important to to essentially assess every single potential as a risk. And our goal is to de-risk every single component of it. So. Awesome. Well, thank you for your time.
[00:35:18] I know you're a busy man.
[00:35:20] Well, yeah. Thank you guys, and I owe you a trip to Vegas. Uh, to Scottsdale. So, uh, no, I would say that while. All right, guys, so I heard you offer them a trip to Vegas. Neil. That's awesome. Books. There you go. And you know.
[00:35:41] And so we've kind of talked about Alpha, your mission statement, your your vision, your due diligence you put into this. I'd also like to now kind of get into like remote scaling and some of the questions that our communication community is asking us to ask you guys. And so I have a list of those. I think a good transition is one of the one of the questions was, is how are you guys able to trust the decade?
[00:36:06] Well, obviously with the certificate program that we've created and, and the the feedback that we get from, from the, from the facility itself, which we do ask for regularly as how we build a trust and and communicate with that that that aid.
[00:36:24] Yeah. Awesome. Um. It is so.
[00:36:28] Widespread at one point. Sorry to interrupt, but before we begin an assignment where we're linking our vt's with an Typekit. There's a couple of days, almost a week, where the remote tech is shadowing an on site tech and working intimately with the tech to develop that rapport. Because ultimately, on a day to day basis, those two are hand in glove, like the pilot copilot analogy. And so we provide that time for them to really get to know each other and develop a nice rhythm. Um, but I just wanted to add that little piece as well. Yeah. And, you know, we audit this relationship. It's not you know, we our partners, like I said, very, you know, forward thinking. And you know, we've had, you know, many tech aids that we've trained, you know and I would say there's been a few probably just weren't up to what was necessary. And you know that that's apparent. You know, I would say pretty quickly you need someone who is forward thinking and, you know, kind of flexible and, you know, understands that there's a there's a hierarchy and some people just don't follow that. And, you know, we we are pretty quick to, to to identify that and then mitigate it either with more training or with just saying that, you know, this is the best role because again, you know, we're we're we're not looking for subpar performance. You know, it just doesn't work in this in this field. And this is you guys know it needs to be you know, everything needs to work fluidly and efficiently. And you know, people need to be learners and forward thinkers. So, you know, the vast majority of people we've it's been great. But we do monitor and we take any of our comments or questions or concerns about that very, you know, very significantly, we will address those.
[00:38:15] So these are experienced techs you're hiring. Do you guys have a minimal years of experience or.
[00:38:21] We'd like somebody to be into the 3 to 5 year minimum. Really. You know, you need to you need to experience real life MRI, you know, without the magnet with the coils. I think somebody right out of school, this would probably they would love him. But all they can really get in that MRI experience that you need, the patience that it requires to talk a patient into it, the compassion of it, the the putting somebody in and seeing them getting nervous and holding a hand that poor you lose. Obviously with the BRT, we've all done it. I've I've sat in machines myself while. Kids were getting scanned, you know, with their parents right there. That part, you know, you don't get with this, which is unfortunate, but but from that experience, you can build on when you're when you're a dot and say, we understand, you know, we're not getting frustrated that it's taken longer or anything. So that's that's what we look for anybody we can teach anybody the physics, we can teach anybody that. But I think you need hands on experience with patients.
[00:39:27] Yeah. Do you feel it yet?
[00:39:29] Yeah. We also have an examination that we, you know, just agree with. Totally. You know, but think, you know, subjective and objective. We also have an examination that any technologist takes before they even start the interview process. Basically it's pretty it's a robust multiple choice and also kind of free answer tests. And we look for them to score, you know, in the, in the, in the top ten percentile or so with, you know, certain pulse sequences, aberrations or issues that you need to repair or identify. So it's I think that's a good screener for us. This, you know, not only do we want compassionate, we want we need a, you know, hot, very high quality tech. So we're able to kind of learn, you know, if they're only scanned on a forever, you know, they need they need to learn Philips. We want someone who's able to pick that up pretty quickly. Then we kind of I would say filter that out with this exam, you know, and if any tech is interested is watching, you know, please reach out to us. We'd be more than happy. Just as we expand. We're definitely looking for, you know, forward thinking technologists to join the team.
[00:40:34] Yeah, it will have your info below so people can hit that link for sure. Um, just kind of shoot through these questions. Do you feel that remote scanning is less safe than conducting MRI in a traditional sense? The site.
[00:40:45] No, actually, I think it's more safe. The role is bifurcated now. Right. So the M.Tech is totally, totally with the patient right. Sitting on site whereas technologists were scanning. We're we're doing paperwork, we're documenting things and then we're talking to the next patient. So we're not really giving 100% to that patient. And we can all admit that as, as techs where with the tech aid is giving 100% to that particular patient at that time, and the technologist is concentrating on the patient that they're scanning at that time. So it's a twofold. I think the patient's getting better quality service, and the technologists is more focused in the last chance to make mistakes.
[00:41:31] And that answers one of my questions because a lot of people have this question. So is it a 1 to 1 tech aid to patient ratio?
[00:41:39] Yes. If you want to take that. Yeah. Yeah. Yes it's a it's a it's a 1 to 1 ratio. That's, that's and that's what Pete was kind of alluding to before with, with one of our early clients kind of wanted to use a tech aid to, to, to treat the, to scan the patient, but then also in the interim lead to a adjacent location and screen another patient. And we just refused because like, the whole thing breaks down, they're exiting zone three or outside of that, you know, the rip. So right now the way it works is a 1 to 1 relationship, one tech aid to one patient from the time they enter zone 304 to the time they exited. Um, and like he was saying that that the tech aid of the constant communication. So there's two sets of ears here, two sets of eyes. We have at least three cameras at any location for the remote scanner to visualize what's going on to the patient, they can see the VR t, they can see the roof, um, whole overall. And if there's power injector involved, they can see the injector. So we say in the way we built this and you know, with time, hopefully, you know, it'll show is that this is a safer environment overall.
[00:42:49] Yeah I think that's important because all really all it takes is just two patients to squeeze the ball at the same time. Right. Yep. And that's a scenario that's very likely to happen. So do you have any policies in place about claustrophobia anaphylactic reaction. You know, like any kind of metal object stuck in the bore. What do we do in these scenarios? Do you want me to take this or.
[00:43:11] Would you like me to. So again, this is the two year prior start. We've actually built a manual. The what ifs. What if the patient is claustrophobic? What if the patient had a the something in their possible right there, right there. We don't let anybody have the real unless they're changed. That's more of our policies and the and that's one of the questions that one we watched the time out is that a person completely changed.
[00:43:36] So that's supersedes the policy of the the site itself. Yeah.
[00:43:40] For the most part mean that should be everybody's policy. I agree. Nobody has pulled anything against that them or what we say okay. We don't put patients in which pay us to do it. And he just because it's a knee. You hear that a lot from techs as well. Um we have a manual for everything. Even if we lose the internet connection on the machine is still knocking. It's usually for just a second. We dial back in and we continue the scan. If it's if it's for longer than that, we let the machine do the do the series that were prescribed. And at that point, the Mrta will take the patient out, let them know this is going to be a little bit of a delay, and then we communicate and get and get back on.
[00:44:24] So speaking of communication is a question maybe you should have asked one of the first one. Does the patient know that the scanning technologist is off site?
[00:44:34] Well, we can be in such a way that the Mr. is taking such good care of attention. So to the patient himself, it's the point is actually mute. It's not really a question of who's hitting Sarah. The Mr. is going to get all the credit for everything on that ill because she took such good care of me. The techs really not the factor that nobody says. Are you scanning or someone scanning from Ohio from here or wherever?
[00:45:02] Guess to to in their perspective, it's kind of irrelevant, right?
[00:45:06] Yeah. And we've asked our client to safety because obviously we're not there on site for the entire interaction. We've asked our clients and we do it with KPIs and everything. And that's one of our questions. Is Saxon as a patient? Notice any difference and overwhelmingly know that they're there. Not only have they not noticed anything there, they there haven't had any complaints. They haven't had any. You know, where there'll be a few complaints here and there. Think along the lines of saying that they're only they're only come at charge is to make sure the patient is safe, comfortable, you know, gets the scan done and in the timely manner that they get. So along those lines, think they're not as distracted with planning an exam with sending, you know, reformat to it to a radiologist who's like hounded, you know, being a radiologist, exactly how that works. But think we're taking away those other demands allows them to focus on on safety, like we said, but also patient satisfaction and happiness. So we we have not heard anything detrimental to negative, but we've also heard some positives that, you know, it's just they haven't had any complaints or any issues with patients or.
[00:46:15] On. Back to the tech, because that's going to be a lot of people. Interest is, is it within their scope to administrate contrast? Or that would need to be on site. How does that play out?
[00:46:33] To get an egg. Okay. So it depends on the state and the site. Actually, if they hire an EMT who is certified in giving injections and the site requires the radiologist do five injections and then then the tech surely can. Other sites used the techs to start IVs and injections. Some of them come. Some of the masters come with a medical background and they have an injection license already. So at that point they can administer. Contrast depends on the state and the site. We follow whatever rules that the state on the site think.
[00:47:14] Are they sites all within the continental US, or are you guys scaling outside of the US from your hope.
[00:47:22] So we'll eventually.
[00:47:22] But another yeah I imagine there's there's steps to it.
[00:47:26] At one of our largest clients. They have all their they have all their master's service. Oh so yeah. Yeah. So that's out above and beyond I don't.
[00:47:36] I'm not even some.
[00:47:39] Technologists are you know, even as a, as a radiologist even though I am the end all I'm at some of these offices. I'm only here so so think that's a very forward thinking thing. And that's something we do say that it's a good idea to to day think but think you know they they bit forward thinking you're doing this. And so along with that that they potentially can then in certain states be eligible to to administer contrast. But again we leave it to the site in the States. You know they tell us is, is, is can can injected it is certified to inject them will go for we don't credential anyone for that. But we made sure that whoever's doing it is is going to be, you know, allowed to do it back in the late 80s when I started. That's how old I am. Um, the radiologists had to eject. And then five years later, we were injecting because the radiologists got sick and tired of getting up. So do you know who knows down the line there might be, you know, ACR or whoever. The guidelines we will follow accordingly that there might be an extra exam or test or something that the techs can inject at that point. But, you know, again, safety is paramount to us. So then the reactions with them contrast. As you know, some are less than contrast. So at least you know we're looking at an exponentially lower reaction rate. So um, you know, it's very safe.
[00:49:03] And speaking of safety with patients and their condition when they come in. Are we doing just walkie talkie outpatients? Are we? Is this hospital is at acute care? Is it inpatients?
[00:49:14] So? So far it's been a walkie talkie part. There's really been no inpatient care yet that we've come across yet. We are talking to hospitals to perhaps get in at that point. You know, that's also what we've spoken in the in that two year period that we didn't do anything. What ifs of that case. Scenario two, but that would be transporting the patient into the room would also integrate in and and also we do have to know the number of people that were going into the room. And are they the ones that took her exam. They have to be vetted as well. So that makes sense. Good thing with the arts and the thing with the hospitals is that that we're also looking to be, you know, an expert on, on AI as well for some of these hospitals. So sometimes they don't have the issue as big as the imaging centers with Stassi. They have the issue with expertise because some of those examples, you know, are critical patients or all this stuff are can get much more complicated, you know, so that's where we are looking to offer services. And we're in talks, like you said. But some hospitals are not necessarily taking over boat scanning. But as you know, we have this complicated, you know, mapping study or something else that we want to do or something new, like a certain type teams that we talked about. But that's what we can come in and offer a service remotely and do that, do that with a complement of technologists. There is not necessarily an MTA, but where we add them is like an expert to kind of help it and, and do a case. So that's another kind of aspect when you talk about acute care, critical care. So, so we that we've, that we've had some clients who are interested in that specifically.
[00:51:02] And where I see that really played a big part as far as benefiting the patient is like these rural hospitals. Where otherwise if they were able to get provided that care, that means that they would have to be either transported to another hospital in a bigger city with these dedicated techs that can specialize in these specialty exams, or they might have to give the car themselves and drive two hours and, you know, or get a hotel or. Yeah. And so yeah, I've been very.
[00:51:30] Yeah. And we have a partner who's been doing this same type operation in Brazil for, for now, about 5 or 6 years. And they, they've kind of proven your point. Exactly. There's actually there's hospitals in the Amazon that have actually you know what it is that system. But for like 2 or 3 years they'd never been touched because they just don't have the ability to scanner the technology so that people there, so they were able to remote in and set up the infrastructure in the Amazon and have a nurse who was trained, you know, to administer the injection also safety wise. And they they've been performing scans out there in remote places where people don't even have places like a car or any kind of transportation out. And they were they also do, but they were able to do both. So we kind of, in our initial talkings were in touch with them and we learned the immense amount. And just like you said, we hoped that we could bring that here to the states, you know, rural centers or underserved areas. I think most of these underlying questions to cut this from job security, right? A lot of people worried about their jobs, just like everybody said, that AI is going to take over radiologists, is not going to take over radiologists. Ai will take over the radiologists that don't use they'll. Same thing goes with remote, right? It's not going to take over. We don't want to take anybody's job. You just want to transfer a different way, a different method of doing MRI by the same skill technologists that are out there.
[00:52:56] Well, David, should I put out a poll before this interview? And we got tons of engagement and a lot of it was fear based and a lot of it had to do with safety. But I think the underlying issue with a lot of technologists is that they're concerned about their jobs being taken away from them. Right. And, you know, we're all concerned about safety. And don't get me wrong, and kudos to you for being so do diligent. But I think they use that. Um, almost always play the quick safety card when really the major concern is their job being taken from me. And, and, and there's a staff shortage right now. You guys are helping to fill that.
[00:53:36] And so what I keep trying to say, you know, along those lines, is that this is a radiologist, right? So there was a transition from film to to digital, right. Radiology, which was, you know, a massive transition. Um, and that was many years ago. But with that came an exponential ability in the output of the radiologist. Right. Like you could go from reading, maybe, you know, 30 plates of x rays a day to now read 220, you know, is the difference. There's a dearth of radiologists. The the thing that you have to factor in is that the growth of healthcare, the growth of imaging is, is is much above this. It's the problem is, is we don't have enough solutions to keep up with the demand. So even remote scanning is not enough to keep up with the the need for more technologists, the need for more radiologists, the need for more imaging centers. Like it's just it's just growing. Because, I mean, that global population is getting older gossip every what? Is just getting more. It's just that's just how you know, work. And the price of imaging is coming down, you know, as time goes on so it becomes more affordable. It becomes a first line. So I know there is that worry, fear and saying the radiologist who didn't want to switch over to the computer, like, well, you know this, there's they're not going to need radiologists anymore because one radiologist can do the job of four.
[00:54:52] But what outpaced that was that that there's just millions more images that that app in those amount of years, you know, you know, like it's 42 million MRI scans are done now versus that is eight. So when this transition ended. So I think that is definitely a worry. But I think this is kind of the writing on the wall. And like Pete said, if they're worried I think you should educate yourself and try, you know, see how you could become a part of it, say, for me and the I can't I have to be a part of AI and and learn about it and how we use it, you know. And so, um, it does help us, but it's not replacing us. And then my response to anyone who's worried about job security as an MRI tech would be that we would love to hire you. Yes, this is just going to say we want you. We want you this to come back. Come join the force.
[00:55:45] Yeah, and I think we'll probably wrap it up. We're gonna actually interview one of your, uh, your virtual technologists here in a bit, but I think we'll wrap it up with one thing that I. I'd noticed and you kind of touched on, it is like, you know, educate yourself. You said that doctor said cursed Tinder. But. But what I found is that a lot of these technologies that are opposed to this, they feel as almost as if it's a quick nope from there with exclamation points. Right. And they need to understand that this isn't up for a ballot. This isn't, you know, whether they vote against it or not, it's going to happen. This is the way of the future. And so use that energy in a more productive way. Come up with ideas of how to make this work versus using that energy to be so opposing to it.
[00:56:30] Let me ask you both a question. Reggie and Rob, how do you guys feel? Be villainous. I mean, this is not a this is not a commercial.
[00:56:36] This is this is a podcast.
[00:56:38] How do you feel about mold scanning?
[00:56:41] And for.
[00:56:42] Me.
[00:56:43] I was very skeptical at first and actually. So we had Dr. Sherlock on last year almost around this time. And I specifically asked him this question, and because I wanted to know his thought on it, and he was really assuring to me because, you know, at the end of the day. Safety is our number one concern. Well, who's one of the most. Notorious safety gurus in this industry. Dr. Sherlock, and he's actually supportive of it. He says, but with that comes checks and balances. You have to do your due diligence like you guys have done it. But he sees it for what it is. This is the way the future and he's being productive in his thought process versus being so negative and being opposed to it. So initially I was more skeptical, but now I see it as this is the way it is. You either get on or get off. So yeah. So you would work for a remote scanner, fully combat ready.
[00:57:38] Would you work for a remote scanner as well? Where can start out with no alpha PT corrects think one of the.
[00:57:44] Best things that you guys are doing. And I don't know if we touched on this, but it's just how you still bring everyone together, right? So it's like the technologists aren't doing this at home, but not in your PJs. There's a location where you guys can bounce things off of each other. Still, if you're having issues or bearish protocol to someone that might have been on. You know, come across this situation before you get. Oh, what'd you guys do with this last saw type of thing? Like, like that should not count on an island by yourself trying, you know? Yeah. Figure this remote thing out.
[00:58:12] So the fact this is funny that you mentioned that we have a few products that we're working on it, and some of that has a component to it that will help solve that problem as well. So we're not just, you know, nuts are still rolling the one trick pony. We have a few things down the road, but we have to get this road. Like Ryan said, make sure all the potholes are filled before we drive that. Right? Right.
[00:58:36] Said.
[00:58:39] That about a few words.
[00:58:41] But actually so we do like to kind of go around the room. We have this is probably our world podcast with the most of the other guests. Normally it's more one on one, but I always ask the same question to kind of wrap it up. Like, what has been the most satisfying or fulfilling moment of your health care career? There's been a few.
[00:58:58] Island born personal is a particular patient that took care of. And there his wife came to me at the funeral. We became friends and she said if it wasn't for me, he would have never lasted for more. I didn't do anything with the rage. I just visited my last book and selfie. I bought glowing glutino the glow sticks. We played a joke on the nurses, we booked the glow sticks and in a urinal and said, and you know, what are you doing? What are you doing here? And actually, my son is named after that patient, so then I'll awesome do that. Very same. Exactly. So but for Anthony's wife is watching. She'll go, what I'm talking.
[00:59:37] About this.
[00:59:38] Rededication. And the other thing is how much how much this is explode. How much from I started when it took to technologists all day long, they're working hard to do five patients and now we're doing them so much quicker, so innovative. And and my son also note we jump on the entrepreneurship part of it, like keeping the light and a nice job. Had a steady income. And you know, I dropped the security for doing something like this, you know.
[01:00:09] So you took a leap of faith. Did what you believe in it, right? I do, I.
[01:00:13] Do, I do believe in it. Like I said, I'll be the oldest, more tech you ever met as a Milwaukee. The Fitbit.
[01:00:18] And they were kind of will finish with you, Dr. Satinder. But what would you say, Ryan?
[01:00:23] Well, I'd say the when when we were able to create a thing that didn't exist, that allowed something to happen that couldn't happen before. And that was we brought on a technologist who could not have done his or her job as a technologist because of an implant that that person had, and that person was able to. Perform his or her trade, use his or her talents as an MRI tech because of the remote setting. And for me, that that was that was alchemy, that was creating something out of nothing and letting someone continue to do what they were best at because of this new paradigm. Um, and that's something that I'm really proud of.
[01:01:13] I'm going to thank you for that.
[01:01:15] Yeah. And, you know, obviously coming from the health care field, I have, you know, many of these I would say that, you know, that I guess in each stage of my career, I had a lot. But I would have to say before Alpha, those were all personal. And now that alpha exists, it's almost an extension of us and would have to say, you know, for me, the the one that most sticks out is most and the most recent is there was a case and I know we talked about the DTI, but we had a patient was ill and just needed to be scanned in Ohio, but there was no place that scanned or was able to do a pediatric cases within the nearest think 3 to 5 hours. The family couldn't, didn't have a transportation, you know, it was and I think the patient was actually acting herniated. Whatever it was, even the hospital couldn't do it. He was able to put together a protocol, a robust protocol, and have the patient scanned and done altogether. Within two hours, the patient went to a facility within 15 minutes of their house, which is a place that we and so much so that, you know, you know, the radiologist would say, one wrote to us and they talked about how the patient's family was so appreciative. So this is all the things I've had in my career. I've been very personal and been kind of one sided, which, you know, think appreciate it for being here. But this was the first thing that I saw that I was a part of that can just that they can just grow. Exponentially. No, we've used that word a lot. But what we've created at Alpha is something that can touch so many more lives and can just do by myself. So that to me, not only did it help that one patient, but I just saw it just had the vision of what we can do to help so many other people in so many different, you know, now, unique situations. So that I would say was my most unique experience, the best experience for me.
[01:03:03] Awesome. Well thank you guys. Appreciate it. We're going to interview one of your ritual texts. Thank you. What you guys are doing for the community is for those of you that have your questions, I had them to I understand them. Educate yourself. Open your mind. This is the future. And yeah, and now we'd love to hear your comments. Comment below and look for the links on how you can get Ahold of these guys. If you're interested in position. They'll be happy to hear from you.
[01:03:31] You can always go to remote MRI scanning.com to.
[01:03:36] Ready. Say the words filtered back.
[01:03:38] Us. We are out.