Hello. My name is David Rhew, and I’m the Global ChiefMedical Officer for Microsoft. I’m a Physician, a Technologist, and a HealthServices Researcher. Over the past 25 yearsI’ve studied how technology can be used toimprove health outcomes, specific access to care, quality of care patient safety, and ways to improve the patientand provider experience. I’m roused today to beable to share with you how mingled reality can be used to transform health careand improve outcomes. To do that I’dlike to share with you some moves and some videos, so let’s just jumpright to that. The real exciting thingsabout mingled reality is that the imagery and the visualizations givesyou the sense that you are actually there and thatthese animations are real. It allows us to be able to immerse ourselves intoenvironments and be able to think of ways thatwe might be able to interact with each other andthe environment in ways that we’venever was just thinking about. Now, oftentimes this isviewed in the context of entertainment or funand stimulating things.But what we’ve alsoseen is that there are several employment clients that could be relevantfor both clinical practice education and training. But before we jumptoo far into this, I wanted to provide adisclaimer regarding the things that I’ll be talking about as part ofthis presentation. I’ll be including bothslides and sharing videos but mainly this is aboutthe art of the possible. These are things that are likely be donewith the stage. Now, in some caseswe have ISV collaborators that have built on theMicrosoft platform and they’re leveraging the Microsofttools to be able to create immersiveexperiences that have been corroborated and endorsed through regulatory mechanisms and are now marketed forcertain use occasions, I’ll showcase some of those.But what we alsowant to recognize is that there’s a desirefor Microsoft to be able to provide theplatform but not certainly replaced the clinicaldecision-making that clinicians have. We also are lookingto make sure that we are not making any claimsregarding the accuracy, safety and reliability of the technology and the programmes as it pertains precisely to the mixed realityclinical help cases. Now, with that said, let’s just rush right into it andlet’s talk about how mingled actuality can empower every individualand organizations across the planet to beable to achieve more. In say to do that let’s start thinking about theparadigm of health care. In fact, there are manythings that we look at healthcare is beingtried and true. These are sayings that oftentimeshad been instilled into our daily practiceone of which is See on, Do One, Teach One.This was coined by Dr. WilliamHalstead in the 1890 s, and it specificallyreferred to the fact that clinicians in the course of training need to see severaltypes of procedures, they need to see several types of cases withcertain conditions. Then they need to performthe procedures on the patients andgain some knowledge. Then eventuallythey get to the top of the pyramidwhere they’re able to communicate and teachothers how to do this. As you can imagine, thisis a very narrow pyramid, it doesn’t allow us to beable to scale this and regrettably that is created problems where reference is thinkof access to care, with virtual reality, with desegregated reality, augmented actuality, we have tools now availableto us to be able to create immersive experiencesthat can transform the opportunity for providingeducation and training.What we want toalso recognize is that the devicesthat we now have available that allowus to be able to change the nature that wesee the environment to be able to see three-dimensionalimages and be able to understand how these personas can interrelate with one another. It allows us to be ableto not only see it but potentially modify the waythat we look at the world. This is a quotefrom Satya Nadella, the CEO of Microsoft. When you vary theway you assure the world, it deepen the world you learn, and that’s exactlywhat we’re talking about here with desegregated reality.In different contexts of clinical utilization occasions we aregoing to focus on three. The first is around holographicpatient consultation. What that are actually implies isin the course of talking to the patient about a procedure or a specific typeof intervention, we oftentimes needto communicate information in waysthat go beyond words. A illustration would be great but the three-dimensionalinteractive picture that one can look at thatmay be specific for them is exactlywhat patients need. Now, in the contextof consultation we’d love to be able to bringconsultants in on every tour, impossible to beable to do that.But with virtual care and with some of the toolswe have now available, we can do remote expertconsultation and have them available all at the time that we’reseeing the patient, and have those consultantsbe able to see the same type of things that the individualclinician is, that’s standing right infront of individual patients. In words of training, simulations that allowus to be able to understand thedifferent dissections, to be able to provideprocedures and enable junior cliniciansto be able to practice in a safe adjusting but alsoteach them the proper way to do things and scaped certain aspects thatcould lead to danger. That’s somethingthat we now have available with these mixedreality works. What I’d like to dois I’d like to start off first talking a little bit more about information and communication technologies thatunderlies a lot of this Now, when we think of desegregated actuality probably the very first thing we think of is the headset, the HoloLens or the HoloLens 2. That is a corepart of what we’re talking about butthe imagery to that, the analysis is actually beingdone to the back-end with a strong platform on Azureis called Microsoft Mesh, and that allows us to be able to create thethree-dimensional idols, it allows us to be able to pull the data from thedifferent sources and be able to provide that level of interactivity inimmersive nature. Additionally, Microsoft Mesh boundaries not just with theHoloLens but a variety of other types of technologytools such as PCs and portable machines as well as other virtual reality headsets, so we can create an ecosystem of different types of devicesthat can be used by clinicians and patientsas they’re immersing themselves or are concerned with men that are inthe immersed environments.Then on top of thatsits the employments. Dynamics 365 has allowedus to be able to create immersiveexperiences that are linked us todifferent individuals. We now have Microsoft Mesh apps, Altspace VR apps, and of course, partners are buildingon these pulpits and the establishment of incrediblyimmersive and important types ofclinical employments exerting the Microsofttechnologies. That’s what I’d liketo share with you, some of thosepartner answers in the healthcare spacethat are really transforming thehealthcare industry. Let’s start focusing onthese marriage solutions. The first is around holographicpatient consultation. As I mentioned earlier, what we’re doing is we’re going beyond simply showinga paint but creating an interactive implement for both patients and providersto be able to communicate. In this speciman whatwe’re going to be talking about is theMicrosoft HoloLens combined with apoQlar’s virtual surgeryintelligence or VSI. Let’s take a look at this video to understand a bitmore about this.[ MUSIC] Medicine is in themidst of digital alter. Mixed reality andartificial intelligence are already improvingpatient care today. The virtual surgery intelligence or VSI is doing just that.With this softwaresolution, MRI, CT and other medicalscans are available in 3D and Microsoft HoloLens2 mixed world glass. This pays the patient a deeper understandingof the results, surgical proceduresand treatment techniques. Before a surgerythe doctor uploads the CT and MRI dataonto HoloLens 2. The VSI recognizes the patientto anatomical landmarks and importances thestored portrait on the surgical places withmillimeter precision. During the after surgery round the patient’sdata is quickly retrieved and displayedusing VSI and HoloLens 2. At-a-glance andwithout a computer the doctor can concentratefully on individual patients, answer questions and discussfollow-up medical care. Being able to easily dictatea report, take photos, and to retrieve archivedimages saves valuable occasion, facilitates everydaylife in research hospitals, and plies quality assurance. That would also makeother treats in the hospital more efficient. VSI and Microsoft HoloLens 2 characterize a brand-new medical standard. What we understood there weretwo important use cases. The first was aroundpre-surgical planning use the HoloLens to help understand exactlywhat the methods used would involve and educatethe patient as well.Then the other was after the surgery or afterthe procedure , now taking a look atall the different ways that these technologiescan be used to improve operational effectivenes but also imagined being able topull down the images from the CT MRI recreate the new structureand compare that to the old. These are the opportunitiesfor how we can apply this in theclinical give. One other thing thatwe’ve seen is that with this type of technologywe can also cater consultation where expertsand other clinicians can all gatheraround the patient virtually andprovide their input, and this was somethingthat we had seen, make full during the pandemic, the Microsoft HoloLens2 in combination with the Microsoft Dynamics3 65 Remote Assist enable clinicians from theNational Health Service to be able to take careof COVID patients.What I’d like to do isI’d like to be able to show you a video that was provided to us by the NHSImperial College Health to be able to understandexactly how this was deployed.[ MUSIC] Looking at now opportunitiesto apply mingled actuality in a real-world settingto be able to provide that level ofvirtual collaboration, there’s actually beenstudies that ought to have accomplished on this to show the significant reductionin PPE as well.In addition to protecting the conditions fromexposure to the virus, what we’ve also determined is a significant decrease in PPE or personalprotective paraphernalium. One other expanse isaugmented learn. This is an opportunity forus to be able to apply Mixed Reality toindividuals that are in the course of training. It could be medical students, nursing students, pharmacy students, anyone that it was necessary to proceduraltraining as well as residents and other types of individuals thatare junior faculty. It provides anincredible opportunity for us to be able to help us understandeverything from the chassis tosurgical procedures. Again, this scenariois a combination of the Microsoft HoloLens2 technologies with, in such cases interactive Kahneman’s hollowanatomy application. This was done and researched at the Case WesternReserve University. What we considered with the Case Western ReserveUniversity analysis, was that the studentsthat we’re employ the cavern dissection solutionwith the HoloLens 2 had a 50 percentage higherretention rate and 40 percent lessclinical class go, so an extraordinary opportunity for us to be able to enhance and improve the efficiency ofteaching for clinicians.Now, let’s get back to what we just talkedabout before, information and communication technologies thatunderlies this. Much of what we’retalking about here is in different contexts ofMicrosoft Mesh. It is on Azure so there’s a significant amount of AIthat’s been applicable but we’ve also built on top of that and on top ofthat we’ve created an opportunity for individualsto be able to collaborate. Imagine being able to go intoa virtual conference room, have an image of theparticular organ in three-dimensionsin front of you, and rather than all of theparticipants being there precisely through a video conferencetheir avatars are there, and avatars can interactwith the actual organ, be able to then dissect it, indicate particular field, have parties look atdifferent angles.This is what is possiblenow with Microsoft Mesh. More recently Microsoft has announced that Mesh can belaunched instantly out of Microsoft Teams whichgives us an opportunity to be able to thenleverage the fact that individuals andorganizations are now leveragingcollaboration tools such as Teams for telehealth and virtual care and then launchinto these environments. An incredibleopportunity to provide intersection between thedifferent Microsoft makes, and that’s exactly whatMicrosoft is doing. We are taking a look at all the differenttechnologies that we have available today, everything from Azureto Teams to Dynamics, and all the scaffolds thatwe have built on top of it including Mesh andintegrating them all. But at the centre of all ofthis is healthcare data, and if we think about howhealthcare data needs to flow from all thedifferent systems the great way tovisualize it is with this circle or thisdiagram in front of us.Imagine it being dividedinto three proportions. In the upperleft-hand part we’re now talking about revelations and ability to understandthe individual at a very personal level. That means we need topull data not only from environmental purposes but likewise from the electronichealth record, from other datasetsand normalized that through open APIsand fire standards. In the process of bringingall these different datasets together on a commonplatform we have had the ability to applyartificial intelligence on top of it and in that context we can apply more than justsimply the context of what we know tobe visualization of the imagery but we alsocan potentially apply AI to alter some of the information intodecision support, ways that we cannow act upon it. Then from there it needs to be collaborated and collaborative, and that is something where the collaborationtools that we’ve just talked about can beincredibly helpful.Part of what we’renow talking about is a transformation of howvirtual care is being combined withartificial intelligence but what we’re also visualizing is that there areother virtual care and AI tools that we haveat our disposal. We have met chatbots andthe rise of the information, the need for consumersto be better informed all being brought into a virtual charge environment. We’ve seen the useof voice technology being convertedfrom articulate to text, understood who’sactually talking and then from there the AIwill allow us to be able to structure that into a clinical progress tone which then can be integratedinto the medical record.This is also somethingthat has been launched during thepandemic as part of the ambient clinical intelligencetechnologies that are now embedded into MicrosoftTeams for virtual attention, we have now anability to transform the way that virtualcare is delivered by bringing AI and ML intothe technology suite. Now what we’re talking about is an opportunity to re-imaginewhat healthcare can be. We’re to do better insights by connecting surgeonsand clinicians with the medical data that mattersmost, better suffers. Now, students canperfect their skills by practising on virtual toolsthat are in three-dimensions.Then cater bettercare by allowing us to be able to providepreoperative planning, post-operative analysis, and better information that’s provided to the patients as part of thisoverall experience. Throughout this all whatwe are learning is that mingled world has anincredible potential to transform the waythat we take care of patients and that we trainclinicians across the world. Thank you very much.[ MUSIC ].
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