The Brightest Minds Speak Up; Andrew Moan
AI & VR Product Innovations
Cleveland Clinic is developing and implementing VR technology for virtual cadaver-based training.
Andrew Moan leads Cleveland Clinic’s investment and product development in virtual and augmented reality (AR/VR) training tools. He partners with physician leaders and external companies to design the technical architecture, build the business case, and launch innovative software and hardware products. Andrew brings a unique perspective to the work. He’s been a U.S. Navy TOPGUN instructor pilot and worked in the tech industry for Apple, Inc., McKinsey & Company, and Microsoft. In his current role, Andrew designed the artificial intelligence (AI) enabled architecture across Cleveland Clinic institutes and is developing the VR training programs for clinical anatomy and surgical training.
HIMSS: What exciting AR/VR applications is Cleveland Clinic either currently using or exploring for the future?
Andrew: Implementation is my favorite word to use at Cleveland Clinic. It’s not about creating the most advanced solution, because you’ll run up against HIPAA regulations, patient concerns, cybersecurity and much more. So, in AR/VR we take the right level of ingenuity and implement it into a solution that solves an actual problem statement. That’s what happened when Cleveland Clinic decided to transition to virtual cadaver-based training.
When looking at the business case for finding the right technology, we determined to leverage the 72-weeks of student medical training and teaching assets already in place. We looked at the digital ecosystem for students, specifically at their phones, personal computers and even some with VR machines. We demonstrated AR versus VR with students and analyzed their feedback. What we learned is that we needed to enable the devices they had. Therefore, we invested in VR so we could port over to their existing devices, while also bringing something new to their educational experience via VR.
AR is still in the research phase, with a lot of excitement, but use cases are still to be determined. So we focused on breaking the traditional constraints of laboratory learning, and designed a solution ecosystem that allows students to learn anatomy on-demand from any device. That’s what they’re used to and what they want.
HIMSS: How would you define the difference between XR, VR, and AR?
Andrew: XR or “extended reality” is more of a design mindset, where you’re designing for use cases in the real and virtual environments. Virtual reality is 100 percent immersion, like you’re in a digital room looking at a digital syllabus. Augmented reality is bringing in a real-world view using an opaque headset or a phone camera, with no real standardization for how much is real and how much is virtual. However, many of the assets are interchangeable, if designed correctly.
HIMSS: How would you describe the current state of healthcare technology in the AR/VR realm?
Andrew: Healthcare is ripe for innovation in all things digital. From a VR standpoint, the hardware technology is mature and the vendors are diverse. The software ecosystem is also diverse with new solutions being deployed daily. We’re actively designing and developing quickly. Augmented reality is still in the research and development phase where we’re testing out solutions that may or may not work.
With VR, the focus is on building the business case for investment and deployment into particular use cases. We’re analyzing uses cases that already exist and identifying where we can save money and accelerate learning. New use cases are challenging, due to the already tightly packed schedule for caregivers. Therefore, we must optimize prior to adding on new responsibilities.
As AR in still in the research phase, there are exciting projects such as creating a medical heads-up display. We’re working with an inventor to put fluorescent guided imaging directly into a wearable display, and overlaying imaging and vitals to enable better time-critical decisions. This is one of many solutions we’re experimenting with. Our goal now is to learn how AR can properly integrate into a physician’s routine.
HIMSS: What do you see as pressing needs in healthcare that could be addressed with AR/VR technology?
Andrew: There’s a worldwide cadaver and medical educator shortage -- while at the same time, costs in education are skyrocketing. VR can scale existing anatomy professors to help educate people elsewhere in virtual live education sessions, while simultaneously reducing costs in cadaver consumption. We’ve unshackled the need to be near the cadaver – so we can expand our reach and accelerate medical education worldwide.
VR training doesn’t end with anatomy -- it can quickly expand to nursing, fellows, procedural, OR, and more. When looking for opportunities, we need to address the training we already have and digitize it. We’re don’t need to reinvent the system. That’s always more costly. We need to find repetitive tasks so we can digitize, optimize, and accelerate learning.
HIMSS: What insights do you bring to health tech by having experience in both the U.S. Navy and leading tech innovators?
Andrew: The way you do things in the military world is super rigorous and standardized, much like the healthcare industry. When I went over to the tech community – it was the complete opposite. No one cares if you’re an 18-year-old with an idea or a 50-year-old. It’s all about the idea, and people constantly challenge the norms and look for ways to fix problems. We do that really well in consumer technology where people are willing to adopt it. What I bring to the healthcare table is combining my experience from both industries and thus challenging the norm and designing to solutions that can be implemented. It’s about setting realistic goals with a plan to constantly improve. Develop to add value now and plan for the future.
HIMSS: How important are partnerships and collaboration in AR/VR?
Andrew: I partner not just internally with physicians but externally with both large and small companies. The Clinic’s strength is in research, diagnosis and patient outcomes – and that’s our focus. We need to bring in big partners like GE, Amazon, Microsoft and others to co-develop and solve complex industry wide problems. Small companies support us by developing ready-to-deploy solutions.
My advice to health tech startups is to develop and promote partnerships. At the Clinic, we design our solutions to serve a broad base of customers who can license and help improve the work we’ve already done. Think about your strengths and your weaknesses, not just landing a big brand name. Healthcare solutions are not simple and will take a properly incentivized partnership to realize a quality outcome.
Once deployed, partnerships in learning and the ability to share data is even more important. We need digital solutions that can integrate with other solutions and enable us. We know the future of healthcare revolves around AI, but without the proper set of data, we’ll never get the answers we need.
HIMSS: Any other advice for startups when it comes to AR/VR technology?
Andrew: Startups need to present both short-term and long-term strategies for the problems they’re solving – and insert digital solutions in a way that’s meaningful. For example, it’s not a huge game-changer to automate a wearable into the electronic health record. We’re already doing that, so the question is “what are we going to do with that information?”
Startups need to be customer-obsessed. They need to design solutions that will simultaneously decrease physician workloads, while enabling increased results in a value-based healthcare model. If it’s not, people just won’t use it. Understand who your audience is, the problem you are trying to solve, and deliver the best “customer experience.” That means getting in front of the doctors to understand their pain points. Same with consumers. As inventors, it’s our job to quickly solve the common pain points, learn from the data, and then continue on a cycle of innovation. That’s where the opportunity is.