Dr. Eric Viire, Medical Director, XPrize Competition

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Mark Masselli: This is Conversations on Health Care. I am Mark Masselli .

Margaret Flinter: A nd I am Margret Flinter .

Mark Masselli: Well Marg a ret , it is the season to be shopping, and not only are
we in the holiday season we are also several weeks into open enrollment under
the Affordable Care Act . We have seen a bit of a reversal from the first open
enrollment . The online portals are all working pretty smoothly at the state and
federal levels this time around , b ut not as many Americans are rushing to shop
for insurance online.

Margaret Flinter: But people do need to be reminded to re - up their health
insurance plans or it will be for them, and it might be a good idea while folks who
are doing that to do some comparison shopping , s ee if the re is a better or more
appropriate deal for them or more comprehensive coverage .

th
Mark Masselli: Open enrollment ends on February 15 .

Margaret Flinter: While we are speaking of shopping, somebody else is
shopping as well , Mark. VA Secretary Robert Mc Donald says that he is looking
to hire new health care providers across the country, and he estimates that the
VA needs to hire about 28,000 more physicians and nurses to meet the needs of
their patient population .

Mark Masselli: He says it's an uphill c limb to sell the perception , but it's his
primary mission and his quest to turn the Veterans Administration around.

Margaret Flinter: And he is offering these clinicians in train ing a picture of
comfortable salaries, long time positions, funded research opportunities , even
loan repayments I understand , and also the chance to serve a population that’s
very much in need and grow ing .

Mark Masselli: Observers say the VA needs much more than personnel ; they
ne ed to update antiquated systems, technologies and protocols. That’s going to
take some time as well .

Margaret Flinter: And our gues t today is on the cutting edge of breakthrough
technologies that could one day revolutionize the way we deliver and use health
care . Dr. Erik Viirre is the Medical and Te chnical Director of the Qualcomm
Tricorder XPRIZE Challenge Competition seeking innovations that can put the
power of health diagnostics right in the palm of your hand.

Mark Masselli : That’s great. Dr. Viire will be am us all up, and he will tell us
abou t some of the remarkable breakthroughs that have already come out of
these competitions.

Margaret Flinter: And Lori Robertson , the Managing Editor of FactCheck.org
also stops by . She is always on the hunt for misstatements spoken about health
policy in the public domain.

Mark Masselli : But no matter what the topic , you can hear all of our shows by
g oing to CHC Radio . And as always , if you have comments , please find us on
Facebook , Tw itter, LinkedIn and Google + ; we love hear ing from you .

Margaret Flin ter: We wi ll get to our interview with Dr . Erik Viirre in just a moment .

Mark Masselli: But first , here is our producer Marianne O'Hare with this week’s
Headline News.

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Marianne O'Hare: I am Marianne O'Hare with these Health Care Headlines .
W all Street has been in some record territory lately and it's bullish on something
else , Obamacare. A group of Wall Street analysts recently predicted a higher
than expected turnout to sign up for Obamacare during the second round of open
enrollment . The analyst s sit e more robust insurance exchange portals operating
more efficiently, m or e young healthy uninsured Americans seeking coverage .
Analysts are predicting 11 million people will enroll in individual health plans
during the second round of open enro llment .

Meanwhile, another study out shows that yes, more Americans are insured under
Obamacare, but th at higher deductibles and out of pocket costs are making it
difficult for many to afford their medical bills, and a quarter of those uninsured
folks pol led still felt they couldn’t afford to purchase health coverage , s till many
Americans unaware they qualify for subsidies to offset the cost of buying
insurance. And there is still uncertainty about those who are re - upping their
insurance after signing up during the first open enrollment . Plans will
automatically be renewed but customers may find there is a better more
affordable plan that better suits them by shopping around.

Ebola continues to be a problem for several West African nations, and the hunt
for a cure continues as well . The FDA has fast track ed and unapproved blood
transfusion system for Ebola patients taken from folks who have survived the
virus. The idea is to take a convalescent plasma supply that’s been through
pathogen inactivation as critical to making this therapy readily available as new
Ebola patients are diagnosed and urgently require treatment .

And sleep experts have been warning for some time that the early start time for
high school students in this country is hampering their l earning outcomes. Teens
require more sleep than the average person and are chronically sleep deprived.
Apparently , the poor resulting perform ance is not just limited to the classroom ;
sleep deprivation is now be ing cited as a major factor in teen car cra shes. When
a teen w h ines that they are tired, parents are advised to listen . It could be
hazardous to their driving also .

I am Marianne O'Hare with these Health Care Headlines .

(Music)

Mark Masselli: We are speaking today with Dr . Erik Viirre, Medica l and Technical
Director for the Qualcomm Tricorder XPRIZE and the Nokia Sensing
XCHALLENGE, ongoing global competition seeking to develop the next
generation of health sensors and diagnostic tools that will transform health care .
Dr. Viirre is Adjunct Pr ofessor in the UC San Diego Departments of
Neuroscience, Surgery and Cognitive Science, and is the Scholar - in - Residence
at the Arthur C Clarke Center for Human Imagination. Dr. Viirre received his
PhD. in Neurophysiology and medical degree at the Universi ty of Western
Ontario in Canada . He is also in the inaugural class at the International Space
University and has done research for the National Institute of Health, the U.S.
Navy and NASA. Dr . Viirre , welcome to Conversations on Health Care .

Dr. Erik Vi irre : Thanks very much . I am so excited to be able to talk about
XPRIZE and our competition.

Mark Masselli: Yeah that was great. And certainly, the Qualcomm Tricorder
XPRIZE takes its name from the medical device used by the physician boats on
Star Tr ek as well as the Nokia Sensing XCHALLENGE which is seeking to create
a porta ble health lab that can work in the palm of anyone’s hands. But before we
get into the particulars of those challenges , tell us a bit of the background of the
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XPRIZE , and as I un derstand it was based on competitions in the early 20
Century aimed at spurring innovations in transatlantic aviation. Charles
Lindbergh was an early winner. So who are some of the key players behind the
modern incarnation of the XPRIZE Foundation , and what are some of the goals
and unifying principles of all the XPRIZE competitions currently underway?

Dr. Erik Viirre : Sure. So our founder, Dr. Peter Diamandis, was really inspired
by reading a story of The Spirit of St. Louis which was flown across t he Atlantic
by Charles Lindbergh to win the Orteig Prize to spur aviation which led to
hundreds and thousands of flights in just two years after the original flight across
the Atlantic. So Peter is our founder and our anchor, but we have so many
amazing p eople that have really helped XPRIZE Foundation along the way,
Anousheh Ansari who really took a leap of faith on a crazy guy with a dream of a
prize to start space flight , and she and her family funded the original XPRIZE 10

years ago , and Sergey and Larr y from Google , and Eric and Wendy Schmidt,
(inaudible 07:25), Rob Mc E wen from Canada, all kinds of really exciting people
who totally believe d in the mission of XPRIZE.

And so our vision is to fill in the gap . Of course , there are startup companies with
the dream, big pharma companies who want to create a blockbuster drug, and
then there is the basic research funded by research foundations and of course
mostly by government institutions . But there are things in the middle that aren’t
going to be an immed iate investment payoff necessarily but are goals that human
society might think are important like non - governmental space flight . Taking
people into space is a different goal now, and so our foundation looks at things
like the health of the oceans, litera cy, even abstruse things like happiness, and of
course health and human well - being.

Margaret Flinter: Well Dr. Viirre, perhaps we could take a look first at the Nokia
Sensing XCHALLENGE. You recently announced an interim challenge winner, a
relatively s mall startup from Cambridge who produced a pretty revolutionary
diagnostic device . What made their product so revolutionary?

Dr. Erik Viirre : The revolution is taking things that are huge devices , that are the
size of refrigerators, and making them lite rally things that can comfortably fit on
your body. And so Team DMI from Cambridge headed by Dr. Eugene Chan is
our most recent Nokia Sensing XCHALLENGE winner, and his technology is just
really cool because he has developed this way of managing tiny amou nts of
fluids of blood, and analyzing that very carefully and quantitatively and then even
taking like the chemical strips that we would use at home for testing the pool and
doctors use in the office, and taking them to the nanoscale so that these things
a re millions of times smaller than the ones that you hold in your hand that are
contained in the blood sample and then run through a beautiful microfluidic
system. So Eugene and his team has been able to build a thing that is
thousands of times smaller to do analysis that now requires a hospital laboratory.

Another one that I would like to bring up is Dr. Esther Rodriguez - Villegas from
the U.K , a nd she has really cool technology that is a small button size sensor that
carries both the power and the transmi tters and the sensors to analyze the
acoustics of breathing. Children with things like crib death or adults with things
like obstructive sleep apnea , th is small sensor can be placed on your neck so
just a c ool miniaturization of technologies that now requ ire straps and belts and
things stuck all over your body that can be use d even on premature babies.

Mark Masselli: I love that you are harnessing the imagination of science fiction,
the Tricorder from Star Trek to spur developers to bring that concept to reality in
these current times. Tell us about some of the leading contenders in this
competition and the ideas they are generating and how you are judging these
potential disruptors in the health care technology , and what are some of the key
criteria you consider when picking a winner?

Dr. Erik Viirre : So we have 10 finalists now from all over the world. Team DMI,
the Nokia Sensing XCHALLENGE winner is one of our contenders in Tricorder,
and Eugene is planning a whole integrated system with his health platform .
So me of the teams from overseas like Team Danvantri from India which has
amazing cost efficiencies in building sensor systems, and Team Dynamical
Biosignals from Taiwan, a home team from EB and Canadian CloudDX from
Toronto, a gain putting variet y of different sensors into platforms , and another
really cool one from here in the United States , Final Frontier, which is really
bringing a strong AI approach to the Tricorder competition. So we are seeing this
brea d th of things like sensors all the way to artificial intelligence technologies in
organizing the competition and w ith the integration of these kinds of technologies
that we are really going to enable a team to win our $10 million competition.

Margaret Flinter: Well Dr. Viirre, certainly as c linicians diagnostic is a key
challenge, but an even a more elusive challenge is getting our patients to
participate in their own health care. Tell us about the goals of the Qualcomm
Tricorder XPRIZE innovations from the perspective of how these innovatio ns
might engage or empower ever yday patients into this process. Is that on the
radar any place?

Dr. Erik Viirre : Absolutely, it's essential , and literally half of the competition
criteria is consumer acceptance of the technologies. So not only do the s ystems
have to deliver, they got to work, but people have to like them. And so in fact, we
have engaged top level consumer survey experts as well as a world - recognized
panel of user experience judges to evaluate first the potential submissions that
ultima tely led to our finalists. But in the finals what will happen is the testers who
will be test - driving these Tricorders around the block will then right after their use
of them have formal consumer surveys, and so these surveys were designed to
really eluc idate how do they like them, is this something th at you would use in
your regular daily life, and literally half of our competition criteria are from those
consumer surveys a nd this really leverages our whole smartphone lifestyle now
where literally on you r smartphone you can order a plane ticket, check - in and
never have a piece of paper, and the final frontier for that really is professional
health care.

Mark Masselli: We are speaking today with Dr. Erik Viirre, Medical and Technical
Director for both th e Qualcomm Tricorder XPRIZE and the Nokia Sensing
XCHALLENG E . Dr. Viirre is Adjunct Professor at the UC San Diego
Departments of Neuroscience , Surgery and Cognitive Science. So Dr. Viirre, we
are at this fertile intersection of medicine, technology , desi gn and innovation, and
so much of modern day innovation has been the result of government - funded
research, and we are certainly in a sticky political climate where scientific funding
agendas are being challenged. Tell our listeners how the competitions li ke
XPRIZE fill the gap, and what can we take from th e sort of moonshot experience
that might inform this new wave of innovation?

Dr. Erik Viirre : Well certainly I worry about reductions in funding from
foundations and government s , b ut these grand challen ges have a long history of
making accomplishments. We talked about Lindberg h , and remember one of the
biggest inc entive prizes was the Longitude Prize , the development of (inaudible
15:01 ) funded by the British government. And so there are places . I don ’t know
that incentive prizes are for everything and for every problem , b ut it’s taking that
human initiative and that competitiveness that we all have and spurring it towards
good.

Margaret Flinter: Well Dr . Viirre , we know that a goal is to have not ju st an
audacious solution but an actionable one. How do you think about helping then
move t hese solutions into action within the health care system ? And presumably
the things you have described say have tremendous ability to both make health
care more fai r and equitably distributed around the world. So what’s your level of
sort of engagement or involvement in seeing these ideas through to actual
implementation ?

Dr. Erik Viirre : Yeah. In fact that’s actually what we are directly about with
XPRIZE. And I like to tell a story from one of our other competitions , the
Progressive Automotive XPRIZE which was for fuel efficiency, which was seven
or eight years ago a crazy goal, a car that could get 100 miles per gallon. So the
competition was about can people build competitive vehicles that would be safe
and drivable, and through the competition a formulation came called MPGe,
miles per gallon equivalent so that they compare different kinds of fuels like
hydrogen and electricity as well as conventional hydroca rbons.

And the cool part is that MPGe is now part of the parlance. I have the great
fortunate of being able to buy an electric car here in California and on the window
sticker the big numbers there up in the corner that says MPGe, and my car that I
could buy on the lot was the 116 MPGe, and so that’s what we do at XPRIZE.
We take things that seem crazy and show that they can work, and that’s my
dream for Tricorder. My real dream is being a total Trekkie myself , having
watched Star Trek in high school an d met so many of the Start Trek people is
that the word Tricorder itself will come to be a term of common parlance that has
common meaning, meaning the sensor systems that we hold in the palm of our
hand that are not just apps but h ave all the sensors buil t into them that can really
help us with our health.

Mark Masselli: You know, just as a side note, I wonder what type of excitement
you get from the work of people , maybe who didn’t come through the XPRIZE,
but sort of doing the work that I think would c ome out of an XPRIZE. Elizabeth
Holmes who certainly is pioneering this whole idea o f just a single drop of blood
where she can do 70 lab tests in her company Theranos .

Dr. Erik Viirre: Yeah, so Theranos is just really exciting. And we see Apple and
Go ogle (inaudible 18:00) now and ironically, that’s exactly what we want to do
with XPRIZE is make these things not just our XPRIZE competitors, although of
course they are our babies and we love them all , b ut as I was saying a moment
ago the idea of having the Tricorder , this idea of oh yeah, this is -- and that’s
what we are really trying to do by showing the way in a public way that will
enable these technologists ride that visibility and say yeah we can do these
things.

Margaret Flinter: Dr. Viirre, wha t are the next steps for the XPRIZE competition?
We have accrued all these promising technologies and participants . How is the
role of the XPRIZE Foundation going to evolve in this next phase, and how does
the foundation facilitate next steps for these b reakthrough innovations?

Dr. Erik Viirre: So next year in 2015, we are going to be running the actual test
program where we will be doing something that has never been done before, a
medical device competition. And so I am so proud and excited that UC S an
Diego has stood up along with XPRIZE to create this test program where people
with 20 different conditions will be identified and then they will be enrolled into
our competition and the Tricorders will be brought to them. So this is not a
paperwork exe rcise ; the Tricorders will really be tested by our human testers,
and we will be determining how well the Tricorders pick up the conditions as well
as the consumer surveys that I was talking about before. And so what I think is
really exciting is that thi s is going to establish a whole new industry where these
technologies will be tested, and in fact, we have established a really productive
and collegial cooperation with the FDA who is working closely with us to manage
our competition, but also to have a l ook at what the future of these mobile health
technologies are going to look like.

Margaret Flinter: We have speaking today with Dr. Erik Viirre, Medical and
Technical Director for both the Qualcomm Tricorder XPRIZE and the Nokia
Sensing XCHALLENG E . You can learn more about his work by going to
www.xprize.org . Dr. Viirre, thank you so much for joining us on Conversations on
Health Care today.
Dr. Erik Viirre: My pleasure.
(Music) Mark Masselli: At Conversation s on Health Care, we want our audience to be truly in the know when it comes to the facts about health care reform and policy. Lori Robertson is an award - winning journalist and managing editor of
FactCheck.org, a non - partisan, non - profit consumer advocate for voters that aim
to reduce the level of deception in U.S. politics. Lori, what have you got for us this week?

Lori Robertson: We found both democrats and republicans stretching the facts
about the role MIT economist Jonathan Gruber played in the cre ation of the
Affordable Care Act after controversial comments by Gruber came to light. At a n
October 2013 Health Economics Conference Gruber said that “Lack of
transparency is a huge political advantage,” and he referred to the stupidity of the
American v oter in talking about the passage of the law. Once the video beg a n
circulating online, Gruber told MSNBC that he basically spoke inappropriately,
but the damage was done. Obama called him “some advisor who never worked
on our staff. ” Yes, he wasn’t on t he White House staff but he was a paid
consultant on health care earning hundreds of thousands of dollars over the
course of a year.

Meanwhile, conservatives including Representative Bill Cassidy of Louisiana
have overstated Gruber’s role , claiming he was the architect of the law. Gruber
who advised Former Massachusetts Governor Mitt Romney on health care has
described himself in the past as one of the architects of the Massachusetts Law
but not the federal one. He said that he worked as a technical cons ultant to the
Obama Administration from 2009 to 2010. That mirrors what others who work ed
closely on the law told us. Gruber was hired by the Department of Health and
Human Services for a one year contract to provide technical assistance that
involve d us ing his micro - simulation model to determine the impact of health
policy. He may not have written the law , but Obama (inaudible 22:10) his
comments brushe d side the fact that he was a highly paid consultant whose
modeling work was instrumental in determini ng the impact of health care policy.
At the same time the claim that Gruber was the architect overstates his role and
overlooked the role of many others in the administration and Congress . And
that’s my fact check for this week. I am Lori Robertson, Man aging Editor of
FactCheck.org.

Margaret Flinter: FactCheck.org is committed to factual accuracy from the
country’s major political players , and is a project of the Annenberg Public Policy
Center at the University of Pennsylvania. If you have a fact that you would like
checked, e - mail us at www.chcradio.com . We will have FactCheck.org’s Lori
Robertson check it out for you here on Conversations on Health Care.
(Music) Margaret Flinter: Each week, Conversations h ighlights a bright idea about how to make wellness a part of our communities and everyday lives. An estimated 22 veterans per day are taking their own lives in what’s being described as a post ware suicide crisis. With a lack of behavioral health clinici ans available for every
veteran who is experiencing difficulty, the VA has launched a campaign aimed at all Americans who know veterans who may be struggling to be aware that they can make a difference just by reaching out. It's called the Power of One ca mpaign , the idea that one person reaching out to one veteran in a caring
manner can make a difference.

Dr. Caitlin Thompson : The power of one small action, one conversation or one
phone call can make a difference in the life of a veteran going through a difficult
time. For free 24x7 confidential support , call the Veterans Crisis Line or the
Military Crisis Line.

Margaret Flinter: According to Dr. Caitlin Thompson, Deputy Director of VA’s
Suicide Prevention Program, the VA has launched a new suicide pre vention
hotline. It’s now collaborating with community groups across the country to
prepare them to better address the needs of these veterans, many of whom don’t
know how to ask for the help they need. Veterans, service members and anyone
concerned abou t them can call the Veterans Crisis Line, 1 - 800 - 273 - 8255. They
can chat online at VeteransCrisisLine.net/chat or send a text to 838 - 255 even if
they are not registered with the VA or enrolled in VA health care. A dedicated
program aimed at reaching out t o veterans across the country, empowering
community groups and individuals to find ways of offering support, getting
veterans the help they need before it’s too late, now that’s a bright idea.

(Music)

Margaret Flinter: This is Conversations on Health Ca re. I am Margaret Flinter.

Mark Masselli: And I am Mark Masselli, peace and health.

Conversations on Health Care, broadcast from the campus of WESU at
Wesleyan University, streaming live at www.wesufm.org and brou ght to you by
the Community Health Center.