Cleveland Clinic Innovations Executive Director Peter O’Neill on their Innovation Strategy

Peter O Neill

Mark Masselli: This is C onversations on H ealth C are I'm Mark Masselli.

Margaret Flinter: I’m Margaret Flinter .

Mark Masselli: Well , Margaret we find ourselves as a nation once again grappling with another
terrible tragedy . A nother gunman opened fire th is time in a Florida school that mass shooting left 17
people dead mostly students , but also some brave teachers who shielded the fleeing students from
the bullets .

Margaret Flinter: Well , Mark all of us in health care have had to look at the gun violence epidemic
for what it is and it is a public health crisis . W e do risk assessments in our clinical practice to help us
understand who may be at risk in their own homes , but we are up against an incredibly formidable
foe . T here are just too many guns in ci rculation in this country and they are simply too easy to
obtain , this is a daunting problem .

Mark Masselli: A fter the Sandy Hook shootings our behavioral health clinicians help families grieving
through the aftermath of that tragedy . W e watched bewil der ed as nothing changed in Washington
in response to Sandy Hook . I think this time the tide may be changing , the teen survivors of the
Florida shooting have begun a grassroots movement to promote rational gun laws .

Margaret Flinter: Well , Mark I don't thin k anyone in the country can fail to be moved by those kids
standing up and saying no more , we need to do something about this . W e have to do better as
health care providers to say nothing of as a nation as a whole . I t's going to take some innovative
appr oaches , it's going to take some legislative approaches and it's going to take some serious
political will .

Mark Masselli: S peaking of innovations it's something our guest today is fully engaged in Peter
O’Neil l is Executive Director of Cleveland Clinic I n novations dedicated to getting their breakthrough
technologies to the marketplace .

Margaret Flinter: Lori Robertson of course will be checking in with us , the managing editor of
F act C heck .org.

Mark Masselli: No matter what the topic you can hear all of o ur shows by going to chcr adio . com . As
always if you have comments please email us at [email protected] or find us on Facebook or
Twitter .

Margaret Flinter: W e'll get to our interview with Peter O'Neil l of the Cle veland Clinic I nnovations in
just a moment .

Mark Masselli: F irst here's our producer Mari anne O'Hare with this week's h eadline n ews.

[Music]

Marianne O’Hare: I'm Marianne O'Hare with the se health care headlines . T he Department of
Health and Human Servic es issued a proposed rule on short term health insurance plans for those in
the insurance marketplace allowing for short term plans th at can be purchased for up to 12 months ,
but they're not required to cover much of what is required by the Affordable Care Act , not the so -

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called 10 Essential Benefits not preexisting conditions or maternity care , preventive care or
prescription drug benefits . E ven a nalysis from HHS shows that plans such as these which might
appeal to younger healthier people would likely ta ke them out of the insurance marketplace pool
leading to higher premiums for those who remain in the marketplaces created under the Affordable
Care Act . I nsurance industry experts caution this move will serve to further destabilize the insurance
marketpla ce and impact the medically and financially vulnerable the most . T he rule is open for
comments .

T here's been a tsunami of comments about guns , violence and public health and so latest mass
shooting at an American school . T he tide may be turning on the to pic , the president and members
of the GOP are responding to a rising tide of criticism over a lack of action on gun control in the wake
of the epidemic of gun violence in this country . S ome gun control measures on the table increased
background checks als o mounting pressure on state and federal lawmakers to take action on the
matter . Meanwhile , students seem to be taking the lead , they convened a large group in Florida
state capital Tallahassee to advocate for stricter gun controls , they were also plannin g a big m arch ,
March 24th against gun violence across the country .

T urning the tide the flu season seems to have plateaued in recent weeks , numbers from the Centers
for Disease Control and Prevention show that visits to the ER and c linicians offices for fl u related
symptoms has tapered a bit . T he CDC saying this year's flu vaccine was about 36% e ffective against
this year's strain of the flu . A dults who got the flu shot had a 36% less likely chance of getting the
flu . T he effect was more protective in ch ildren , about 60% of kids who got the vaccine had a better
protective effect against acquiring flu . I’m Maria nne O’Hare with the se health care headlines.

Mark Masselli: We're speaking today with Peter O’Neill Executive Director of the Cleveland Clinic
I n novations the commercialization arm of the Cleveland Clinic whose mission is to bring
technological breakthroughs being developed by clinicians into the health care marketplace .
F ounded in 2000 Cleveland Clinic I nnovations has already brought hundreds of products to the
health care marketplace . Mr . O'Neill has been with CCI for 10 years , previously serving a s Senior
Commercialization Officer. He earned his BS in aeronautical science at MIT. Pete welcome to
C onversations on Health Care.

Peter O’Neill: T hank you for having me and that kind introduction .

Mark Masselli: Wonder if you could share with our listeners more about the mission at Cleveland
Clinic I nnovations and how it's designed to interface with the Cleveland Clinic health systems to
bring thes e innovations from the bench to bedside more easily .

Peter O’Neill: T he members of the innovations team we are employees of the health system . W e
don't treat patients directly , like every employee of the Cleveland Clinic we think of ourselves as
caregive rs . T he way we think about that is we help patients by working with our inventors to
translate their ideas into products that help patients . O ur highest level mission is ultimately about
helping patients . W e do work with Cleveland C linic employees throu ghout the h ealth system,
mostly the employees here in Cleveland but it does include employees in Florida , Las Vegas , Abu
Dhabi and soon to be London . M ost of our innovations come from our doctors , but we also receive
many inventions from nurses , researche rs , people that work in facilities , people that work on our I T

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t echnology projects so r eally open to working with caregivers all across the system . Y ou mentioned
that marketplace you know that is a real emphasis for us is bringing products to the marketpl ace.

Margaret Flinter: Well, Pete -- reminded listening to you of our interview with the just retired
Cleveland Clinic CEO Dr Toby Cosgrove. He talked about the Cleveland Clinic ’s philosophy about
innovation . I remember him saying every clinician should have an opportunity to promote their
potentially disruptive ideas in health care and health care delivery . I know that the Cleveland Clinic
I nnovations has already launched hundreds of patents into the marketplace . I think our listeners
would be really fascinated to hear about some of the more notable products that have been
developed at CCI that maybe we now think of as just part of the larger landscape .

Peter O’Neill: Well you mentioned Toby who is not only a great leader of the Cleveland Clinic , h e
a lso happens to be the most prolific inventor in our history . H e was a world renowned
cardiovascular surgeon and was instrumental in bringing a number of heart valves to the
marketplace that have been used and achieved more than a hundred thousand patients today . T oby
on his own but also through his leadership role is part of promoting that innovative culture at the
Cleveland Clinic . M any of our inventions are captured in companies , recently one of our companies
Cleveland Heart Lab was recently acquired b y Q u est D iagnostics and the technologies in that
com pany are being used to build a Center for Cardiovascular I nf lammation D iagnostics here in
Cleveland . W e're proud of both the technical and market impact of that but also there's the regional
economic imp act of that of Cleveland Heart Lab. I ntellects or another one of our companies was
that was acquired did some pioneering work in deep brain stimulation . W e also have technologies
from others of our caregivers . R ight now one of our more interesting proje cts we’re working on was
developed by one of our nurses recognize that in the operating room doctors have many layers of
non - breathable protective gowns that they wear , it's h ot . T he doctors and some of the surgeons can
be doing a surgery for many hours , s o she developed a cooling vest to help the se surgeons get
through their procedure and t o stay as focused as possible on their patients . A s you said we've got
hundreds of products that have gotten to the marketplace from our caregivers .

Mark Masselli: Pe te we were reading health care informatics and noted that Cleveland is the next
hot spot to watch for innovation in the health care space . Most folks usually th ink of Silicon Valley
when they’re considering where the restructuring is coming from . I’m w on der ing if you could talk
about the unique approach at CCI that is helping put Cleveland on the map . I have a good friend
who's a CEO of a genom ic Company down in Stanford near New York and he tells me that he can't
get any Google engineers to travel north of Chelsea's market in Manhattan . T ell us how you're able
to get folks to come to Cleveland or are you bringing some folks in virtually as well ?

Peter O’Neill: I do think an ingredient of what Cleveland and Cleveland Clinic b ring is a very
collaborative perspective on business . W e frequently interact with companies that want to connect
with t he thought leading clinicians here at the Cleveland Clinic . C leveland Clinic we're all employees
it's a single group practice as a result we have tremendous access to large amounts of data . Another
role th at Cleveland Clinic Innovations i s collaboration s that helped facilitate access to that data . I've
personally been involved in some work where people were able to go back into those data sets and
do some data min ing and effectively do some retro spective studies i n a very , very cost efficient kind

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of way . I think Cleveland is sometimes underappreciated for its pipeline of talent and we think very
well of the universities that are here in town and have great connec tion to them a s source s of talent .

I saw the CEO of E xplor is which was another one of our companies acquired it was acquired by IBM.
He talked about being in Cleveland as a real asset because of the access to talent , y ou can ’t talk
about being here withou t the comparison of the Silicon Valley without at least mentioning cost .
When you’re starting a company you know h eck even companies I think you mentioned Google I
mean even Google the ir salary costs are non - trivial and the salaries and other costs of doi ng business
here in Cleveland are just that much less than places like Boston and San Francisco . A n early stage
or any entrepreneur has make a mistake if they don't at least consider growing their business in
Cleveland .

Margaret Flinter: I want to talk a bout this continuum of ideas to cost and I think we couldn’t agree
with you more the people closest to the patients are l ikely to be the most inspired . I t's incredible to
have an incubator to actually take things to the point where they're in the market o r at the bedside
or in the home of the patient wherever . Y ou need a pretty robust infrastructure for capital
investment , product development , how does your venture division work to support all this
innovation work ? I t's a unusual model.

Peter O’Neill: W e could very easily and quickly decide that we're going to form a company , instead
we do a lot of very rigorous internal diligence to challenge whether an opportunity should have a
spinoff company . W e've had some very successful projects , I mean I mention ed Dr . Cosgrove’s
valves , I mean those were those were done through a direct license and not through a startup . I
think step one is to be rigorous about deciding to start companies at all . W ith regard to funding , the
way we think of it is de - risking . W e have funding that we apply in the sort of five to 50,000 dollar
range to do some early stage prototyping . I f a project achieves the right kind of success there then
we have some different sources of funding , so maybe 500,000 d ollars range and then we hav e the
ability to access millions of dollars . W e recognize that not all projects are going to be successful so
we -- I think the expression is fail fast . T hat's why we designed our prototyping and other early stage
projects to give us that decisive answer about whether a project is going to be successful in the
marketplace .

Mark Masselli: W e're speaking today with Peter O’Neill E xecutive D irector of Cleveland Clinic
I nnovations the commercialization arm of the Cleveland Clinic whose mission is to bring
te chnological breakthroughs being developed by its clinicians into the health marketplace . Pete
you've not only focused on product development w ithin your own organization , the Cleveland Clinic
also puts out a list every year of the top 10 products or techn ologies that are bound to disrupt health
care . I'm sure all of our listeners are interested in hearing what your predictions were for 2018 and
also th e process that you go about in picking those top 10 health care breakthroughs each year .

Peter O’Neill: W e do something on the order of 200 interviews , most of those are with Cleveland
C linic employees . W e're always interested in the perspectives of the marketplace . T hat lead to
about 110 ideas , d iscussed every one of those ideas in detail . I t's an impres sive process and every
year I'm a credibly appreciative of the time a nd investment and energy that are at our caregivers
give us the support that project . I think you asked about predictions for 2018.

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Mark Masselli: E verybody l oves predictions .

Peter O’N eill: I think last year there were a couple of projects that were concluded we ’ re not quite
ready . W e look for projects that are going to have impact within the next calendar year , so
sometimes we say hey, this is maybe a year or two away . S ome of the p rojects in remote health
management and artificial intelligence are on our radar . T here's a balance between waiting too long
and feeling like oh it's yesterday's news versus saying it too early but those are definitely innovations
that we're keeping track of.

Margaret Flinter: Pete, m oving beyond Cleveland and even the United States we've been watching
the degree to which the Cleveland Clinic is casting its influence all around the world , opening
institutions in Canada , in the U K, Abu Dubai . T his also go es back to our conversation with Toby
Cosgrove it was clear it was not just about bricks and mortar but also about really bringing the model
of care. The health care delivery model to communities to provide better health care for people and
raise the bar in health care overall . Al so about expanding maybe some of the telehealth protocols
and using these international hubs as a way to improve clinician training around the country . H ow
do you think all of that work around the world is going to have an impac t back at home at Cleveland
Clinic I nnovations ?

Peter O’Neill: T he US health care market is obviously a huge part of the worldwide market if not the
whole market , and so we very much appreciate our ability through our foreign hospitals to get direct
insig hts into the way other parts of the world deliver health care . A s we think about the types of
technologies that can be embraced here in the United States and other places in the world , we bring
those additional perspectives to help us evaluate technology . H istorically we've evaluated
technologies on sort of three criteria patentability , market size , clinical effectiveness. A fourth and
growing influence for us is value , and I think some of foreign markets have some really strong ways
of delivering value lower cost solutions for their patients . We recently establishe s collaboration with
the Silicon Valley bas e accelerator P lug and play , they're going to be opening an office here in
Cleveland . T hat is a direct benefit to us is to getting P lug and play ’s g lobal network of viewing
startups in all different kinds of parts of health care , delivering filtered list of those companies to us
to look at . W e're really excited about that , that's an exciting way for us to continue to have a
worldwide reach .

Mark Mass elli: Pete that also picks up on the collaboration that we've talked about on the show
before with Apple Stanford H ealth and American well a sort of a first of its kind the h ealth
arrhythmia study looking to use Apple Watch users and scale up that researc h . T his seems to m e
emerging trend , I'm wondering how you think this will be helpful in bringing disruptive health
technologies to the marketplace sooner ?

Peter O’Neill: I do and you mention that moving away from bricks and mortar and you think about
com panies like Apple , Google , Amazon , Microsoft , IBM these are all companies that have
successfully disrupted other markets , they're looking at health care . S eems like almost every week I
see some story about some nontraditional health care company getting i nvolved in health care . W e
collaborate with lots of those companies and that's exciting for us because we know that's a
necessary direction for health care costs , value , convenience , patients . Cleveland Clinics main

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campus is amazing but a patient if the y can stay home and get diagnosed at home that's still better .
When you talk about managing the wellness of patients that really should be done in a remote
setting , and so yes all of this – you use the disruption and you nailed it . T hat's exactly what's coming
and I think those kinds of companies are -- that's exactly why we enjoy working with them .

Margaret Flinter: W e've been speaking today with Peter O'Neill Executive Director of Cleveland
Clinic I nnovation s the commercialization arm of the Cleveland Clinic whose mission is to bring
technological breakthroughs being developed by its clinicians into the health care market . Y ou can
learn more about their work by going to Cleveland Clinic .org or follow them on Twitter @ Cleveland
Clinic . Pete thank you s o much for joining us on C onversations on Health Care today .

Peter O’Neill: T hank you both for having me.

[Music]

Mark Masselli: At Conversations on Health Care, we want our audience to be truly in the know
when it comes to the facts about health care re form and policy. Lori Robertson is an award - winning
journalist and Managing Editor of FactCheck.org, a non - partisan, nonprofit consumer advocate for
voters that aim to reduce the level of deception in US politics. Lori, what have you got for us this
week ?

Lori Robertson: President Donald Trump distorted the facts about a protest in the United Kingdom
regarding the universal health care system there. Trump tweeted that while democrats are pushing
for universal health care quote, “Thousands of people are marching in the UK because their system
is going broke and not working.” The London demonstrators marched in support of the system and
urge the government to better fund it. The United Kingdom's National Health Service is a single
payer system, the govern ment pays for health care which is free at the point of service with the
exception of some prescription eye care or dental cost and funded through taxes. Trump’s tweet
suggests the demonstrating were opposed to that universal health care system, that's no t accurate.
BBC reported that thousands demonstrated in London on February third quote calling for more
government support for the NHS. The groups behind the rally put out a joint statement responding
to Trump's tweet, they said the demonstrators wanted quote, “To show their love for the principles
of universal and comprehensive care free at the point of use.”

They were protesting they said against British government policies they view as trying to quote.
“Move us more to an American style system.” In Fe bruary the New York Times wrote about
budgetary austerity in the UK that had limited the growth of health spending to below the historical
norm. As a result patients can wait months for procedures though public satisfaction with NHS
remains high. The pro testors in the UK carried signs that read more staff more beds more fun and
save our NHS. As for democrats in the US some are pushing for universal health care. Senator
Bernie Sanders introduced a Medicare for All Act last fall co - sponsored by 16 democra ts and a
majority of house democrats were co - sponsors of a Medicare for All bill in that chamber last year.
That's my fact check for this week, I'm Lori Robertson Managing Editor of Fact Check.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

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you have a fact that you’d like checked, email us at CHCradio.com we’ll have FactCheck.org’s, Lori
Robertson, check it out for you, here on Conversations on Healthcare.

Mark Masselli: Each week conversations highlights a bright idea about how to make wellness a part
of our communities and everyday lives. Pregnancy is normally an exciting time for most women but
according to the research an estimated 10% of prenatal women experience some kind of depression
during their pregnancy, and many are reluctant to treat their depression with medication for fear of
harming the fetus.

Dr. Cynthia Battle: In fact a higher pe rcentage are experiencing lower grade depressive symptoms
and left untreated those mild to moderate symptoms can progress in some cases lead to a more
serious postpartum depression.

Mark Masselli: Dr Cynthia B attle is a P sychologist at Brown University wi th the practice at Women's
and Infants Hospital in Providence . S he and her colleagues decided to test a cohort of pregnant
women to see if a targeted prenatal yoga class might have a positive impact on women dealing with
prenatal depression .

Dr. Cynthia B attle: It was a typical kind of h alf a yoga that would include physical postures , breathing
exercises , meditation exercises . W e enrolled 34 women who are pregnant and we measured their
change in depressive symptoms over that period of time .

Mark Masselli : N ot only were women able to manage their depressive incidents they also bonded
with other pregnant women during the program and found additional support from their group .

Dr. Cynthia Battle: W e found that women on average w ere reporting that they were reporting much
less . W omen who are depressed during pregnancy unfortunately do often have less ideal birth
outcomes . One thing we're interested in seeing is when we provide prenatal yoga program can it
improves mood and then can we even see some positive effects in terms of the birth outcome .

Mark Masselli: A guided non - medical yoga exercise program designed to assist pregnant women
through depression symptoms . H elping them successfully navigate those symptoms without
medication , ensuring a safer pregn ancy and a healthier outcome for mother and baby . No w that's a
bright idea.

[Music]

Margaret Flinter: This is Conversations on Health Care I’m Margaret Flinter.

Mark Masselli: I’m Mark Masselli, peace and health.

Conversations on Health Care broadcast f rom WESU at Wesleyan University, streaming live at
www.wesufm.org and brought to you by the Community Health Center.

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