>>from the Cube Studios in Palo Alto and Boston connecting with thought leaders all around the world. This is a cube conversation. Welcome to the >>Special Cube program. We are here with the Amazon Web Services Public Sector Partner Awards program. It's a celebration of AWS public sectors partners and their end user customers where there's been innovation and we're pleased to have on this show here, the award winner for the most innovative AI and ML Artificial intelligence and machine learning solution. Axial three D is the partner, and the end user is Belfast Hospital. He got Roger Johnson, the CEO of actual three D, and Dr Tim Brown consulted transplant surgeon at Belfast Hospital, who has been doing amazing things not only on the as an innovative partner, but really during Covic making things happen by solving the problem of the surgical gap in the number of surgeries that you're doing really high performance saving lives. Congratulations. First of all, congratulations. Roger. Dr Kimberly. Thanks for joining me. >>Re pleasure. >>Okay, let's get into it. First of all, Dr Tim Brown, I really want to commend you on the amazing work that you're doing before we get into some of the partnership awards conversations. You have been at the front lines solving a lot of problems around the gap between the number of surgeries that could take place with Cove. It, um, tell that story real quick. I really think it's super important. Take a minute to >>explain. Yeah, thanks for the opportunity. And it's been an incredible rollercoaster for the last three months, pretty much all of the transplant programs across the world who have been affected by Coupet of shut down but with some pretty innovative on the grill leadership team Working advances with managed to open a program up again. And and Belfast, we have a bytes and 50 to 50 disease donor transplants year over the last three months, with just a 90 90 kidney transplants. Pretty much we've cleared the whole waiting list in Northern Ireland, pretty much for people waiting for a kidney transplant at this time. And it's been a remarkable few weeks, but it really is a testament to the critical care community. People that work in intensive care is the high marks, a support organ donation. Of course, our donors who have given so selflessly at such a tragic time for them. So I'd like to pay tribute to all of our donors into the amazing people who have been involved in the team. Mark belt faster this time. >>That's super amazing. Can you just I just want to pause from and just captured the number of order of magnitude. You said it was 6 to 10 year and you didn't 90 90. >>Yeah, so six weeks basically Teoh, two years work in six weeks old in the middle of the night as well. So it's been It's been hard of hard work, so you can see the sleeplessness. I'm trying to catch up with a minute, but it's been really, really satisfying. An incredible I come for patients and legacy of this of this, the program is gonna last about faster. 40 years. >>Well, I want to say congratulations. I'll give you my Cube Award for not changing the world but saving the world. One person at a time. 90 interviews and six weeks. That's amazing. That's like thinking clearing the waiting list. You really changing lives there. Congratulations. >>That's very kind of you. Thank you very much. >>Roger. Good. A great partner and customer. You have here. Talk about this award. You guys have talked about the company? What is this all about? Why you guys in this position? Why are you winning? >>Yes, So I think our motivation for our company is driven by our partners, such such as? In what they're doing transforms care And even in these horrific situation, our scenarios. We have the moment with Kobe. Think you're hearing the start of the amazing story our job is to give Surgeons liked him the best possible insight that he can have going into his surgeries For the last 20 years, surgeons of relied largely on two D imaging, so C, t and memory scans or for being able to plan their surgeries when it's murdered, technology should apply them much greater insight or they actually perform the surgery. So we've created a technology that platforms on AWS that allows us to turn those traditional hard to understand to the images into micro millimeter precise models off the patients exact anatomy. The value hopefully, two amazing colleagues like Tim is that instead of trying to interpret what a two D image CD or memory scan might mean he can actually see for the first time before he opens the patient up exactly what he's going to find when when he when he starts the surgery. So he immediately start to complete that planning before the surgery actually takes. So hopefully that analyze a number of benefits to results without the shorter operations. Find less surgical meeting we brought into the surgery. Hopefully, faster Surgeries names last risk of infection For patients being shorter Time means most >>awesome. Dr. Brian, I want to get your take on this. Can you describe the impact on your side because you know the future of work, which is everyone's been talking about in the tech industry for many years now, with code we were just talking about. The success is you're having and changing lives and saving lives. The notion of work workplace work, forces, work loads, work flows are all changing. Certainly the workplace people aren't as on site as they used to be. The workforce has to be protected. How does the AI and how does the actual three D help you and your work flows? Are you getting more done? Can you give specifics around the impact to your job? >>Yeah, it's a bit It's been a fantastic journey to date. We're still learning away. It's a journey. We're trying to work out exactly where this lies in. The fact that Kubla does not come along, which has changed, or working practices, that means that we have to look for different solutions on this, I think, is very 100 solution to amend. My practice over the last three years has been in terms of complex and real surgery on oncological surgery, where we have, for example, a tumor and kidney where we think, my goodness, we're gonna have to take this kidney I and throw it in the bin because it's very badly disease. So the index case that we were involved with that was building a child who wanted to donate his kidney to his daughter. But when we worked him up, we find a tumor in his kidney, which ordinarily would have to be discarded. But thanks to the imaging that Excel was able to produce for us, we were able to plan Well, geez, well cut well and as a result of kidney, I really plan a removal of the tumor from the kidney itself. We really repair kidney and then transplant it into his daughter. So with the technology that was available, we were able to save two lives on one particular case on, and it's really grown from there on. We've been involved in five or six different, really complex cases where the imaging has changed the outcomes for our patients who ordinarily wouldn't have been able to. Chief insight comes, I think, the AI interface on the AI solution we've developed in our partnership with the Excel. As I said, it's a journey and we're still finding our way. But to insights that I've really got our the first is that what we want to do is reduce variability, not just in our in our observers, from the way that we interpret imaging tradition is what you're saying is, look a two D images. We're now able to sit and look at this, emerging in a three dimensional space on our desk. Rather than trying to reconstruct these things in your head, we can look at them and discuss the different images with our colleagues in real time, a zealous that which I think is probably the most important thing, is that we're not able to engage our patients and a partnership. Before we had a bit of an unfair advantage that we're able to interpret these images because 20 or 30 years of getting used to doing this as professionals. But the patients are presented with some incredibly difficult decisions to make by their own health and with very little understanding that. But now I can handle the model of their own disease very easy to understand, and that gives my patient autonomy to make the decisions about their own bodies back again. And I think that's a hugely powerful, powerful tool for these guys have about potential decisions that they have to make that more effective for the rest of their lives. >>So the problem you're solving was one of the technical problem. So you're trying to figure out manually, get more insight into the the imaging and to the customer or the patient. This case customer, the patient. I can make a better decision. Those are two problems, statements that seem to be the big ones that I missed. Anything? >>Absolutely, absolutely. >>Okay, so actual three d you guys have a great solution? How >>did you >>get here? Tell us about your story. What's what's What's the big trajectory for you guys? In terms of the value proposition, it seems to be amazing and again highlights. The advantages of technology really solves the problem. But the outcome on the patient side is pretty phenomenal. >>Yes, so the chance for us is there or the development that we have made. The lately, we admit, is to be able to automatically turn these two D images into three D models. So we take each of the slices off of memory or cities. Using AWS is machine learning. We construct three D macro millimeter precise representation of For me. That's only possible. First of all, we treat the algorithms that we created on Amazon platform using over a 1,000,000 pre labeled CDs. Consume our system automatically detect. Yeah, it's a level. What is bone? What is ligament? What is on our earlier vessel? With the training that we're able to perform, we've been able to with with these 1,000,000 images we've been able to in effect, tree and our system automatically detect the parts of me with this micro service level that hasn't been previously possible. This technology, or the ability to create three D models, has existed for maybe 10 or 15 years, but it's it's needed. Experts like him who were, in effect manually code the two D image pixel level and could affect so some software and turn it into a three D image. Typically, too, it's in ours, often expert like them to do. And the problem is, Tim could only do one of the time. We estimate there about three million of these complex surgeries each year in the world that need open effort from greatly from this enhanced imaging. And we couldn't get 33 million under these, especially. And that. So we have this process no on the AWS platform, with dozens of these models in parallel, and each more will take maybe a few minutes to turn from the CD into the into the three D representation. So through the park off the Amazon Public cloud, we've been able to provide this this powerful machine learning automated solution that can actually scale toe man >>Dr Brian talk about the impact because, I mean Andy Jassy, the CEO of AWS, always talks about this. When I interviewed him, he says, you know, we're here to help do the heavy lifting this sounds like some pretty heavy lifting. What was just talked about? I mean, the manual work involved. You essentially have a collective intelligence and supercomputer power with AWS. What's your take on this as this evolves? Why isn't everyone doing this? >>Yeah, well, I don't know why. Every minute. That's that's That's the key question. It really is. From my perspective, there is no heavy lifting at all, and what I do is I push a couple buttons. I put a bit of data, and I send it off. From my perspective, it is about as easy as it gets is probably a ZTE sending email, which we do hundreds of times a day. And so, from from my perspective, I'm delighted to say there's no heavy lifting until I get a patient's data. I send data through to excel, who will then fool me and say, Listen to what is it exactly that we want to have a personal service from actual on? A couple days later, there's a delivery of a beautiful life size three D representation model, will check and then take to plan on and treat a patient with. So the heavy lifting really has all been done. A Z Roger alluded to in the past. It was hugely time consuming work that required a huge amount of training. But basically that's being replaced with a push of a button on. These supercomputers have taken all of my heavy lifting away on, and I think this is one of the true representation. Zoff technology really, really advances real world solutions and my patients are benefactors. From this >>Roger Dr Brown. Lay out the architecture because, first of all, pretend I want to take this every single friend that I have here in California and around the world. I want to just deploy this. What's the architecture and what's needed on the deployment side? Say it to Belfast as you deploy this. What's kind of involved in you? Just take us through high level. I must be cloud scales. Amazing, No doubt about it. We just talked about that. But what's involved in the architecture side of my standing? A bunch PC two's Is there sage maker involvement? What's the architecture and then deployment? What does that look like? >>Sure, So again, a slight step back. One of the challenges when, when we is the MedTech community try and introduce innovation into health and hospitals that the hospitals i t. Infrastructure network definition is often very locked on. So we're trying to bring new software and load it and install it in the hospital data system. That is a huge, often lengthy process that has to be done through lots of hoops in terms off Hey, network a compliance. Lots of different steps along the journey and that often wants from a good reasons, is a significant barrier to the timely adoption off innovative technologies in the cars. What a what a platform a selfie on AWS allies were just another website, as Tennis said, is, uh, only that, though his only existence with actual three D in terms of the interface is dragging and dropping the CT scan into our website into a portal portal exists quickly on the AWS instance. In one of our region, we are working with a little in the US. Never leave the US We use the the public client version in US East. We take advantage of many features within AWS, but a sage maker is probably a core of what we do. It's not innovation that AWS introduced know several years ago that was like juice this this machine learning trained set of algorithms that allow us to give this disruption. >>And it sounds like the more you use it, the more get smarter. Or is that as well? >>Absolutely. So our journey is, As Tim said, we're on a journey not only in terms off the technology and you're very receptive. In terms of yes, the more we train it, the more we treated on specific anatomy types or pathology types or trouble types, the better our system gets recognizing the specific characteristics of those. More importantly, this is about a journey I having made this disruption, we make the change and transformation off new standards of care pathways. That's the innovation that we just enable. It's amazing. Surgical teams like hymns. Let me transformation >>Dr Brown on your side. You're sitting there. I got a big problem trying to solve these problems. I got patients one but one better outcomes. They want to live. I don't want to throw away kitty, so I don't have to you to solve that problem that when when they bring that over, what was it like over on your side of the house is a practitioner. Deploying it. You've got you've got two jobs going. You're kind of doing I t integration on one hand and you're a surgeon on the other, trying to make things happen. You know what I see? This is not a lot of I t here. What's the deployment? Looks like. >>Yeah, deployment means I don't know. Why ever announces doing that. Such a straightforward, easy situation. It's that's remarkable. Ready? It's such a good solution, and I think part of any sort of change management program, and this again is change management. It's challenging the way we think about things. It's challenging people's comfort zones on any time we need to do change. We've got this anatomy of change. You've got innovators go early, adopters will lead the doctors, and I think what we're going to see over the next 5 to 10 years is people are recognizing that this technology is a game changer, possibly being driven by their patients who say I'm on the three D model and I want to see what this actually looks like because basically not black and white picture you're showing me doesn't make any sense to me and I think there's going to be the two drivers is that the first is that we want to have a consistency of care on the lack of variation in our care across across old old services. But as well is that patients? I think we're gonna drive this as well. So once once we get the innovators and the early adopters of this technology on board, then we'll see a tipping point. And that's that's when it becomes an acceptable normal thing for people to do. When they come in the hospital, they'll be sure print tight off their three d printed like moral off their pathology. I'm not a huge demand for their decision making for treatment processes, and that's a true collaboration between doctor or surgeon on the patient. That's that's where we need to be in the 21st century. It's it's going to be a collaborative decision making process. You talked about the pressures, journeys and this This is a really integral part. This is the roadmap of your journey to a large extent. So I think this I can see this being rolled out worldwide, being driven by patients buying a correction and variability of healthcare provision. >>That's a great example is an innovative award winner for the most innovative use of artificial intelligence and machine learning. Three D images saving lives Congratulations, Tim Rogers. Phenomenal Final question As we end this out, what's the scar tissue pun intended? You know, What did you learn? What was some of the things that you could share with folks as people look at this and say This is an example of cloud scale and the technology for good. What lessons have you learned? What can you share for folks? Take a minute to explain the split. Roger. We'll start with you. >>Yeah, sure. So I think a number off lessons for us on this journey Assistances, This is Ah, we're at the start of a journey of understanding the power off the what three d imaging can bring just to providing a consistent use variable care, but also as a stem also alluded to in terms of off the patient understanding, I think that patient understanding is one of the huge leap forwards that way. Didn't set out initially thinking we're going to be able to help educate on better inform patients. But that was one of the derive benefits suddenly part. So that was a great lesson. I think there is incredible levels of adoption that we're starting to see across the US across Europe because it's so easy to adopt. Compared to traditional methods, surgeons registered for Canadian start transacting and instead of us almost as opposed to having to have these huge I t programs. So I think we're now starting to really scratch the surface and start seeing the benefits of this isn't an administrative system. It's not me. HR system. It's not a finance system. Or maybe a healthcare was comfortable. And using public like this is core hard core clinical services, clinical diagnosis. Clinical education on the Amazon cloud is enabling that it just wouldn't be possible with this technology we started. Actually, the lessons were learning or just just >>Dr Tim Brown and take us home and the segment with your take lessons learned and advice to others. >>I think the lessons learned are the doctors and health care providers are all extremely wary off change of new innovations because they feel that already they're overburdened. Probably my colleagues in the states and across Europe perfectly like they were a bit over, burdened by all the things that we have to do, and this may potentially have been more difficult or wants to your workloads. And actually, let's make your workload along each year convincing people and getting people to understand that this really does make your life a lot easier. It actually removes all the scar tissue, removes the difficulties that have been put in place by by organizations on once. People realize that, that's what that there is no heavy lifting. And this will make a huge difference to your practices, your patients understanding of your practice, and we'll stop so people really realize that the tipping point will be achieved. I'm looking forward to that day because this this is going to be the new normal in the next 5 to 10 years. >>While the performance that you're putting up the numbers of 90 transplant successfully over six weeks dwarfs the full year, last year really kind of shows the outcome is a game changer. And again, congratulations on your success. Roger think Thank you for coming on Corrections on being the award winner. Eight of his partner for the most innovative AI and machine learning solutions. Thanks for taking the time for this 80 s partner awards program. Thank you. >>Thank you. >>Okay, I'm John Furrier. We're covering the AWS Public Sector Partner Awards program put on by the Cube and AWS Public Sector Partners. Thanks for watching. Yeah, Yeah, yeah, yeah, yeah.