How to convert medical knowledge into digital assets that work for you [PODCAST]

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“Instead of trading up for a faster horse by drawing in the exam room, it felt like I’d just built a motor car.

I created a new workflow around my digital assets. When patients checked in for a clinic visit, I scanned the chart for their visit diagnosis and fired off a content link with the relevant videos. My MA roomed the patient and they watched content while I completed other tasks. When I enter the room, their questions are more targeted, insightful and our visits are faster and more satisfying.

Doctors are unique in that our knowledge and experience are incredibly valuable, but distributed scarcely via single episode live events. When we convert our knowledge into digital assets that can be consumed at scale, we earn time, efficiency and carve space to do only the things we can do.”

David Grew is a radiation oncologist and can be reached on Twitter @doctorgrew.

He shares his story and discusses his KevinMD article, “How to convert medical knowledge into digital assets that work for you.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show we have David Grew. He is a radiation oncologist, and he wrote the KevinMD article “How to convert medical knowledge into digital assets that work for you.” David, welcome to the show.

David Grew: Thanks so much for having me.

Kevin Pho: So we’ll get into the article in a little bit, but first off, can you share your story and journey to where you are today?

David Grew: Sure. So I grew up in Connecticut and did college in the Bronx, New York, at Fordham, and then went on to do grad school and med school down at Tulane. One thing that I did along the way there was I worked for an MCAT test-prep company, so I spent a lot of time in front of a whiteboard teaching college students how to take the MCAT test. I always had a passion for teaching, specifically using simple visuals to get across complex subjects.

I ended up finding my way into the field of radiation oncology, and I’ve really taken that passion for teaching, using visuals to supplement verbal explanations, into my practice. So I’m in private practice here in Hartford, and I’ve been in practice now for seven years.

Kevin Pho: So give us some examples and stories of how you, as a radiation oncologist, incorporate teaching into your everyday practice.

David Grew: Sure. So one of the simplest settings that I use this in is lung cancer. Patients with a lung cancer can have a difficult time visualizing the disease, the treatment options, and what would and would not make sense for them. So sometimes we will show patients the actual CT scan, and that can be helpful sometimes, but sometimes the anatomy is just too complex, or maybe there’s a centrally located lung cancer that’s very close to the vessels. It’s just not easy and obvious to see.

So what I’ll do in those cases, or what I started doing a couple of years back, was just drawing with simple pen and paper to illustrate for them: “All right, here are your airways. Here’s where the tumor is. If we were going to do surgery, you’d actually have to remove almost the entire lung, and you’re someone with COPD. You’re already on supplemental oxygen, so it’s not a surgery that you would survive or thrive after.”

So this, really building the foundational knowledge for the patients with visuals to understand what their treatment options are, allows them to almost derive for themselves what the best treatment would be. In that case I gave, it would be radiation, a non-surgical treatment for a cancer. So I’ve seen things like a light bulb go off for patients once they see it visually: “Oh, I got it. I can’t lose an entire lung. We’ve got to go with this non-surgical treatment instead.”

Kevin Pho: So you take that visual teaching one step further, and you talk about that in your KevinMD article. It’s titled “How to convert medical knowledge into digital assets that work for you.” Now, for those who didn’t get a chance to read your article, can you just walk my audience through it and share the story of why you decided to write it?

David Grew: Yeah. So about a year or so into the pandemic, we still had these visitor restrictions where patients with a new diagnosis of cancer could not come into the oncology office with any guests. So they were there to receive all this information about their disease and treatment options all by themselves. They would go home, and then their family and friends would ask them, “OK, what would the doctor say?” The burden was on them to report back to them accurately what transpired and what we recommended. That’s a huge burden for them.

And so I started really aggressively making these pen-and-paper explanations, and then one day patients started to ask to keep those paper explanations. The light bulb went off: OK, this is actually something that’s useful to them. Maybe I should digitize this so that we can leverage a digital asset instead of a unique pen-and-paper version of it, so that I could share it with patients at scale. I still always have the conversation with the patient one-on-one, but if they have a digital version of it, they can review it at home on demand. They can also share it with their entire family.

You can probably relate to this as a physician: Patients oftentimes have a support team that’s like 10 individuals between their friends and their extended family. So with a digital asset, they can just forward that information around easily, and everyone can consume it.

Kevin Pho: So give us an example of the workflow of how you would digitize patient information so you can post it on a platform like YouTube, for instance.

David Grew: Sure. So to be clear, one of the first things I realized was I would not be able to create content that was unique to an individual patient, because of all of the obvious HIPAA compliance hurdles there. So what I have created was, going back to the lung cancer example, converting some of these pen-and-paper drawings to a two- or three-minute verbal explanation paired, at the same time, with a digital whiteboard illustration: simply drawn lungs, the tumor, radiation coming in, and then a list walking through the side effects and expectations. Then, once that’s completed, that asset can be shared by email with the patient, so they have it now on their phone, and they can forward it to the family.

So it took me some time. I definitely stumbled and tripped throughout that process and created some pretty bad stuff at the beginning. But over time, as you practice and you start to see what resonates with patients, when you put them on YouTube, you get a lot of very fast feedback as to what’s quality stuff and what’s being ignored. You really get a sense of what people are looking for and what’s helpful to them. So over time the quality just gradually improved because of the feedback from the hive.

Kevin Pho: Now give us a sense of the scope of your digital assets. How many topics do you cover, how many of these assets have you created, and how long have you been doing this?

David Grew: So I started doing this in December of 2020, so just over a year. We’re in mid-February now, so about a year and a couple of months, and I have created, I think, about 50 short patient education videos.

The scope is rather narrow because I’m a radiation oncologist, so at this point I’m mostly just creating stuff for myself and my own patients. But I have had outreach from physicians in other specialties, for example, interventional cardiologists who do the TAVR procedure for aortic stenosis, a valve replacement through a catheter. They have these repetitive conversations 10 times in a day where they have to explain this procedure, so they are kind of desperate to incorporate some form of a digital asset that they can use to preload the conversation with the patient with a short educational video. So I’ve done some stuff like that for other specialties, some stuff for urologists, but the bulk of my content is for oncology.

Kevin Pho: So you would think that something like this already exists, that you don’t have to reinvent the wheel. So give us a sense of how common these short patient education digital assets are. Are they readily available? Do you have to create a lot of these radiation oncology videos from scratch because they don’t exist? I was under the impression that companies kind of created these.

David Grew: A lot of companies do create these. So I interviewed 40 or 50 physicians before I really started rolling with this as a business, and what I was hearing from them was that the commercially created stuff often missed the mark. It was either just way too vague, so that it wasn’t remotely helpful for their patients, or it was way too specific, so it’s naming certain devices or procedures that aren’t used in that individual’s practice, and so it became more of a confusing thing for patients. So what doctors and patients were seeking was something that was appropriately generic, if you will, so that it was actually useful clinically.

And I think that physicians are actually very uniquely positioned to be the missing piece in that, right? Because we have the knowledge to know what is just too generic and should be tossed out. And we also, generally, unless you’re being paid by pharma or a device company, can keep it down the middle of the road in terms of bias. So the doctor creator is a category that I’m working on creating here, in terms of useful bedside or point-of-care digital patient education.

Kevin Pho: Give us a sense of what kind of tools you use to create a typical patient education video, and what software you use.

David Grew: Good question. So I started with just buying an iPad and an Apple Pencil and then a quality microphone, so I use a Blue Yeti mic. The software that I’m using is called Explain Everything. It’s just an app; it’s a mobile app, a web app, and an iPad app. It’s by a company that was actually founded by a teacher, so it’s really initially designed for classroom education.

What I like about it is the interface is extremely simple. The aesthetic that I’m going for is that simple white background with black ink on it, which is basically what I and most other doctors, I think, do. We’re just drawing on that table paper, right? So you draw it out for your patient there, and they really do appreciate the simplicity of that aesthetic. And so I’m not trying to create stuff that is very computer-generated anatomically, like some bleeding tumor in a lung or a breast. I’m just creating very simple black-and-white images, and this application tends to do a great job of that because it’s for elementary education.

Kevin Pho: And in general, how long does it normally take you to create a video from scratch?

David Grew: Right. So I have four kids, so oftentimes it’s interrupted. But if I have about an hour to an hour and a half, I would say, of uninterrupted time, I can create a ready-to-ship two- to three-minute patient education video.

Kevin Pho: We’re talking to David Grew. He’s a radiation oncologist, and he wrote the KevinMD article “How to convert medical knowledge into digital assets that work for you.” So David, one thing I love about your story is that this is just another form of medical communication, and as physicians, medical communication is really the key to what we do. Now, if other physicians are interested in creating digital assets similar to what you do, what kind of red flags, what kind of advice and tips can you give to them?

David Grew: Yeah, good question. The mistake that I made at the beginning was starting with something that was so broad and so nuanced. The most common question I get is “What even is cancer?” Well, that’s a good question. It’s a legitimate question from my patients. However, starting with something that broad is incredibly difficult because of all of the different forks in the road along that explanation for all of our different patients.

So what I recommend is auditing your workflow, auditing your weekly schedule, maybe for two or three weeks or a month, and seeing what the things are that you have said to your patients. If you said it more than three times in a week, that is ripe for automation, or converting to digital. And I’m not suggesting that people should then go and, when a patient asks that question, say, “Oh, you know what, I’m just going to send you this video instead of answering.” It’s more about layering an additional piece of knowledge transfer on top of the live encounter. So in that sense, you’re not replacing; you’re just supplementing, to improve the patient experience and to improve the efficiency of your practice.

Kevin Pho: And my final question: What are some of your take-home messages that you want to leave with the KevinMD audience?

David Grew: The biggest thing for me has been capturing my frustration with inefficiencies in the health care system and just beginning to build my own solution without permission. You don’t need to ask anybody for permission. If you have a problem in your practice and you think you can see a better way to solve this problem, just start building it. If you build it in public, leveraging public platforms like YouTube, LinkedIn, and Twitter, people will give you feedback live, and you can make your solution better and better as time goes on.

So I think so many of us who are disenchanted with the health care system in the United States are missing that you actually can change the way that you work with your patients, and you don’t need permission from anyone to improve it. So that would be my advice: Just start. Don’t ask permission. Just start building.

Kevin Pho: And how do people reach you?

David Grew: So I’m on Twitter at DoctorGrew; it’s G-R-E-W. I am also on LinkedIn and pretty active there. And I have a YouTube channel called Dr. Grew Explains Cancer, where I post most of my digital assets. And then there’s my website, where either physicians or institutions can do enterprise licensing of all of my videos, at PrimrMed.com. So it’s P-R-I-M-R, no E. So any of those places, and I’d love to chat.

Kevin Pho: David, thank you so much for sharing your time and insight, and thanks again for being on the show.

David Grew: Thanks for having me.

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