“If someone is suffering a stroke, they’re losing two million brain cells a minute,” explains David Kizner, general counsel (GC) and chief privacy officer at Viz.ai. The clock is ticking, you want to get them treated as fast as possible so they survive; and the faster you treat them, the more likely they are to survive without lifelong deficits.”
Strokes are the fifth leading cause of death, and a significant cause of disability in the United States that affects about eight hundred thousand people per year. Strokes are caused when a blood vessel in the brain is blocked by a clot or ruptures, preventing oxygen and nutrients from reaching part of the brain, causing brain cells to die. Around 85 percent of strokes are caused by a clot, called ischemic strokes, and around 15 percent of strokes are caused by a rupture, called hemorrhagic strokes.
Ischemic strokes are treated using clot-busting drugs, and a minimally invasive surgical procedure called a mechanical thrombectomy, where a surgeon uses specialized equipment to pull the clot from the brain to restore blood flow. With either of these options, Kizner emphasizes time is of the essence.
“If someone is suffering a stroke, they’re losing two million brain cells a minute. The clock is ticking, you want to get them treated as fast as possible in order to survive, and hopefully survive without life-long deficits.”David Kizner
“The challenge is that of the five thousand or so hospitals in the United States, maybe one thousand of those hospitals can perform a mechanical thrombectomy,” he says. “We refer to these hospitals as hub hospitals. If an ambulance takes a patient in need of a mechanical thrombectomy to one of the other four thousand hospitals, referred to as spoke hospitals, they must be diagnosed and transferred to a hub hospital for treatment. Our solution is designed to alert the specialists and care team at the hub hospital within minutes of a computed tomography (CT) scan of the head being performed on a patient at a spoke hospital when our artificial intelligence algorithm detects a suspected ischemic stroke in the CT scan.”
Kizner continues, “We’ve shown that we speed up time to treatment by alerting physicians at those hub hospitals, who can then pull those patients in to the hub hospital from the spoke hospital very quickly utilizing patient transfer workflow and communication enabled through our application.”
Available on iPhone or Android, the company’s solution does not replace a radiologist and is not for primary diagnosis, but is a computer-assisted triage solution, notifying clinicians of scans of patients needing priority review. When the product sends an alert, it is “Nudging the clinician to say, ‘Hey, this is a case you should prioritize because the artificial intelligence algorithm thinks it has detected a condition,’” Kizner says. In addition to AI algorithms that detect ischemic and hemorrhagic strokes, Viz.ai now offers products that detect suspected aneurysms, pulmonary embolisms, and aortic dissections.
“It could be late at night or at their kid’s soccer game, or wherever they are, if they [on call physicians] get an alert on Viz.ai they can pretty quickly determine whether or not they need to head to the hospital.”David Kizner
The “engine” behind the AI in the product? The workflow and ability of the care team to collaborate and coordinate care for a patient through a secure, HIPAA-compliant, mobile app.
Kizner says that in addition to improving patient outcomes, the company’s products help to reduce clinician burnout—a common promise of health technology. For example, physicians in the stroke space share that when on call, they have the advantage of reviewing CT scans on the mobile app.
“It could be late at night or at their kids’ soccer game, or wherever they are, if they [on-call physicians] get an alert on Viz.ai they can quickly determine whether or not they need to head to the hospital,” he says. “While the primary goal is to improve patient access to life saving treatments, we’re pleased that we can also help improve clinician quality of life.”
With over twenty years of law practice under his belt, Kizner understands and sympathizes with the burden of the clinician. His mother was a nurse before she retired, and his wife works as a speech-language pathologist at Stanford Medical Center where she currently works with outpatient head and neck cancer patients, but previously worked in the hospital, including helping stroke patients to recover speech and swallowing function. These familial ties to healthcare workers greatly inspire him, but he says, “I’ve always had an interest in doing tech work.”
This passion brought Kizner to Silicon Valley in what he refers to as “back in the heyday of the dot.com boom.” While at a large law firm, the GC worked with Stentor, a start-up client in the healthcare IT space that made an innovative picture archive and communication system, as their first in-house counsel.
“That was my first taste of working as an in-house lawyer for a health tech company. It was an amazing experience; it was very different from big law firm law. I really liked the mission.”
“We’ve shown that we speed up time to treatment by alerting physicians at those hub hospitals they can pull those patients in very quickly and the communication is all enabled through our application.”David Kizner
Following on, five years into his time at Stanford University Medical Center, Kizner began consulting for Viz. Not long after, when Viz.ai received its first FDA product clearances, he joined the start-up as general counsel. From this type of position—an in-house counsel at a start-up—Kizner feels he can have a greater impact than at a larger organization by having far more influence on the strategy and direction of the company. Plus, he adds, “there’s an intensity to it that I enjoy.”
With his overseeing both legal and compliance, Kizner remains very active and tied to the business. “It’s really soup to nuts, everything you can imagine in a legal role,” he says. This position allows the GC to lead in his style.
“My leadership philosophy is to hire really good people, who are experienced at their jobs, are confident, and have impeccable judgment, and to provide them the tools to enable them to do their work and the freedom to make decisions,” says Kizner.
Leveraging his experience in law firms, health tech start-ups and as a lawyer for a prestigious academic medical center, he guided his team through a successful expansion into Europe, relationships with some of the largest life sciences companies, and building an effective privacy and compliance program needed to meet General Data Protection Regulation, HIPAA and other privacy regulationss.
Kizner credits the success of implementing his leadership approach to hiring individuals possessing the same passion for making a difference in people’s lives. When interviewing candidates, especially those without healthcare experience, he jokes. “Look there’s nothing wrong with working for a video game company, or some other product. But, there’s something special about working in healthcare, when you know the products you’re making are being used by clinicians to impact people’s lives.”
“David is an insightful, strategic thinker focused on positioning Viz.AI for long term success. David’s passion for his work is infectious and it has been a pleasure partnering with him to advance the company’s legal objectives.”
–Adrian Percer, Patent Litigation Partner
It has been a great pleasure for Excis Networks to play a part in both Viz.ai’s and David’s success, and we offer our congratulations. They have been driven by a desire to innovate and change healthcare for the better by the use of AI, improved hospital workflows, and faster diagnosis of an increasing number of diseases to improve patient outcomes.
Excis Networks shares Viz.ai’s and David’s vision for constant improvement, and it is a core tenet of the way we work. We are specialists in helping Software as a Service Companies enter new markets, such as the EU. Our services ensure they are compliant with laws and regulations, such as the GDPR, NIS Directive, and Medical Device Regulations.
Our techno-legal practice covers data protection, cybersecurity, and legal services, providing a unique, full data lifecycle coverage that includes key areas of compliance. We specialise in medical devices, medical software as a service and biometrics, other areas of AI application, and technical innovation.
If you would like more information about Excis Networks, we would welcome a discussion about how we can help you in a similar way to Viz.ai.
Please contact Paul Benedek at [email protected] or call +44 7976 411586 for a chat.